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PHECC Paramedic study materials
PHECC Paramedic study resources

PHECC Paramedic practice questions

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Question 1Advanced Paramedic

A 62-year-old man in refractory ventricular fibrillation has received two shocks, CPR, and one dose of adrenaline. Which antiarrhythmic is indicated at this point in the cardiac arrest algorithm?

  1. Adenosine 6 mg rapid IV push
  2. Amiodarone 300 mg IV bolus Correct answer.
  3. Atropine 3 mg IV bolus
  4. Sodium bicarbonate 50 mmol IV

Explanation

In refractory VF/VT after the third shock, an antiarrhythmic such as amiodarone 300 mg IV is given, followed by a further 150 mg after the fifth shock. Atropine has no role in VF, adenosine is for stable narrow-complex tachycardia, and bicarbonate is not routine in cardiac arrest.

Question 2Advanced Paramedic

Which finding on a 12-lead ECG most strongly suggests a posterior myocardial infarction?

  1. ST elevation in leads II, III and aVF
  2. ST elevation in V1 and V2 with Q waves
  3. ST depression in leads V1–V3 with tall R waves Correct answer.
  4. Peaked T waves across the precordial leads

Explanation

Posterior infarction is reflected as reciprocal change in the anterior leads: horizontal ST depression, prominent R waves and upright T waves in V1–V3. ST elevation in II, III and aVF indicates inferior injury, and peaked T waves suggest hyperkalaemia or hyperacute anterior ischaemia.

Question 3Advanced Paramedic

What is the initial energy setting for a biphasic defibrillator in adult cardiac arrest?

  1. 120 J Correct answer.
  2. 50 J
  3. 360 J
  4. 200 J

Explanation

Manufacturer-recommended biphasic energy is used, typically in the range of 120–200 J; 120 J is a recognised initial setting. Escalation to maximum energy is used for subsequent shocks if the first is unsuccessful.

Question 4Advanced Paramedic

A patient with severe asthma has a silent chest and rising PaCO2. What does this combination indicate?

  1. Improving airflow obstruction
  2. Mild exacerbation
  3. Adequate response to bronchodilators
  4. Impending respiratory failure Correct answer.

Explanation

A silent chest reflects minimal air movement, and a rising or normalised PaCO2 in acute severe asthma signals fatigue and impending respiratory failure. Both findings are life-threatening and mandate urgent ventilatory support.

Question 5Advanced Paramedic

Which of the following is a recognised indication for emergency synchronised cardioversion?

  1. Asystole
  2. Unstable narrow-complex tachycardia with a palpable pulse Correct answer.
  3. Ventricular fibrillation
  4. Pulseless electrical activity

Explanation

Synchronised cardioversion is used for tachyarrhythmias with an organised rhythm and a pulse when the patient is haemodynamically unstable. Shockable arrest rhythms such as VF are treated with unsynchronised defibrillation.

Question 6Advanced Paramedic

A patient presents with a widened QRS, peaked T waves and a history of missed dialysis. Which treatment is most appropriate initially?

  1. IV amiodarone
  2. Oral potassium binder
  3. IV calcium chloride Correct answer.
  4. IV furosemide

Explanation

Hyperkalaemia with ECG changes is treated with IV calcium to stabilise the myocardium, followed by measures to shift and remove potassium. Calcium protects against arrhythmia while definitive elimination is arranged.

Question 7Advanced Paramedic

What is the recommended initial dose of adrenaline in adult cardiac arrest?

  1. 0.5 mg IV every 10 minutes
  2. 1 mg IV every 3–5 minutes Correct answer.
  3. 0.1 mg IV every minute
  4. 3 mg IV once

Explanation

In adult cardiac arrest, 1 mg of adrenaline (1:10,000) is given IV every 3–5 minutes until return of spontaneous circulation. This standard dose applies to both shockable and non-shockable rhythms.

Question 8Advanced Paramedic

Which sign best distinguishes an opioid overdose from other causes of reduced consciousness?

  1. Pinpoint pupils with respiratory depression Correct answer.
  2. Hyperreflexia with clonus
  3. Dilated pupils with tachycardia
  4. Hypertension with bradycardia

Explanation

The classic opioid toxidrome is pinpoint pupils, respiratory depression and reduced consciousness. Dilated pupils suggest sympathomimetic or anticholinergic toxicity, and hyperreflexia suggests serotonin syndrome.

