What signs and symptoms should alert the paramedic to decompensated shock? (Select three correct answers)

Assessment of an unresponsive elderly patient reveals warm, dry skin. The patient is hypotensive, tachycardic, and has normal respirations. The patient takes Glucophage. The BEST explanation for these findings and treatment is

En RouteThe paramedic is dispatched to a residence for a 65-year-old patient who fell off a ladder. Dispatch reports the distance was approximately 14 feet.  The time of the call is 1300. The response time is 10 minutes. The paramedic is partnered with an EMT, no additional resources are available at this time. The weather is clear, and the temperature is 77F (25C).  A local community hospital is 15 minutes away and a comprehensive medical facility is about 25 minutes away. 

What further evaluation or treatment is imperative in this patient? 

A pediatric patient was involved in an auto-versus-pedestrian MVC. On arrival the patient is lethargic, has cool and pale skin, and is hypotensive with absent peripheral pulses. The paramedic should suspect: (Select two correct answers)

Which of the following signs and symptoms are most consistent with an anaphylactic reaction? (Select two correct answers)

Based on the above information, which of the following actions would be most beneficial?

EN ROUTE A paramedic is dispatched to a local convenience store for an elderly patient who was found alone and confused in the restroom. The time of the call is 1400 on a clear summer afternoon with ambient temperatures exceeding 100F (38C). The region is a medium-sized city with moderate traffic. A stand-alone ED is approximately 8 minutes away, a regional trauma center is 25 minutes away, and an ICU-capable medical center is 15 minutes away with normal traffic. The paramedic is partnered with an EMT in a standard-equipped ALS ambulance.

What should be the paramedic’s primary concern once on scene?

En RouteA paramedic is dispatched to a residence for a welfare check on an 85-year-old patient. The time of the call is 0900 on a clear summer morning with a temperature of 84oF (29oC). The region is a medium-sized city with moderate traffic. Response time is approximately 6 minutes. A stand-alone ED is approximately 8 minutes away, a regional trauma center is 25 minutes away, and an ICU-capable medical center is 15 minutes away with normal traffic.The paramedic is partnered with an EMT in a standard-equipped ALS ambulance.The dispatch notes state the family has been unable to contact the patient who lives alone. They are en route and about 20 minutes away. A local fire engine and law enforcement agency is also responding.  On Scene Upon arrival at the scene, law enforcement officers state there was no answer when they knocked on the door, and that they are about to gain access to the residence by force. Once inside, the patient is found lying on his right side on the floor of the living room. The patient has a palpable radial pulse and is breathing 20 times a minute. The patient’s skin is cool and clammy. Rapid exam is pertinent for a small hematoma on his right temple. When the patient is rolled onto their back, the respirations become sonorous. The patient does not respond to verbal or painful stimuli. Vital signs are BP 142/80, P 77, RR 14, SpO2 96%. Lung sounds are clear bilaterally.The patient’s history is unknown but the following medications were found on the counter: Aspirin, Humulin kwikpen, hydrochlorothiazide, Percocet, simvastatin, and metoprolol. Post Scene The paramedic is unable to obtain IV access and opted to administer IM glucagon. The patient was packaged up and transport initiated. Family was notified to meet the patient at the hospital. While en route to the hospital, repeat vital signs are BP 130/78, P 68, RR 10, SpO2 92%. Capillary blood glucose is 40 ten minutes after glucagon administration. Pupils are unchanged and there are no other injuries noted on exam.