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Rescue 1122 EMT study materials
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Rescue 1122 EMT practice questions

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Question 1Ambulance Service (medical emergencies and pre-hospital care)

During adult CPR in the field, what is the correct compression-to-ventilation ratio for a single rescuer with a bag-valve mask?

  1. 5 compressions to 1 ventilation
  2. 30 compressions to 2 ventilations Correct answer.
  3. 10 compressions to 2 ventilations
  4. 15 compressions to 2 ventilations

Explanation

Current adult basic life support guidance uses a universal 30:2 ratio for a single rescuer, whether or not an advanced airway is placed. Compressions are delivered at 100 to 120 per minute with a depth of about 5 to 6 cm, and interruptions are minimized.

Question 2Ambulance Service (medical emergencies and pre-hospital care)

A patient is unresponsive, not breathing normally, and has no palpable carotid pulse. What is the most appropriate immediate action?

  1. Give two rescue breaths and reassess the pulse for 1 minute
  2. Place the patient in the recovery position and monitor
  3. Apply oxygen by nasal cannula at 2 L/min
  4. Start chest compressions and activate the emergency response system Correct answer.

Explanation

Absence of a pulse with no normal breathing defines cardiac arrest, and the priority is immediate high-quality chest compressions plus activation of the emergency response system and request for a defibrillator. Delay in starting compressions reduces survival.

Question 3Ambulance Service (medical emergencies and pre-hospital care)

Which finding most strongly suggests that an automated external defibrillator should be attached to a collapsed patient?

  1. The patient is unresponsive, pulseless, and not breathing normally Correct answer.
  2. The patient complains of severe central chest pain
  3. The patient is drowsy but breathing at 20 per minute
  4. The patient has a systolic blood pressure of 90 mmHg

Explanation

An AED is indicated for a patient in cardiac arrest, meaning unresponsive, without normal breathing, and without a pulse. Early defibrillation of a shockable rhythm such as ventricular fibrillation is the key determinant of survival in out-of-hospital arrest.

Question 4Ambulance Service (medical emergencies and pre-hospital care)

A conscious adult is choking with a silent cough and cannot speak. What should the EMT do first?

  1. Lay the patient flat and begin chest compressions
  2. Give a drink of water to help clear the obstruction
  3. Deliver up to five back blows between the shoulder blades Correct answer.
  4. Perform a blind finger sweep of the mouth

Explanation

A silent cough with inability to speak indicates severe airway obstruction, and standard adult protocol begins with up to five sharp back blows, followed by abdominal thrusts if the obstruction persists. Blind finger sweeps are avoided because they can push the object deeper.

Question 5Ambulance Service (medical emergencies and pre-hospital care)

What is the normal adult resting respiratory rate range used when assessing a patient in the ambulance?

  1. 12 to 20 breaths per minute Correct answer.
  2. 24 to 30 breaths per minute
  3. 4 to 8 breaths per minute
  4. 30 to 40 breaths per minute

Explanation

A normal adult respiratory rate is generally accepted as 12 to 20 breaths per minute. Rates outside this range, especially above 24 or below 10, indicate respiratory compromise requiring closer assessment and support.

Question 6Ambulance Service (medical emergencies and pre-hospital care)

Which oxygen delivery device provides the highest inspired oxygen concentration to a spontaneously breathing patient?

  1. Nasal cannula at 2 L/min
  2. Simple face mask at 5 L/min
  3. Venturi mask at 28 percent
  4. Non-rebreather mask at 12 to 15 L/min Correct answer.

Explanation

A non-rebreather mask with a reservoir bag at 12 to 15 L/min can deliver roughly 85 to 95 percent oxygen, making it the highest-concentration device for a spontaneously breathing patient. Nasal cannulae and fixed-performance Venturi masks deliver much lower fractions.

Question 7Ambulance Service (medical emergencies and pre-hospital care)

When should an EMT apply cervical spine motion restriction to a trauma patient?

