Question 1

You have been called to a public pool for an unresponsive patient. On arrival you find lifeguards performing CPR with a pocket mask and oxygen on a 67-year-old male. They report that the patient was in the water and was seen clutching his chest seconds before going unresponsive. He was immediately pulled from the water and CPR was initiated. They estimate that CPR has been performed for 5 minutes. Assessment shows the man to be unresponsive, apneic, and pulseless. Which one of the following is your first response?

Accepted Answer

Given the scenario of a patient who is unresponsive, apneic, and pulseless after being pulled from a pool, the immediate priority is to prepare for AED application. Since the patient is wet, drying off his chest is essential to ensure proper adhesion and function of the AED pads, which is why option D is the correct first response.

Question 2

The EMT realizes that the best means of preventing failure of the AED is to:

Accepted Answer

Regular checks at the beginning of each shift ensure that the AED and its components are functional and ready for use, which is crucial for preventing failure during an emergency.

Question 3

An EMT has just received a "Shock Advised" message from the AED. Just before delivering the shock, the EMT must:

Accepted Answer

Before delivering the shock, it is crucial to ensure that all rescuers are clear of the patient to prevent possible injury. Therefore, choice C is the best answer. The analyze button need not be pressed again as the shock advisory is already displayed, and the oral airway should be left in place unless it interferes with the shock delivery. Holding the patient's head is also not necessary.

Question 4

You have been assigned to a football game to provide standby coverage. While taking a break, you decide to walk to a nearby concession stand for a soft drink. On the way, you come across a group of people standing around a male patient who collapsed and is on the ground. Your assessment reveals him to be unresponsive, not breathing, and pulseless. A bystander states that the patient collapsed less than a minute earlier. An AED is located less than a minute from your location. The nearest EMT is 5 minutes from your location. Which one of the following should you do immediately?

Accepted Answer

The patient is in cardiac arrest and the best course of action is to attempt defibrillation using the AED as soon as possible. Therefore, the immediate action should be to retrieve the nearby AED. Bystanders should be instructed to call for emergency medical services (EMS) and start CPR until the AED arrives.

Question 5

The owner of a day care center for adults with Alzheimer's disease calls you to ask about an AED at her facility. Specifically, she asks if she will need a physician to oversee the AED program. Your reply should be:

Accepted Answer

According to the American Heart Association, "A medical director is responsible for developing and overseeing the AED program, which includes training personnel, developing policies and procedures, and ensuring compliance with state and local regulations. The medical director should also provide medical oversight, including authorizing the use of an AED under his or her license and ensuring that quality assurance and maintenance programs are in place." Therefore, the owner of the day care center will need a physician medical director since the AED can only be used with his or her permission under his or her license.

Question 6

The EMT would recognize which of the following as the most probable case of cardiogenic shock?

Accepted Answer

Cardiogenic shock occurs when the heart is unable to pump enough blood to meet the body's needs. Myocardial infarction (heart attack) is a common cause of cardiogenic shock. Severe vomiting and diarrhea, gastrointestinal bleed, and systemic infection are not direct causes of cardiogenic shock.

Question 7

A patient with a severe gastrointestinal bleed is in shock. Which of the following would best correct the patient's underlying problem?

Accepted Answer

The patient's underlying problem is blood loss leading to shock. Therefore, the best option to correct the underlying problem is blood replacement to restore blood volume and oxygen-carrying capacity. Intravenous fluids, high-concentration oxygen, and electrolyte replacement may be necessary as supportive care, but they do not address the underlying problem of blood loss.

Question 8

After two cardiac arrests, a large home improvement center has purchased a fully automated AED. You have been asked to provide education on its use. During an instructional session, a student asks you what will happen when the AED indicates that a shock is indicated. Your response should be:

Accepted Answer

When an AED indicates that a shock is indicated, it means that the heart rhythm has been analyzed and it has been determined that a shock is necessary to reset the heart's electrical activity. The AED will automatically administer the shock, and it is important for rescuers to clear the patient and not touch them during this process to avoid injury.

Question 9

You are transporting a patient in cardiac arrest. The AED is being used and a shock has been advised. Prior to administering the shock, what should you do?

Accepted Answer

Before administering a shock with an AED, it's crucial to ensure that no one is in contact with the patient or any surface connected to the patient, such as the stretcher, to avoid conducting the shock to anyone other than the patient.

