EMT VCE Exam Download

Subcutaneous emphysema following blunt chest trauma strongly suggests air leaking from the lung into surrounding tissues, often associated with pneumothorax. NREMT trauma priorities stress that airway and breathing take precedence over all other interventions.

Option D is correct because the child is already in moderate respiratory distress, indicating inadequate ventilation. Assisting ventilations with a BVM ensures oxygen delivery and adequate tidal volume while preparing for rapid transport.

Option A is important but does not address the immediate life threat.

Option B may help with pain or flail segments but does not correct ventilation.

Option C is no longer routinely indicated and does not address breathing.

NREMT emphasizes correcting life-threatening airway and breathing problems before movement or transport.

Comprehensive and Detailed Explanation From Exact Extract:

Albuterol, a common beta-2 adrenergic agonist used in inhalers, stimulates bronchial smooth muscle relaxation. However, stimulation of beta receptors can also produce systemic effects such as:

Tachycardia (due to beta-1 cross-reactivity)

Nervousness (from central stimulation)

Coughing (a local airway response)

Confusion and drowsiness are not typical side effects of beta-agonists. Hypotension is rare unless severe overdose occurs.

Comprehensive and Detailed Explanation From Exact Extract:

After ROSC in an unresponsive patient, the left lateral recumbent position (also called the recovery position) is preferred to:

Maintain an open airway

Prevent aspiration if vomiting occurs

Promote drainage of secretions

Supine or Trendelenburg positions increase the risk of aspiration. Elevating the head to 45° may reduce intracranial pressure, but it’s not standard post-ROSC care in an unresponsive patient unless airway protection is ensured.

NREMT guidelines emphasize that patient refusal is only valid if the patient has decision-making capacity. This patient has a severe headache with critically elevated blood pressure, which raises concern for conditions such as hypertensive emergency, intracranial hemorrhage, or stroke—all of which can impair cognition.

Option D is correct because the EMT must first determine whether the patient is alert, oriented, understands the risks, and can communicate a rational decision. Without capacity, a refusal is not legally or ethically valid.

Option A is incorrect because a refusal form should only be signed after capacity is confirmed.

Option B does not address the legal and ethical priority.

Option C is unnecessary unless the patient lacks capacity and poses a danger to themselves or others.

NREMT stresses that EMTs must protect patient autonomy while ensuring informed refusal, especially in high-risk presentations.