  1. When the mechanism or findings suggest possible spinal injury Correct answer.
  2. Only when the patient is unconscious
  3. Routinely for every patient who has fallen
  4. Only when the patient reports neck pain

Explanation

Cervical motion restriction is applied when the mechanism of injury or clinical findings raise suspicion of spinal injury, and it is then reassessed. It is not applied reflexively to every fall or only to patients with pain or unconsciousness, since distracting injuries and altered mental status can mask spinal damage.

Question 8Ambulance Service (medical emergencies and pre-hospital care)

Which statement correctly describes the purpose of the primary survey in pre-hospital care?

  1. To determine the patient's insurance and billing details
  2. To perform a full head-to-toe examination before any treatment
  3. To identify and immediately treat life-threatening conditions Correct answer.
  4. To record a complete medical and family history

Explanation

The primary survey follows an ABCDE approach to find and correct immediate threats to airway, breathing, circulation, disability, and exposure. The detailed history and head-to-toe examination belong to the secondary survey, which follows stabilization.

Question 9Ambulance Service (medical emergencies and pre-hospital care)

A patient with suspected opioid overdose has a respiratory rate of 4 per minute and pinpoint pupils. What is the priority intervention?

  1. Assist ventilations with a bag-valve mask and give naloxone per protocol Correct answer.
  2. Apply a nasal cannula at 2 L/min and observe
  3. Place the patient in the recovery position and transport without support
  4. Give oral glucose and reassess in 10 minutes

Explanation

Opioid toxicity causes hypoventilation through central respiratory depression, so the immediate priority is to support ventilation with a bag-valve mask and administer naloxone according to protocol. Oxygen alone does not correct inadequate minute ventilation.

Question 10Ambulance Service (medical emergencies and pre-hospital care)

An adult with a known history of asthma is in severe respiratory distress with a silent chest and exhaustion. What does a silent chest most likely indicate?

  1. That the patient is hyperventilating
  2. A normal finding during a severe attack
  3. Complete recovery from the asthma attack
  4. Impending respiratory failure with minimal air movement Correct answer.

Explanation

A silent chest in severe asthma means airflow is so reduced that wheezing cannot be generated, which signals impending respiratory failure. It is an ominous sign requiring urgent ventilatory support and rapid transport.

Question 11Ambulance Service (medical emergencies and pre-hospital care)

Which finding best distinguishes anaphylaxis from a simple allergic reaction in the pre-hospital setting?

  1. Airway swelling or hypotension after allergen exposure Correct answer.
  2. Sneezing and clear nasal discharge
  3. Mild itching without systemic symptoms
  4. Localized urticaria at the contact site

Explanation

Anaphylaxis involves systemic involvement such as airway oedema, bronchospasm, or hypotension, whereas a simple allergic reaction remains localized. Adrenaline is indicated for anaphylaxis with airway or circulatory compromise, not for isolated skin symptoms.

Question 12Ambulance Service (medical emergencies and pre-hospital care)

A patient with a suspected acute myocardial infarction reports chest pain. Which action best reflects current pre-hospital priorities?

  1. Give nitrates to every patient with chest pain regardless of blood pressure
  2. Give aspirin as protocol allows, obtain a 12-lead ECG, and transport urgently Correct answer.
  3. Withhold all medication until hospital arrival
  4. Encourage the patient to walk to the ambulance to improve circulation

Explanation

Early aspirin, a diagnostic 12-lead ECG, and rapid transport to a facility capable of reperfusion are the cornerstones of pre-hospital STEMI care. Nitrates are contraindicated in hypotension and should never be given indiscriminately.

Question 13Ambulance Service (medical emergencies and pre-hospital care)

What is the correct compression depth for an adult during CPR?

  1. Approximately 3 cm
  2. Approximately 1 to 2 cm
  3. Approximately 8 to 10 cm
  4. Approximately 5 to 6 cm Correct answer.

Explanation

Adult chest compressions should reach a depth of about 5 to 6 cm while allowing full chest recoil between compressions. Shallower compressions reduce cardiac output, and excessive depth increases the risk of internal injury.

Question 14Ambulance Service (medical emergencies and pre-hospital care)

A trauma patient has a suspected tension pneumothorax with severe dyspnoea, unilateral absent breath sounds, and hypotension. What is the most appropriate action?

  1. Provide high-flow oxygen and arrange urgent decompression and transport Correct answer.
  2. Give oral fluids to raise blood pressure
  3. Apply a tight dressing over the entire chest
  4. Position the patient supine and observe

Explanation

Tension pneumothorax is a life-threatening emergency requiring high-flow oxygen and urgent decompression, followed by rapid transport to a trauma facility. Observation or oral fluids would allow the obstructive shock to progress.

Question 15Ambulance Service (medical emergencies and pre-hospital care)

A patient with a suspected stroke has a blood glucose of 2.8 mmol/L. Why is this finding critical?

  1. It confirms a haemorrhagic stroke
  2. Hypoglycaemia can mimic stroke and must be corrected Correct answer.
  3. It indicates the patient is dehydrated
  4. It shows the stroke is not time critical

Explanation

Hypoglycaemia can produce focal neurological deficits that closely resemble stroke, and it is rapidly reversible. Checking and correcting glucose is therefore a mandatory step in stroke assessment before attributing findings to cerebral ischaemia.

Question 16Ambulance Service (medical emergencies and pre-hospital care)

During transport, a patient with a severe head injury becomes increasingly drowsy. Which action is most appropriate?

  1. Give a large fluid bolus to raise blood pressure rapidly
  2. Hyperventilate the patient continuously to reduce carbon dioxide
  3. Maintain airway, ventilation, and oxygenation while avoiding hypotension Correct answer.
  4. Place the patient in a head-down position

Explanation

In traumatic brain injury, preventing hypoxia and hypotension is the mainstay of pre-hospital care because both worsen secondary brain injury. Routine prolonged hyperventilation is avoided since it can cause cerebral ischaemia through vasoconstriction.

Question 17Ambulance Service (medical emergencies and pre-hospital care)

Which patient presentation most strongly suggests hypoglycaemia rather than hyperglycaemia in the field?

  1. Gradual onset of thirst and frequent urination over days
  2. Deep sighing respiration with fruity breath
  3. Sudden confusion with sweating and tremor in a diabetic patient Correct answer.
  4. Dry skin with a history of missed insulin doses

Explanation

Hypoglycaemia typically presents acutely with autonomic features such as sweating, tremor, and confusion, and it is rapidly reversible with glucose. Hyperglycaemia tends to develop gradually with polyuria, thirst, and in severe cases Kussmaul breathing.

Question 18Ambulance Service (medical emergencies and pre-hospital care)

A patient is in the third trimester of pregnancy and has painless vaginal bleeding. What is the correct pre-hospital approach?

  1. Provide oxygen, monitor for shock, and transport without a vaginal examination Correct answer.
  2. Delay transport until bleeding stops completely
  3. Advise the patient to walk to reduce bleeding
  4. Perform a sterile vaginal examination to assess dilatation

Explanation

Painless vaginal bleeding in late pregnancy suggests placenta praevia, and a digital vaginal examination is contraindicated because it can provoke catastrophic haemorrhage. Care focuses on oxygen, shock monitoring, and rapid transport with obstetric notification.

Question 19Ambulance Service (medical emergencies and pre-hospital care)

A child is unresponsive and has a palpable pulse but is not breathing adequately. What is the recommended approach?

  1. Start chest compressions at 100 per minute
  2. Give abdominal thrusts
  3. Provide rescue breaths at the appropriate paediatric rate and reassess Correct answer.
  4. Place the child in the recovery position without ventilating

Explanation

When a pulse is present but breathing is inadequate, rescue breathing is provided at the paediatric rate with reassessment of pulse and breathing. Chest compressions are reserved for the pulseless child or when the pulse is clearly inadequate.

Question 20Ambulance Service (medical emergencies and pre-hospital care)

Which statement about scene safety is most consistent with pre-hospital practice?

