Ligand-gated channels are typically found on _________________.  Select the three answers that apply.   Do not select all the options.  That will result in a score of zero for this question.

Nodes of Ranvier are gaps between adjacent

Clinical Judgement: Enroute phase You are dispatched to a residential home for a 9-year-old male complaining of severe abdominal pain. The mother states he has been sick for two days with fever, nausea, and worsening pain. Which of the following is a complication of abdominal pain?

A 2 year-old patient is sitting on the mother’s lap. The patient’s ECG is shown below: PALS ECG 3.jpg Which of the following interventions are most important for the patient’s survival after aggressive ventilatory support? Select the three answer options that are correct. 

Scenario: Enroute  The Paramedic is dispatched to a birthing center for a 29-year-old patient who is in active labor. The time of the call is 0600. The response time will be 10 minutes.   The Paramedic is partnered with an EMT, and a BLS fire department engine crew is dispatched with an ambulance. The patient is located inside the birthing center. It’s a clear spring afternoon, and the temperature is 88°F (31°C). A small hospital is located 15 minutes away, and the nearest comprehensive medical facility is 30 minutes away.   Scenario: Scene  The patient (70 kilograms) is sitting awake in the birth center water room inside a bathtub. The midwife states the patient has been in labor for 5 hours and started having imminent delivery 10 minutes ago. The infant’s head is delivered, but you notice the umbilical cord is tightly wrapped around the neck. The patient has a history of 39-week gestation, gravida 4, parity 3, and no abortions. Prenatal care is up to date, and no complication reported with previous and current pregnancy. Patient’s birth plan was a water birth, and no complications were indicated prior to labor. The patient has allergies to penicillin and iodine. The patient’s skin is cool, clammy, and diaphoretic. The amniotic sac has ruptured with 200 mL of vaginal bleeding visible; patients obey motor commands. Eyes are open, and the pupils are 5 mm and reactive to light. The vital signs are BP 110/60, P 118, R 20, SpO2 96% on room air, and T 98.6°F (37°C). The blood glucose is 80 mg/dL.   Scene  What is your first intervention? 

A 72-year-old male has accidentally displaced his Foley catheter while sleeping. Which of the following situations would contraindicate reinsertion of an indwelling catheter if medical control permits the skill?

Which of the following is the most likely clinical finding in a pediatric patient with a significant hemothorax?

Clinical Judgement: On scene phase You are dispatched to a residential home for a 6-year-old female; 44 pound with burn injuries. The caregiver states the child “accidentally spilled hot water on herself” while playing in the kitchen. Upon arrival to the scene no immediate hazards were visible; The home is cluttered, dirty, with no visible hot water spill or cooking equipment near the area, Caregiver (mother, 25 years old) appears nervous and avoids eye contact. The mother reports the child “grabbed a pot of boiling water off the stove.” The story changes slightly upon further questioning. Patient has No known medical conditions and no allergies. No signs of inhalation injury, respiratory rate 26 breaths/min, SpO2 97% on room air, HR 140 bpm, capillary refill 2 seconds. Crying but responsive, Glasgow Coma Scale (GCS) 14. Patient has visible blister burns covering bilateral lower legs with Distinct “glove and stocking” burns, No splash marks, and Multiple bruises in various healing stages on arms and back. The best initial pain management strategy for a pediatric burn patient is opiate management. Morphine is supplied as 10 mg/1 mL. How many milliliters will you administer?

Clinical Judgement: On scene phase You are dispatched to a residential neighborhood for a 6-year-old male; 36 pound who was struck by a vehicle while crossing the street. Bystanders reported the child was thrown several feet and hit his head on the pavement. Traffic has been stopped, and bystanders are gathered. Reports indicate the child was hit by a car traveling approximately 30 mph (48 km/h). Bystanders stated child was running across the street when struck. Witnesses state he briefly lost consciousness. The patient is lying supine on the pavement, helmet not worn. Patients has no medical history and no known drug allergies. Patient has decreased level of consciousness with vomiting noted, Shallow, irregular, respiratory rate 24 breaths/min, SpO2 94% on room air, Pale skin, weak radial pulse at 130 bpm, capillary refill >3 seconds, Glasgow Coma Scale (GCS): 10. Right pupil dilated and sluggishly reactive, Posturing (decorticate).No significant bleeding, but bruising and deformity seen on the forehead. The patient has a deteriorating GCS (now 8), posturing, and one fixed pupil. What is your immediate priority?

During a long-distance transfer of a patient with a feeding tube, you suspect the G-tube is either kinked or obstructed. The feeding machine is giving an alarm of “obstruction”. What should your FIRST action be?