Question 10

Your cardiac arrest patient has regained a pulse after two shocks. Which of the following actions would be appropriate?

Accepted Answer

The answer of Your cardiac arrest patient has regained a...

Question 11

You are transporting an unresponsive 31-year-old female patient who suffered cardiac arrest. On scene Emergency Medical Responders (EMRs) shocked her once with the AED and she regained a pulse. She remains unresponsive and is breathing shallowly. Ventilations are being provided with a bag-valve mask. An EMR has agreed to ride to the hospital with you to provide assistance in caring for the patient. Which one of the following instructions given to the EMR is most appropriate?

Accepted Answer

Leaving the AED on a patient who has regained a pulse but remains unresponsive is appropriate because it allows for immediate re-analysis and defibrillation if the patient re-enters cardiac arrest during transport.

Question 12

Your ambulance service director has given you the go ahead to replace an old AED with a new AED produced by a different manufacturer. Before making the purchase, you must receive authorization to do so by the:

Accepted Answer

The AED medical director is the best authority to authorize the replacement of an AED with a new one produced by a different manufacturer. They have the appropriate knowledge and expertise to ensure that the new AED is safe and effective for use.

Question 13

You have applied the AED's electrodes to an obese male patient in cardiac arrest. When you press the analyze button, the AED gives you a "check electrode" message. In looking at the patient, which one of the following would most likely be responsible for this message?

Accepted Answer

A common cause for an AED to give a "check electrode" message is poor electrode contact. This can be due to various factors, such as a hairy chest or excessive body fat. In this scenario, the obese patient's chest and abdomen may be interfering with the electrode contact, leading to the message.

Question 14

A patient in early shock informs the EMT that that he has had severe diarrhea and vomiting over the past four days. Given this history, the EMT should recognize the pathophysiology of the shock as:

Accepted Answer

The history of severe diarrhea and vomiting suggests that the patient may be experiencing hypovolemic shock due to loss of plasma volume. The loss of fluid and electrolytes through diarrhea and vomiting results in decreased blood volume, which can lead to inadequate tissue perfusion and shock.

Question 15

Which one of the following activities related to the use of an AED would a medical director carry out?

Accepted Answer

Reviewing cases in which an AED was used but no shock was advised is a responsibility that falls under the medical director's oversight, as they are responsible for ensuring proper usage and protocol adherence. Choices A, B, and C are more likely to be carried out by an operations manager or logistics coordinator.

Question 16

A 51-year-old male who suffered cardiac arrest has regained a pulse after one shock from the AED. The dispatcher informs you that the paramedic unit you have requested for assistance is coming from the eastern end of the county and has a 20-minute ETA. The hospital is 15 minutes west of your location. Which one of the following would be most appropriate?

Accepted Answer

In this scenario, the priority should be to transport the patient to the hospital as quickly as possible to continue with advanced care. Waiting for the paramedic unit to arrive on scene or meeting them at a halfway point could delay transport and potentially compromise the patient's care. It is appropriate to inform ALS of the intent to transport and provide updates on the patient's condition during transport.

Question 17

The EMT understands that when paramedics administer IV fluids as treatment for hemorrhagic shock, the fluids will:

Accepted Answer

IV fluids do not carry oxygen, so they do not directly help in getting more oxygen to the cells. They primarily help in maintaining blood volume and pressure.

Question 18

You are instructing a first-aid class at a local chemical plant. The course includes instruction regarding an AED that is to be placed in the plant. What point would you emphasize about the most common cause of AED failure?

Accepted Answer

The most common cause of AED failure is dead batteries. Therefore, it is important to emphasize that the batteries should be checked regularly to ensure the AED is functioning properly when needed.

Question 19

Which one of the following actions performed by the EMT indicates appropriate care with the AED when treating a patient in cardiac arrest?

Accepted Answer

Removing hair from a patient's chest by quickly removing electrodes ensures good pad contact and effective AED function.

Question 20

You are transporting a 57-year-old male who went into cardiac arrest at home. After two shocks and CPR, he regained a pulse, but remains unresponsive and in respiratory arrest. During transport, your reassessment reveals the absence of a carotid pulse. Which one of the following should you do first?

Accepted Answer

The absence of a carotid pulse indicates the patient is in cardiac arrest once again, and immediate intervention is necessary. Therefore, the first step should be to stop the ambulance and analyze the heart rhythm with the AED to determine if a shock is needed.

Quiz 15: Shock and Resuscitation