KITSAP COUNTY EMS PROTOCOLS EXAM PRACTICE 2026/2027 –
COMPREHENSIVE PRACTICE EXAM WITH 150+ VERIFIED QUESTIONS, ANSWERS
& RATIONALES – ADVANCED REVIEW FOR CERTIFICATION AND PROFESSIONAL
PRACTICE
i. Trauma Triage and Destination Protocols
i.i. Level 1 and Level 2 Trauma Criteria
i.ii. Level 3 and Level 4 Trauma Criteria
i.iii. Burn Triage and Special Considerations
ii. Medical Emergency Protocols
ii.i. Cardiac Arrest and Post-ROSC Management
ii.ii. Respiratory Emergencies and CPAP
ii.iii. Seizure and Neurological Emergencies
ii.iv. Obstetric and Gynecological Emergencies
iii. Pharmacology and Medication Administration
iii.i. Kitsap County Formulary and Scope of Practice
iii.ii. High-Risk Medications and Dosage Calculations
iii.iii. Medication Documentation Requirements
iv. Behavioral Health and Patient Restraint
iv.i. Behavioral Health Response Policy
iv.ii. Restraint Monitoring and Law Enforcement Coordination
v. Documentation and Quality Assurance
v.i. Electronic Health Report (EHR) Requirements
v.ii. Clinical Documentation Standards
vi. Operational Procedures and Medical Direction
vi.i. Universal Patient Care Protocol
vi.ii. Medical Control and Base Station Contact
vi.iii. Scope of Practice by Certification Level
DESCRIPTION
This comprehensive practice examination is designed to assess advanced clinical
judgment, protocol compliance, and decision-making skills for EMS providers
operating under the Kitsap County EMS and Trauma Care Council and the
Northwest Region Patient Care Protocols. Covering trauma triage, medical
emergencies, pharmacology, behavioral health, documentation, and operational
procedures, this exam targets paramedics, EMTs, and EMS supervisors preparing
for certification, recertification, or promotion. The questions emphasize scenario-
based application, regulatory interpretation, and exceptions to standard protocols.
This resource contains 150 questions with verified answers and detailed rationales.
,Purchase and instantly get a downloadable and editable PDF for convenient study
and review.
Question 1
A 34-year-old male is involved in a motorcycle crash at approximately 30 mph. He
is alert and oriented, with a Glasgow Coma Scale score of 15. His systolic blood
pressure is 118 mmHg, and his respiratory rate is 22 breaths per minute. He has an
open femur fracture with controlled bleeding. According to Kitsap County trauma
triage criteria, what is the appropriate destination?
A. Transport to the closest appropriate hospital (Level 3).
B. Transport to Harborview Medical Center (Level 2).
C. Contact medical control and consider transport to a trauma center (Level 4).
D. Transport to a pediatric-capable trauma center.
**🔴 Correct Answer: B. Transport to Harborview Medical Center (Level 2). **
*🔵 Explanation: An open femur fracture meets Level 2 trauma criteria under the
Kitsap County protocol, which specifies that two or more proximal long-bone
fractures or an open long-bone fracture warrants transport to Harborview Medical
Center. The patient's stable vital signs do not downgrade the anatomic criteria.
Level 3 applies to high-energy mechanisms without anatomic injury, and Level 4
requires medical control consultation for special patient considerations. *
Question 2
A 7-year-old child falls from a second-story window, a height of approximately 12
feet. The child is crying, has a GCS of 14, a systolic blood pressure of 92 mmHg,
and a respiratory rate of 26 breaths per minute. There are no obvious external
injuries. According to Kitsap County pediatric trauma triage guidelines, what is the
correct trauma level?
A. Level 1 trauma — transport to Harborview.
B. Level 2 trauma — transport to Harborview.
C. Level 3 trauma — transport to the closest appropriate hospital.
D. Level 4 trauma — contact medical control.
**🔴 Correct Answer: C. Level 3 trauma — transport to the closest appropriate
hospital. **
*🔵 Explanation: Pediatric falls greater than 10 feet or 2–3 times the height of the
child meet Level 3 trauma criteria, which directs transport to the closest
appropriate hospital. Level 1 requires GCS less than 14, systolic blood pressure less
than 90, or respiratory rate less than 10 or greater than 29. This child's GCS of 14
and systolic pressure of 92 do not meet Level 1 criteria. Level 2 requires anatomic
injury not present here. *
,Question 3
A 28-year-old female is 38 weeks pregnant and involved in a motor vehicle
collision with 14 inches of intrusion at the occupant site. She is complaining of
abdominal pain and has a respiratory rate of 24 breaths per minute. Her GCS is 15,
and systolic blood pressure is 104 mmHg. What is the appropriate triage level and
destination?