Question 9Advanced Paramedic

A patient with a suspected cervical spine injury is being transported. Which measure best reduces secondary spinal injury?

  1. Removal of the collar during transport
  2. Manual in-line stabilisation with a rigid collar and head blocks Correct answer.
  3. Flexion of the head to open the airway
  4. Routine traction of the neck

Explanation

Restricting spinal movement with manual in-line stabilisation, a correctly fitted collar and lateral head blocks limits secondary injury. Traction and forced flexion are contraindicated, and the collar should remain until spinal injury is excluded.

Question 10Advanced Paramedic

Which finding is most consistent with tension pneumothorax?

  1. Bilateral crackles with a normal blood pressure
  2. Dullness to percussion on the affected side
  3. Fever with a productive cough
  4. Tracheal deviation away from the affected side with hypotension Correct answer.

Explanation

Tension pneumothorax causes mediastinal shift away from the affected side, severe respiratory distress and obstructive shock. Immediate needle decompression is required before imaging.

Question 11Advanced Paramedic

What is the first-line treatment for anaphylaxis in an adult?

  1. Adrenaline 0.5 mg IM into the anterolateral thigh Correct answer.
  2. Oral antihistamine
  3. Nebulised salbutamol
  4. IV hydrocortisone 200 mg

Explanation

Intramuscular adrenaline 0.5 mg (1:1000) into the anterolateral thigh is the first-line treatment for anaphylaxis and should be given without delay. Steroids, antihistamines and bronchodilators are adjuncts, not initial therapy.

Question 12Advanced Paramedic

A patient has a blood glucose of 2.8 mmol/L and is unconscious but protecting their airway. What is the most appropriate initial management?

  1. IV glucose followed by oral carbohydrate when awake Correct answer.
  2. No treatment until the patient wakes
  3. Oral glucose gel immediately
  4. IM glucagon as first choice

Explanation

For a hypoglycaemic patient with IV access, IV glucose is given to restore levels, followed by oral carbohydrate to prevent recurrence. Glucagon is reserved for cases without IV access, and oral glucose is unsafe in an unconscious patient.

Question 13Advanced Paramedic

Which feature distinguishes a simple partial seizure from a generalised tonic-clonic seizure?

  1. Bilateral limb involvement
  2. Loss of consciousness
  3. Preserved awareness in a simple partial seizure Correct answer.
  4. Postictal confusion

Explanation

A simple partial (focal aware) seizure preserves consciousness, whereas generalised seizures involve loss of consciousness. Postictal confusion and bilateral motor activity are more typical of generalised seizures.

Question 14Advanced Paramedic

A patient with suspected stroke has a blood glucose of 2.5 mmol/L. What is the priority action?

  1. Activate the stroke pathway immediately
  2. Correct the hypoglycaemia before further stroke assessment Correct answer.
  3. Perform a CT scan before any treatment
  4. Give aspirin 300 mg

Explanation

Hypoglycaemia can mimic stroke and must be corrected first, as it is rapidly reversible and can cause permanent harm if untreated. Stroke pathway activation follows once glucose is corrected.

Question 15Advanced Paramedic

Which ECG change is characteristic of hyperkalaemia?

  1. ST elevation with reciprocal depression
  2. Sawtooth flutter waves
  3. Tall, peaked T waves with a widened QRS Correct answer.
  4. Prolonged QT interval with U waves

Explanation

Hyperkalaemia produces tall peaked T waves, QRS widening and ultimately a sine-wave pattern. ST elevation with reciprocal change indicates infarction, and U waves suggest hypokalaemia.

Question 16Advanced Paramedic

A patient with a large burn to the chest develops increasing respiratory distress and reduced breath sounds on one side. What is the most likely cause?

  1. Simple anxiety
  2. Circumferential eschar restricting ventilation Correct answer.
  3. Pulmonary embolism
  4. Bronchospasm from smoke inhalation alone

Explanation

A circumferential chest burn can restrict chest expansion, producing respiratory compromise. Escharotomy may be required to relieve the constriction.

Question 17Advanced Paramedic

Which intravenous fluid is preferred for initial resuscitation in a trauma patient with haemorrhagic shock?

  1. Free water infusion
  2. Large volumes of 5% dextrose
  3. Hypertonic saline as routine
  4. Balanced crystalloid in limited volumes Correct answer.

