Kern County EMT Protocols and Procedures
5002.00 Questions and Answers Emergency
Medical Services Study Solution | A+ Graded.
Jurisdiction: Kern County, California | Governing Body: Kern County Emergency Medical
Services (KCEMS) | Provider Level: EMT-Basic | Base Hospital: Kern Medical (Level II Trauma
Center)
Total Questions: 100 | Passing Standard: 80% (per KCEMS reaccreditation requirements)
DOMAIN I: Patient Assessment & Scene Safety (Questions 1–15) — 15%
Q1. You arrive on scene of a motor vehicle collision. Your FIRST action according to Kern County
EMT protocol is:
• A. Begin primary assessment on the patient
• B. Perform scene size-up (BSI, scene safety, MOI, resources needed)
• C. Apply cervical collar
• D. Obtain baseline vital signs
Correct Answer: B Rationale: Scene size-up is always first: ensure scene safety (BSI, hazards),
determine mechanism of injury/nature of illness, and request additional resources if needed.
Patient care cannot begin safely if the scene is unsafe.
Q2. An adult patient is unresponsive with no suspected trauma. What is the correct airway
maneuver?
• A. Jaw-thrust
• B. Head-tilt, chin-lift
• C. OPA only
• D. NPA only
Correct Answer: B Rationale: For non-trauma patients, head-tilt chin-lift is the preferred airway
maneuver to open the airway. Jaw-thrust is reserved for suspected cervical spine injury. Airway
adjuncts (OPA/NPA) are used AFTER opening the airway manually.
,Q3. List the components of the primary assessment (ABCDE) in order and identify one
intervention for each component within EMT scope.
Complete Answer:
• A – Airway: Assess patency, obstruction, gag reflex. Intervention: Head-tilt chin-lift (non-
trauma) or jaw-thrust (trauma); suction; OPA/NPA if indicated.
• B – Breathing: Assess rate, depth, rhythm, SpO2, accessory muscle use, cyanosis.
Intervention: Oxygen via nasal cannula or non-rebreather; assist ventilations with BVM if
inadequate.
• C – Circulation: Assess pulse (rate, regularity, quality), skin (color, temp, moisture),
capillary refill, life-threatening bleeding. Intervention: Direct pressure; tourniquet for
extremity hemorrhage; hemostatic gauze; treat for shock.
• D – Disability: Assess AVPU, pupils (size, equality, reactivity), stroke assessment (FAST-
ED). Intervention: Protect airway if altered; position of comfort.
• E – Exposure: Remove clothing to assess for injuries; prevent hypothermia. Intervention:
Keep patient warm; cover after assessment.
Q4. During scene size-up, which of the following is considered a "high-risk" mechanism of injury
requiring immediate trauma center consideration?
• A. Fall from standing
• B. Motor vehicle collision with intrusion >12 inches on occupant side
• C. Bicycle fall with helmet use
• D. Low-speed rear-end collision
Correct Answer: B Rationale: Per Kern County Trauma Triage Tool: high-risk mechanisms include
falls >20 ft (adult), MVC with intrusion >12 in occupant side or >18 in any side, ejection, death in
same compartment, rollover, motorcycle crash >20 mph, and auto vs. pedestrian/bicyclist
thrown/run over.
,Q5. A patient involved in a high-speed rollover collision is ambulatory at the scene and denies
pain. According to Kern County selective spinal immobilization criteria, should this patient be
immobilized?
• A. No, because the patient is ambulatory and denies pain
• B. Yes, because high-risk mechanism alone meets criteria
• C. Only if the patient is >65 years old
• D. Only if the patient shows neurologic deficit
Correct Answer: B Rationale: Kern County selective spinal immobilization requires
immobilization for high-risk mechanism (rollover MVC) regardless of ambulatory status or
absence of pain, unless ALL criteria are negative including low-risk mechanism.
Q6. The DCAP-BTLS mnemonic is used during which assessment phase?
