A three-year-old child was found wandering in a neighborhood…

A three-year-old child was found wandering in a neighborhood park.  You are called to evaluate and most likely, transport the child to the hospital.  You see that the child has old bruises in multiple areas of his body along with burn scars.  These are present on all limbs, the back and abdomen.  You suggest to the police that the best explanation for these injuries is:

Enroute phaseScenario:The paramedic unit is dispatched to a…

Enroute phaseScenario:The paramedic unit is dispatched to a residential structure fire for a 42-year-old male reportedly burned while attempting to extinguish flames in his kitchen. The call was received at 0758. Estimated response time is 7 minutes. The paramedic is partnered with an EMT, and a BLS engine company is also responding. The outside temperature is 62°F (17°C) on a clear spring morning. According to fire personnel on scene, the patient has burns to the chest and arms and was exposed to smoke for several minutes before exiting. He is reported to be conscious but in significant pain.What pre-arrival preparation is most appropriate for this patient’s presentation?

Enroute phaseScenario: The paramedic unit is dispatched to a…

Enroute phaseScenario: The paramedic unit is dispatched to an elementary school nurse’s office for a 7-year-old female who developed difficulty breathing and a rash shortly after eating lunch. The call was received at 1147. Estimated response time is 6 minutes. The paramedic is partnered with an EMT, and a BLS engine crew is also en route. The temperature is 72°F (22°C) and skies are clear. According to the school nurse, the child has a known peanut allergy and her symptoms started within minutes of exposure. The school has an EpiPen available and is awaiting EMS arrival. Based on dispatch information, which symptom most strongly suggests the child is experiencing anaphylaxis?

Enroute phaseScenario: The paramedic unit is dispatched to a…

Enroute phaseScenario: The paramedic unit is dispatched to a group home for a 26-year-old male who is reportedly experiencing a psychiatric crisis. The call was received at 1012. The estimated response time is 6 minutes. The paramedic is partnered with an EMT, and a BLS fire engine crew is also responding. It is overcast and 54°F (12°C) with light traffic. According to dispatch, the patient is locked in his room, yelling that people are trying to hurt him. Staff report he has a history of schizophrenia and is off his medications.OnScene phaseScenario: The patient (approx. 70 kilograms) is pacing rapidly in a small, cluttered bedroom. He is shouting that “they’re watching through the walls” and refuses to sit or allow physical contact. He appears disheveled, sweaty, and paranoid. Staff report he has not taken his prescribed medications for three days. No weapons are visible, and the patient has not made threats of violence. He is not responding to attempts at de-escalation and continues to shout and mumble incoherently.Vital signs: BP 138/88, HR 116, RR 20, SpO₂ 98% RA, Temp 99.2°F (37.3°C). No signs of trauma are present. Postscene phaseScenario:With law enforcement assistance, the patient is safely escorted to the stretcher and secured with soft restraints. He continues to speak incoherently but does not resist transport. An IV is established for access, and cardiac monitoring is applied. The patient is drowsy during transport but occasionally becomes agitated and pulls at the restraints. He does not acknowledge EMS crew or answer questions. Vitals are stable: BP 130/84, HR 102, RR 18, SpO₂ 99% on room air, Temp 98.9°F (37.2°C).Why is transport to a psychiatric-capable facility appropriate even if the patient calms down en route?

A patient complaining of chest pain is also having difficult…

A patient complaining of chest pain is also having difficulty breathing.  The patient states that he ate 3 hours ago, he takes aspirin and coumadin on a daily basis, and his pain started 20 minutes before 911 was called. Which of the assessment findings from the above scenario best illustrates the utilization of the OPQRST mnemonic?

You are treating a patient whom bystanders indicate was stru…

You are treating a patient whom bystanders indicate was struck in the head by a flower pot that fell off of a ledge.  The patient was unconscious but is now conscious and confused with equal and reactive pupils.  She is disoriented and suffering from retrograde and anterograde amnesia.  She is also complaining of a headache and light sensitivity.  Which of the following is the patient MOST likely suffering from?