CTAS Case Study Practice
You arrive on a scene to find a 20 year old male, a possible heroin overdose. The
patient is unresponsive with a GCS of 3. Vitals signs are: B/P 106/60, pulse 64 and
regular, respirations 6 and shallow. You are assisting the patient's respirations with a
BVM. What is the Arrival CTAS Level? - (correct Answer) - Arrival CTAS Level 1
This patient is a level 1 because of two (2) first order modifiers; his respiratory rate of
6 requiring assisted ventilation and his unresponsiveness with a GCS of 3.
You administer 0.8 mg of naloxone on the scene and at the time of departure the patient is moaning. You
determine that his GCS is now 8. Reassessment of his vital signs reveals a blood pressure of 110/65,
pulse of 80 and regular, respirations of 12 and O2 saturation of 98% on high concentration oxygen via a
non-rebreather mask. What is the patient's CTAS Level on departure? - (correct Answer) - Departure
CTAS Level 1
Though the patient's condition has improved, his GCS is still <9.
During transport to the hospital the patient becomes more responsive. 5 minutes from
the hospital you determine the patient's GCS to be 14, pulse 70, respirations 14 and O2
saturation of 98% on high concentration oxygen via a non-rebreather mask. What is
the patient's Departure CTAS Level? - (correct Answer) - CTAS Level Arrive Destination 3
Though the patient's condition has improved significantly and his vital signs are now
within normal ranges, even if the CTAS level appears to be a 4, Rule # 3 states that a
patient's CTAS level cannot go down more than 2 levels from the Arrival CTAS.
2. Your patient is an unresponsive 36 year old female who was involved in a head-on
crash. She has no eye opening or verbal response and withdraws to pain. Vital signs
are: respirations 28, pulse 120, B/P 76/48, GCS 6. Her skin is pale, moist and cool.
Your findings include an unstable pelvis and an open femur fracture. What is the
Arrival CTAS Level? - (correct Answer) - Arrival CTAS Level 1
This patient is exhibiting both hemodynamic instability (increased heart rate, decreased
blood pressure and cool skin) and a GCS of 6. Either of these first order modifiers would
make her CTAS Level 1.
,3. Your patient is 20 months old and has been experiencing vomiting and diarrhea for 3
days. The child lies still, presents with cracked lips, sunken eyes and tenting skin. You
note the child is lethargic. Vital signs are: pulse 180 with a very weak brachial pulse,
respirations 44 and shallow. What is the Arrival CTAS Level? - (correct Answer) - Arrival CTAS Level 1
This is an extremely ill child with a marked elevation of respiratory rate and tachycardia
and likely hypotension. This patient is potentially pre-arrest and thus a CTAS Level 1.
4. You attend to a 76 year old female with COPD complaining of moderate SOB, able to
speak in sentences, with an expectorating cough and a mild fever. She states she has
recently been placed on an antibiotic for a chest infection. Initial vital signs were:
respirations 26, pulse 120, B/P 110/70, O2 saturation 92% (on room air). Chest
assessment revealed diffuse wheezes in both lungs.
You manage the patient using your Bronchoconstriction Medical Directive. Just prior
to transport the patient indicates that she feels better. Your assessment of the patient
now reveals: respirations 20, pulse 110, O2 saturation 95%. Her wheezes have
diminished.
What was this Patient's Arrival CTAS Level? What is the Departure CTAS Level? - (correct Answer) - Arrival
CTAS Level 3
This patient presents with mild/moderate respiratory distress with an O2 saturation of
92-94% with an exacerbation of a chronic problem. She initially had abnormal vital
signs with a decreased O2 saturation that stabilized with treatment.
Departure CTAS Level 4
At the time of transport, her condition improved to a 4.
5. Your patient appears to have suffered a stroke (CVA). The patient has slurred speech
and your exam reveals facial dropping and left-sided weakness. Her blood sugar is
normal. Vital signs are: GCS 13, B/P 225/120, pulse 68, respirations 18. The patient
was last observed in their usual state of health 1 hour ago. - (correct Answer) - CTAS Level 2
Patients with a presenting complaint of an acute stroke (<3.5 hours) should be
considered Level 2. Also, by the second order modifier for Hypertension/Blood
, Pressure, the patient is a CTAS Level 2.
