Enroute Phase Scenario: The AEMT is dispatched to a local fitness center for a 58-year-old male who collapsed while using a treadmill. A bystander on scene reports that the patient is unresponsive and not breathing. The time of the call is 1412. The response time is estimated at 8 minutes. The AEMT is partnered with an EMT, and a fire department BLS engine crew is also en route. The patient is located inside the gym. It is a warm spring afternoon with moderate traffic in the area. The nearest hospital is 10 minutes away. Gym staff have been instructed to retrieve the on-site AED and bring it to the patient. What factor for this scene may allow for faster implementation of life-saving interventions than in other out-of-hospital cardiac arrest events? 

Enroute Phase Scenario:  The AEMT is dispatched to a dentist’s office for a 32-year-old male who is reported to be weak, dizzy, and slightly agitated. The call was received at 1015. The estimated response time is 9 minutes. The AEMT is partnered with an EMT, and a BLS fire department engine crew is also en route. The patient is located inside the dental office. It is a cool spring morning with heavy rainfall in the area, and the temperature is 42°F (6°C). A small hospital is located 12 minutes from the scene, while the nearest comprehensive medical facility is 30 minutes away.  OnScene Phase Scenario:  The patient (70 kilograms) is seated upright in a dental chair and appears visibly diaphoretic. The office staff states that the patient seemed confused upon arrival and has become increasingly irritable and slow to respond. The patient has a history of diabetes, seizures, and hyperlipidemia, and was instructed to fast after midnight for a scheduled dental procedure. The patient takes insulin, carbamazepine, hydrocodone/acetaminophen (for dental pain), and atorvastatin. The patient has no known allergies to medications. There are no signs of trauma, and the patient is able to follow simple commands. Eyes are open, and the pupils are 5 mm and reactive to light. The patient’s skin is diaphoretic. The vital signs are: blood pressure is 156/90 mmHg, pulse is 124 beats per minute, respirations are 10 per minute, SpO₂ is 95% on room air, temperature is 98°F (37°C), and the blood glucose is 47 mg/dL.  Based on the patient’s history and presentation, what is the most likely cause of his current condition? 

Which of the following is your most important consideration regarding protecting evidence at a crime scene and providing care?

Enroute Phase Scenario:  The AEMT is dispatched to a dentist’s office for a 32-year-old male who is reported to be weak, dizzy, and slightly agitated. The call was received at 1015. The estimated response time is 9 minutes. The AEMT is partnered with an EMT, and a BLS fire department engine crew is also en route. The patient is located inside the dental office. It is a cool spring morning with heavy rainfall in the area, and the temperature is 42°F (6°C). A small hospital is located 12 minutes from the scene, while the nearest comprehensive medical facility is 30 minutes away.  OnScene Phase Scenario:  The patient (70 kilograms) is seated upright in a dental chair and appears visibly diaphoretic. The office staff states that the patient seemed confused upon arrival and has become increasingly irritable and slow to respond. The patient has a history of diabetes, seizures, and hyperlipidemia, and was instructed to fast after midnight for a scheduled dental procedure. The patient takes insulin, carbamazepine, hydrocodone/acetaminophen (for dental pain), and atorvastatin. The patient has no known allergies to medications. There are no signs of trauma, and the patient is able to follow simple commands. Eyes are open, and the pupils are 5 mm and reactive to light. The patient’s skin is diaphoretic. The vital signs are: blood pressure is 156/90 mmHg, pulse is 124 beats per minute, respirations are 10 per minute, SpO₂ is 95% on room air, temperature is 98°F (37°C), and the blood glucose is 47 mg/dL.  Based on the patient’s presentation, which of the following is the most appropriate treatment? 

Enroute Phase Scenario: The AEMT is dispatched to a local fitness center for a 58-year-old male who collapsed while using a treadmill. A bystander on scene reports that the patient is unresponsive and not breathing. The time of the call is 1412. The response time is estimated at 8 minutes. The AEMT is partnered with an EMT, and a fire department BLS engine crew is also en route. The patient is located inside the gym. It is a warm spring afternoon with moderate traffic in the area. The nearest hospital is 10 minutes away. Gym staff have been instructed to retrieve the on-site AED and bring it to the patient. OnScene Phase Scenario: The patient (approximately 80 kilograms) is found lying supine on the floor of a fitness center. The patient is unresponsive, pulseless, and not breathing. A bystander began chest compressions approximately two minutes before EMS arrival. Gym staff report that the patient had been jogging on a treadmill before suddenly collapsing. The AED has just arrived on scene. The AEMT confirms absence of a carotid pulse and initiates resuscitation efforts. High-quality chest compressions are continued, and a bag-valve mask is connected to high-flow oxygen to begin ventilation. The AED is attached, and the initial rhythm analysis indicates ventricular fibrillation shock advised. No signs of trauma are present. The patient has no known allergies. The patient’s medical history and medications are currently unknown.  Based on the rhythm analysis of ventricular fibrillation, what is the next most appropriate immediate intervention? 

