FINAL PARAMEDIC FISDAP COMPLETE 2026/2027 Ultimate
Comprehensive Guide | Actual Questions & Verified Answers | All
Domains: Trauma, Medical, Airway, Cardiology, OBGYN,
Operations, Pediatrics, Geriatrics | Pass Guarantee
TRAUMA (Questions 1–25)
1. Dispatch: 19:40 hrs. EMS-1 dispatched to single-vehicle MVC, car vs. utility pole,
estimated 35 mph. Extrication complete on arrival.
Scene: 22-year-old restrained driver, side-impact on driver door. Airbag deployed.
Patient: Complains of left chest pain and dyspnea.
Vitals: HR 118, BP 94/60, RR 26, SpO₂ 89 % RA, GCS 15.
Exam: Trachea midline, JVP 2 cm, absent breath sounds left lower chest,
dullness to percussion, crepitus over ribs 6–8.
Next most appropriate intervention?
A. 2 L warmed NS wide open
B. Needle decompression L 2nd ICS
C. 14-gauge IV, draw trauma labs, initiate massive transfusion protocol
D. Left-sided tube thoracostomy
Correct Answer: D
Rationale: Clinical hemothorax (dullness + absent sounds) with mild shock; requires
drainage, not needle decompression. Massive transfusion not yet indicated (BP
responding). Tube thoracostomy is definitive pre-hospital if system allows.
2. Dispatch: Fall from height, 14 ft.
Patient: 34-year-old male, landed on feet, now with severe low-back pain and
inability to move lower extremities.
Vitals: HR 98, BP 140/80, RR 20, SpO₂ 98 %, GCS 15.
Exam: Tenderness over T12–L1, no step-off palpated, motor 0/5 both lower
, extremities, sensory absent below umbilicus, DTRs absent.
Highest priority?
A. High-dose methylprednisolone 30 mg/kg IV
B. Log-roll onto long board and secure with straps
C. Establish 2 large-bore IVs while maintaining spinal alignment
D. Apply traction splint to both lower extremities
Correct Answer: C
Rationale: Spinal motion restriction + vascular access are priorities; steroids no longer
recommended. Traction splint inappropriate for spine injury.
3. Dispatch: Motorcycle crash at 40 mph, rider thrown 20 ft.
Patient: 27-year-old male, helmet scuffed, no loss of consciousness.
Vitals: HR 110, BP 100/70, RR 24, SpO₂ 93 %, GCS 14 (E4 V4 M6).
Exam: Right chest abrasion, breath sounds decreased right, hyper-resonant
percussion, trachea deviated left.
Field diagnosis?
A. Flail chest
B. Tension pneumothorax
C. Simple pneumothorax
D. Massive hemothorax
Correct Answer: B
Rationale: Trauma + unilateral absent sounds + tracheal deviation + tachycardia =
tension pneumothorax until proven otherwise.
4. Patient: 6-year-old struck by SUV at low speed, bumper impact to pelvis.
Vitals: HR 140, BP 80/40, RR 28, SpO₂ 97 %, GCS 14.
Exam: Distended abdomen, tender, no external bleeding; pelvis stable.
Estimated blood loss class?
A. Class I
B. Class II
C. Class III
D. Class IV
,Correct Answer: C
Rationale: Pediatric HR > 140 with hypotension for age (BP < 90 systolic) suggests
30–40 % blood loss (Class III).
5. Burn scenario: Adult male, flash fire in garage. Burns: anterior chest/abdomen
(complete), both anterior arms, anterior neck, genitalia.
Using Rule of Nines, total BSA burned?
A. 27 %
B. 36 %
C. 45 %
D. 54 %
Correct Answer: C
Rationale: Anterior trunk 18 %, each arm 4.5 % (×2 = 9 %), neck 4.5 %, genitalia 1 % →
32.5 %; closest 36 % (includes portions of arms/neck).
6. Penetrating trauma: 9 mm gunshot to right anterior chest, 4th ICS mid-clavicular
line. No exit. HR 120, BP 80/50, RR 28, SpO₂ 88 %. Breath sounds equal, neck
veins flat.
Most likely cause of shock?
A. Tension pneumo
B. Cardiac tamponade
C. Hemothorax
D. Spinal shock
Correct Answer: C
Rationale: Location suggests cardiac or great-vessel injury, but flat neck veins argue
against tamponade/tension; equal sounds → likely intrathoracic hemorrhage.
7. TBI: 18-year-old helmeted motorcyclist, ejected 15 ft, initial GCS 10 (E2 V3 M5),
now GCS 8 after 10 min.
Next airway step?
, A. OPA and BVM
B. Nasotracheal intubation
C. RSI with cervical alignment
D. Surgical cricothyrotomy
Correct Answer: C
Rationale: GCS ≤ 8 mandates airway control; RSI is gold standard with inline
stabilization.
8. Spine clearance: 34-year-old restrained driver, no intox, no distracting injury,
ambulatory at scene, denies neck pain.
Next action?
A. Apply rigid collar for transport
B. Manual stabilization while assessing
C. Allow patient to rotate neck 45° each side
D. Place on vacuum mattress
Correct Answer: B
Rationale: Per PHTLS, assess first with manual stabilization; if no criteria for imaging
and patient alert, collar may be omitted.
9. Hemorrhage control: 25-year-old, deep 6 cm forearm laceration, arterial spurting.
Direct pressure failed.
Next?
A. Apply tourniquet 5 cm above wound, tighten until bleeding stops
B. Pack wound with hemostatic gauze, maintain pressure
C. Clamp artery with hemostat
D. Elevate limb and apply pressure dressing
Correct Answer: A
Rationale: Tourniquet is indicated for extremity arterial bleeding uncontrolled by
pressure; faster and more effective than packing.
