NREMT EMT - Emergency Medical Technicians Exam

Comprehensive and Detailed Explanation From Exact Extract:

According toPediatric Basic Life Support (PBLS) guidelinesby theAmerican Heart Association (AHA), when a child becomes unresponsive due to foreign body airway obstruction (FBAO), the immediate next step is to beginchest compressions. This is donebefore checking the airway or giving breathsbecause the airway is presumed obstructed. The compressions may dislodge the object.

After 30 compressions, open the airway and check for visible objects. If none are seen, attempt rescue breaths. This protocol reflects the high risk of complete airway blockage in children with sudden collapse following a choking episode.

Comprehensive and Detailed Explanation From Exact Extract:

In patients with asthma experiencing respiratory failure, improper ventilation (especially excessive rates) can lead to air trapping and increased intrathoracic pressure, reducing venous return and worsening hypotension. Thecorrect techniqueis to ventilate slowly to allow full exhalation — around1 breath every 5–6 secondsfor adults.

CPAPis contraindicated in unresponsive patients who cannot maintain their own airway. Anon-rebreather maskwould be insufficient for an unresponsive patient, andforceful ventilationrisks barotrauma.

Comprehensive and Detailed Explanation From Exact Extract:

Dehydration signs in infantsinclude:

Poor skin turgor(elasticity)

Sunken fontanelles(indicative of fluid loss)

Delayed capillary refill(>2 seconds)

Flushed skin is more common infever or heat illness, not dehydration.Hypotension, not hypertension, is associated with dehydration in late stages.

Comprehensive and Detailed Explanation From Exact Extract:

Children compensate for shock through increasedheart rate,respiratory rate, andvasoconstriction, which delays blood pressure drop. Therefore:

Tachycardiais often thefirst sign

Prolonged capillary refill(>2 seconds) is an early indicator

Tachypneasupports perfusion

Blood pressureis alate signin pediatric shock. SpOâ‚‚ is helpful but does not specifically indicate shock. Blood glucose may be abnormal in other metabolic conditions but is not an early marker of volume loss.

Comprehensive and Detailed Explanation From Exact Extract:

The symptoms and vital signs (wheezing, hypotension, high pulse rate, respiratory distress) are strongly indicative ofanaphylaxis, which is alife-threatening allergic reaction. Bilateral wheezing and hypotension further confirm systemic involvement. Thefirst-line treatment is intramuscular epinephrine, which:

Reverses bronchospasm (via beta-2 adrenergic effects)

Raises blood pressure (via alpha-1 vasoconstriction)

Improves airway tone and reduces mucosal edema

A metered-dose inhaler may help in mild bronchospasm but is insufficient duringanaphylactic shock. Positive pressure ventilations are a secondary measure if respiratory failure occurs. Nitroglycerin is contraindicated due to low BP.

Comprehensive and Detailed Explanation From Exact Extract:

Pertinent negativesare findings that arenot present, butwould be clinically relevant if they were. For example:

“No neck or back pain”helps rule out spinal injury

“No loss of consciousness”informs head trauma assessment

Statements about behavior or initial refusal (B, E) may be documented under patient behavior or refusal, but they are not pertinent negatives. Positive findings like abdominal tenderness arepertinent positives.

Comprehensive and Detailed Explanation From Exact Extract:

Forpediatric BLS with two rescuers, currentAHA Guidelines (2020)recommend:

Two-thumb encircling hands technique: Most effective for infants; provides consistent depth and control.

Compression ratio of 15:2: Enhances ventilation without compromising perfusion.

Compression depth: 1/3 of chest or approximatelyone-half the chest's depth.

CPR begins ifpulse <60 bpm with signs of poor perfusion, not at 72 bpm. Rate of180/minis excessive; ideal rate is100–120/min.

Comprehensive and Detailed Explanation From Exact Extract:

Anepidural hematomaclassically presents with a“lucid interval”— a brief period of regained consciousness following head trauma, followed by rapid deterioration. This is due to arterial bleeding, often from themiddle meningeal artery, leading to increasing intracranial pressure.

Signs include:

High blood pressure

Decreasing respiratory rate

Altered LOC or unresponsiveness

Subdural hemorrhages are slower venous bleeds, common in elderly patients. Subarachnoid hemorrhage often presents with "worst headache of life." Intracerebral bleeds are less commonly linked to lucid intervals.