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. Post Scene The crew suctioned the patient’s airway and is currently providing ventilatory support with a BVM. The patient was secured to a long spine board and transport initiated toward the trauma center. A rapid trauma assessment reveals the following: pupils 6mm and minimally reactive, bleeding to the posterior head that is controlled, trachea is midline and no JVD, bruising over the left chest with equal rise and fall, abdomen is soft and nondistended, pelvis is stable, open fracture to the right thigh with bleeding that is dark red and oozing. Vital signs are BP 145/80, P 62,  RR 10, SpO2 90% with a BVM at 15 LPM. 

The following ECG is obtained from an alert and oriented 4-year-old patient with shortness of breath and palpitations. The paramedic should: 

Which statement best describes the role of the emergency operations center at mass casualty incidents?

The following ECG is obtained. What should the paramedic suspect and what is the first line treatment?  Treatment (Choose 1) Condition (Choose 1)

You are assessing a patient with suspected cardiogenic shock. Which of the following findings would best help you determine that this is a left-sided heart issue?

 Your unit is the first to arrive at the scene of an MVC with 8 patients. Your supervisor arrives on scene, who has more than 15 years experience. You should:

You are analyzing an EKG rhythm strip. The R-R intervals are constant and spaced 13 small boxes apart. There are no P waves visible, and the QRS width is 80 ms. Your interpretation:

Which of the following are considered intrapartum (delivery) emergencies? (Select three correct answers)

A patient has received an electrical shock from a high voltage electrical line. The patient is unresponsive and has a 3rd degree burn to the palm of the left hand and right foot. The paramedic should have a high index of suspicion for which type of injury?

 patient with a narrow complex tachycardia with a rate of 180, a blood pressure of 74/40, and is lethargic. You should: