SNHD EMT PARAMEDIC PROTOCOL EXAM LATEST
2024 ACTUAL EXAM 300 QUESTIONS AND
CORRECT DETAILED |ALREADY GRADED A+
Chest pain and suspected acute coronary syndrome history - answer-Age; medications: viagra, levitra,
cialis; past medical history of MI, angina, diabetes; allergies; recent physical exertion; palliation,
provocation; quality; region, radiation, referred; severity (1-10); time of onset, duration, repetition
Chest pain and suspected acute coronary syndrome signs and symptoms - answer-CP, pressure, ache,
vise-like pain, tight; location, substernal, epigastric, arm, jaw, neck, shoulder; radiation of pain; pale,
diaphoretic; shortness of breath; nausea, vomiting, dizziness; time of onset
Chest pain and suspected acute coronary syndrome differential - answer-Trauma vs medical; angina vs
MI; pericarditis; pulmonary embolism; asthma, COPD; pneumothorax; aortic dissection or aneurysm; GE
reflux or hiatal hernia; esophageal spasm; chest injury or pain; pleural pain; drug overdose (cocaine,
methamphetamine
Chest pain and suspected acute coronary syndrome pearls - answer-Diabetics, geriatrics, and female
patients often have atypical pain; have a high index of suspicion
Perform a 12 lead ECG on all patients 35 yo or older experiencing vague jaw/chest/abdominal discomfort
Chest pain and suspected acute coronary syndrome QI metrics - answer-12 lead ECG within 5 min of
patient contact
Pain reassessed after every intervention
Pain control documented
Childbirth/labor 1 - answer-General adult assessment
Pregnant patient with signs of impending delivery
Childbirth/Labor 2 normal presentation - answer-Puncture amniotic sac if not already broken
Deliver and support the head
,Suction the mouth then nose; if mechanism present, repeat several times
Deliver upper shoulder, then lower shoulder
Deliver remainder of the baby
Clamp and cut the cord
If multiple births, repeat steps
Deliver placenta
Childbirth/labor 2 limb presentation - answer-Place patient in left lateral recumbent position
Childbirth/labor 2 breech position - answer-Support body of baby during delivery of head
Childbirth/labor 2 cord presentation - answer-Position patient in Trendelenburg and slightly on left
side Wrap cord and keep it moist
Insert gloved hand to lift baby off cord; obtain and document cord pulse
Childbirth/labor 3 - answer-Attempt vascular acces
Patient hypoperfusion?
Yes: administer 500 mL NS or LR; repeat as needed not to exceed 2000 ml
No: continue general patient care
Transport to appropriate facility
Childbirth/labor history - answer-Due date; time contractions started/duration/frequency; rupture of
membranes (meconium); Time and amount of any vaginal bleeding; sensation of fetal movement;
prenatal care; past medical and delivery history, medications; gravida/para status; high risk pregnancy
Childbirth/labor signs and symptoms - answer-Spasmodic pain, vaginal discharge or bleeding;
crowning or urge to push; meconium
,Childbirth/labor differential - answer-Abnormal presentation; prolapsed cord; placenta previa;
abruptio placenta
Childbirth/labor pearls - answer-Document all times (delivery, contraction, duration, and frequency)
Some bleeding is normal; copious amounts of blood or free bleeding is abnormal
Record APGAR at one and five minutes after birth
APGAR of 7-10 is normal, while 4-7 requires resuscitative measures
APGAR - answer-Activity/muscle tone: 0 absent; 1 arms/legs flexed; 2 active movement
Pulse: 0 absent; 1 below 100; 2 above 100
Grimace/reflex irritability: 0 no response; 1 grimace; 2 sneeze, cough, pulls away
Appearance: 0 blue-grey, pale all over; 1 normal, except extremities; 2 normal over entire body
Respiration: 0 absent; 1 slow, irregular; 2 good, crying
Cold related illness 1 - answer-General adult assessment
Remove from environment
Temperature measurement
Remove wet clothing
Dry/warm patient
Passive warming measures
Cold related illness 2 localized cold injury - answer-Monitor and reassess
General wound care
Do not rub skin to warm
Do not allow refreezing
Continue general patient care and transport
Cold related illness 2 systemic hypothermia - answer-Awake with/without altered mental status
, -Respiratory distress? Yes-> *Respiratory distress
-No -> next step
Unresponsive -> pulse present? No: *Cardiac arrest; Yes -> Next step
Cold related illness 3 - answer-Active warming measures
Vascular access
Cardiac monitor
NS or LR 500 mL IV/IO; repeat to effect SBP > 90; max 2 L
*General adult trauma assessment
*Shock
Monitor and reassess
Transport
Cold related illness history - answer-Age, very young and old; exposure to decreased temperatures,
may occur in normal temperatures; past medical history/medications; drug or alcohol use;
infections/sepsis; time of exposure/wetness/wind chill
Cold related illness signs and symptoms - answer-AMS/coma; cold, clammy; shivering; extremity pain;
bradycardia; hypotension or shock
Cold related illness differential - answer-Sepsis; environmental exposure; hypoglycemia; stroke; head
injury; spinal cord injury
Cold related illness pearls - answer-Extremes of age are more prone to cold emergencies
Obtain and document patients temperature
If temperature is unknown, treat based on suspected temperature