  1. Personal protective equipment is optional when the patient appears well
  2. Traffic control is the sole responsibility of the ambulance crew
  3. Rescuers should ensure the scene is safe before approaching the patient Correct answer.
  4. Scene safety is assessed after patient contact is made

Explanation

Scene safety is assessed before any patient contact so that rescuers do not become additional casualties. Hazards such as traffic, fire, electricity, or violence must be controlled or the rescue deferred until specialist services secure the area.

Question 21Ambulance Service (medical emergencies and pre-hospital care)

A patient has been submerged in water and is now unresponsive with no breathing. Which action is correct according to basic life support principles?

  1. Open the airway with head tilt and give rescue breaths, then start CPR Correct answer.
  2. Delay CPR until the patient is fully dry
  3. Begin with abdominal thrusts to remove water
  4. Place the patient in the recovery position and wait

Explanation

In drowning, hypoxia is the cause of arrest, so ventilation is emphasized: open the airway, give rescue breaths, and begin CPR with compressions. Attempts to drain water from the lungs are ineffective and delay resuscitation.

Question 22Ambulance Service (medical emergencies and pre-hospital care)

A patient with a suspected fractured femur has significant swelling and a deformed thigh. Why is traction splinting appropriate in this situation?

  1. It completely replaces the need for analgesia
  2. It should be applied before assessing distal pulses
  3. It is contraindicated for all mid-shaft femur fractures
  4. It reduces pain and bleeding by realigning the femur Correct answer.

Explanation

Traction splinting of a mid-shaft femur fracture reduces muscle spasm, pain, and internal bleeding by restoring alignment and length. Distal neurovascular status must be assessed and documented before and after application.

Question 23Ambulance Service (medical emergencies and pre-hospital care)

Why is a 12-lead ECG obtained in the field for a patient with chest pain, rather than relying on a single lead rhythm strip?

  1. It measures cardiac enzymes directly
  2. Multiple leads detect ST elevation that a single lead may miss Correct answer.
  3. A single lead always shows ST elevation clearly
  4. The 12-lead replaces the need for a physical examination

Explanation

A 12-lead ECG examines the heart from multiple anatomical perspectives, allowing detection of ST elevation in territories that a single monitoring lead cannot reliably show. This enables pre-hospital activation of reperfusion pathways.

Question 24Ambulance Service (medical emergencies and pre-hospital care)

A patient with severe sepsis is being transported. Which pre-hospital intervention most directly addresses the underlying pathophysiology?

  1. Withholding fluids to prevent oedema
  2. Applying a traction splint to the limbs
  3. Giving a bronchodilator to reduce fever
  4. Administering oxygen and IV fluids as protocol allows to support perfusion Correct answer.

Explanation

Sepsis involves widespread vasodilation, capillary leak, and impaired tissue perfusion, so supporting oxygenation and circulating volume is central to pre-hospital management. Early recognition and rapid transport with pre-alert allow timely antibiotics and definitive care.

Question 25Ambulance Service (medical emergencies and pre-hospital care)

A patient has a chemical burn to the eye from an industrial solvent. What is the most appropriate immediate pre-hospital action?

  1. Apply a tight eye patch without irrigation
  2. Irrigate the eye copiously with water or saline and transport Correct answer.
  3. Neutralize the chemical with an acid or alkali solution
  4. Delay irrigation until arrival at hospital

Explanation

Chemical eye burns require immediate, copious irrigation to dilute and remove the agent and limit tissue damage. Chemical neutralization is dangerous because it generates heat and further injury, and delay worsens outcomes.

Question 26Ambulance Service (medical emergencies and pre-hospital care)

An EMT is called to a road traffic crash and finds a motorcyclist lying beside the bike on a busy highway. Before approaching the patient, what is the most appropriate first action?

  1. Request traffic control and ensure the scene is safe before making patient contact Correct answer.
  2. Remove the patient's helmet before checking the scene
  3. Begin the primary survey immediately to save time
  4. Ask the patient to stand and walk to the ambulance

Explanation

Scene safety precedes patient contact in every pre-hospital response; uncontrolled traffic can injure both the crew and the casualty. Traffic control, positioning of the vehicle and personal protective equipment must be arranged first. Only once the scene is safe does the primary survey begin.

