It is 2000 hours. Your unit is dispatched to a run-down home for a man complaining of diarrhea. When you arrive, you notice a foul, fecal smell. You meet the patient, a sixty-eight-year-old man, in the living room. He complains of nausea and diarrhea over the past three days. He notes his bowel movements have been “very dark, almost black.” He is awake, alert, and […]

Street Scene Questions 1. What is your first priority when starting to assess this patient? 2. Assuming his airway is patent, what are the essential elements in assessing this patient’s breathing? 3. What type of emergency care should you be prepared to give? As you assess the patient, you note he is breathing rapidly with an audible wheeze. He seems very tired. He can speak […]

Critical Thinking Exercises 1. After assuring the scene is safe, the EMT should open this patient’s airway and, if necessary, support it with an airway adjunct. Her altered mental status, slow respiratory rate, and cyanosis all point to respiratory failure. This patient needs immediate respiratory assistance with a bag-valve mask and supplemental oxygen. 2. At a minimum, this patient needs immediate supplemental oxygen. Further assessment […]

  1. A patient found on the floor with no pulse or respirations must be immediately ventilated with a bag-valve mask and high-concentration oxygen. 2. A fourteen-year-old patient with a fractured femur and strong but mildly rapid pulse and respirations is likely experiencing significant pain. Administer oxygen and help relieve her pain by stabilizing the broken extremity. 3. A sixty-four-year-old alert patient with chest pain […]

Critical Thinking Exercises Airway assessment is a critical skill. The purpose of this exercise will be to consider how you might assess and manage patients with signs of an airway problem. 1. On arrival at the emergency scene, you find an adult female patient with gurgling sounds in the throat and inadequate breathing slowing to almost nothing. How do you proceed to protect the airway? […]

“Control to unit 144,” your radio blurts out. You respond, “Go ahead, control.” Dispatch tells you that you have a priority-one response to a man down, age unknown, found on the corner of Salina and Jefferson Street. Dispatch also notes that prearrival questioning indicates the patient is not breathing. Brian, your partner, drives, and while en route, you make sure that you have a plan. […]

Critical Decision Making 1. The sixteen-year-old asthma patient’s airway will not likely stay open. Although asthma is primarily a breathing problem, his attack is leading to a decrease in mental status, which threatens his airway. 2. The seventy-two-year-old female patient’s airway will likely stay open unless her condition significantly worsens. Her problem is likely a breathing issue and not related to her airway. She may […]

Street Scene Questions 1. How would you interpret the child’s behavior of clinging to his mother? Do you believe it is a normal/good sign or a sign of serious injury? 2. Immobilizing the patient’s spine will mean restricting his movement. How do you anticipate the patient will respond to this? 3. Would involving the mother be helpful? How? You continue to assess the child. You […]

Critical Thinking Exercises Adolescent patients can offer special challenges to the EMT. The purpose of this exercise will be to consider how you might handle the challenge described here. • You are called for a sixteen-year-old girl with abdominal pain. She is with friends at the park. She seems hesitant to answer any of your questions. What characteristic of adoles- cent development is most likely […]

1. A three-year-old boy who is groggy with a pulse of 60/minute is abnormal. He should be alert and active with a pulse of 80–120/minute. 2. A sixty-five-year-old man describing a feeling of “skipping heart beats” and a pulse of 130/minute is abnormal. A normal rate for his age is 70/minute. He may be suffering from any number of fast heart rhythms. 3. A forty-two-year-old […]