SNHD AEMT PROTOCOLS EXAM FINAL PAPER
2026 COMPLETE QUESTIONS WITH CORRECT
ANSWERS
◉ Adult altered mental status/syncope signs and symptoms.
Answer: decreased mental status or lethargy; changes in baseline
mental status; bizarre behavior; hypoglycemia; hyperglycemia;
irritability
◉ Adult altered mental status/syncope Differential. Answer: head
trauma; CNS (stroke, tumor, seizure, infection), Cardiac (MI, CHF);
hypothermia; infection; thyroid; shock (septic, metabolic,
traumatic); diabetes; toxicological or ingestion; acidosis/alkalosis;
environmental exposure; hypoxia; electrolyte abnormality;
psychiatric disorder
◉ Adult altered mental status/syncope pearls. Answer:
Recommended exam: mental status, HEENT, skin, heart, lung,
abdomen, back, extremities, neuro
Pay careful attention to the head exam for signs of injury
Be aware of AMS as presenting sign of an environmental toxin or
Haz-Mat exposure, and protect personal safety and that of other
responders
Do not let alcohol confuse the clinical picture; alcohol is not
commonly a cause of total unresponsiveness to pain
,If narcotic overdose or hypoglycemia is suspected, administer
narcan or glucose prior to advanced airway procedures
◉ Adult behavioral emergency. Answer: 1. Scene safety
2. General adult assessment
3. Consider medical causes for the patients behavior: hypoxia,
intoxication/overdose, hypoglycemia/electrolytes, head injury, post-
ical state
4. Suspected excited delirium? Yes: paramedic
No:
5. Implement the SAFER model
6 Threatened or acted in a way that suggests threat to self or others?
Threatened to harm self: consider behavioral restrains, no prone
position, consider law enforcement escort, consider a flight risk ->
transport
Threatened to harm others: 4-point restraints, hood if indicated; no
prone position -> persistent risk Paramedic
No threats to self or others: transport
◉ Excited delirium syndrom. Answer: medical emergency-
combination of delirium, psychomotor agitation, anxiety,
hallucinations speech disturbances, disorientation, violent behavior,
insensitivity to pain, hyperthermia, and increased strength.
,Potentially life threatening and associated with the use of physical
control measures including restraints, taser, or similar device.
Most common in male subjects with a history of serious mental
illness and/or acute or chronic drug abuse, particularly stimulants.
◉ Adult behavioral emergency history. Answer: situational crisis;
psychiatric illness/medications; injury to self or threats to others;
medic alert tag; substance abuse/overdose; diabetes
◉ Adult behavioral emergency signs and symptoms. Answer:
Anxiety, agitation, confusion; affect change, hallucinations;
delusional thoughts, bizarre behavior; combative, violent;
expression of suicidal/homicidal thoughts
◉ Adult behavioral emergency differential. Answer: AMS
differential; alcohol intoxication; toxin/substance abuse; medication
effect or overdose; withdrawal syndromes; depression; bipolar;
schizophrenia; anxiety disorder
◉ Adult behavioral emergency Pearls. Answer: Law enforcement
assistance should be requested on all calls involving potential
violent patients
Under no circumstances are patients to be transported restrained in
the prone position
Recommended exam: mental status, skin, heart, lung, neuro
, Consider all possible medical/trauma causes for behavior
Do not irritate the patient with a prolonged exam
EMS providers are mandatory reporters in regard to suspected
abuse of any vulnerable person
◉ Dystonic reaction. Answer: Condition causing involuntary muscle
movements or spasms typically of the face, neck, and upper
extremities
Typically an adverse reaction to drugs such as Haloperidol (may
occur with administration)
When recognized, administer Diphenhydramine 50 mg IM/IV/IO
◉ SAFER. Answer: Stabilize the situation by containing and lowering
the stimuli
Assess and acknowledge the crisis
Facilitate the identification and activation of resources (chaplain,
family, friends or police)
Encourage the patient to use resources and take action in his/her
best interest
Recovery or referral - leave patient in care of responsible person or
professional, or transport to appropriate facility
◉ Adult Burns thermal exposure. Answer: 1. General adult
assessment
2026 COMPLETE QUESTIONS WITH CORRECT
ANSWERS
◉ Adult altered mental status/syncope signs and symptoms.
