It was previously believed that 27% of car owners wash their car every other week.  An agency wants to re-evaluate this claim and get more updated results.  How many car owners should be randomly sampled to estimate the proportion who wash their car every other week, with a margin or error of 1% and a 90% confidence level? Type your answer in the box, but you MUST show work on scrap paper.

True or False:If we have a two-tail test with

Enroute phaseScenario:The paramedic unit is dispatched to a residential care facility for an 82-year-old male who is experiencing difficulty breathing and is unable to lie flat. The call was received at 0915. Estimated response time is 6 minutes. The paramedic is partnered with an EMT, and a BLS fire engine crew is also responding. It is a cool fall morning, 48°F (9°C), with overcast skies and light traffic. According to staff on scene, the patient has a history of heart problems. They report the patient was doing well earlier in the day but became increasingly short of breath after breakfast and now appears pale and anxious.Based on the patient’s presentation and reported medical history, which medication combination most strongly supports a diagnosis of congestive heart failure?

Enroute phaseScenario:The paramedic crew is dispatched to a private residence for a 21-year-old female who was found unresponsive in her bedroom by her roommate. The call was received at 1535. The response time is estimated at 7 minutes. The paramedic is partnered with an EMT, and an ALS supervisor is en route. It is a mild spring afternoon, 64°F (18°C), and traffic is light. The roommate reports by phone that the patient has a history of depression and may have ingested “a bunch of pills.” The patient takes amitriptyline and alprazolam, according to the caller. Law enforcement is not yet on scene.OnScene phaseScenario: The patient (approximately 60 kilograms) is found supine on her bedroom floor. She is unresponsive to verbal stimuli but withdraws from painful stimuli. There are several empty medication bottles nearby labeled amitriptyline 50 mg and alprazolam 1 mg. Pupils are dilated and sluggishly reactive. The patient’s skin is warm and dry. No signs of trauma are noted. Vital signs are: BP 88/50, HR 132, RR 8, SpO₂ 91% on room air, Temp 97.8°F (36.5°C). ECG shows sinus tachycardia with a wide QRS complex.PostScene phaseScenario: The patient is ventilated with a BVM and oxygen. A large-bore IV is established, and sodium bicarbonate 1 mEq/kg IV is administered. ECG shows slight QRS narrowing post-treatment. The patient remains unconscious but has a palpable radial pulse. En route to the ED, she begins posturing with one arm flexed and jaw clenching. Updated vitals: BP 92/56, HR 122, RR assisted at 12, SpO₂ 98%, ECG QRS 110 ms.What is the most appropriate pharmacologic action if the patient begins seizing en route?

The EMS crew is dispatched to a residence for a 25-year-old patient who is weak, dizzy, and slightly agitated. The time of the call is 1000. The response time will be 9 minutes. The patient is located inside the residence. There is heavy rainfall in the response area. It is a cool morning, and the temperature is 42°F (6°C). A small hospital is located 12 minutes away, and the nearest comprehensive medical facility is 30 minutes away. Scene  The patient responds to verbal stimuli and is laying down in bed and does not want to be bothered. The family member states that the patient reported feeling weak during breakfast, and then became confused. The patient has a history of seizures, diabetes, and hyperlipidemia. Medications include insulin that is being administered by an automated external pump, carbamazepine, gabapentin, and atorvastatin. The patient allergies to penicillin medications. The patient’s skin is diaphoretic. There are no signs of trauma, and the patient obeys motor commands. Eyes are open, and the pupils are 5 mm and reactive to light. The vital signs are BP 166/90, P 124, R 12, SpO2 95% on room air, and T 98°F (37°C). The blood glucose is 47 mg/dL. Patient begins to vomit and becomes more confused what is your next action?

Enroute phaseScenario: The paramedic unit is dispatched to an elementary school nurse’s office for a 7-year-old female who developed difficulty breathing and a rash shortly after eating lunch. The call was received at 1147. Estimated response time is 6 minutes. The paramedic is partnered with an EMT, and a BLS engine crew is also en route. The temperature is 72°F (22°C) and skies are clear. According to the school nurse, the child has a known peanut allergy and her symptoms started within minutes of exposure. The school has an EpiPen available and is awaiting EMS arrival.On scene phaseScenario:The patient (25 kg) is found sitting upright in the school nurse’s office, visibly distressed. She is scratching at her neck and chest, which are covered in raised, red hives. Her lips are swollen, and she is audibly wheezing. The child is anxious and only able to speak in two- to three-word phrases. The nurse confirms that she did not yet administer the EpiPen but did place the child on oxygen via non-rebreather mask. The child’s caregiver has been contacted and is en route to the school.Vital signs: BP 88/52, HR 144, RR 30, SpO₂ 91% on oxygen, Temp 98.4°F (36.9°C).What is the most critical reason to administer epinephrine early in pediatric anaphylaxis?

