Medical Technicians EMT Release Date

The correct answers are A. The patient is likely contagious to others and B. Airway management is a concern for this patient.

Key Diagnosis: Suspected Meningitis

The patient presents with:

Fever

Headache

Stiff neck

Lethargy

These are classic signs of meningitis, a serious infection of the central nervous system.

Why A is correct (Contagious):

Certain forms of meningitis (especially bacterial meningitis) are highly contagious

Spread via respiratory droplets

NREMT-aligned guidance states:

“Patients with suspected meningitis should be considered contagious.”

“Use appropriate PPE and precautions.”

Why B is correct (Airway concern):

Decreased level of consciousness (lethargy) increases risk of:

Airway compromise

Vomiting and aspiration

Continuous airway monitoring is critical

“Altered mental status requires close airway monitoring.”

Why the other options are incorrect:

C. Minimal stimuli to prevent vomiting❌ More associated with head injury or increased ICP, not primary meningitis management

D. Cannot treat without parent consent❌ In emergencies, implied consent applies, especially in minors

E. Full decontamination required❌ Not indicated — meningitis is not a hazardous materials exposure

Exact Extracts (NREMT-aligned EMT educational references):

“Meningitis may present with fever, headache, stiff neck, and altered mental status.”

“Consider patients contagious and use PPE.”

“Airway management is a priority in patients with decreased LOC.”

Clinical Priority Summary:

Suspected meningitis requires infection control precautions and airway vigilance, making A and B the correct answers.

The patient’s complaint of difficulty breathing is an airway/breathing issue and takes precedence over a controlled extremity bleed. The first action is to administer oxygen and evaluate respiratory effort.

Though reassessing the wound is important, oxygenation is the priority when airway compromise or respiratory distress is present. Tourniquets are for uncontrolled bleeding, which is not the case here.

The correct answer is A. Fluid overload.

Missed dialysis → inability to remove excess fluid

Shortness of breath + crackles → fluid in the lungs (pulmonary edema)

Hypertension (188/90)

Tachycardia (120)

Low-normal SpO₂ (92%)

These findings strongly indicate fluid overload leading to pulmonary edema.

Patients who miss dialysis retain excess fluid

Fluid accumulates in the lungs → crackles and respiratory distress

Hypertension is common due to increased circulating volume

B. Bronchiolitis → Typically seen in infants/children, not adults

C. Pneumonia → May cause crackles, but does not explain missed dialysis + fluid retention + hypertension pattern

D. Ascites → Fluid in the abdomen, not primarily causing lung crackles or acute respiratory distress

“Patients with renal failure who miss dialysis may develop fluid overload.”

“Pulmonary edema presents with crackles and respiratory distress.”

“Hypertension is commonly associated with fluid overload states.”

Dehydration signs in infants include:

Poor skin turgor (elasticity)

Sunken fontanelles (indicative of fluid loss)

Delayed capillary refill ( > 2 seconds)

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