Explanation

Permissive hypotension with limited balanced crystalloid and early blood products is preferred in haemorrhagic shock. Excessive crystalloid worsens dilutional coagulopathy and oedema.

Question 18Advanced Paramedic

What is the mechanism of action of naloxone?

  1. Inhibition of acetylcholinesterase
  2. Calcium channel blockade
  3. Competitive antagonism at opioid receptors Correct answer.
  4. Beta-adrenergic agonism

Explanation

Naloxone is a competitive opioid antagonist that reverses opioid-induced respiratory depression and sedation. It has no effect on non-opioid causes of reduced consciousness.

Question 19Advanced Paramedic

A patient has a suspected pelvic fracture with haemodynamic instability. Which manoeuvre is most appropriate during transport?

  1. Flexing the hips to reduce pain
  2. Log-rolling the patient repeatedly
  3. Application of a pelvic binder at the level of the greater trochanters Correct answer.
  4. Applying traction to the lower limbs

Explanation

A pelvic binder applied at the level of the greater trochanters reduces pelvic volume and limits haemorrhage. Repeated log-rolling, hip flexion and traction can worsen bleeding and instability.

Question 20Advanced Paramedic

Which finding suggests a tension pneumothorax rather than a simple pneumothorax?

  1. Mild dyspnoea with normal vital signs
  2. Hyperresonance alone
  3. Localised pleuritic pain
  4. Hypotension with distended neck veins Correct answer.

Explanation

Tension pneumothorax causes obstructive shock with hypotension and distended neck veins due to impaired venous return. Simple pneumothorax typically causes pain and dyspnoea without haemodynamic compromise.

Question 21Advanced Paramedic

A patient with severe sepsis has a lactate of 4 mmol/L and hypotension. What is the priority intervention?

  1. Immediate diuresis
  2. Oral rehydration and observation
  3. Beta-blockade to reduce tachycardia
  4. Rapid fluid resuscitation and early antibiotics Correct answer.

Explanation

Septic shock requires prompt fluid resuscitation and early broad-spectrum antibiotics to restore perfusion and treat infection. Diuresis and beta-blockade would worsen haemodynamics.

Question 22Advanced Paramedic

Which ECG rhythm is described as a regular narrow-complex tachycardia at approximately 150 beats per minute with no visible P waves?

  1. Ventricular fibrillation
  2. Complete heart block
  3. Ventricular tachycardia
  4. Supraventricular tachycardia Correct answer.

Explanation

A regular narrow-complex tachycardia without visible P waves is typical of SVT. Ventricular rhythms are broad-complex, and complete heart block is bradycardic with dissociated P waves.

Question 23Advanced Paramedic

A patient has sustained a head injury and is deteriorating with a fixed dilated pupil. Which intervention is most appropriate?

  1. Place the patient supine with the head flat
  2. Administer a hypotonic fluid bolus
  3. Hyperventilate aggressively for a prolonged period
  4. Elevate the head, maintain oxygenation and consider hypertonic therapy Correct answer.

Explanation

A fixed dilated pupil suggests raised intracranial pressure with herniation. Elevating the head, ensuring oxygenation and considering hypertonic therapy reduce intracranial pressure; prolonged hyperventilation and hypotonic fluids are harmful.

Question 24Advanced Paramedic

What is the recommended compression-to-ventilation ratio for adult one-rescuer CPR?

  1. 5:1
  2. 30:2 Correct answer.
  3. 15:2
  4. 10:2

Explanation

Adult CPR uses a 30:2 ratio of compressions to ventilations for both one- and two-rescuer scenarios. A 15:2 ratio is used for paediatric resuscitation with two rescuers.

Question 25Advanced Paramedic

A patient with a known aortic aneurysm presents with sudden severe abdominal and back pain and hypotension. What is the most appropriate management?

  1. Oral analgesia and observation
  2. Rapid transport with cautious fluid resuscitation Correct answer.
  3. Vigorous fluid loading to normalise blood pressure
  4. Immediate thrombolysis

Explanation

A leaking or ruptured abdominal aortic aneurysm requires urgent surgical repair; prehospital care involves rapid transport and cautious resuscitation to avoid raising blood pressure and worsening bleeding. Thrombolysis and observation are inappropriate.

Question 26Advanced Paramedic

Which intravenous induction agent is most appropriate for rapid sequence intubation in a haemodynamically unstable trauma patient?

