EMS1055 FINAL EXAM QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS GRADED A++ LATEST UPDATE
Know the pulse points and what they mean in regards to SBP
- Carotid (60mm Hg systolic for palpation)
- Femoral (70mm Hg systolic for palpation)
- Radial (80mm Hg systolic for palpation)
- Pedal (90-100mm Hg systolic for palpation)
Know how to assess an AVPU score
A: Alert (Gentle shake)
V: Verbal ("Are you okay?")
P: Pain (Sternal rub)
U: Unresponsive (No response to either)
Know how to open an airway and when you use each method
- Head tilt chin lift
- Jaw thrust maneuver
- Clear possible obstructions
- Airway adjuncts
- OPA
- NPA
- King tube
- Intubation
,- Talking = established airway
- Always check airway for a patient that is not alert
head tilt-chin lift maneuver
- Place patient on back
- Place on hand on forehead and apply firm pressure backward
- Place tips of your fingers under the bony part of the lower jaw
- Lift chin forward and tilt back the head
DO NOT USE on suspected c-spine injury
jaw-thrust maneuver
- Use if you suspect a neck injury
- Place patient on back
- Place fingers behind the lower jaw and move the jaw forward
- Tilt head back to a neutral or slight sniffing position
- Use your thumbs to pull down the lower jaw opening the mouth enough to allow
breathing
Know how to use suction
Suction from back to front, and do not suction for than 15 seconds
Airway adjuncts
- Oral airway (OPA)
- Nasal airway (NPA)
,- King tube
- Intubation
Know how to measure an OPA and when to use it
- Used in patients with no gag reflex
- Measure from the edge of the mouth to the angle of the jaw to determine correct size
- Insert with the tip pointing to the top of the head then rotate 180 degrees until in
position
Know how to measure an NPA and when to use it
- Can use on patient with a gag reflex; is not to be used on patients with head injuries
- Patients who are snoring or have ETOH are common
- Measure from nostril to tip of earlobe
- Right nare (nostril) is largest, but either one can be used
- Use twisting motion as you insert
Know what the Golden Hour means
60 minute time period after a severe injury and initiation of surgery for the injured
trauma patient; starts when injury happens, ends in surgery
Know how to assess a trauma patient according to ITLS Trauma Assessment
XABC:
X - eXsanguinating hemorrhage
A - Airway
B - Breathing
C - Circulation
, - Obtain baseline vital signs
If altered mental status:
- Brief neurological exam; pupils, GCS, and signs of cerebral herniation
- Look for medical alert tags
- Consider other causes
Know the different lung sounds
- Stridor: strained, high pitched sound heard on inspirations; caused by upper airway
obstruction in pharynx or larynx
- Rales: fluid in lungs, crackly (like someone sucking up pop); cause by pulmonary
edema and CHF
- Wheezes: continuous high pitched whistling sound; common in asthma, COPD,
anaphylactic patients
- Rhonchi: in the bronchi, rattling noise, mucous in lungs, and upper airway
Know the reasons to stop a primary survey in trauma
1. Cardiac arrest
2. Airway obstruction
3. Life-threatening bleed (arterial) hemorrhage
4. Scene is no longer safe
Know the components of the primary and secondary survey in trauma patients
Primary:
- Scene size-up (PPE, scene safety, initial triage, need for extra help/equipment, MOI)
- Initial assessment (general impression, hemorrhage, LOC, chief complaint, CABC's)
- Rapid trauma survey vs. focused exam
COMPLETE SOLUTIONS GRADED A++ LATEST UPDATE
Know the pulse points and what they mean in regards to SBP
- Carotid (60mm Hg systolic for palpation)
- Femoral (70mm Hg systolic for palpation)
- Radial (80mm Hg systolic for palpation)
- Pedal (90-100mm Hg systolic for palpation)
Know how to assess an AVPU score
A: Alert (Gentle shake)
V: Verbal ("Are you okay?")
P: Pain (Sternal rub)
U: Unresponsive (No response to either)
Know how to open an airway and when you use each method
- Head tilt chin lift
- Jaw thrust maneuver
- Clear possible obstructions
- Airway adjuncts
- OPA
- NPA
- King tube
- Intubation
,- Talking = established airway
- Always check airway for a patient that is not alert
head tilt-chin lift maneuver
- Place patient on back
- Place on hand on forehead and apply firm pressure backward
- Place tips of your fingers under the bony part of the lower jaw
- Lift chin forward and tilt back the head
DO NOT USE on suspected c-spine injury
jaw-thrust maneuver
- Use if you suspect a neck injury
- Place patient on back
- Place fingers behind the lower jaw and move the jaw forward
- Tilt head back to a neutral or slight sniffing position
- Use your thumbs to pull down the lower jaw opening the mouth enough to allow
breathing
Know how to use suction
Suction from back to front, and do not suction for than 15 seconds
Airway adjuncts
- Oral airway (OPA)
- Nasal airway (NPA)
,- King tube
- Intubation
Know how to measure an OPA and when to use it
- Used in patients with no gag reflex
- Measure from the edge of the mouth to the angle of the jaw to determine correct size
- Insert with the tip pointing to the top of the head then rotate 180 degrees until in
position
Know how to measure an NPA and when to use it
- Can use on patient with a gag reflex; is not to be used on patients with head injuries
- Patients who are snoring or have ETOH are common
- Measure from nostril to tip of earlobe
- Right nare (nostril) is largest, but either one can be used
- Use twisting motion as you insert
Know what the Golden Hour means
60 minute time period after a severe injury and initiation of surgery for the injured
trauma patient; starts when injury happens, ends in surgery
Know how to assess a trauma patient according to ITLS Trauma Assessment
XABC:
X - eXsanguinating hemorrhage
A - Airway
B - Breathing
C - Circulation
, - Obtain baseline vital signs
If altered mental status:
- Brief neurological exam; pupils, GCS, and signs of cerebral herniation
- Look for medical alert tags
- Consider other causes
Know the different lung sounds
- Stridor: strained, high pitched sound heard on inspirations; caused by upper airway
obstruction in pharynx or larynx
- Rales: fluid in lungs, crackly (like someone sucking up pop); cause by pulmonary
edema and CHF
- Wheezes: continuous high pitched whistling sound; common in asthma, COPD,
anaphylactic patients
- Rhonchi: in the bronchi, rattling noise, mucous in lungs, and upper airway
Know the reasons to stop a primary survey in trauma
1. Cardiac arrest
2. Airway obstruction
3. Life-threatening bleed (arterial) hemorrhage
4. Scene is no longer safe
Know the components of the primary and secondary survey in trauma patients
Primary:
- Scene size-up (PPE, scene safety, initial triage, need for extra help/equipment, MOI)
- Initial assessment (general impression, hemorrhage, LOC, chief complaint, CABC's)
- Rapid trauma survey vs. focused exam
