EMTprep Free Training Materials

How do you determine whether a patient is stable or unstable initially?

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Look at vital signs and signs of shock. Is blood pressure significantly low? Is the patient pale, cool, and diaphoretic? Are they altered mentally, or unresponsive? If so, they are an unstable patient. Stable patients have adequate vital signs that may be a little out of the normal range, but do not cause the patient to be symptomatic. Symptomatic typically means that they are altered mentally, or displaying signs of shock due to their condition or heart rhythm.

What are your H’s and T’s that need to be assessed in a cardiac arrest code?

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Hypoxia, hypovolemia, hydrogen ions (acidosis), hypoglycemia, hypo/hyperkalemia, hypothermia, tension pneumothorax, tamponade (cardiac), toxins, thrombosis (pulmonary and cardiac)

Which rhythm do you deliver a defibrillation shock to?

A. Pt in SVT with a pulse of 170

B. Pt in sinus tachycardia with a pulse of 140

C. Pt in ventricular tachycardia with a pulse of 200

D. Pt in ventricular fibrillation with no pulse

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D. Defibrillation is used in patients that do not have a pulse, and are in ventricular tachycardia or ventricular fibrillation

When do you use the 15:2 CPR compression ratio?

A. Pulseless child <2 years with one rescuer 

B. Pulseless child <12 months with one rescuer 

C. Child <12 months with a pulse of 55 with two or more rescuers 

D. Pulseless child <20kg with two or more rescuers 

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C. Anytime a child has a pulse less than 60, CPR is needed. 15:2 compression ratio is used in infants <12 months when two or more rescuers are present

Describe management of a patient with chest pain that is presenting with signs of shock.

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Oxygen, monitor, IV. Aspirin 324 mg, nitroglycerin (0.4mgx3 if BP is above 100 systolic), and fentanyl 25-100mcg for pain. Code 3 transport to nearest cardiac hospital, obtain 12 leads en route. STEMI alert for the hospital. Consider fluid bolus to support BP if low. Monitor vital signs, and be prepared to assist ventilations with a BVM or potentially manage a cardiac arrest.

How do you distinguish between a 2nd degree type 1 and a 2nd degree type 2 heart block?

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Type 1 presents with PR intervals >0.2 seconds that gradually elongate until a QRS complex is dropped. Type 2 presents with PR intervals that do not elongate, and randomly drop QRS complexes.

What is the correct dosage in joules for the first defibrillation dose for a 30kg child?

A. 60 joules

B. 120 joules

C. 15 joules

D. 75 joules 

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A. First dose is 2J/kg in children

At what pulse rate do you initiate CPR on a child?

A. Below 50

B. Below 60

C. Below 70

D. Below 80

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B. CPR is initiated on children with a pulse less than 60. This pulse rate is not adequate to perfuse the child’s body effectively.

Explain the difference between sinus tachycardia and SVT.

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In SVT, no P waves are distinguishable because the P waves and the T waves are shown together; in sinus tachycardia, a P wave is able to be distinguished. SVT is usually a rate of 150 or higher, and typically is symptomatic.

An idioventricular rhythm is between:

A. 20-40bpm

B. 40-60bpm

C. 60-80bpm

D. 60-100bpm

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A. Idioventricular rate is 20-40, because the electrical impulse originates in the ventricles instead of the SA node.