Question 27Ambulance Service (medical emergencies and pre-hospital care)

A patient is bleeding heavily from a deep laceration to the forearm and direct pressure with a dressing has not controlled it. What is the next appropriate step?

  1. Wash the wound with saline and reapply a fresh dressing
  2. Elevate the limb and continue the same dressing
  3. Wait for hospital staff to manage the bleeding
  4. Apply a tourniquet proximal to the wound and note the time Correct answer.

Explanation

When direct pressure fails to control life-threatening limb bleeding, a tourniquet is applied proximal to the wound and the application time is recorded. This is the recognised pre-hospital step for catastrophic extremity haemorrhage. Documentation of time is essential because it guides later surgical decisions.

Question 28Ambulance Service (medical emergencies and pre-hospital care)

Which finding in a patient with a suspected pelvic fracture should most raise concern for internal haemorrhage?

  1. A small abrasion on the lateral thigh
  2. A feeling of instability and increasing pallor with a rising pulse Correct answer.
  3. Pain reproduced when the pelvis is compressed once
  4. Localised bruising over the iliac crest

Explanation

The pelvis can hold a large volume of blood, so instability with pallor and a rising pulse suggests significant concealed haemorrhage and developing shock. These signs should prompt urgent transport and shock management. Bruising and pain alone are less specific indicators of blood loss.

Question 29Ambulance Service (medical emergencies and pre-hospital care)

An adult is unresponsive, not breathing normally, and has no palpable pulse. CPR is started. What compression-to-ventilation ratio should be used with a bag-valve mask?

  1. 5 compressions to 1 ventilation
  2. 10 compressions to 2 ventilations
  3. 30 compressions to 2 ventilations Correct answer.
  4. 15 compressions to 2 ventilations

Explanation

For adult cardiac arrest with a single or two-rescuer team using a bag-valve mask, the standard ratio is 30 compressions to 2 ventilations. This maintains adequate coronary perfusion while limiting interruptions. The 15:2 ratio applies to paediatric resuscitation with two rescuers.

Question 30Ambulance Service (medical emergencies and pre-hospital care)

A patient with a severe asthma attack has received nebulised salbutamol but remains distressed with a rising carbon dioxide level and decreasing respiratory effort. What does this trend most likely indicate?

  1. A normal response to beta-agonist therapy
  2. Improvement of bronchospasm after treatment
  3. Impending respiratory failure requiring urgent ventilatory support Correct answer.
  4. Development of a simple chest infection

Explanation

A rising carbon dioxide with falling respiratory effort in severe asthma signals fatigue and impending respiratory failure rather than improvement. Such patients need urgent assisted ventilation and rapid transport. Bronchodilator therapy alone is no longer sufficient.

Question 31Ambulance Service (medical emergencies and pre-hospital care)

A patient with a suspected cervical spine injury must be moved because of an immediate fire hazard. What is the most appropriate technique?

  1. Having the patient sit up and walk with assistance
  2. Pulling the patient by the arms while a colleague holds the legs
  3. Manual in-line stabilisation with a coordinated log-roll or lift onto a spine board Correct answer.
  4. Dragging the patient by the shoulders to move quickly

Explanation

When a hazardous scene forces movement of a patient with suspected spinal injury, the spine is kept aligned using manual in-line stabilisation and a coordinated log-roll or lift. This minimises secondary injury during the urgent move. The hazard justifies moving, but alignment should still be maintained as far as possible.

Question 32Ambulance Service (medical emergencies and pre-hospital care)

An EMT is preparing to ventilate a patient with a bag-valve mask. Which action best reduces the risk of gastric insufflation?

  1. Ventilating as fast as possible to raise oxygen levels
  2. Squeezing the bag fully and forcefully with each breath
  3. Using the largest available mask regardless of fit
  4. Delivering each breath over about one second just until the chest rises Correct answer.

Explanation

Gastric insufflation occurs when airway pressure exceeds the opening pressure of the lower oesophageal sphincter, which forceful or excessive ventilation causes. Delivering each breath over roughly one second and stopping when the chest rises limits peak pressure. A well-fitting mask and gentle technique also help.

