Blog

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.Based on the nature of the incident, what complication should the paramedic anticipate beyond thermal injury?

Enroute phaseScenario:The paramedic crew is dispatched to a private residence for a 21-year-old female who was found unresponsive in her bedroom by her roommate. The call was received at 1535. The response time is estimated at 7 minutes. The paramedic is partnered with an EMT, and an ALS supervisor is en route. It is a mild spring afternoon, 64°F (18°C), and traffic is light. The roommate reports by phone that the patient has a history of depression and may have ingested “a bunch of pills.” The patient takes amitriptyline and alprazolam, according to the caller. Law enforcement is not yet on scene.What is the primary concern about airway management in suspected overdose?

You are called to treat a patient with a history of a brain tumor who has a blood pressure of 200/100, respirations of 4, pulse of 40, and temperature of 102 degrees Fahrenheit. Which of the following is your MOST appropriate initial intervention?

The EMS crew is dispatched to a residence for a 25-year-old patient who is weak, dizzy, and slightly agitated. The time of the call is 1000. The response time will be 9 minutes. The patient is located inside the residence. There is heavy rainfall in the response area. It is a cool morning, and the temperature is 42°F (6°C). A small hospital is located 12 minutes away, and the nearest comprehensive medical facility is 30 minutes away. Scene  The patient responds to verbal stimuli and is laying down in bed and does not want to be bothered. The family member states that the patient reported feeling weak during breakfast, and then became confused. The patient has a history of seizures, diabetes, and hyperlipidemia.  Medications include insulin that is being administered by an automated external pump, carbamazepine, gabapentin, and atorvastatin. The patient allergies to penicillin medications. The patient’s skin is diaphoretic. There are no signs of trauma, and the patient obeys motor commands. Eyes are open, and the pupils are 5 mm and reactive to light. The vital signs are BP 166/90, P 124, R 12, SpO2 95% on room air, and T 98°F (37°C). The blood glucose is 47 mg/dL. Based on the patient findings, what is the most probable medical emergency and what is the correct treatment for that emergency? Move the most probable emergency with your answer and the correct treatment with your answer.

Enroute phaseScenario:The paramedic crew is dispatched to a public library for a 34-year-old male who is reported to be unconscious in the restroom. The call was received at 1217. The response time is estimated at 6 minutes. The paramedic is partnered with an EMT, and a BLS fire engine crew is also en route. The temperature is 66°F (19°C), with clear skies and light pedestrian traffic. The caller, a library staff member, reports the patient was found slumped on the floor and is “barely breathing.” No known medications or allergies have been reported. What is a common sign associated with the overdose that may help confirm the diagnosis on scene?

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.OnScene phaseScenario:The patient (approx. 85 kilograms) is alert and seated outside the home. He has partial-thickness burns across the anterior chest, both forearms, and hands, with blistering and severe pain. His eyebrows and nasal hairs are singed, and he has a persistent cough. He is hoarse and has soot around the mouth and nose. No other trauma is observed. The patient reports using a fire extinguisher and then evacuating himself. He is anxious and asking for help.Initial vital signs: BP 134/88, HR 126, RR 28, SpO₂ 94% on room air, Temp 99.1°F (37.3°C), Pain 9/10. Approximately what percentage of total body surface area (TBSA) is burned using the Rule of Nines?

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?

The preferred way to handle an amputated part is to:

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?

You thought your patient was experiencing a pericardial tamponade.  What would be the greatest negative result of your misdiagnosis if the patient was really experiencing a tension pneumothorax?