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. 

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.

An elderly patient complains of dyspnea and generalized weakness that woke them up. The patient is sitting on the side of the bed in a tripod position. Which of the following signs and symptoms should the paramedic expect if this patient is suffering from left-heart failure as opposed to right-heart failure? Left-heart failure: (Choose 3) Right-heart failure: (Choose 3)

An 18 year old patient complains of diffuse periumbilical pain that is increasing and moving towards their lower right quadrant. They present with a low fever and nausea. You should:

A child with altered mental status has a history of diabetes mellitus. Which of the following signs and symptoms should the paramedic expect to see if the patient was suffering from a hypoglycemic event? (Select three correct answers)

After initiating transcutaneous pacing and obtaining electrical capture on the ECG monitor, paramedics should next:

What is the order of a rescue operation?

During intubation, the tip of the curved blade:

An unresponsive trauma patient is suspected to have a cervical spine injury. The patient is breathing shallowly at 16 times per minute, there is no muscle tone below the level of the shoulders, and the skin is pink, warm, and dry. Which of the following should the paramedic expect to find? (Select two correct answers)

An elderly patient has a complaint of weakness, nausea, and mild chest pain. The monitor shows the following rhythm and pulse, respirations are 24, and BP is 80/40. The paramedic should suspect what field impression and what is the best initial treatment? Management: (Choose 1) Impression: (Choose 1)