FINAL PARAMEDIC FISDAP COMPLETE Actual Exam 2026/2027
Trauma, Medical, Airway, Cardiology, OBGYN, Operations Complete
Certification Exam | Actual Questions & Verified Answers | All
Domains Covered | Pass Guarantee
SECTION 1: TRAUMA (Questions 1–30)
Dispatch: “MVC, car vs. tree, driver trapped, smoke from engine.” You
arrive to find a 34-year-old male, seat-belted, air-bag deployed, conscious
but confused. BP 90/60, HR 120, RR 24, SpO₂ 94 % RA. Chest deformity
L-side, decreased breath sounds L-lower, painful chest wall. FAST positive
in spleno-renal view. Which is the highest priority intervention?
A. Splint probable femur fracture
B. Needle decompress L-chest
C. Apply tourniquet to L-arm laceration
D. 2 L NS wide open
Correct Answer: B
Rationale: Confusion + hypotension + decreased breath sounds + chest
deformity = tension pneumothorax until proven otherwise; immediate
needle decompression required per PHTLS. FAST positive may indicate
hemorrhage, but airway/breathing is first.
Same patient: after successful needle decompression BP 100/70, HR 110.
You note a 4-cm deep, 2-cm wide penetrating wound to L-chest, air
bubbles audible. What is the NEXT management step?
A. Occlusive dressing taped on three sides
B. 14-gauge angiocath left 2nd ICS
C. Intubate immediately
D. 1 L NS bolus
Correct Answer: A
Rationale: Open pneumothorax is converted to closed with three-sided
occlusive dressing; allows air escape on exhalation and prevents tension.
Chest tube is definitive hospital care.
Scene: industrial explosion, 29-year-old male, ambulatory at scene but
coughing soot. BP 110/70, HR 104, RR 22, SpO₂ 96 % on 6 L O₂. Facial
burns, singed nasal hairs, hoarse voice. No other trauma. Most
appropriate field impression?
,A. Superficial partial-thickness burns only
B. Inhalation injury with impending airway compromise
C. Flail chest
D. Mild smoke exposure, discharge on scene
Correct Answer: B
Rationale: Soot, singed hairs, hoarseness = inhalation injury; airway edema
can progress rapidly. Early intubation is safer than waiting for stridor or
obtundation.
Continuing Q3: 10 minutes transport, voice now muffled, accessory
muscle use, SpO₂ 90 % on 15 L NRB. BP 100/60, HR 120. BEST airway
management?
A. Continue NRB, prepare for hospital RSI
B. RSI with etomidate & succinylcholine, 7.5 ETT
C. Blind nasotracheal intubation
D. Needle cricothyrotomy
Correct Answer: B
Rationale: Clinical decline mandates definitive airway; RSI is gold
standard. Succinylcholine acceptable unless deep burns > 24 h
(hyperkalemia risk) — not stated here. BNTI is contraindicated with facial
burns/airway edema.
Triage scenario: MCI, school bus crash, 18 patients. You find a 7-year-old
female, conscious, RR 40, HR 150, BP 80/50, obvious femur deformity,
pelvis stable, no external bleeding. Cap refill 4 s. Using JumpSTART, what
triage tag?
A. Green (minor)
B. Yellow (delayed)
C. Red (immediate)
D. Black (expectant)
Correct Answer: C
Rationale: Pediatric RPM: RR > 45 is immediate; here RR 40 (high but not >
45), HR > 120, altered perfusion (cap refill > 2 s), hypotensive for age →
Red (circulatory compromise).
Same child: you initiate traction splint, 20 mL/kg NS bolus, morphine 0.1
mg/kg IV. Re-assess BP 90/60, HR 130, RR 30, cap refill 3 s. Next
intervention?
,A. Second 20 mL/kg bolus
B. Apply PASG
C. Fentanyl 2 mcg/kg IV for pain
D. Initiate TXA 1 g infusion
Correct Answer: C
Rationale: Hemodynamics improved; adequate perfusion restored. Pain
control remains — fentanyl is preferred (less histamine release). Second
bolus not yet indicated. TXA is for severe hemorrhage or traumatic brain
injury (TBI) with bleeding, not isolated femur.
Scene: high-speed MVC, 25-year-old male ejected, unresponsive. GCS 3,
BP 60/40, HR 140, RR 6. Asymmetrical chest wall movement, pelvis
unstable, no radial pulses. Bilateral femoral fractures obvious. What is the
sequence of interventions?
A. Intubate → bilateral chest needle decompression → apply pelvic binder
→ bilateral tourniquets → 1 g TXA → 1 L warm NS
B. Apply pelvic binder → intubate → tourniquets → 2 L NS → chest
decompression
C. Tourniquets → intubate → pelvic binder → chest decompression →
TXA → limited crystalloid
D. 2 L NS → intubate → tourniquets → pelvic binder
Correct Answer: C
Rationale: MARCH/PAWS algorithm: massive external hemorrhage control
first (tourniquets), then airway (intubate), breathing (chest decompression
for asymmetry), circulation (pelvic binder for instability, TXA, limited
crystalloid until radial pulses return). Tourniquets before airway in
exsanguinating patient.
