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. 

 Paramedics respond to an unresponsive patient with a suspected narcotic overdose. Vital signs are BP 90/55, RR 4, P 62, SpO2 88%. Which of the following is most accurate for this patient?

Which of the following capnographs should the paramedic expect to see?

EN ROUTEA paramedic is dispatched to a local residence for a welfare check on a patient whose family hasn’t been able to contact for the past two hours. The family stated that the patient has an extensive history of alcohol abuse and mental health problems and needs to go to the hospital. It is currently 2215 on a clear fall night, and the temperature is 77F (25C). The response time is about 6 minutes. There is a community based standalone ED about 5 minutes away, and a level 2 trauma center with most capabilities about 25 minutes away and an in-patient psychiatric facility 15 minutes away. Dispatch notes they have attempted to call the patient with no response. Law enforcement is responding and is expected to arrive just prior to the ambulance. A 2-crew fire engine is about 8 minutes away. ON SCENEUpon arrival at the scene, the paramedic is greeted by a local law enforcement officer who states that the patient was witnessed through the front window of the residence with a firearm, appearing to be in emotional distress. After repeated requests law enforcement was able to get the patient to open the door and the patient was then searched and placed in handcuffs for the safety of the patient and first responders. Law enforcement reports the patient has been cooperative and provides the paramedic with an expired bottle of Trazadone that appears to be completely full and states that this is the only medication found within the home. During assessment, the patient is observed to be in good physical health with normal weight and tone for age (20 years old); however when the paramedic attempts to ask general medical questions, the patient refuses to respond, only stating repeatedly that they are “fine” and that they “just need to sleep”. The paramedic notes a smell of alcohol on the patient and observes that the patient has a flat affect with minimal eye contact. The patient is adamant they do not want to go to the hospital, and they just want to go to bed. Law enforcement then requests that the paramedic transport the patient to the local psychiatric hospital for evaluation.

 An adult patient is choking and coughing forcefully. The paramedic should:

The crew responds to an incident where there is very limited access to a patient trapped in a vehicle. Which of the following assessments should occur?