A. Level 1 trauma — transport to Harborview.
B. Level 2 trauma — transport to Harborview.
C. Level 3 trauma — transport to the closest appropriate hospital.
D. Level 4 trauma — contact medical control for destination guidance.
**🔴 Correct Answer: C. Level 3 trauma — transport to the closest appropriate
hospital. **
*🔵 Explanation: Intrusion greater than 12 inches at the occupant site meets Level
3 trauma criteria for high-energy impact. The patient's vital signs and GCS do not
meet Level 1 criteria. Although she is pregnant, this does not automatically
upgrade the trauma level without specific anatomic or physiologic criteria.
Transport should proceed to the closest appropriate hospital, with consideration
for obstetric capabilities. *
Question 4
A 45-year-old male is found with a self-inflicted gunshot wound to the head. He
has an open depressed skull fracture and is unresponsive with a GCS of 6. His
systolic blood pressure is 88 mmHg, and respiratory rate is 8 breaths per minute.
What is the correct trauma triage level?
A. Level 1 trauma — transport to Harborview.
B. Level 2 trauma — transport to Harborview.
C. Level 3 trauma — transport to the closest appropriate hospital.
D. Level 4 trauma — contact medical control.
**🔴 Correct Answer: A. Level 1 trauma — transport to Harborview. **
*🔵 Explanation: This patient meets Level 1 trauma criteria with a GCS less than
14, systolic blood pressure less than 90 mmHg, and respiratory rate less than 10
breaths per minute. While an open depressed skull fracture is also a Level 2
anatomic criterion, the presence of any Level 1 physiologic criterion mandates
Level 1 triage. Transport to Harborview Medical Center is required. *
Question 5
A 62-year-old female is involved in a high-speed auto crash with ejection from the
vehicle. She is alert and oriented with a GCS of 15. Her systolic blood pressure is
130 mmHg, and respiratory rate is 18 breaths per minute. She has no obvious
external injuries. What is the appropriate trauma triage level?
, A. Level 1 trauma — transport to Harborview.
B. Level 2 trauma — transport to Harborview.
C. Level 3 trauma — transport to the closest appropriate hospital.
D. Level 4 trauma — contact medical control.
**🔴 Correct Answer: C. Level 3 trauma — transport to the closest appropriate
hospital. **
*🔵 Explanation: Ejection from an automobile is a Level 3 trauma criterion based
on high-energy mechanism of injury. The patient's normal vital signs and GCS do
not meet Level 1 or Level 2 criteria. Level 2 requires anatomic injury such as
penetrating trauma, flail chest, or pelvic fracture. Therefore, transport to the
closest appropriate hospital is indicated. *
Question 6
A 19-year-old male is struck by a vehicle traveling at approximately 25 mph. He
has a GCS of 15, a systolic blood pressure of 110 mmHg, and a respiratory rate of
20 breaths per minute. He complains of pain in his left leg but has no deformity or
open wounds. What is the correct trauma triage level?
A. Level 1 trauma.
B. Level 2 trauma.
C. Level 3 trauma.
D. Level 4 trauma.
**🔴 Correct Answer: C. Level 3 trauma. **
*🔵 Explanation: Auto versus pedestrian impact at greater than 20 mph meets
Level 3 trauma criteria based on mechanism of injury. The patient has no anatomic
or physiologic criteria that would elevate him to Level 1 or Level 2. Level 4 applies
to special patient populations or age considerations, not mechanism alone. *
Question 7
A 55-year-old male is in a motor vehicle collision with 19 inches of intrusion at a
site other than the occupant site. He is hemodynamically stable with a GCS of 15.
According to Kitsap County trauma triage protocols, what is the appropriate triage
level?