Warm saline or LR may be used
2024 ACTUAL EXAM 300 QUESTIONS AND
CORRECT DETAILED |ALREADY GRADED A+
Chest pain and suspected acute coronary syndrome history - answer-Age; medications: viagra, levitra,
cialis; past medical history of MI, angina, diabetes; allergies; recent physical exertion; palliation,
provocation; quality; region, radiation, referred; severity (1-10); time of onset, duration, repetition
Chest pain and suspected acute coronary syndrome signs and symptoms - answer-CP, pressure, ache,
vise-like pain, tight; location, substernal, epigastric, arm, jaw, neck, shoulder; radiation of pain; pale,
diaphoretic; shortness of breath; nausea, vomiting, dizziness; time of onset
Chest pain and suspected acute coronary syndrome differential - answer-Trauma vs medical; angina vs
MI; pericarditis; pulmonary embolism; asthma, COPD; pneumothorax; aortic dissection or aneurysm; GE
reflux or hiatal hernia; esophageal spasm; chest injury or pain; pleural pain; drug overdose (cocaine,
methamphetamine
Chest pain and suspected acute coronary syndrome pearls - answer-Diabetics, geriatrics, and female
patients often have atypical pain; have a high index of suspicion
Perform a 12 lead ECG on all patients 35 yo or older experiencing vague jaw/chest/abdominal discomfort
Chest pain and suspected acute coronary syndrome QI metrics - answer-12 lead ECG within 5 min of
patient contact
Pain reassessed after every intervention
Pain control documented
Childbirth/labor 1 - answer-General adult assessment
Pregnant patient with signs of impending delivery
Childbirth/Labor 2 normal presentation - answer-Puncture amniotic sac if not already broken
Deliver and support the head
,Suction the mouth then nose; if mechanism present, repeat several times
Deliver upper shoulder, then lower shoulder
Deliver remainder of the baby
Clamp and cut the cord
If multiple births, repeat steps
Deliver placenta
Childbirth/labor 2 limb presentation - answer-Place patient in left lateral recumbent position
Childbirth/labor 2 breech position - answer-Support body of baby during delivery of head
Childbirth/labor 2 cord presentation - answer-Position patient in Trendelenburg and slightly on left
side Wrap cord and keep it moist
Insert gloved hand to lift baby off cord; obtain and document cord pulse
Childbirth/labor 3 - answer-Attempt vascular acces
Patient hypoperfusion?
Yes: administer 500 mL NS or LR; repeat as needed not to exceed 2000 ml
No: continue general patient care
Transport to appropriate facility
Childbirth/labor history - answer-Due date; time contractions started/duration/frequency; rupture of
membranes (meconium); Time and amount of any vaginal bleeding; sensation of fetal movement;
prenatal care; past medical and delivery history, medications; gravida/para status; high risk pregnancy
Childbirth/labor signs and symptoms - answer-Spasmodic pain, vaginal discharge or bleeding;
crowning or urge to push; meconium
,Childbirth/labor differential - answer-Abnormal presentation; prolapsed cord; placenta previa;
abruptio placenta
Childbirth/labor pearls - answer-Document all times (delivery, contraction, duration, and frequency)
Some bleeding is normal; copious amounts of blood or free bleeding is abnormal
Record APGAR at one and five minutes after birth
APGAR of 7-10 is normal, while 4-7 requires resuscitative measures
APGAR - answer-Activity/muscle tone: 0 absent; 1 arms/legs flexed; 2 active movement
Pulse: 0 absent; 1 below 100; 2 above 100
Grimace/reflex irritability: 0 no response; 1 grimace; 2 sneeze, cough, pulls away
Appearance: 0 blue-grey, pale all over; 1 normal, except extremities; 2 normal over entire body
Respiration: 0 absent; 1 slow, irregular; 2 good, crying
Cold related illness 1 - answer-General adult assessment
Remove from environment
Temperature measurement
Remove wet clothing
Dry/warm patient
Passive warming measures
Cold related illness 2 localized cold injury - answer-Monitor and reassess
General wound care
Do not rub skin to warm
Do not allow refreezing
Continue general patient care and transport
Cold related illness 2 systemic hypothermia - answer-Awake with/without altered mental status
, -Respiratory distress? Yes-> *Respiratory distress
-No -> next step
Unresponsive -> pulse present? No: *Cardiac arrest; Yes -> Next step
Cold related illness 3 - answer-Active warming measures
Vascular access
Cardiac monitor
NS or LR 500 mL IV/IO; repeat to effect SBP > 90; max 2 L
*General adult trauma assessment
*Shock
Monitor and reassess
Transport
Cold related illness history - answer-Age, very young and old; exposure to decreased temperatures,
may occur in normal temperatures; past medical history/medications; drug or alcohol use;
infections/sepsis; time of exposure/wetness/wind chill
Cold related illness signs and symptoms - answer-AMS/coma; cold, clammy; shivering; extremity pain;
bradycardia; hypotension or shock
Cold related illness differential - answer-Sepsis; environmental exposure; hypoglycemia; stroke; head
injury; spinal cord injury
Cold related illness pearls - answer-Extremes of age are more prone to cold emergencies
Obtain and document patients temperature
If temperature is unknown, treat based on suspected temperature
Warm saline or LR may be used