Question 33Ambulance Service (medical emergencies and pre-hospital care)

Why is a nasopharyngeal airway often preferred over an oropharyngeal airway in a patient who is drowsy but has an intact gag reflex?

  1. It is better tolerated because it does not stimulate the gag reflex as strongly Correct answer.
  2. It seals the oesophagus and prevents aspiration
  3. It can be used without any lubrication or measurement
  4. It delivers oxygen directly to the lungs

Explanation

An oropharyngeal airway tends to provoke gagging and vomiting in patients with an intact gag reflex, whereas a nasopharyngeal airway is generally better tolerated. It is measured from the nostril to the earlobe and lubricated before insertion. It does not seal the oesophagus or deliver oxygen itself.

Question 34Ambulance Service (medical emergencies and pre-hospital care)

A patient has been stung by a bee and within minutes develops widespread urticaria, wheeze and a fall in blood pressure. Which medication is the priority?

  1. Oral corticosteroid alone
  2. Nebulised saline
  3. Intramuscular adrenaline into the anterolateral thigh Correct answer.
  4. Oral antihistamine

Explanation

This is anaphylaxis with airway, breathing and circulatory involvement, and intramuscular adrenaline is the first-line treatment. It is given into the anterolateral thigh for rapid absorption. Antihistamines and steroids are adjuncts and act too slowly to reverse acute compromise.

Question 35Ambulance Service (medical emergencies and pre-hospital care)

Which of the following best describes the purpose of the secondary survey in pre-hospital care?

  1. A review of the patient's insurance details
  2. A head-to-toe assessment and history to identify injuries not found in the primary survey Correct answer.
  3. A test of the ambulance's equipment before departure
  4. A repeat check of the airway only

Explanation

The secondary survey is a systematic head-to-toe examination with history taking, performed after the primary survey and initial stabilisation. Its purpose is to detect injuries and conditions that were not immediately life-threatening. Findings guide further treatment and transport decisions.

Question 36Ambulance Service (medical emergencies and pre-hospital care)

A patient has a blood glucose of 1.9 mmol/L, is drowsy but able to swallow, and has no intravenous access. What is the most appropriate initial management?

  1. Withhold all glucose until hospital arrival
  2. Give oral glucose and monitor the airway and consciousness Correct answer.
  3. Give oral water only
  4. Give intramuscular glucagon immediately

Explanation

A conscious patient who can swallow safely can be treated with oral glucose, which is rapid and appropriate in the pre-hospital setting. Airway protection and repeat glucose monitoring are essential. Intravenous or intramuscular routes are reserved for patients who cannot take oral treatment.

Question 37Ambulance Service (medical emergencies and pre-hospital care)

A patient has sudden severe tearing chest pain radiating to the back, a noticeable difference in blood pressure between the arms, and a history of hypertension. Which condition should be suspected?

  1. Acute pericarditis
  2. Musculoskeletal chest pain
  3. Aortic dissection Correct answer.
  4. Gastro-oesophageal reflux

Explanation

Tearing pain radiating to the back with inter-arm blood pressure difference in a hypertensive patient is the classic picture of aortic dissection. Pre-hospital care focuses on gentle handling, pain relief, oxygen if indicated and rapid transport to a facility capable of definitive management. This is a time-critical emergency.

Question 38Ambulance Service (medical emergencies and pre-hospital care)

A patient with a suspected acute stroke has a blood pressure of 190/110 mmHg and is otherwise stable. What is the appropriate pre-hospital approach to this blood pressure?

  1. Delay transport until the pressure falls on its own
  2. Give intravenous fluids to raise it further
  3. Do not actively lower it; ensure airway, oxygen if needed, and rapid transport Correct answer.
  4. Give a fast-acting antihypertensive to bring it to normal

Explanation

In acute ischaemic stroke, cerebral perfusion depends on systemic pressure, so pre-hospital crews generally avoid actively lowering blood pressure unless specific protocols direct otherwise. Priorities are airway, breathing, circulation, glucose check and rapid transport to a stroke-capable centre. Uncontrolled reduction can extend the infarct.