A. Level 1 trauma.
B. Level 2 trauma.
C. Level 3 trauma.
D. Level 4 trauma.
**🔴 Correct Answer: C. Level 3 trauma. **
*🔵 Explanation: Intrusion greater than 18 inches at any site (non-occupant)
meets Level 3 trauma criteria for high-energy impact. The patient's stable vital
COMPREHENSIVE PRACTICE EXAM WITH 150+ VERIFIED QUESTIONS, ANSWERS
& RATIONALES – ADVANCED REVIEW FOR CERTIFICATION AND PROFESSIONAL
PRACTICE
i. Trauma Triage and Destination Protocols
i.i. Level 1 and Level 2 Trauma Criteria
i.ii. Level 3 and Level 4 Trauma Criteria
i.iii. Burn Triage and Special Considerations
ii. Medical Emergency Protocols
ii.i. Cardiac Arrest and Post-ROSC Management
ii.ii. Respiratory Emergencies and CPAP
ii.iii. Seizure and Neurological Emergencies
ii.iv. Obstetric and Gynecological Emergencies
iii. Pharmacology and Medication Administration
iii.i. Kitsap County Formulary and Scope of Practice
iii.ii. High-Risk Medications and Dosage Calculations
iii.iii. Medication Documentation Requirements
iv. Behavioral Health and Patient Restraint
iv.i. Behavioral Health Response Policy
iv.ii. Restraint Monitoring and Law Enforcement Coordination
v. Documentation and Quality Assurance
v.i. Electronic Health Report (EHR) Requirements
v.ii. Clinical Documentation Standards
vi. Operational Procedures and Medical Direction
vi.i. Universal Patient Care Protocol
vi.ii. Medical Control and Base Station Contact
vi.iii. Scope of Practice by Certification Level
DESCRIPTION
This comprehensive practice examination is designed to assess advanced clinical
judgment, protocol compliance, and decision-making skills for EMS providers
operating under the Kitsap County EMS and Trauma Care Council and the
Northwest Region Patient Care Protocols. Covering trauma triage, medical
emergencies, pharmacology, behavioral health, documentation, and operational
procedures, this exam targets paramedics, EMTs, and EMS supervisors preparing
for certification, recertification, or promotion. The questions emphasize scenario-
based application, regulatory interpretation, and exceptions to standard protocols.
This resource contains 150 questions with verified answers and detailed rationales.
,Purchase and instantly get a downloadable and editable PDF for convenient study
and review.
Question 1
A 34-year-old male is involved in a motorcycle crash at approximately 30 mph. He
is alert and oriented, with a Glasgow Coma Scale score of 15. His systolic blood
pressure is 118 mmHg, and his respiratory rate is 22 breaths per minute. He has an
open femur fracture with controlled bleeding. According to Kitsap County trauma
triage criteria, what is the appropriate destination?
A. Transport to the closest appropriate hospital (Level 3).
B. Transport to Harborview Medical Center (Level 2).
C. Contact medical control and consider transport to a trauma center (Level 4).
D. Transport to a pediatric-capable trauma center.
**🔴 Correct Answer: B. Transport to Harborview Medical Center (Level 2). **
*🔵 Explanation: An open femur fracture meets Level 2 trauma criteria under the
Kitsap County protocol, which specifies that two or more proximal long-bone
fractures or an open long-bone fracture warrants transport to Harborview Medical
Center. The patient's stable vital signs do not downgrade the anatomic criteria.
Level 3 applies to high-energy mechanisms without anatomic injury, and Level 4
requires medical control consultation for special patient considerations. *
Question 2
A 7-year-old child falls from a second-story window, a height of approximately 12
feet. The child is crying, has a GCS of 14, a systolic blood pressure of 92 mmHg,
and a respiratory rate of 26 breaths per minute. There are no obvious external
injuries. According to Kitsap County pediatric trauma triage guidelines, what is the
correct trauma level?
A. Level 1 trauma — transport to Harborview.
B. Level 2 trauma — transport to Harborview.
C. Level 3 trauma — transport to the closest appropriate hospital.
D. Level 4 trauma — contact medical control.
**🔴 Correct Answer: C. Level 3 trauma — transport to the closest appropriate
hospital. **
*🔵 Explanation: Pediatric falls greater than 10 feet or 2–3 times the height of the
child meet Level 3 trauma criteria, which directs transport to the closest
appropriate hospital. Level 1 requires GCS less than 14, systolic blood pressure less
than 90, or respiratory rate less than 10 or greater than 29. This child's GCS of 14
and systolic pressure of 92 do not meet Level 1 criteria. Level 2 requires anatomic
injury not present here. *
,Question 3
A 28-year-old female is 38 weeks pregnant and involved in a motor vehicle
collision with 14 inches of intrusion at the occupant site. She is complaining of
abdominal pain and has a respiratory rate of 24 breaths per minute. Her GCS is 15,
and systolic blood pressure is 104 mmHg. What is the appropriate triage level and
destination?
