You have achieved ROSC in a 77-year-old female. She remains unresponsive and her vital signs are BP 94 /58, P 82, and R 18. In what position should she be placed?
Correct Answer: B
The correct answer is B. Left lateral recumbent. This patient has return of spontaneous circulation (ROSC) but remains unresponsive. In such cases, airway protection becomes the priority. According to NREMT and resuscitation guidelines: * Unresponsive patients who are breathing adequately should be placed in the recovery position (lateral recumbent) to maintain a patent airway and reduce the risk of aspiration. * This position allows secretions or vomit to drain out of the mouth instead of entering the airway. Why B is correct: * "Place unresponsive patients with adequate breathing in the recovery position." * The left lateral recumbent position is the standard recovery position used in EMS. Why the other options are incorrect: * A. Supine: Increases risk of airway obstruction and aspiration in an unresponsive patient. * C. Trendelenburg: Not recommended; can worsen respiratory function and does not improve outcomes. * D. Head elevated 45°: May be used in conscious patients or certain conditions, but not ideal for an unresponsive patient without airway control. Exact Extracts: * "Unresponsive patients who are breathing adequately should be placed in the recovery position." * "The recovery position helps maintain an open airway and reduces aspiration risk." * "Airway management is the priority after ROSC." References: NREMT EMT Education Standards - Cardiology & Resuscitation NREMT National Continued Competency Program (NCCP) - Post-Resuscitation Care AHA BLS Guidelines - Post-Cardiac Arrest Care
Question 132
Which of the following patient presentations at a mass casualty incident would indicate a red triage priority? Select the two answer options that are correct.
Correct Answer: B,C
The correct answers are B. Respiratory rate of 32 and C. Decorticate posturing. This question is based on START triage (Simple Triage and Rapid Treatment), which is used in mass casualty incidents to rapidly categorize patients. Red (Immediate) category includes patients with: * Respiratory rate greater than 30 breaths/min * Poor perfusion (capillary refill > 2 seconds or no radial pulse) * Altered mental status (unable to follow commands) Why B is correct: * A respiratory rate of 32 breaths per minute exceeds the START triage threshold of 30. * NREMT triage guidance states: * "If respirations are greater than 30 per minute, tag the patient as immediate (red)." Why C is correct: * Decorticate posturing indicates severe brain injury and altered mental status. * These patients cannot follow commands, placing them in the red (immediate) category. Why the other options are incorrect: * A. Pulselessness: In START triage, pulseless and apneic patients are categorized as black (deceased /expectant), not red. * D. Controlled major hemorrhage: If bleeding is controlled and no other critical findings are present, the patient may be delayed (yellow). * E. Inability to flex the right knee: This is an isolated orthopedic injury and typically categorized as minor (green) or delayed. Exact Extracts: * "Respirations greater than 30 per minute # Immediate (red)." * "Patients unable to follow commands are categorized as immediate." * "Apneic patients who do not resume breathing are tagged deceased." References: NREMT EMT Education Standards - EMS Operations (Mass Casualty Incidents) NREMT National Continued Competency Program (NCCP) - Triage and Incident Management START Triage Guidelines (endorsed in EMS education standards)
Question 133
What are the proper procedures for performing CPR on a 9-month-old patient? Select the three answer options that are correct.
Correct Answer: A,C,E
The correct answers are A. Check the brachial artery for a pulse, C. Use a compression depth of at least two inches, and E. Use the two-thumb-encircling-hands technique for two rescuers. 1. Check the brachial artery (A): For infants (less than 1 year old), the correct pulse check site is the brachial artery, not the carotid. * "For infants, assess the brachial pulse." 2. Compression depth (C): Infant chest compressions should be about 1/3 the depth of the chest, which is approximately 1.5-2 inches. * "Compress the chest at least one-third its depth (about 1.5-2 inches in infants)." 3. Two-thumb-encircling-hands technique (E): When two rescuers are present, this is the preferred method because it: * Produces better compressions * Improves perfusion * "Use the two-thumb encircling technique for two-rescuer infant CPR." Why the other options are incorrect: * B. Compression rate is over 120/min # IncorrectCorrect rate is 100-120/min, not over 120 * D. Compression area just above nipple line # IncorrectCorrect location is just below the nipple line on the sternum * F. Ventilate one breath every 3 seconds # IncorrectWith advanced airway: 1 breath every 2-3 seconds (20-30/min), not fixed at 3 seconds Exact Extracts (NREMT/AHA-aligned references): * "Check the brachial pulse in infants." * "Compression depth should be at least one-third the chest diameter." * "Use the two-thumb encircling technique for two rescuers." * "Compression rate is 100-120 per minute." Clinical Priority Summary: Proper infant CPR includes brachial pulse assessment, correct compression depth, and appropriate technique, making A, C, and E correct. References: NREMT EMT Education Standards - Cardiology & Resuscitation American Heart Association (AHA) Guidelines for CPR and ECC NREMT National Continued Competency Program (NCCP)
Question 134
What are the components of the START triage system?
Correct Answer: D
START (Simple Triage and Rapid Treatment) is a triage method taught by the National Registry of Emergency Medical Technicians for use in mass-casualty incidents. START allows rescuers to quickly prioritize patients based on the severity of their conditions using objective criteria that can be assessed in under 60 seconds. The correct components of the START system are Respirations, Perfusion, and Mental Status (RPM), making Option D correct. EMTs first assess whether the patient is breathing and evaluate respiratory rate. Next, perfusion is assessed by checking radial pulse or capillary refill. Finally, mental status is evaluated by determining whether the patient can follow simple commands. Option A describes elements of a general patient assessment, not START triage. Option B refers to the primary assessment sequence, not mass-casualty triage. Option C lists triage categories rather than assessment components. NREMT emphasizes START triage as a rapid, standardized approach to manage large numbers of patients efficiently while maximizing survivability.