Question 39Ambulance Service (medical emergencies and pre-hospital care)

An adult collapses in a public place and a bystander starts CPR. An automated external defibrillator is available. What should the EMT do first on arrival?

  1. Confirm the arrest, apply the AED pads and follow its prompts while continuing CPR Correct answer.
  2. Give two rescue breaths before any other action
  3. Check the pupils before using the defibrillator
  4. Take over compressions and delay defibrillation until the ambulance is reached

Explanation

Early defibrillation is the key intervention for shockable cardiac arrest rhythms, so the AED should be applied as soon as the arrest is confirmed while CPR continues. The device analyses the rhythm and advises shocks. Minimising interruptions to compressions improves survival.

Question 40Ambulance Service (medical emergencies and pre-hospital care)

Why should an EMT avoid hyperventilating a patient with a severe traumatic brain injury?

  1. It increases the risk of spinal injury
  2. It causes the patient to become hyperglycaemic
  3. It prevents the use of oxygen therapy
  4. Excessive ventilation lowers carbon dioxide and can reduce cerebral blood flow Correct answer.

Explanation

Carbon dioxide is a potent cerebral vasodilator; hyperventilation lowers it and constricts cerebral vessels, reducing blood flow to an already injured brain. Ventilation should target normal rates and adequate oxygenation. Hyperventilation is reserved for specific herniation signs under protocol.

Question 41Ambulance Service (medical emergencies and pre-hospital care)

A patient has been in a house fire and has soot around the mouth, hoarse voice and stridor. What is the most important pre-hospital concern?

  1. Progressive airway swelling that may obstruct the airway Correct answer.
  2. Anxiety from the incident
  3. Carbon monoxide poisoning only
  4. Isolated skin burns on the limbs

Explanation

Soot, hoarseness and stridor after smoke inhalation suggest thermal or chemical injury to the upper airway, which can progress to obstruction. Early recognition and urgent transport, with preparation for airway support, are essential. Carbon monoxide exposure may coexist but does not explain stridor.

Question 42Ambulance Service (medical emergencies and pre-hospital care)

A patient has a partial-thickness burn covering the entire anterior chest and abdomen and the entire front of both thighs. Using the rule of nines, what approximate total body surface area is involved?

  1. 18%
  2. 27% Correct answer.
  3. 36%
  4. 45%

Explanation

The anterior trunk accounts for 18% and each anterior thigh for 4.5%, giving 9% for both, for a total of about 27%. The rule of nines allocates 18% to the front of the trunk and 9% to each whole lower limb. Accurate estimation guides fluid resuscitation and destination decisions.

Question 43Ambulance Service (medical emergencies and pre-hospital care)

A woman in the third trimester of pregnancy is involved in a car crash and has abdominal pain and vaginal bleeding. What is the most appropriate pre-hospital action?

  1. Massage the abdomen to assess uterine tone repeatedly
  2. Delay transport to allow the pain to settle
  3. Give oral fluids to maintain hydration
  4. Transport promptly on her left side with monitoring for shock and fetal wellbeing Correct answer.

Explanation

Abdominal pain and vaginal bleeding after trauma in late pregnancy raise concern for placental abruption and maternal-fetal compromise, requiring prompt transport. Positioning on the left side reduces compression of the inferior vena cava by the gravid uterus. Monitoring for shock and fetal heart tones guides care.

Question 44Ambulance Service (medical emergencies and pre-hospital care)

A patient with a suspected fractured tibia has an open wound over the fracture site with bone visible. What is the correct pre-hospital management?

  1. Apply a traction splint directly over the wound
  2. Irrigate the wound with hydrogen peroxide and leave it open
  3. Push the bone back under the skin before splinting
  4. Control bleeding, cover the wound with a sterile dressing and immobilise the limb Correct answer.

Explanation

An open fracture is managed by controlling haemorrhage, covering the wound with a sterile dressing and immobilising the limb in the position found. Bone ends are never pushed back because this introduces contamination deeper into the tissues. Antibiotics and surgical care are arranged at hospital.