Enroute Phase Scenario:  The AEMT is dispatched to a community dental office for a 28-year-old female patient who is reportedly acting strangely and refusing to allow anyone near her. The call was received at 1440. The estimated response time is 9 minutes. The AEMT is partnered with an EMT, and a BLS fire department engine crew is also en route. Law enforcement has been requested but has not yet arrived on scene. It is overcast and 52°F (11°C) on a mild afternoon. Traffic in the area is moderate. The patient is located in a private dental suite within the office. The nearest hospital is 10 minutes from the scene.  OnScene Phase Scenario:  The patient (approximately 40 kilograms) is standing in the corner of a private dental suite, mumbling incoherently and clutching her chest. She appears visibly frightened and refuses to sit, make eye contact, or respond to verbal commands. The dental staff states that the patient was agitated upon arrival and repeatedly claimed that someone was “chasing her.” The patient has a history of anxiety and a prior psychiatric admission, and she takes sertraline for depression. She has no known drug allergies. There are no signs of trauma. The patient has not attempted to harm herself or others but is refusing to answer questions or follow instructions. Law enforcement has arrived and is standing outside the room. The patient’s level of consciousness appears intact, but her behavior is paranoid and disorganized. No vital signs have been obtained at this time.  Which of the following historical elements increases the likelihood that this is a psychiatric emergency requiring transport? 

Which of the following would be an atypical finding in a patient experiencing cardiac tamponade?

Enroute Phase Scenario: The AEMT is dispatched to a local fitness center for a 58-year-old male who collapsed while using a treadmill. A bystander on scene reports that the patient is unresponsive and not breathing. The time of the call is 1412. The response time is estimated at 8 minutes. The AEMT is partnered with an EMT, and a fire department BLS engine crew is also en route. The patient is located inside the gym. It is a warm spring afternoon with moderate traffic in the area. The nearest hospital is 10 minutes away. Gym staff have been instructed to retrieve the on-site AED and bring it to the patient. OnScene Phase Scenario: The patient (approximately 80 kilograms) is found lying supine on the floor of a fitness center. The patient is unresponsive, pulseless, and not breathing. A bystander began chest compressions approximately two minutes before EMS arrival. Gym staff report that the patient had been jogging on a treadmill before suddenly collapsing. The AED has just arrived on scene. The AEMT confirms absence of a carotid pulse and initiates resuscitation efforts. High-quality chest compressions are continued, and a bag-valve mask is connected to high-flow oxygen to begin ventilation. The AED is attached, and the initial rhythm analysis indicates ventricular fibrillation shock advised. No signs of trauma are present. The patient has no known allergies. The patient’s medical history and medications are currently unknown. Post Scene Phase Scenario:  The patient (approximately 80 kilograms) remains unconscious following return of spontaneous circulation (ROSC) after 12 minutes of CPR and two defibrillation shocks. The patient’s skin is pale and cool, and there is no evidence of trauma. The advanced airway remains secured and in place, and the patient is ventilated with a bag-valve mask connected to high-flow oxygen. The carotid pulse is present at 84 beats per minute, and respirations are shallow at 8 breaths per minute. Pupils are 3 mm and reactive to light. The AEMT notes oxygen saturation at 89% with BVM ventilation. The patient is secured and prepared for transport. Vital signs are BP 106/70, P 84, R 8 (assisted), SpO₂ 89% on BVM, and T 98.6°F (37°C). No spontaneous movements or responses to verbal stimuli are observed. Why is it important to maintain oxygenation and ventilation in this post-cardiac arrest patient? 

Which of the following would be the MOST appropriate to include in a radio report to the hospital when you are involved with a mass casualty incident?

Which of the following conditions is most likely to present with pelvic pain, fever, and chills?