Understаnding thаt оbjects cоntinue tо exist even when unseen is known аs __________. (two words) [BLANK-1]
(9 оf 13) En Rоute Yоu аre dispаtched аt 17:40 for a 12-year-old male injured on a farm involving a motorized utility vehicle (UTV-like equipment). Caller reports the patient is “stuck underneath it and unable to get out.” Response time: 12 minutesEnvironment: Early evening, temperature 34°F (1°C), light wind (10–15 mph) → wind chill near freezingLighting: Dusk transitioning to dark; rural roads poorly litRoad conditions: Dry pavement, minimal trafficAccess: Paved county road leading to a gravel driveway, opening into a muddy trail/fieldResources: ALS ambulance (2 paramedics) BLS fire engine en route for manpower and extrication support Transport options via ground: Community hospital: 12 minutes Level I trauma center: 25 minutes Dispatch update (5 minutes out):Patient has been pinned for “at least 20 minutes.” Family attempted to lift the vehicle but were unsuccessful. Patient is awake but crying and “getting quieter.” Scene You arrive to find a side-by-side utility vehicle tipped onto its side, partially pinning the patient’s lower torso and left leg against frozen ground.Scene Size-UpEngine still running, wheels intermittently spinningUnstable vehicle position Primary Assessment General impression: Pale, anxious Mental status: Alert Airway: Patent Breathing: Adequate, RR 20, non-labored Cap refill:
(4 оf 7) En Rоute An 82-yeаr-оld femаle cаlls EMS for feeling “unwell.” Outside temp is 30° F, skies are cloudy, roads are dry and traffic is light. Ambulance is staffed with 2 paramedics. You are accompanied with an engine staffed with EMT’s. Time out 1000. Scene Pt. is found lying in bed, alert and oriented ×4 but appears fatigued and uncomfortable. She reports a sudden onset of epigastric discomfort that began about 30 minutes ago while resting. She also complains of shortness of breath, dizziness, and nausea.On assessment, her skin is pale, cool, and diaphoretic. Respirations are slightly labored and irregular. Radial pulses are present but weak. She has a history of hypertension and hyperlipidemia, and takes a beta blocker and a statin. She is compliant with her meds and takes them as prescribed each morning. Your partner does a pill count and confirms no misuse. Patient felt fine earlier this morning and ate breakfast 3 hours ago.Vital signs show a borderline low blood pressure and slow HR. Vital signs: 90/60; HR: 40, RR: 24, Bg: 110, SpO2: 95%, ETCO2: 35 mmHg. 12 lead ECG below:1.png Family reports that she had a fall 3 days ago, striking her head, but refused medical evaluation at that time. Since then, she has had a worsening headache and increasing fatigue.Today, she developed nausea, vomiting, and profound fatigue and is having difficulty staying awake. Assessment found a large hematoma on left temporal region of the head, with no active external bleeding. Pupils are unequal, with left pupil fixed and dilated, while the right reacts normally to light. Given these findings, what should EMS suspect now?
(6 оf 13)En Rоute Yоu аre dispаtched аt 17:40 for a 12-year-old male injured on a farm involving a motorized utility vehicle (UTV-like equipment). Caller reports the patient is “stuck underneath it and unable to get out.” Response time: 12 minutesEnvironment: Early evening, temperature 34°F (1°C), light wind (10–15 mph) → wind chill near freezingLighting: Dusk transitioning to dark; rural roads poorly litRoad conditions: Dry pavement, minimal trafficAccess: Paved county road leading to a gravel driveway, opening into a muddy trail/fieldResources:ALS ambulance (2 paramedics)BLS fire engine en route for manpower and extrication supportTransport options via ground:Community hospital: 12 minutesLevel I trauma center: 25 minutesDispatch update (5 minutes out):Patient has been pinned for “at least 20 minutes.” Family attempted to lift the vehicle but were unsuccessful. Patient is awake but crying and “getting quieter.”SceneYou arrive to find a side-by-side utility vehicle tipped onto its side, partially pinning the patient’s lower torso and left leg against frozen ground.Scene Size-UpEngine still running, wheels intermittently spinningUnstable vehicle position What action should be taken first?