Continuing Q7: after above sequence, radial pulses return, BP 80/50, HR
120, GCS still 3. Next priority?
A. 2 L warm NS wide open
B. Initiate blood product request and transport to trauma center
C. Bilateral chest tubes
D. Needle cricothyrotomy
Correct Answer: B
Rationale: Patient needs blood and damage-control surgery; crystalloid is
temporizing. Transport to appropriate facility (≤ 60 min) is priority once
, ABCs stabilized. Chest tubes are hospital procedure unless tension
re-develops.
A 19-year-old male presents after fall from height, complains of severe
low-back pain, unable to move legs. BP 100/60, HR 110, RR 20, SpO₂ 98 %
RA. Motor: 0/5 bilateral lower extremities; sensory absent below
umbilicus. Pelvis stable, no other injuries. What is the field impression?
A. Thoracic vertebral fracture T6
B. Lumbar burst fracture L1 with spinal shock
C. Simple lumbar strain
D. Bilateral femur fracture
Correct Answer: B
Rationale: Neurological level at umbilicus ≈ T10; absent motor/sensory
below suggests thoracolumbar injury with spinal cord involvement.
Neurogenic/spinal shock manifests as hypotension and bradycardia (here
relative bradycardia for hypotension). High-dose steroids are no longer
recommended; goal is spinal motion restriction and rapid transport.
Same patient: you initiate spinal motion restriction (vacuum mattress), 1 L
NS bolus, maintain MAP > 85 mmHg per AANS guidelines. Re-assess BP
90/60, HR 100. Next intervention?
A. Second 1 L NS bolus
B. Start norepinephrine drip
C. Apply PASG
D. Init dopamine 10 mcg/kg/min
Correct Answer: A
Rationale: MAP = 90/3 ≈ 70 mmHg, still below target (≥ 85). Second
crystalloid bolus is appropriate in field; vasopressors are hospital-initiated
unless prolonged transport and continued hypotension after adequate
volume (≤ 2 L).
Scene: house fire, 55-year-old male rescued by firefighters, unconscious.
Soot around nares, singed hair, BP 100/70, HR 120, RR 8 shallow, SpO₂ 88
% RA, GCS 6. You have RSI capability. Best initial airway management?
A. Insert OPA and bag-mask ventilate
B. RSI with video laryngoscopy, 8.0 ETT, cuff visible
C. Nasopharyngeal airway and 15 L NRB
D. Needle cricothyrotomy
Trauma, Medical, Airway, Cardiology, OBGYN, Operations Complete
Certification Exam | Actual Questions & Verified Answers | All
Domains Covered | Pass Guarantee
SECTION 1: TRAUMA (Questions 1–30)
Dispatch: “MVC, car vs. tree, driver trapped, smoke from engine.” You
arrive to find a 34-year-old male, seat-belted, air-bag deployed, conscious
but confused. BP 90/60, HR 120, RR 24, SpO₂ 94 % RA. Chest deformity
L-side, decreased breath sounds L-lower, painful chest wall. FAST positive
in spleno-renal view. Which is the highest priority intervention?
A. Splint probable femur fracture
B. Needle decompress L-chest
C. Apply tourniquet to L-arm laceration
D. 2 L NS wide open
Correct Answer: B
Rationale: Confusion + hypotension + decreased breath sounds + chest
deformity = tension pneumothorax until proven otherwise; immediate
needle decompression required per PHTLS. FAST positive may indicate
hemorrhage, but airway/breathing is first.
Same patient: after successful needle decompression BP 100/70, HR 110.
You note a 4-cm deep, 2-cm wide penetrating wound to L-chest, air
bubbles audible. What is the NEXT management step?
A. Occlusive dressing taped on three sides
B. 14-gauge angiocath left 2nd ICS
C. Intubate immediately
D. 1 L NS bolus
Correct Answer: A
Rationale: Open pneumothorax is converted to closed with three-sided
occlusive dressing; allows air escape on exhalation and prevents tension.
Chest tube is definitive hospital care.
Scene: industrial explosion, 29-year-old male, ambulatory at scene but
coughing soot. BP 110/70, HR 104, RR 22, SpO₂ 96 % on 6 L O₂. Facial
burns, singed nasal hairs, hoarse voice. No other trauma. Most
appropriate field impression?
,A. Superficial partial-thickness burns only
B. Inhalation injury with impending airway compromise
C. Flail chest
D. Mild smoke exposure, discharge on scene
Correct Answer: B
Rationale: Soot, singed hairs, hoarseness = inhalation injury; airway edema
can progress rapidly. Early intubation is safer than waiting for stridor or
obtundation.
Continuing Q3: 10 minutes transport, voice now muffled, accessory
muscle use, SpO₂ 90 % on 15 L NRB. BP 100/60, HR 120. BEST airway
management?