  1. Midazolam
  2. Propofol
  3. Thiopentone
  4. Ketamine Correct answer.

Explanation

Ketamine preserves sympathetic tone and blood pressure, making it the induction agent of choice when haemodynamic instability is present. Propofol, thiopentone and midazolam all cause significant vasodilatation and myocardial depression that can precipitate profound hypotension in a shocked patient.

Question 27Advanced Paramedic

A patient is being ventilated with a bag-valve mask and the capnography waveform suddenly disappears while the chest continues to rise. Which cause should be considered first?

  1. Hyperventilation
  2. Bronchospasm
  3. Oesophageal intubation
  4. Circuit disconnection Correct answer.

Explanation

An abrupt loss of the capnography waveform with continued chest movement suggests loss of CO2 return to the sensor, most commonly a disconnection or obstruction in the breathing circuit. Oesophageal intubation would not produce chest rise, and bronchospasm produces a sloping waveform rather than complete loss.

Question 28Advanced Paramedic

Which finding is the earliest reliable indicator of hypovolaemia in an adult trauma patient?

  1. Narrowing pulse pressure Correct answer.
  2. Rising respiratory rate
  3. Bradycardia
  4. Falling blood pressure

Explanation

A narrowing pulse pressure reflects the early compensatory rise in systemic vascular resistance before systolic blood pressure falls. Blood pressure is maintained until substantial volume loss has occurred, so it is a late sign.

Question 29Advanced Paramedic

Which manoeuvre is used to confirm correct placement of a supraglottic airway device?

  1. Waveform capnography Correct answer.
  2. Checking cuff pressure
  3. Chest auscultation alone
  4. Auscultation over the epigastrium

Explanation

Continuous waveform capnography is the recommended standard for confirming and monitoring all advanced airway placement, including supraglottic devices. Auscultation alone is unreliable and epigastric sounds indicate oesophageal placement rather than confirming correct position.

Question 30Advanced Paramedic

Which action is most appropriate when a patient with a tracheostomy tube develops sudden respiratory distress and the tube cannot be suctioned?

  1. Remove the tube and ventilate via the stoma or face Correct answer.
  2. Instil saline into the tube
  3. Increase suction pressure and reattempt
  4. Inflate the cuff further

Explanation

An obstructed tracheostomy that cannot be cleared is a life-threatening emergency; the tube should be removed and the patient ventilated via the stoma or, if that fails, by face mask while the stoma is occluded. Further cuff inflation or saline instillation does not relieve a solid obstruction and delays definitive management.

Question 31Advanced Paramedic

Which parameter is used to calculate the shock index?

  1. Heart rate divided by systolic blood pressure Correct answer.
  2. Mean arterial pressure divided by heart rate
  3. Systolic blood pressure divided by respiratory rate
  4. Diastolic pressure divided by heart rate

Explanation

The shock index is the heart rate divided by the systolic blood pressure, with a normal value around 0.5 to 0.7. A raised index can identify occult hypoperfusion before conventional vital signs become abnormal.

Question 32Advanced Paramedic

Which feature on a 12-lead ECG suggests a posterior myocardial infarction?

  1. ST elevation in leads V1 to V4
  2. Prolonged PR interval
  3. ST depression in leads V1 to V3 with tall R waves Correct answer.
  4. Peaked T waves in lead II

Explanation

Posterior infarction produces reciprocal changes in the anterior leads, namely ST depression, prominent R waves and upright T waves in V1 to V3. ST elevation in V1 to V4 indicates an anterior infarct instead.

Question 33Advanced Paramedic

A patient with a wide-complex tachycardia is haemodynamically stable. What is the most appropriate initial management?

  1. Amiodarone infusion Correct answer.
  2. Observation only
  3. Immediate synchronised cardioversion
  4. Adenosine bolus

Explanation

For a stable broad-complex tachycardia, current resuscitation guidance supports an antiarrhythmic such as amiodarone. Synchronised cardioversion is reserved for the unstable patient, and adenosine is not indicated for broad-complex rhythms of uncertain origin.

Question 34Advanced Paramedic

Which nerve block provides analgesia for a patient with a fractured femoral shaft in the prehospital setting?

  1. Intercostal block
  2. Digital block
  3. Femoral nerve block Correct answer.
  4. Interscalene block

Explanation

A femoral nerve block anaesthetises the anterior and medial thigh and provides effective analgesia for femoral shaft fractures. The interscalene block targets the shoulder, while digital and intercostal blocks address entirely different regions.

