Some quick scenarios from my interview..

[splitintlemt]

I had my paramedic program interview today and it included some scenarios so how do you guys think I did. heres a couple of ?'s and my responses.. ( I don't remember ages or all info so bare with me.)

They didn't want an assessment, they wanted to know what was going on with the patient, that is all.

1. Older lady, out walking starts experiencing chest pain, skin pale, cool and diaphoretic. Bp was normal, respirations were rapid and pulse was rapid as I remember....

A. I went with MI but stated Angina Pectoris at first, but was asked to choose between the two.

2. Dispatched to convalescent home for an elderly patient, Ill, high fever, rales and rapid respiratory rate and pulse.

A. I went with Pneumonia.

3. MCI, two patients were given, one, a man slumped over in the drivers seat of a car and a child with a nearly amputated arm bleeding profusely.

A. I said I would treat the man slumped over in the car first.

This is the question I wanted to get some of your opinions on as I was unsure..

[medic429]

:shock:

Can you clarify the statement that they wanted to know what was going on with the patient? In reading, I could think of quite a few things that might be happening to all patients, but without assessing them, how would you know based on the info. you were given? I don't understand how you can determine that. old people + chest pain [s:3cc1fcafe5]equal[/s:3cc1fcafe5] MI all the time.

For example the elderly lady-they wanted to know MI or Angina, is that what you're saying? Because I would really want a history and further assesment including how rapid is her pulse? How rapid is her breathing? Is it labored, shallow? Is it adequate? Any cyanosis? Edema? What's a "normal" BP? What does the monitor say?

I could go on and on, but I think you get the picture....I would start with a much broader field of what could possibly be going on-just curious how you got MI with what you were given.

[Dustdevil]

:shock:

Can you clarify the statement that they wanted to know what was going on with the patient? In reading, I could think of quite a few things that might be happening to all patients, but without assessing them, how would you know based on the info. you were given? I don't understand how you can determine that. old people + chest pain [s:da53f1d850]equal[/s:da53f1d850] MI all the time.

I think what they may have been looking for was for you to realise that this must be treated as an MI until it is ruled out, even though it might just be angina or something else. They are obviously looking at your critical thinking skills here, not so much your medical knowledge.

If those two patients were all you had on the "MCI," then I would have had to go with the kid. Not because he's a kid, but because he has an ABC problem that can be -- and must be -- immediately fixed. The slumped guy is going to require a lot of evaluation before you can even begin treating him. He can wait another thirty seconds, and may not even need me at all.

Did they ask you to explain your answers, or just give them? The "MCI" question could really go either way, depending on your reasoning. Physiologically speaking, I believe I am correct. However, strictly blind triaging could put it in your favour too. It's not uncommon to try and seduce you into jumping on the sexy injury (the kid) while overlooking their priority of the slumped guy. If they are more interested in a cookbook answer than in hearing your reasoning, then they are missing the boat.

Good topic! Thanks for posting this, because this kind of thing is extremely helpful to those preparing for interviews! :thumbright:

[splitintlemt]

:shock:

Can you clarify the statement that they wanted to know what was going on with the patient? In reading, I could think of quite a few things that might be happening to all patients, but without assessing them, how would you know based on the info. you were given? I don't understand how you can determine that. old people + chest pain [s:1fb66b6403]equal[/s:1fb66b6403] MI all the time.

For example the elderly lady-they wanted to know MI or Angina, is that what you're saying? Because I would really want a history and further assesment including how rapid is her pulse? How rapid is her breathing? Is it labored, shallow? Is it adequate? Any cyanosis? Edema? What's a "normal" BP? What does the monitor say?

I could go on and on, but I think you get the picture....I would start with a much broader field of what could possibly be going on-just curious how you got MI with what you were given.

I said it is probably Angina or MI and then I was asked to choose between the two.

At most they gave me the vitals of the patient which I can't remember the exact blood pressures. The blood pressure on the chest pain was within 90- 150 systolic. I asked for a history and then was told that the info given is all the info I get.

I understand what you are saying tho, a better assesment would have been helpful.

Dust: Thats what I figured about the MI. I was leaning towards the kid as well for the exact same reason but went with the man..

I'll find out next week if I'm accepted.

[mrmeaner]

The most interesting question I was ever asked at an interview was for intern work with Harley Davidson. The question was "Why are manhole covers round?"

[certguy]

I agree the LOL should be treated as an MI till proven otherwise . They really didn't give you much to go on .

The nursing home call sounds good , but again , not much info .

The 2 MVA pts are interesting . I think I would've asked if the child was screaming or quiet . With a screaming pt. you know they're conscious and have a good airway . You have to watch out for the quiet ones . The slumped driver may have an airway problem and therefore , should go first . We use this type of scenerio when training CERT members . If we're searching a room with several pts . It's natural to want to go to the screamer , but in doing that , you may lose others to airway problems . Both pts would be red tags , but remember , airway is first in ABC's .

[njmedic1485]

The most interesting question I was ever asked at an interview was for intern work with Harley Davidson. The question was "Why are manhole covers round?"

Was the answer "To fit the manhole" ?

[Just Plain Ruff]

no the answer to the manhole cover is this

they are round because a square manhole cover will not fit a round manhole hole.

If the manhole hole was a square then the manhole cover would be square cause it would be stupid to try to use a circle manhole cover.

You gotta think outside the box on that type of question.

[captainstandup]

The MI is a no brainier, plan and prepare for the worst hope for the best but always let assessment and response to treatment direct your actions while maintaining that cautious little voice in the back of your mind that asks "could I be wrong" or "what am I missing". This will keep you sharp and help you learn and improve as you become a true clinician instead of someone who just sits in the captain’s chair during transport.

I understand your not really being allowed the time to ask detailed questions / assess your convalescent home patient limited your responses. Please always bear in mind there are a few other questions that would really help in field differentiation between pneumonia and perhaps CHF, COPD, Asthma etc. Its also important to remember concomitant conditions may present especially in the elderly patient. For example; the elderly patient may have been suffering from septic shock from a bad UTI leading to fever. Sepsis can lead to widespread vasodilatation overworking an older heart leading to pump failure and congestive failure. BP, skin color, effort of breathing, certainly breath sounds and the presence of or absence of orthopnea are really good pieces of information among many others.

The MVA was completely directed toward assessing your critical thinking skills. In your mind the issue came down to, do I treat an airway problem in the adult accident victim or life threatening hemorrhage in the child? Suddenly you are conflicted; the palms are sweaty as you weigh the options. Child vs. adult, adult vs. child, airway vs. hemorrhage, emotionally the child trumps the older person, EMT training teases you into believing the older persons airway is more imminently life threatening that hemorrhage in the child. They wanted to hear you say you would immediately employ hemorrhage control measure to the child and if possible simply tilt the older patients head back to determine if they were viable. Dust is right; the older person may not need your help.

My point is not to say you were wrong, but is to inspire you to grab each and every "molecule" of information in assessing patients. Then when you reassess and reassess and reassess during care you will develop a clearer clinical picture and can direct treatment accordingly.

You are already taking the first best step possible. Asking questions is huge regardless of whether you are a new EMT or a seasoned Paramedic.

By the way, the worst question I was ever asked in a promotional interview was "if you were an animal, which animal would you be?" Again this was intended to evaluate critical thinking, and communication skills given the fact it was entirely foreign to all other medical and managerial questions asked.

[spenac]

I actually got asked something along the lines of We're going to hire you, there are three people that need a partner, one is white, one is black, one is mexican. Which one do you not want to work with?