A. Continue NRB, prepare for hospital RSI
B. RSI with etomidate & succinylcholine, 7.5 ETT
C. Blind nasotracheal intubation
D. Needle cricothyrotomy
Correct Answer: B
Rationale: Clinical decline mandates definitive airway; RSI is gold
standard. Succinylcholine acceptable unless deep burns > 24 h
(hyperkalemia risk) — not stated here. BNTI is contraindicated with facial
burns/airway edema.
Triage scenario: MCI, school bus crash, 18 patients. You find a 7-year-old
female, conscious, RR 40, HR 150, BP 80/50, obvious femur deformity,
pelvis stable, no external bleeding. Cap refill 4 s. Using JumpSTART, what
triage tag?
A. Green (minor)
B. Yellow (delayed)
C. Red (immediate)
D. Black (expectant)
Correct Answer: C
Rationale: Pediatric RPM: RR > 45 is immediate; here RR 40 (high but not >
45), HR > 120, altered perfusion (cap refill > 2 s), hypotensive for age →
Red (circulatory compromise).
Same child: you initiate traction splint, 20 mL/kg NS bolus, morphine 0.1
mg/kg IV. Re-assess BP 90/60, HR 130, RR 30, cap refill 3 s. Next
intervention?
,A. Second 20 mL/kg bolus
B. Apply PASG
C. Fentanyl 2 mcg/kg IV for pain
D. Initiate TXA 1 g infusion
Correct Answer: C
Rationale: Hemodynamics improved; adequate perfusion restored. Pain
control remains — fentanyl is preferred (less histamine release). Second
bolus not yet indicated. TXA is for severe hemorrhage or traumatic brain
injury (TBI) with bleeding, not isolated femur.
Scene: high-speed MVC, 25-year-old male ejected, unresponsive. GCS 3,
BP 60/40, HR 140, RR 6. Asymmetrical chest wall movement, pelvis
unstable, no radial pulses. Bilateral femoral fractures obvious. What is the
sequence of interventions?
A. Intubate → bilateral chest needle decompression → apply pelvic binder
→ bilateral tourniquets → 1 g TXA → 1 L warm NS
B. Apply pelvic binder → intubate → tourniquets → 2 L NS → chest
decompression
C. Tourniquets → intubate → pelvic binder → chest decompression →
TXA → limited crystalloid
D. 2 L NS → intubate → tourniquets → pelvic binder
Correct Answer: C
Rationale: MARCH/PAWS algorithm: massive external hemorrhage control
first (tourniquets), then airway (intubate), breathing (chest decompression
for asymmetry), circulation (pelvic binder for instability, TXA, limited
crystalloid until radial pulses return). Tourniquets before airway in
exsanguinating patient.
Continuing Q7: after above sequence, radial pulses return, BP 80/50, HR
120, GCS still 3. Next priority?
A. 2 L warm NS wide open
B. Initiate blood product request and transport to trauma center
C. Bilateral chest tubes
D. Needle cricothyrotomy
Correct Answer: B
Rationale: Patient needs blood and damage-control surgery; crystalloid is
temporizing. Transport to appropriate facility (≤ 60 min) is priority once
, ABCs stabilized. Chest tubes are hospital procedure unless tension
re-develops.
A 19-year-old male presents after fall from height, complains of severe
low-back pain, unable to move legs. BP 100/60, HR 110, RR 20, SpO₂ 98 %
RA. Motor: 0/5 bilateral lower extremities; sensory absent below
umbilicus. Pelvis stable, no other injuries. What is the field impression?
A. Thoracic vertebral fracture T6
B. Lumbar burst fracture L1 with spinal shock
C. Simple lumbar strain
D. Bilateral femur fracture
Correct Answer: B
Rationale: Neurological level at umbilicus ≈ T10; absent motor/sensory
below suggests thoracolumbar injury with spinal cord involvement.
Neurogenic/spinal shock manifests as hypotension and bradycardia (here
relative bradycardia for hypotension). High-dose steroids are no longer
recommended; goal is spinal motion restriction and rapid transport.
Same patient: you initiate spinal motion restriction (vacuum mattress), 1 L
NS bolus, maintain MAP > 85 mmHg per AANS guidelines. Re-assess BP
90/60, HR 100. Next intervention?
A. Second 1 L NS bolus
B. Start norepinephrine drip
C. Apply PASG
D. Init dopamine 10 mcg/kg/min
Correct Answer: A
Rationale: MAP = 90/3 ≈ 70 mmHg, still below target (≥ 85). Second
crystalloid bolus is appropriate in field; vasopressors are hospital-initiated
unless prolonged transport and continued hypotension after adequate
volume (≤ 2 L).
Scene: house fire, 55-year-old male rescued by firefighters, unconscious.
Soot around nares, singed hair, BP 100/70, HR 120, RR 8 shallow, SpO₂ 88
% RA, GCS 6. You have RSI capability. Best initial airway management?
A. Insert OPA and bag-mask ventilate
B. RSI with video laryngoscopy, 8.0 ETT, cuff visible
C. Nasopharyngeal airway and 15 L NRB
D. Needle cricothyrotomy
