Inadequate chest rise is noted while ventilating an 8-month-old infant. The paramedic should:

Which of the following is true about the greater pelvis? 

The IC fossa is located on which aspect of the femur?

When is it appropriate to remove an impaled object?

EN ROUTEIt is 2130 and you are staffing a 2-paramedic transporting ambulance. Your unit is dispatched to a residence for an 18-month-old child with altered mental status. It is a clear summer night, and the temperature is 86F (30C). The response time is about 10 minutes. There is a community hospital about 5 minutes away, and a level 2 trauma center with most capabilities about 15 minutes away.Dispatch notes state the patient has been sick the last 3 days and is now difficult to arouse. ON SCENE The father leads you into the living room where you find the patient (22lbs) lying in the mother’s lap. The child does not respond to the crew approaching. The mother states the patient has had a cough and congestion the last 3 days and is now difficult to arouse. The patient has had an intermittent fever up to 102F (39C).  The patient has no significant past medical history, born full term with an uncomplicated delivery. Parents report the patient is up to date on vaccinations.  The patient’s skin is pale and mottled with a capillary refill of 5 seconds. There are no signs of trauma. The patient’s breathing is mildly labored with occasional grunting, nasal flaring and subcostal retractions. Lung sounds are rhonchi in the right lower lobe. Eyes open when CBG is obtained and the patient whimpers and tries to pull away. Pupils are 4mm and reactive to light. The patient has a weak brachial pulse. The vital signs are P 156, R 48, SpO2 92% on room air, and T 101F (38C). The blood glucose is 122. POST SCENE The patient is packaged onto the stretcher and transport is initiated to the level 2 hospital.  The patient remains lethargic. She is becoming harder to arouse but will open her eyes when stimulated. Vital signs are P 184, R 52, and SpO2 94% on high flow oxygen. 

A patient with persistent substernal chest pain radiating to the left arm. Vital signs are BP 90/62, P 110, RR 22, and pulse oximetry 98% on 4 L/min O2 by nasal cannula. The paramedic should next:

En RouteA paramedic is dispatched to a residence for a welfare check on an 85-year-old patient. The time of the call is 0900 on a clear summer morning with a temperature of 84oF (29oC). The region is a medium-sized city with moderate traffic. Response time is approximately 6 minutes. A stand-alone ED is approximately 8 minutes away, a regional trauma center is 25 minutes away, and an ICU-capable medical center is 15 minutes away with normal traffic.The paramedic is partnered with an EMT in a standard-equipped ALS ambulance.The dispatch notes state the family has been unable to contact the patient who lives alone. They are en route and about 20 minutes away. A local fire engine and law enforcement agency is also responding.  On Scene Upon arrival at the scene, law enforcement officers state there was no answer when they knocked on the door, and that they are about to gain access to the residence by force. Once inside, the patient is found lying on his right side on the floor of the living room. The patient has a palpable radial pulse and is breathing 20 times a minute. The patient’s skin is cool and clammy. Rapid exam is pertinent for a small hematoma on his right temple. When the patient is rolled onto their back, the respirations become sonorous. The patient does not respond to verbal or painful stimuli. Vital signs are BP 142/80, P 77, RR 14, SpO2 96%. Lung sounds are clear bilaterally.The patient’s history is unknown but the following medications were found on the counter: Aspirin, Humulin kwikpen, hydrochlorothiazide, Percocet, simvastatin, and metoprolol. Post Scene The paramedic is unable to obtain IV access and opted to administer IM glucagon. The patient was packaged up and transport initiated. Family was notified to meet the patient at the hospital. While en route to the hospital, repeat vital signs are BP 130/78, P 68, RR 10, SpO2 92%. Capillary blood glucose is 40 ten minutes after glucagon administration. Pupils are unchanged and there are no other injuries noted on exam. 

The resistance of a patient’s lung tissue to ventilation is referred to as:

Which of the following trauma situations would best benefit from immediate treatment as soon as it is recognized prior to transport? (Select two correct answers)

An elderly patient was a restrained driver of a vehicle that sustained a lateral impact to the driver’s side door. The patient is unresponsive, trachea is midline, neck veins are flat, and lung sounds are absent on the left side with hypo-resonance noted. There are broken ribs on the left side and the abdomen is flat and non-tender. The paramedic should suspect which injury and what is the best management?  Management (Choose 1) Injury (Choose 1)