Answer: decreased mental status or lethargy; changes in baseline
mental status; bizarre behavior; hypoglycemia; hyperglycemia;
irritability
◉ Adult altered mental status/syncope Differential. Answer: head
trauma; CNS (stroke, tumor, seizure, infection), Cardiac (MI, CHF);
hypothermia; infection; thyroid; shock (septic, metabolic,
traumatic); diabetes; toxicological or ingestion; acidosis/alkalosis;
environmental exposure; hypoxia; electrolyte abnormality;
psychiatric disorder
◉ Adult altered mental status/syncope pearls. Answer:
Recommended exam: mental status, HEENT, skin, heart, lung,
abdomen, back, extremities, neuro
Pay careful attention to the head exam for signs of injury
Be aware of AMS as presenting sign of an environmental toxin or
Haz-Mat exposure, and protect personal safety and that of other
responders
Do not let alcohol confuse the clinical picture; alcohol is not
commonly a cause of total unresponsiveness to pain
,If narcotic overdose or hypoglycemia is suspected, administer
narcan or glucose prior to advanced airway procedures
◉ Adult behavioral emergency. Answer: 1. Scene safety
2. General adult assessment
3. Consider medical causes for the patients behavior: hypoxia,
intoxication/overdose, hypoglycemia/electrolytes, head injury, post-
ical state
4. Suspected excited delirium? Yes: paramedic
No:
5. Implement the SAFER model
6 Threatened or acted in a way that suggests threat to self or others?
Threatened to harm self: consider behavioral restrains, no prone
position, consider law enforcement escort, consider a flight risk ->
transport
Threatened to harm others: 4-point restraints, hood if indicated; no
prone position -> persistent risk Paramedic
No threats to self or others: transport
◉ Excited delirium syndrom. Answer: medical emergency-
combination of delirium, psychomotor agitation, anxiety,
hallucinations speech disturbances, disorientation, violent behavior,
insensitivity to pain, hyperthermia, and increased strength.
,Potentially life threatening and associated with the use of physical
control measures including restraints, taser, or similar device.
Most common in male subjects with a history of serious mental
illness and/or acute or chronic drug abuse, particularly stimulants.
◉ Adult behavioral emergency history. Answer: situational crisis;
psychiatric illness/medications; injury to self or threats to others;
medic alert tag; substance abuse/overdose; diabetes
◉ Adult behavioral emergency signs and symptoms. Answer:
Anxiety, agitation, confusion; affect change, hallucinations;
delusional thoughts, bizarre behavior; combative, violent;
expression of suicidal/homicidal thoughts
◉ Adult behavioral emergency differential. Answer: AMS
differential; alcohol intoxication; toxin/substance abuse; medication
effect or overdose; withdrawal syndromes; depression; bipolar;
schizophrenia; anxiety disorder
◉ Adult behavioral emergency Pearls. Answer: Law enforcement
assistance should be requested on all calls involving potential
violent patients
Under no circumstances are patients to be transported restrained in
the prone position
Recommended exam: mental status, skin, heart, lung, neuro
, Consider all possible medical/trauma causes for behavior
Do not irritate the patient with a prolonged exam
EMS providers are mandatory reporters in regard to suspected
abuse of any vulnerable person
◉ Dystonic reaction. Answer: Condition causing involuntary muscle
movements or spasms typically of the face, neck, and upper
extremities
Typically an adverse reaction to drugs such as Haloperidol (may
occur with administration)
When recognized, administer Diphenhydramine 50 mg IM/IV/IO
◉ SAFER. Answer: Stabilize the situation by containing and lowering
the stimuli
Assess and acknowledge the crisis
Facilitate the identification and activation of resources (chaplain,
family, friends or police)
Encourage the patient to use resources and take action in his/her
best interest
Recovery or referral - leave patient in care of responsible person or
professional, or transport to appropriate facility
◉ Adult Burns thermal exposure. Answer: 1. General adult
assessment
