What should be the paramedic’s primary concern once on scene?

Which of the following is a physiological change associated with aging? (Select three correct answers)

A 3-year-old is found to be minimally responsive with a BP of 70/42, P 80, RR 44. Which of the following best describes this situation:

The crew responds to an incident where there is very limited access to a patient trapped in a vehicle. Which of the following assessments should occur?

An elderly patient takes medication to control heart rate, lower BP, and increase urinary output. The paramedic should suspect the patient has a history of:

A 5-year-old patient has a possible spinal injury. Which of the following is a special consideration regarding this patient?

While assessing a patient complaining of severe chest pain, a difference of 20 mmHg in systolic readings is noted between the left and right arm. The paramedic recognizes:

En RouteThe paramedic is dispatched to a residence for a 65-year-old patient who fell off a ladder. Dispatch reports the distance was approximately 14 feet.  The time of the call is 1300. The response time is 10 minutes. The paramedic is partnered with an EMT, no additional resources are available at this time. The weather is clear, and the temperature is 77F (25C).  A local community hospital is 15 minutes away and a comprehensive medical facility is about 25 minutes away.  On Scene The patient (62kg) is found laying on the ground on their left side. There is an overturned ladder nearby. The wife reports the patient was cleaning out the gutter when she heard a crash. The patient was initially moaning but now she cannot wake him up. The patient has a history of hypertension and takes hydrochlorothiazide and atenolol. The patient is allergic to sulfa drugs. The initial exam is pertinent for pale, clammy skin. Blood and vomit are noted around the patient’s mouth. There is obvious deformity to the right leg with pooling of dark blood under his pants. The patient moans and draws his arms to his chest when the trapezius muscle is squeezed.  A weak carotid pulse is present. Respirations are 28 and shallow.

A trauma patient has an impaled object in the cheek, an abdominal evisceration, an open pneumothorax, and a suspected closed head injury. Which injury should the paramedic treat first? 

EN ROUTEIt is 0930 and you are staffing a 2-paramedic transporting ambulance. Your unit is dispatched for a 68-year-old male with chest pain. He has a history of diabetes, high cholesterol, and high blood pressure. It is a rainy spring day, and the temperature is 75F (24C). The response time is about 8 minutes. There is a community hospital about 15 minutes away, and a level 2 trauma center with most capabilities about 25 minutes away.Dispatch notes the patient woke from sleep with severe chest pain. The patient’s wife is on scene. ON SCENEThe wife leads you into the bedroom where you find the patient (60kg) sitting on the edge of the bed leaning forward with his hands on his thighs.  He makes eye contact when the crew arrives but appears tired and is in moderate respiratory distress. The wife states that the patient was feeling dizzy and had a headache last night but woke up suddenly and couldn’t breathe.The patient has a history of diabetes, high cholesterol, and high blood pressure. The patient has no allergies to medications. The wife reports a 2 pack per day smoking history. His medications include a baby aspirin, atorvastatin, Glucophage, and atenolol. The patient’s skin is pale and diaphoretic. There are no signs of trauma, and the patient obeys motor commands. The patient can only speak 2-3 word sentences and has moderate accessory muscle use. Eyes are open, pupils are 5mm and reactive to light. The vital signs are BP 78/42, P 226, R 36, SpO2 88% on room air, and T 98F (37C). The blood glucose is 120. The EtCO2 is 38. On further exam you note the patient has bilateral fine basilar crackles.