• A. Scene size-up
• B. Primary assessment
• C. Secondary assessment (head-to-toe physical exam for trauma)
• D. Reassessment
Correct Answer: C Rationale: DCAP-BTLS (Deformities, Contusions, Abrasions,
Punctures/Penetrations, Burns, Tenderness, Lacerations, Swelling) is the systematic approach
for the head-to-toe physical exam during the secondary assessment of trauma patients.
Q7. Which vital sign finding in an adult patient indicates decompensated shock?
• A. Systolic BP 110 mmHg
• B. Heart rate 88 bpm
• C. Systolic BP 86 mmHg
• D. Respiratory rate 16/min
Correct Answer: C Rationale: Systolic BP <90 mmHg in adults indicates decompensated shock
(hypotension). Kern County trauma triage criteria specifically use SBP <90 as a physiologic
criterion for trauma center transport.
, Q8. During the primary assessment, you note a patient has unequal pupils. This finding is
documented during which component?
• A. Airway
• B. Breathing
• C. Circulation
• D. Disability
Correct Answer: D Rationale: Pupil assessment (size, equality, reactivity) is part of the Disability
component (D) of the primary assessment, along with AVPU and stroke assessment.
Q9. What is the correct order of the SAMPLE history?
• A. Signs/Symptoms, Allergies, Medications, Past history, Last oral intake, Events
• B. Symptoms, Allergies, Medications, Past history, Last meal, Events
• C. Signs/Symptoms, Allergies, Medications, Past history, Last oral intake, Events leading
to illness/injury
• D. Symptoms, Allergies, Medicines, Previous history, Lunch, Events
Correct Answer: C Rationale: SAMPLE = Signs/Symptoms, Allergies, Medications, Past medical
history, Last oral intake, Events leading to present illness/injury.
Q10. A trauma patient has a Glasgow Coma Scale (GCS) score of 13. According to Kern County
trauma triage criteria, what is the appropriate transport destination?
• A. Local community hospital
• B. Trauma center (Level I or II)
• C. Urgent care
• D. Base hospital for evaluation
Correct Answer: B Rationale: GCS <14 is a physiologic criterion mandating transport to a
trauma center (Level I or II). Kern Medical is the designated Level II Trauma Center in Kern
County.
5002.00 Questions and Answers Emergency
Medical Services Study Solution | A+ Graded.
Jurisdiction: Kern County, California | Governing Body: Kern County Emergency Medical
Services (KCEMS) | Provider Level: EMT-Basic | Base Hospital: Kern Medical (Level II Trauma
Center)
Total Questions: 100 | Passing Standard: 80% (per KCEMS reaccreditation requirements)
DOMAIN I: Patient Assessment & Scene Safety (Questions 1–15) — 15%
Q1. You arrive on scene of a motor vehicle collision. Your FIRST action according to Kern County
EMT protocol is:
• A. Begin primary assessment on the patient
• B. Perform scene size-up (BSI, scene safety, MOI, resources needed)
• C. Apply cervical collar
• D. Obtain baseline vital signs
Correct Answer: B Rationale: Scene size-up is always first: ensure scene safety (BSI, hazards),
determine mechanism of injury/nature of illness, and request additional resources if needed.
Patient care cannot begin safely if the scene is unsafe.
Q2. An adult patient is unresponsive with no suspected trauma. What is the correct airway
maneuver?
• A. Jaw-thrust
• B. Head-tilt, chin-lift
• C. OPA only
• D. NPA only
Correct Answer: B Rationale: For non-trauma patients, head-tilt chin-lift is the preferred airway
maneuver to open the airway. Jaw-thrust is reserved for suspected cervical spine injury. Airway
adjuncts (OPA/NPA) are used AFTER opening the airway manually.
,Q3. List the components of the primary assessment (ABCDE) in order and identify one
intervention for each component within EMT scope.
Complete Answer:
• A – Airway: Assess patency, obstruction, gag reflex. Intervention: Head-tilt chin-lift (non-
trauma) or jaw-thrust (trauma); suction; OPA/NPA if indicated.
• B – Breathing: Assess rate, depth, rhythm, SpO2, accessory muscle use, cyanosis.
Intervention: Oxygen via nasal cannula or non-rebreather; assist ventilations with BVM if
inadequate.