6. A 56 year old male complains of general weakness and feeling unwell. He denies
dizziness, nausea, vomiting or pain. He missed his dialysis yesterday and wants to see
the doctor in the Emergency Department. Vital signs are: blood pressure 105/60, pulse
60 and regular, respirations 14 and regular and O2 saturation of 96% on room air. What
is his Arrival CTAS Level? - (correct Answer) - Arrival CTAS Level 3
Some patients are difficult to assign a CTAS Level. In these cases, paramedics should
consider the history and assessment findings and assign the CTAS Level based on their
interpretation of how acutely ill the patient is and the potential for deterioration. This is a
stable patient however he has missed dialysis and has the potential to have significant
electrolyte imbalances and could deteriorate suddenly.
While transporting and 15 minutes from the hospital, the patient states he feels worse.
He is not quite as alert and repeat vitals indicate a pulse of 45, respirations 18, B/P
80/70 and an O2 saturation of 96%. You patch to the hospital when you are
approximately 10 minutes away to update them on this change in the patient's
condition.
What is the patient's revised CTAS Level that should be reported to the hospital? - (correct Answer) -
CTAS Level 1
The patient has deteriorated and by the First Order Modifier for Hemodynamic Stability
the patient is considered hemodynamically unstable. The Emergency Department will
need to prepare a resuscitation room for the patient.
7. A 6 year old girl fell off a swing and presents with an obviously fractured wrist. Her
pulses, motor and sensation are normal in the injured limb. She is in moderate
discomfort (5/10). Her vitals are normal and she is alert. You have it splinted and are
now on your way to the ED. What is the Arrival and Departure CTAS Level? - (correct Answer) - Arrival
CTAS Level 3
This girl has a fracture and using the First Order/Non-physiologic Modifier for Pain
indicates a pain scale that is in a moderate level at 5/10. It should be noted that there is no
You arrive on a scene to find a 20 year old male, a possible heroin overdose. The
patient is unresponsive with a GCS of 3. Vitals signs are: B/P 106/60, pulse 64 and
regular, respirations 6 and shallow. You are assisting the patient's respirations with a
BVM. What is the Arrival CTAS Level? - (correct Answer) - Arrival CTAS Level 1
This patient is a level 1 because of two (2) first order modifiers; his respiratory rate of
6 requiring assisted ventilation and his unresponsiveness with a GCS of 3.
You administer 0.8 mg of naloxone on the scene and at the time of departure the patient is moaning. You
determine that his GCS is now 8. Reassessment of his vital signs reveals a blood pressure of 110/65,
pulse of 80 and regular, respirations of 12 and O2 saturation of 98% on high concentration oxygen via a
non-rebreather mask. What is the patient's CTAS Level on departure? - (correct Answer) - Departure
CTAS Level 1
Though the patient's condition has improved, his GCS is still <9.
During transport to the hospital the patient becomes more responsive. 5 minutes from
the hospital you determine the patient's GCS to be 14, pulse 70, respirations 14 and O2
saturation of 98% on high concentration oxygen via a non-rebreather mask. What is
the patient's Departure CTAS Level? - (correct Answer) - CTAS Level Arrive Destination 3
Though the patient's condition has improved significantly and his vital signs are now
within normal ranges, even if the CTAS level appears to be a 4, Rule # 3 states that a
patient's CTAS level cannot go down more than 2 levels from the Arrival CTAS.
2. Your patient is an unresponsive 36 year old female who was involved in a head-on
crash. She has no eye opening or verbal response and withdraws to pain. Vital signs
are: respirations 28, pulse 120, B/P 76/48, GCS 6. Her skin is pale, moist and cool.
Your findings include an unstable pelvis and an open femur fracture. What is the
Arrival CTAS Level? - (correct Answer) - Arrival CTAS Level 1
This patient is exhibiting both hemodynamic instability (increased heart rate, decreased
blood pressure and cool skin) and a GCS of 6. Either of these first order modifiers would
make her CTAS Level 1.