A. Level 1 trauma — transport to Harborview.
B. Level 2 trauma — transport to Harborview.
C. Level 3 trauma — transport to the closest appropriate hospital.
D. Level 4 trauma — contact medical control for destination guidance.
**🔴 Correct Answer: C. Level 3 trauma — transport to the closest appropriate
hospital. **
*🔵 Explanation: Intrusion greater than 12 inches at the occupant site meets Level
3 trauma criteria for high-energy impact. The patient's vital signs and GCS do not
meet Level 1 criteria. Although she is pregnant, this does not automatically
upgrade the trauma level without specific anatomic or physiologic criteria.
Transport should proceed to the closest appropriate hospital, with consideration
for obstetric capabilities. *
Question 4
A 45-year-old male is found with a self-inflicted gunshot wound to the head. He
has an open depressed skull fracture and is unresponsive with a GCS of 6. His
systolic blood pressure is 88 mmHg, and respiratory rate is 8 breaths per minute.
What is the correct trauma triage level?
A. Level 1 trauma — transport to Harborview.
B. Level 2 trauma — transport to Harborview.
C. Level 3 trauma — transport to the closest appropriate hospital.
D. Level 4 trauma — contact medical control.
**🔴 Correct Answer: A. Level 1 trauma — transport to Harborview. **
*🔵 Explanation: This patient meets Level 1 trauma criteria with a GCS less than
14, systolic blood pressure less than 90 mmHg, and respiratory rate less than 10
breaths per minute. While an open depressed skull fracture is also a Level 2
anatomic criterion, the presence of any Level 1 physiologic criterion mandates
Level 1 triage. Transport to Harborview Medical Center is required. *
Question 5
A 62-year-old female is involved in a high-speed auto crash with ejection from the
vehicle. She is alert and oriented with a GCS of 15. Her systolic blood pressure is
130 mmHg, and respiratory rate is 18 breaths per minute. She has no obvious
external injuries. What is the appropriate trauma triage level?
, A. Level 1 trauma — transport to Harborview.
B. Level 2 trauma — transport to Harborview.
C. Level 3 trauma — transport to the closest appropriate hospital.
D. Level 4 trauma — contact medical control.
**🔴 Correct Answer: C. Level 3 trauma — transport to the closest appropriate
hospital. **
*🔵 Explanation: Ejection from an automobile is a Level 3 trauma criterion based
on high-energy mechanism of injury. The patient's normal vital signs and GCS do
not meet Level 1 or Level 2 criteria. Level 2 requires anatomic injury such as
penetrating trauma, flail chest, or pelvic fracture. Therefore, transport to the
closest appropriate hospital is indicated. *
Question 6
A 19-year-old male is struck by a vehicle traveling at approximately 25 mph. He
has a GCS of 15, a systolic blood pressure of 110 mmHg, and a respiratory rate of
20 breaths per minute. He complains of pain in his left leg but has no deformity or
open wounds. What is the correct trauma triage level?
A. Level 1 trauma.
B. Level 2 trauma.
C. Level 3 trauma.
D. Level 4 trauma.
**🔴 Correct Answer: C. Level 3 trauma. **
*🔵 Explanation: Auto versus pedestrian impact at greater than 20 mph meets
Level 3 trauma criteria based on mechanism of injury. The patient has no anatomic
or physiologic criteria that would elevate him to Level 1 or Level 2. Level 4 applies
to special patient populations or age considerations, not mechanism alone. *
Question 7
A 55-year-old male is in a motor vehicle collision with 19 inches of intrusion at a
site other than the occupant site. He is hemodynamically stable with a GCS of 15.
According to Kitsap County trauma triage protocols, what is the appropriate triage
level?
A. Level 1 trauma.
B. Level 2 trauma.
C. Level 3 trauma.
D. Level 4 trauma.
**🔴 Correct Answer: C. Level 3 trauma. **
*🔵 Explanation: Intrusion greater than 18 inches at any site (non-occupant)
meets Level 3 trauma criteria for high-energy impact. The patient's stable vital
