Paramedic National Registry Review Questions and Answers(A+ GRADED)

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Paramedic National Registry Review Assessment Sequence Correct Answer: BSI Scene Size Up Scene Safety MOI/NOI Number of Pt. Additional Resources Consider C-Spine Primary Survey ... General Impression AVPU Chief Complaint/Life Threats Airway, Breathing, Circulation Treatment/Transport Medical Assessment Correct Answer: History of Present Illness Past Medical History Secondary Assessment Vitals Field Impression Interventions Reassessment Verbal Report Trauma Assessment Correct Answer: SAMPLE Secondary Assessment Assess baseline vitals Manage secondary injuries Reassess Stridor, Snoring, Gurgling Correct Answer: Stridor - harsh, high-pitched sound, swelling, foreign body in upper airway. Snoring - tongue Gurgling - fluids in upper airway, suction CDC Trauma Guidelines for Transport Correct Answer: IF YES TO STEP ONE OR TWO TRANSPORT TO A LEVEL 1 TRAUMA CENTER Step 1: Physiological Criteria GCS below 14 Systolic below 90 Respirations <10 or >29 (<20 under 1yr) Ventilation assistance needed Step 2: Anatomic Criteria Penetrating wounds head, neck, torso, high extremities Chest wall instability Amputation proximal to wrist/ankle Longbone fx x2 Crushed/devolved/mangled/pulseless extremity Pelvic fx Open/depressed skull fx Paralysis IF YES TO STEP THREE OR FOUR TRANSPORT TO TRAUMA CENTER, NOT NECESSARILY LEVEL ONE Step3: MOI Criteria Adult falls >20' / Children >10' or 2x height Vehicle intrusion >12" occupant side or 18" anywhere Partial or complete ejection Death in same passenger compartment Vehicle data consistent with high injury risk Auto vs. Bed thrown, run over or >20mph Motorcycle crash >20mph Step 4: Special Considerations Elderly falls <55yrs Systolic <100 in >65yrs Pediatric Trauma Bleeding and anticoagulants Burns Pregnancy >20 weeks EMS Judgement IF BURNS WITH NO FURTHER TRAUMA USE A BURN CENTER GCS Correct Answer: Eyes - 4 spont, 3 speech, 2 pain, 1 absent Verbal - 5 orient, 4 not orient, 3 inapp, 2 incomp, 1 absent Motor - 6 obeys, 5 pain loc, 4 pain withdraw, 3 flexion (decorticate), 2 extension (decerebrate), 1 absent Decorticate Correct Answer: Elbows, wrists, fingers flexed Legs extended and internally rotated Decerebrate Correct Answer: Worse condition consistent with brain stem injury Extended and internally rotated elbows and legs, trismus, legs stiff and feet extended Babinski's Response Correct Answer: Signifies CNS Problems Big toe moves upward and other toes fan out when stroking bottom of foot Pupils Symptoms Correct Answer: Dilated (mydriasis) - cardiac arrest, shock, cerebral hypoxia, cocaine, epinephrine, amphetamines Constricted (miosis) - narcotics, CNS disorders, glaucoma meds, bright light Unequal - brain injury, bring tumor, stroke, artificial eye, some eye medications, eye injury or disease Anisocoria - normal unequal pupils Nystagmus - rapid involuntary movements of the eye(s) JVD Correct Answer: Best seen at 45 deg angle May be caused by: diaphragmatic rupture, tension pneumothorax, cardiac tamponade, right heart failure, traumatic asphyxia, chronic bronchitis Flat Neck Veins Correct Answer: Best seen supine May be caused by hemothorax, dehydration, shock Apneustic Breathing Correct Answer: CNS Injury or Shock Long, deep breaths that are stopped during inspiration then a period of apnea Biot's (ataxic) Respirations Correct Answer: Usually Increased ICP Irregular periods of breathing or gasping with apnea Cheyne-Stokes Respirations Correct Answer: Neurological Conditions Increasing in rate and depth, decreasing in rate and depth with periods of apnea Hyperventilations Correct Answer: Emotional event or neurological condition Rapid and shallow Kussmaul's Respirations Correct Answer: DKA Rapid and deep Rales/Crackles Lung Sounds Correct Answer: Fluid in small airways/alveoli [Show More]

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