Comprehensive Guide | Actual Questions & Verified Answers | All
Domains: Trauma, Medical, Airway, Cardiology, OBGYN,
Operations, Pediatrics, Geriatrics | Pass Guarantee
TRAUMA (Questions 1–25)
1. Dispatch: 19:40 hrs. EMS-1 dispatched to single-vehicle MVC, car vs. utility pole,
estimated 35 mph. Extrication complete on arrival.
Scene: 22-year-old restrained driver, side-impact on driver door. Airbag deployed.
Patient: Complains of left chest pain and dyspnea.
Vitals: HR 118, BP 94/60, RR 26, SpO₂ 89 % RA, GCS 15.
Exam: Trachea midline, JVP 2 cm, absent breath sounds left lower chest,
dullness to percussion, crepitus over ribs 6–8.
Next most appropriate intervention?
A. 2 L warmed NS wide open
B. Needle decompression L 2nd ICS
C. 14-gauge IV, draw trauma labs, initiate massive transfusion protocol
D. Left-sided tube thoracostomy
Correct Answer: D
Rationale: Clinical hemothorax (dullness + absent sounds) with mild shock; requires
drainage, not needle decompression. Massive transfusion not yet indicated (BP
responding). Tube thoracostomy is definitive pre-hospital if system allows.
2. Dispatch: Fall from height, 14 ft.
Patient: 34-year-old male, landed on feet, now with severe low-back pain and
inability to move lower extremities.
Vitals: HR 98, BP 140/80, RR 20, SpO₂ 98 %, GCS 15.
Exam: Tenderness over T12–L1, no step-off palpated, motor 0/5 both lower
, extremities, sensory absent below umbilicus, DTRs absent.
Highest priority?
A. High-dose methylprednisolone 30 mg/kg IV
B. Log-roll onto long board and secure with straps
C. Establish 2 large-bore IVs while maintaining spinal alignment
D. Apply traction splint to both lower extremities
Correct Answer: C
Rationale: Spinal motion restriction + vascular access are priorities; steroids no longer
recommended. Traction splint inappropriate for spine injury.
3. Dispatch: Motorcycle crash at 40 mph, rider thrown 20 ft.
Patient: 27-year-old male, helmet scuffed, no loss of consciousness.
Vitals: HR 110, BP 100/70, RR 24, SpO₂ 93 %, GCS 14 (E4 V4 M6).
Exam: Right chest abrasion, breath sounds decreased right, hyper-resonant
percussion, trachea deviated left.
Field diagnosis?
A. Flail chest
B. Tension pneumothorax
C. Simple pneumothorax
D. Massive hemothorax
Correct Answer: B
Rationale: Trauma + unilateral absent sounds + tracheal deviation + tachycardia =
tension pneumothorax until proven otherwise.
4. Patient: 6-year-old struck by SUV at low speed, bumper impact to pelvis.
Vitals: HR 140, BP 80/40, RR 28, SpO₂ 97 %, GCS 14.
Exam: Distended abdomen, tender, no external bleeding; pelvis stable.
Estimated blood loss class?
A. Class I
B. Class II
C. Class III
D. Class IV
,Correct Answer: C
Rationale: Pediatric HR > 140 with hypotension for age (BP < 90 systolic) suggests
30–40 % blood loss (Class III).
5. Burn scenario: Adult male, flash fire in garage. Burns: anterior chest/abdomen
(complete), both anterior arms, anterior neck, genitalia.
Using Rule of Nines, total BSA burned?
A. 27 %
B. 36 %
C. 45 %
D. 54 %
Correct Answer: C
Rationale: Anterior trunk 18 %, each arm 4.5 % (×2 = 9 %), neck 4.5 %, genitalia 1 % →
32.5 %; closest 36 % (includes portions of arms/neck).
6. Penetrating trauma: 9 mm gunshot to right anterior chest, 4th ICS mid-clavicular
line. No exit. HR 120, BP 80/50, RR 28, SpO₂ 88 %. Breath sounds equal, neck
veins flat.
Most likely cause of shock?
A. Tension pneumo
B. Cardiac tamponade
C. Hemothorax
D. Spinal shock
Correct Answer: C
Rationale: Location suggests cardiac or great-vessel injury, but flat neck veins argue
against tamponade/tension; equal sounds → likely intrathoracic hemorrhage.
7. TBI: 18-year-old helmeted motorcyclist, ejected 15 ft, initial GCS 10 (E2 V3 M5),
now GCS 8 after 10 min.
Next airway step?
, A. OPA and BVM
B. Nasotracheal intubation
C. RSI with cervical alignment
D. Surgical cricothyrotomy
Correct Answer: C
Rationale: GCS ≤ 8 mandates airway control; RSI is gold standard with inline
stabilization.
8. Spine clearance: 34-year-old restrained driver, no intox, no distracting injury,
ambulatory at scene, denies neck pain.
Next action?
A. Apply rigid collar for transport
B. Manual stabilization while assessing
C. Allow patient to rotate neck 45° each side
D. Place on vacuum mattress
Correct Answer: B
Rationale: Per PHTLS, assess first with manual stabilization; if no criteria for imaging
and patient alert, collar may be omitted.
9. Hemorrhage control: 25-year-old, deep 6 cm forearm laceration, arterial spurting.
Direct pressure failed.
Next?
A. Apply tourniquet 5 cm above wound, tighten until bleeding stops
B. Pack wound with hemostatic gauze, maintain pressure
C. Clamp artery with hemostat
D. Elevate limb and apply pressure dressing
Correct Answer: A
Rationale: Tourniquet is indicated for extremity arterial bleeding uncontrolled by
pressure; faster and more effective than packing.