Question 35Advanced Paramedic

Which finding most strongly suggests that a patient in status epilepticus requires immediate airway intervention?

  1. Gurgling respirations with inability to clear secretions Correct answer.
  2. Oxygen saturation of 94% on room air
  3. Bilateral limb jerking
  4. A post-ictal Glasgow Coma Scale of 12

Explanation

Gurgling respirations with retained secretions indicate that the airway is not being protected and that aspiration risk is high, warranting prompt airway management. Ongoing motor activity or mild desaturation alone does not mandate immediate intubation.

Question 36Advanced Paramedic

Which action is required before administering a fibrinolytic to a patient with suspected ST-elevation myocardial infarction?

  1. Obtaining a chest radiograph
  2. Performing a peak flow measurement
  3. Confirming the absence of contraindications such as recent haemorrhagic stroke Correct answer.
  4. Measuring the serum potassium

Explanation

Fibrinolysis carries a substantial bleeding risk, so a structured screen for absolute and relative contraindications, including recent haemorrhagic stroke, must be completed first. Potassium, chest radiography and peak flow do not determine eligibility for thrombolysis.

Question 37Advanced Paramedic

A patient has a suspected open pneumothorax with a sucking chest wound. Which initial dressing approach is recommended?

  1. Packing the wound with gauze
  2. A fully occlusive dressing taped on all four sides
  3. A vented chest seal or a dressing taped on three sides Correct answer.
  4. No dressing until arrival at hospital

Explanation

An open chest wound is managed with a vented seal or a three-sided dressing that allows air to escape during expiration, reducing the risk of converting to a tension pneumothorax. A fully occlusive four-sided seal traps air and can cause deterioration.

Question 38Advanced Paramedic

Which finding distinguishes a hypoglycaemic cause of altered consciousness from a post-ictal state?

  1. A witnessed tonic-clonic phase
  2. Presence of urinary incontinence
  3. A capillary glucose below 4 mmol/L that reverses with glucose Correct answer.
  4. Bilateral upgoing plantar reflexes

Explanation

A low capillary glucose that resolves with glucose administration confirms hypoglycaemia as the cause of the altered consciousness. Incontinence, witnessed convulsions and extensor plantar responses can occur in either setting and do not discriminate between them.

Question 39Advanced Paramedic

Which is the correct initial energy setting for synchronised cardioversion of an unstable adult with atrial fibrillation?

  1. 100 J
  2. 200 J Correct answer.
  3. 360 J
  4. 50 J

Explanation

For an unstable adult with atrial fibrillation, synchronised cardioversion is typically commenced at 200 J biphasic and escalated if unsuccessful. Lower energies are used for atrial flutter, while 360 J is reserved for refractory ventricular arrhythmias.

Question 40Advanced Paramedic

A trauma patient has a Glasgow Coma Scale score of 13 (E3 V4 M6), is breathing adequately, and has no signs of shock. According to prehospital triage guidance, which action is most appropriate?

  1. Discharge the patient at scene with head injury advice
  2. Transport directly to a major trauma centre because the GCS is below 14 Correct answer.
  3. Treat and transport to the nearest emergency department without major trauma centre involvement
  4. Request a psychiatric review before deciding on destination

Explanation

A GCS of 13 or less after head injury is a recognised physiological triage criterion that mandates transport to a major trauma centre, even when the airway and circulation appear stable. The reduced score reflects significant brain injury risk that outweighs proximity to a local hospital.

Question 41Paramedic

A patient has a tension pneumothorax with severe respiratory distress and hypotension. What is the most appropriate immediate intervention?

  1. Application of a non-rebreather mask at 15 L/min
  2. Insertion of a supraglottic airway
  3. Administration of nebulised salbutamol
  4. Needle decompression at the second intercostal space midclavicular line Correct answer.

Explanation

Tension pneumothorax is a life-threatening emergency requiring immediate relief of pleural pressure; needle decompression is the priority procedure before other supportive measures. Oxygen and airway adjuncts do not relieve the underlying pressure.

Question 42Paramedic

In an adult, which finding best indicates that effective chest compressions are being delivered during CPR?

  1. An end-tidal CO2 reading that rises to above 1.3 kPa (10 mmHg) Correct answer.
  2. A compression rate of 60 per minute with deep compressions
  3. A palpable carotid pulse with each compression
  4. Visible chest recoil and a systolic pressure above 90 mmHg

Explanation

A rising end-tidal CO2 value during CPR reflects improved pulmonary blood flow and is a recognised indicator of compression quality. Chest recoil is required but does not by itself confirm effective perfusion.

