The EMTCity Test

[Happiness]

You are called to a home and you go into the bathroom to find a 300 lb male appox 42 years old. You notice that he is over the toilet with dry heaves. He is pale and sweaty. bp is 180/80, and pulse is 120 and bounding. He has no complaints of chest pain but does complain of exahaustion. His other complaint is that he is dizzy as soon as he moves. He discribes it as the room is spinning.

The diagnosis of this pt was an inner ear infection, so my question would be why did this pt present as a cardiac issue.

Is this what you want

[tamaith]

great idea. are the quest going to just for medics or are there also going to be emt-b questions as well.

[WolfmanHarris]

The questions should not be level of training specific with regards to interventions. That being said, with a focus on patho, A&P, pharm and the like, it will likely not be familiar to a Basic whose education is limited to what they learned in Basic. Now if you have a background in this or have spent the extra time studying than sure. But as per my first post, I'm looking for questions that make you work and apply many different concepts. Not necessarily easy, but definitely not parroted right from the textbook.

Thanks for the questions so far folks but please consider the following things. Since its my hope of turning this into a resource that'll be around for awhile I'm looking for a bit more than the standard chime in. Before you post a question please preface it with which category you feel it best fits so that I can add your name to the list and we can make sure all areas are covered. Please take the time to write the answer for your question and post it in spoiler tags, so that the answer isn't visible.

The questions and answers can obviously be reviewed by everyone here for input and feedback.

Wendy, thanks for the offer. I'll get back to you on what if anything you'll need to do. I'll flying by the seat of my pants here.

Chbare, those are the questions I was hoping for. Knowledge not skills. Challenging, but within scope of a proper education. Your scenarios have consistently had me hitting the books, so I'd be glad to see what you have to add in the way of questions.

I'm thinking at this point that maybe I'll start another thread to post the finalized questions and answers as they come together and use this one to hash everything out. Thoughts?

- Matt

[chbare]

Let me see if I understand correctly? You are looking for questions that are better suited for BLS providers? The questions I had in mind dive into some fairly complex subjects. Nothing out of left field; however, I definitely have a taste for going beyond, "we give NTG for chest pain" level of understanding. Obviously, the answers to these questions will most likely not be found in an EMT-B textbook. I do not want to present questions that would be considered inappropriate or incompatible with your ideas.

Take care,

chbare.

[Just Plain Ruff]

Matt, I have a lot of time on my hands when I'm working. I'll be editor number 2. Any reason to work with The Illustrious Eydawn I get, I take.

[DwayneEMTP]

...would have a mind for anal retentive details.

Yeah, I had to read that twice, as the first time I read "Eydawn". Only upon review did I see it was actually a sentence and not just a name..

Just sayin'....

Dwayne

[Arizonaffcep]

Count me in, in whatever fashion you need.

Edited to add:

You might want to hit up Vent for some intricate respiratory questions...

[chbare]

The three questions below would most likely belong in the neurological section of the quiz. Let me know if this is the type of question that you had in mind.

1) You respond to a small ER to transfer a 50-year-old male with a closed head injury to a tertiary care center. The patient is intubated, sedated, paralyzed, and on a mechanical ventilator. His vital signs are: 150/100 P-52 regular SPo2-100%. The ER Nurse reports the following radiographic findings as noted by CT scan: “The patient has a large lense shaped hematoma under the calvarium of the left temple. The Falx Cerbri is shifted to the right and compression of the ventricles is also noted.” Which of the following answers is most correct?

A: You should suspect a ruptured aneurism and massive sub-arachnoid hematoma.

B: You should suspect an epidural hematoma with rupture of the middle meningeal artery.

C: You should suspect an epidural hematoma with rupture of the Cerbri artery.

D: You should suspect diffuse axonal insult (DAI) injury based on the CT findings.

2) You respond to the scene of a drive by shooting. Police report a 19-year-old male was hit in the head by a single gunshot round. They believe the patient was hit by a 40 caliber full metal jacket round fired from a Glock 22 handgun at a range of approximately 10 yards. First responder crews have initiated care and have placed an LMA (laryngeal mask airway). The patient is unresponsive and apneic. The first responder crews have been ventilating the patient at a rate of 28 times a minute. You verify proper LMA placement with objective and subjective findings. Upon initiating waveform capnography, you note an end tidal Co2 of 17. Which of the following answers is most correct?

A: You suspect the patient was hit by a bullet traveling less than 2,500 feet per second and you suspect metabolic acidosis causing the end tidal CO2 findings.

B: You suspect the patient was hit by a bullet traveling approximately 3000 feet per second and you suspect the poor seal of the LMA is causing gastric inflation.

C: You suspect the bullet hit the breathing center of the brain causing underlying metabolic and respiratory complications.

D: You suspect the patient was hit by a bullet traveling less than 2,800 feet per minute and you suspect possible impaired cerebral perfusion relating to vasoconstriction.

3) You are called to transport an elderly patient who is status post closed head injury from the hospital back to an assisted care facility. The patient has past history of congestive heart failure CHF and is currently receiving furosemide. Upon examination the patient’s nurse tells you; “in spite of fluid restriction the patient had 4 liters of urine output last night.” What answer is most correct?

A: You suspect diabetes insipidus.

B: You suspect syndrome of inappropriate anti-diuretic hormone.

C: you suspect Addison’s disease.

D: You suspect an over dose of furosemide.

Take care,

chbare.