Question 45Ambulance Service (medical emergencies and pre-hospital care)

A patient with a suspected hip dislocation has severe pain and the leg is shortened and internally rotated. What is the appropriate pre-hospital approach?

  1. Immobilise in the position found and provide analgesia during transport Correct answer.
  2. Forcefully reduce the dislocation in the field
  3. Apply traction to the limb regardless of pain
  4. Ask the patient to bear weight to test stability

Explanation

Suspected hip dislocation is immobilised in the position found, with analgesia and gentle handling during transport. Pre-hospital reduction attempts risk further injury to the joint, vessels and nerves. Definitive reduction occurs in hospital under controlled conditions.

Question 46Ambulance Service (medical emergencies and pre-hospital care)

Which of the following best describes the role of the emergency operations centre in an ambulance service?

  1. Providing definitive surgical treatment to trauma patients
  2. Training EMTs in advanced airway procedures
  3. Receiving emergency calls, prioritising them and dispatching the appropriate resources Correct answer.
  4. Maintaining the ambulance fleet's fuel records only

Explanation

The emergency operations centre is the entry point for emergency calls; it triages and prioritises them and dispatches the right resources. Accurate call-taking and dispatch directly affect response times and patient outcomes. Clinical treatment and fleet administration are separate functions.

Question 47Ambulance Service (medical emergencies and pre-hospital care)

An EMT is documenting care after a call. Which practice best supports continuity of care and legal defensibility?

  1. Writing only the final diagnosis after reaching hospital
  2. Leaving out interventions that did not change the outcome
  3. Completing the record several days later from memory
  4. Recording objective findings, interventions, times and the patient's response contemporaneously Correct answer.

Explanation

Contemporaneous documentation of objective findings, interventions, timings and responses supports handover and provides a reliable legal record. It allows the receiving team to understand what was done and when. Delayed or selective recording undermines accuracy and accountability.

Question 48Ambulance Service (medical emergencies and pre-hospital care)

A patient is trapped in a vehicle with a crushed leg and has been extricated after 45 minutes. The limb is swollen and pulseless. What complication should the EMT anticipate during and after release?

  1. Crush syndrome with hyperkalaemia and cardiac arrhythmias Correct answer.
  2. Simple muscle strain
  3. Anaphylactic shock from dust exposure
  4. Immediate hypoglycaemia

Explanation

Prolonged limb compression causes muscle breakdown and release of potassium and myoglobin into the circulation when the limb is freed, producing crush syndrome. Hyperkalaemia can trigger life-threatening arrhythmias. Early recognition, monitoring and rapid transport with fluid therapy per protocol are important.

Question 49Ambulance Service (medical emergencies and pre-hospital care)

A patient with severe dehydration from gastroenteritis has a weak, rapid pulse and cool skin. Which pre-hospital measure most directly addresses the underlying problem?

  1. Encouraging vigorous exercise to improve circulation
  2. Applying a heating pad to the limbs
  3. Giving a single dose of oral antihistamine
  4. Establishing intravenous access and giving isotonic crystalloid as per protocol Correct answer.

Explanation

In hypovolaemia from dehydration, restoring circulating volume with isotonic crystalloid directly addresses the deficit. Vital signs and mental status are monitored during infusion. Antihistamines, external warming and exercise do not correct volume loss.

Question 50Ambulance Service (medical emergencies and pre-hospital care)

A patient is confused and combative after a fall from height. Which action best protects the airway during transport?

  1. Restrain the patient tightly to the stretcher without airway monitoring
  2. Leave the patient unattended to prepare the vehicle
  3. Place a pillow under the head to keep the neck flexed
  4. Position the patient to maintain a patent airway with continuous monitoring and suction ready Correct answer.

Explanation

A confused patient with a head injury is at risk of airway compromise from vomiting, secretions or loss of tone. Positioning to maintain patency, continuous monitoring and ready suction protect the airway. Restraint without airway vigilance or leaving the patient alone is unsafe.