,3. Your patient is 20 months old and has been experiencing vomiting and diarrhea for 3
days. The child lies still, presents with cracked lips, sunken eyes and tenting skin. You
note the child is lethargic. Vital signs are: pulse 180 with a very weak brachial pulse,
respirations 44 and shallow. What is the Arrival CTAS Level? - (correct Answer) - Arrival CTAS Level 1
This is an extremely ill child with a marked elevation of respiratory rate and tachycardia
and likely hypotension. This patient is potentially pre-arrest and thus a CTAS Level 1.
4. You attend to a 76 year old female with COPD complaining of moderate SOB, able to
speak in sentences, with an expectorating cough and a mild fever. She states she has
recently been placed on an antibiotic for a chest infection. Initial vital signs were:
respirations 26, pulse 120, B/P 110/70, O2 saturation 92% (on room air). Chest
assessment revealed diffuse wheezes in both lungs.
You manage the patient using your Bronchoconstriction Medical Directive. Just prior
to transport the patient indicates that she feels better. Your assessment of the patient
now reveals: respirations 20, pulse 110, O2 saturation 95%. Her wheezes have
diminished.
What was this Patient's Arrival CTAS Level? What is the Departure CTAS Level? - (correct Answer) - Arrival
CTAS Level 3
This patient presents with mild/moderate respiratory distress with an O2 saturation of
92-94% with an exacerbation of a chronic problem. She initially had abnormal vital
signs with a decreased O2 saturation that stabilized with treatment.
Departure CTAS Level 4
At the time of transport, her condition improved to a 4.
5. Your patient appears to have suffered a stroke (CVA). The patient has slurred speech
and your exam reveals facial dropping and left-sided weakness. Her blood sugar is
normal. Vital signs are: GCS 13, B/P 225/120, pulse 68, respirations 18. The patient
was last observed in their usual state of health 1 hour ago. - (correct Answer) - CTAS Level 2
Patients with a presenting complaint of an acute stroke (<3.5 hours) should be
considered Level 2. Also, by the second order modifier for Hypertension/Blood
, Pressure, the patient is a CTAS Level 2.
6. A 56 year old male complains of general weakness and feeling unwell. He denies
dizziness, nausea, vomiting or pain. He missed his dialysis yesterday and wants to see
the doctor in the Emergency Department. Vital signs are: blood pressure 105/60, pulse
60 and regular, respirations 14 and regular and O2 saturation of 96% on room air. What
is his Arrival CTAS Level? - (correct Answer) - Arrival CTAS Level 3
Some patients are difficult to assign a CTAS Level. In these cases, paramedics should
consider the history and assessment findings and assign the CTAS Level based on their
interpretation of how acutely ill the patient is and the potential for deterioration. This is a
stable patient however he has missed dialysis and has the potential to have significant
electrolyte imbalances and could deteriorate suddenly.
While transporting and 15 minutes from the hospital, the patient states he feels worse.
He is not quite as alert and repeat vitals indicate a pulse of 45, respirations 18, B/P
80/70 and an O2 saturation of 96%. You patch to the hospital when you are
approximately 10 minutes away to update them on this change in the patient's
condition.
What is the patient's revised CTAS Level that should be reported to the hospital? - (correct Answer) -
CTAS Level 1
The patient has deteriorated and by the First Order Modifier for Hemodynamic Stability
the patient is considered hemodynamically unstable. The Emergency Department will
need to prepare a resuscitation room for the patient.
7. A 6 year old girl fell off a swing and presents with an obviously fractured wrist. Her
pulses, motor and sensation are normal in the injured limb. She is in moderate
discomfort (5/10). Her vitals are normal and she is alert. You have it splinted and are
now on your way to the ED. What is the Arrival and Departure CTAS Level? - (correct Answer) - Arrival
CTAS Level 3
This girl has a fracture and using the First Order/Non-physiologic Modifier for Pain
indicates a pain scale that is in a moderate level at 5/10. It should be noted that there is no