• C – Circulation: Assess pulse (rate, regularity, quality), skin (color, temp, moisture),
capillary refill, life-threatening bleeding. Intervention: Direct pressure; tourniquet for
extremity hemorrhage; hemostatic gauze; treat for shock.
• D – Disability: Assess AVPU, pupils (size, equality, reactivity), stroke assessment (FAST-
ED). Intervention: Protect airway if altered; position of comfort.
• E – Exposure: Remove clothing to assess for injuries; prevent hypothermia. Intervention:
Keep patient warm; cover after assessment.
Q4. During scene size-up, which of the following is considered a "high-risk" mechanism of injury
requiring immediate trauma center consideration?
• A. Fall from standing
• B. Motor vehicle collision with intrusion >12 inches on occupant side
• C. Bicycle fall with helmet use
• D. Low-speed rear-end collision
Correct Answer: B Rationale: Per Kern County Trauma Triage Tool: high-risk mechanisms include
falls >20 ft (adult), MVC with intrusion >12 in occupant side or >18 in any side, ejection, death in
same compartment, rollover, motorcycle crash >20 mph, and auto vs. pedestrian/bicyclist
thrown/run over.
,Q5. A patient involved in a high-speed rollover collision is ambulatory at the scene and denies
pain. According to Kern County selective spinal immobilization criteria, should this patient be
immobilized?
• A. No, because the patient is ambulatory and denies pain
• B. Yes, because high-risk mechanism alone meets criteria
• C. Only if the patient is >65 years old
• D. Only if the patient shows neurologic deficit
Correct Answer: B Rationale: Kern County selective spinal immobilization requires
immobilization for high-risk mechanism (rollover MVC) regardless of ambulatory status or
absence of pain, unless ALL criteria are negative including low-risk mechanism.
Q6. The DCAP-BTLS mnemonic is used during which assessment phase?
• A. Scene size-up
• B. Primary assessment
• C. Secondary assessment (head-to-toe physical exam for trauma)
• D. Reassessment
Correct Answer: C Rationale: DCAP-BTLS (Deformities, Contusions, Abrasions,
Punctures/Penetrations, Burns, Tenderness, Lacerations, Swelling) is the systematic approach
for the head-to-toe physical exam during the secondary assessment of trauma patients.
Q7. Which vital sign finding in an adult patient indicates decompensated shock?
• A. Systolic BP 110 mmHg
• B. Heart rate 88 bpm
• C. Systolic BP 86 mmHg
• D. Respiratory rate 16/min
Correct Answer: C Rationale: Systolic BP <90 mmHg in adults indicates decompensated shock
(hypotension). Kern County trauma triage criteria specifically use SBP <90 as a physiologic
criterion for trauma center transport.
, Q8. During the primary assessment, you note a patient has unequal pupils. This finding is
documented during which component?
• A. Airway
• B. Breathing
• C. Circulation
• D. Disability
Correct Answer: D Rationale: Pupil assessment (size, equality, reactivity) is part of the Disability
component (D) of the primary assessment, along with AVPU and stroke assessment.
Q9. What is the correct order of the SAMPLE history?
• A. Signs/Symptoms, Allergies, Medications, Past history, Last oral intake, Events
• B. Symptoms, Allergies, Medications, Past history, Last meal, Events
• C. Signs/Symptoms, Allergies, Medications, Past history, Last oral intake, Events leading
to illness/injury
• D. Symptoms, Allergies, Medicines, Previous history, Lunch, Events
Correct Answer: C Rationale: SAMPLE = Signs/Symptoms, Allergies, Medications, Past medical
history, Last oral intake, Events leading to present illness/injury.
Q10. A trauma patient has a Glasgow Coma Scale (GCS) score of 13. According to Kern County
trauma triage criteria, what is the appropriate transport destination?
• A. Local community hospital
• B. Trauma center (Level I or II)
• C. Urgent care
• D. Base hospital for evaluation
Correct Answer: B Rationale: GCS <14 is a physiologic criterion mandating transport to a
trauma center (Level I or II). Kern Medical is the designated Level II Trauma Center in Kern
County.