Question 43Paramedic

Which of the following is the recommended first-line drug for an adult in cardiac arrest with a shockable rhythm?

  1. Adrenaline 1 mg intravenously Correct answer.
  2. Atropine 1 mg intravenously
  3. Sodium bicarbonate 50 mmol intravenously
  4. Amiodarone 300 mg intravenously

Explanation

Adrenaline 1 mg is given after the third shock in shockable-rhythm cardiac arrest and repeated every three to five minutes. Amiodarone is given after adrenaline but is not the first-line drug.

Question 44Paramedic

A 6-year-old child is in respiratory distress with stridor at rest and drooling. Which action is most appropriate?

  1. Give oral fluids to assess swallowing
  2. Keep the child calm in a position of comfort and arrange urgent transport Correct answer.
  3. Place the child supine and apply cricoid pressure
  4. Inspect the throat with a tongue depressor

Explanation

Stridor at rest with drooling suggests critical upper airway obstruction such as epiglottitis; agitation or instrumentation can precipitate complete obstruction. The priority is minimal handling, a position of comfort, and rapid transfer.

Question 45Paramedic

Which of the following best describes the purpose of the primary survey in the paramedic assessment?

  1. To identify and immediately treat life-threatening conditions Correct answer.
  2. To document baseline observations for the patient record
  3. To determine the patient's eligibility for transport
  4. To obtain a complete medical history

Explanation

The primary survey follows an airway, breathing, circulation, disability and exposure approach to find and correct threats to life before moving on. History gathering and documentation occur later in the assessment.

Question 46Paramedic

A patient with a suspected cervical spine injury is found supine and requires airway management. Which technique best maintains spinal alignment while opening the airway?

  1. Hyperextension of the neck
  2. Turning the head to the side
  3. Head-tilt chin-lift
  4. Jaw thrust with manual in-line stabilisation Correct answer.

Explanation

The jaw thrust with manual in-line stabilisation opens the airway while limiting movement of the cervical spine. Head-tilt chin-lift and neck hyperextension can displace an unstable spine.

Question 47Paramedic

Which finding is most consistent with a hypoglycaemic episode in a conscious adult?

  1. Blood glucose of 5 mmol/L with deep rapid breathing
  2. Blood glucose of 12 mmol/L with polyuria
  3. Blood glucose of 3.0 mmol/L with sweating and confusion Correct answer.
  4. Blood glucose of 7 mmol/L with dry skin

Explanation

A blood glucose below 3.5 mmol/L with autonomic symptoms such as sweating and altered mental state indicates hypoglycaemia. Values within the normal range or elevated do not fit this picture.

Question 48Paramedic

A patient in anaphylaxis has received intramuscular adrenaline. What is the recommended dose and route for an adult?

  1. 2 mg orally
  2. 0.5 mg intramuscularly into the anterolateral thigh Correct answer.
  3. 1 mg intravenously as a bolus
  4. 0.1 mg subcutaneously into the abdomen

Explanation

The adult dose of adrenaline in anaphylaxis is 0.5 mg of 1:1000 solution given intramuscularly into the anterolateral thigh, repeated as needed. Intravenous adrenaline is reserved for specialist settings with cardiac monitoring.

Question 49Paramedic

Which sign is most suggestive of a pelvic fracture in a trauma patient?

  1. Pain on gentle compression of the iliac crests Correct answer.
  2. Pain on palpation of the sternum
  3. Localised tenderness over the clavicle
  4. Reduced breath sounds at the left base

Explanation

Pain on gentle compression of the pelvis suggests disruption of the pelvic ring and warrants cautious handling and haemorrhage control. Other findings listed relate to different body regions.

Question 50Paramedic

What is the most appropriate initial management for a patient with a suspected open fracture of the tibia with moderate bleeding?

  1. Manipulate the limb to restore alignment before dressing
  2. Irrigate the wound vigorously and apply a tight tourniquet
  3. Cover with a sterile dressing, control bleeding and immobilise the limb Correct answer.
  4. Apply ice directly to the exposed bone

Explanation

Open fractures require control of bleeding and protection of the wound with a sterile dressing, followed by immobilisation to reduce further injury and contamination. Vigorous irrigation and direct ice are not prehospital priorities.