Enroute phaseScenario:The paramedic unit is dispatched to a residential structure fire for a 42-year-old male reportedly burned while attempting to extinguish flames in his kitchen. The call was received at 0758. Estimated response time is 7 minutes. The paramedic is partnered with an EMT, and a BLS engine company is also responding. The outside temperature is 62°F (17°C) on a clear spring morning. According to fire personnel on scene, the patient has burns to the chest and arms and was exposed to smoke for several minutes before exiting. He is reported to be conscious but in significant pain.OnScene phaseScenario:The patient (approx. 85 kilograms) is alert and seated outside the home. He has partial-thickness burns across the anterior chest, both forearms, and hands, with blistering and severe pain. His eyebrows and nasal hairs are singed, and he has a persistent cough. He is hoarse and has soot around the mouth and nose. No other trauma is observed. The patient reports using a fire extinguisher and then evacuating himself. He is anxious and asking for help.Initial vital signs: BP 134/88, HR 126, RR 28, SpO₂ 94% on room air, Temp 99.1°F (37.3°C), Pain 9/10. What is the most appropriate immediate intervention for this patient?

Enroute phaseScenario: The paramedic unit is dispatched to a group home for a 26-year-old male who is reportedly experiencing a psychiatric crisis. The call was received at 1012. The estimated response time is 6 minutes. The paramedic is partnered with an EMT, and a BLS fire engine crew is also responding. It is overcast and 54°F (12°C) with light traffic. According to dispatch, the patient is locked in his room, yelling that people are trying to hurt him. Staff report he has a history of schizophrenia and is off his medications.OnScene phaseScenario: The patient (approx. 70 kilograms) is pacing rapidly in a small, cluttered bedroom. He is shouting that “they’re watching through the walls” and refuses to sit or allow physical contact. He appears disheveled, sweaty, and paranoid. Staff report he has not taken his prescribed medications for three days. No weapons are visible, and the patient has not made threats of violence. He is not responding to attempts at de-escalation and continues to shout and mumble incoherently.Vital signs: BP 138/88, HR 116, RR 20, SpO₂ 98% RA, Temp 99.2°F (37.3°C). No signs of trauma are present. Postscene phaseScenario:With law enforcement assistance, the patient is safely escorted to the stretcher and secured with soft restraints. He continues to speak incoherently but does not resist transport. An IV is established for access, and cardiac monitoring is applied. The patient is drowsy during transport but occasionally becomes agitated and pulls at the restraints. He does not acknowledge EMS crew or answer questions. Vitals are stable: BP 130/84, HR 102, RR 18, SpO₂ 99% on room air, Temp 98.9°F (37.2°C).Which of the following documentation elements is most important for this type of case?

Enroute phaseScenario: The paramedic unit is dispatched to an elementary school nurse’s office for a 7-year-old female who developed difficulty breathing and a rash shortly after eating lunch. The call was received at 1147. Estimated response time is 6 minutes. The paramedic is partnered with an EMT, and a BLS engine crew is also en route. The temperature is 72°F (22°C) and skies are clear. According to the school nurse, the child has a known peanut allergy and her symptoms started within minutes of exposure. The school has an EpiPen available and is awaiting EMS arrival.On scene phaseScenario:The patient (25 kg) is found sitting upright in the school nurse’s office, visibly distressed. She is scratching at her neck and chest, which are covered in raised, red hives. Her lips are swollen, and she is audibly wheezing. The child is anxious and only able to speak in two- to three-word phrases. The nurse confirms that she did not yet administer the EpiPen but did place the child on oxygen via non-rebreather mask. The child’s caregiver has been contacted and is en route to the school.Vital signs: BP 88/52, HR 144, RR 30, SpO₂ 91% on oxygen, Temp 98.4°F (36.9°C).What other medication may be considered after epinephrine and airway management are initiated?

Enroute phaseScenario:The paramedic crew is dispatched to a private residence for a 21-year-old female who was found unresponsive in her bedroom by her roommate. The call was received at 1535. The response time is estimated at 7 minutes. The paramedic is partnered with an EMT, and an ALS supervisor is en route. It is a mild spring afternoon, 64°F (18°C), and traffic is light. The roommate reports by phone that the patient has a history of depression and may have ingested “a bunch of pills.” The patient takes amitriptyline and alprazolam, according to the caller. Law enforcement is not yet on scene.Which preparation step is most important for this type of call?