EMT Training Course and Exam

[Burke 13]

ERT EMT Training
Exam to be completed and directly messaged to Burke for grading. 

Examination available for Fire Department and SWAT members. 
Exempt members EMS members, and Paramedics.

Emergency Medical Technicians provide first response basic life support in emergency settings. Basic life support is to treat minor injuries, as well as administer first aid while waiting for more advanced care to arrive. Suitable emergency responders to test for EMTs are Fire Department Members and SWAT members. Other players will not be able to take this training. Players trained as Paramedics, OR those entering EMS are not required to take this test, but still advised to review the program. 

EMTs may provide first aid skills, included in standard first aid, as well as administer oxygen therapy. Most procedures allowed are considered non-invasive.

Before entering any scene, always practice scene safe. Ensure that the scene is safe for entry before entering, otherwise you risk becoming a patient yourself.

The first step when getting a patient is to assess vital signs. Pulse, respirations and Blood Pressure, as well as their temperature are important vital signs. Normal values range for ages and sexes, but for standardized purposes pulse rate ranges between 60-100 for normal, the higher the number being more concerning. These are resting rates. Surprise, exertion or fear can raise this, and medications can raise or lower this number. Pulse rate is how many times the heart beats in one minute. Quick manual measure can be done by placing the finger on the side of the neck, or the wrist, and counting the beats in a six second time frame, and adding a zero to that number. 

Respirations per minute are normal if between 12-20. Outside of these ranges is cause for concern. RPM is the rate at which a person breaths. Because of the low number, to observe, count the respirations in 30 seconds, and if the rate it normal, double it. 

Blood pressure is measured as diastolic/systolic, because of the variations, see below for a chart:

Please note that while 100/75 is okay, 50/20 is generally the sign of a crisis, causing blood pressure to be low. Blood pressure is the measurement of the pressure on the vessels with each heart beat. This is measured with a Blood Pressure (BP) cuff. 

Temperature is the body's temperature. Excessive temp is a fever or hyperthermia, while low temp is hypothermia. Both can be cause for concern. The normal body temperature is 98.6 F and is measured with a thermometer.

All these vitals are not always necessary, however when time permits, all vitals should be taken. 

Prioritizing injuries on arrival and assessment are done with Acronyms, known as ABCD and SAMPLE.

ABCD stands for Airway, Breathing, Circulation, and Deadly Bleeds. Patients should be assessed in the order of Airway. Is there any obstruction to their airway? Breathing is questioning whether or not the patient has normal breathing, and if anything is obstructing this. Circulation is to check for any circulatory emergencies. Is their heart beating, and is the blood circulating? Last is to check for deadly bleeds. A minor wound on the head or hand is not considered a deadly bleed, but a heavy bleed can turn to loss of life quickly. EMTs should take measures to correct any issues in ABCD.

SAMPLE questions:

If your patient is conscious and alert, ask these questions and record their answers. If not, try to get these questions answered from another person with the patient. 

Typical procedures practiced by EMTs are:

CPR: Direct intervention for patients who do not have an effective heart rate. Where possible, respirations should be given with a Bag Valve Mask.

AED: Shocking the heart into normal rhythm by use of an automated external defibrillator. CPR must take place for an AED to be used.

Airways: Placement of tubes into the mouth or nose to allow breathing on an unconscious person not breathing effectively. May be used with a bag valve mask to help effectiveness.

Splinting and Immobilization: Splinting a broken bone to stabilize, or stabilizing a person with traumatic injuries. 

Wound Care: Bandaging and stopping bleeding.

Medication Administration: EMTs are only able to help administer prescribed medications to a patient. The exceptions to this are Naloxone may be administered to any presumed opioid overdoses, as well as EpiPens may be administered to persons in anaphylactic shock, if it is prescribed. Additionally, Oxygen, Glucose and activated charcoal may be administered by EMTs. 

 

Exam Questions. You must get 9/10 Multiple Choices and 2/3 Scenarios correct. Scenarios are graded as pass fail.

1. EMTs can administer prescribed medications to an unconscious patient, or a patient unable to administer to themselves, for reasons such as injury to their arms.

• True/False

2. EMTs should administer oxygen to every patient, as this has been shown to benefit injuries. 

• True/False

3. If a patient has an airway blockage and an injury to their neck, the patient should stabilize their neck before addressing the airway blockage.

• True/False

4.  Hypothermia is a medical emergency, but hyperthermia is not.

• True/False

5. A patient can have an increased or decreased heart rate, blood pressure or temperature without it being a medical emergency.

• True/False

6. Which of the following is an acceptable medication for EMTs to administer alone in Saratoga?

1. Naloxone
2. Dilantin 
3. Amoxicillin
4. An opioid, such at fentanyl

7. You are called to the scene of a car versus tree accident. Upon arrival, you find the car to be engulfed in flames, with fire showing from underneath the hood and inside the passenger compartment. You can see that the operator of this vehicle is unconscious and slumped over the steering wheel. Which of the following is your first priority?

1. Ensuring Safety of any bystanders
2. Ensuring safety of the fire department
3. Starting immediate rescue of the patient
4. Ensuring your own personal safety and that of your partner

8. You arrive at a scene of a fall from ladder. Which of the following is important for patient care?

1. How tall the ladder is
2. What the patient was wearing at the time of the fall
3. If the patient lost consciousness
4. Was the patient distracted when he or she fell

9. You arrive at an MVA with 3 patients, all with visible minor injuries. Two patients do not want to be treated, while one is complaining of neck and back pain. What actions should you take?

1. Treat the one patient and ignore the other two. 
2. Treat all patients, as they are all injured.
3. Obtain refusals from the initial two, and then treat the third.
4. Treat the third patient, while your partner obtains refusal from patient one and two.

10. You encounter a patient who was found face down in a swimming pool after taking a dive into the shallow end and likely hitting his head.. On arrival, he is face up, being supported by another individual. He is breathing and has a pulse, but is unconscious. How should you proceed?

1. Jump into the water and start CPR immediately.
2. Remove the patient from the water and start CPR.
3. Remove from water and c-collar patient, then transport. 
4. Wait for a trained water rescue team before proceeding any further.

SCENARIOS 
Please answer these with detail around how an EMT should approach this scene. In character posting is not required. 

S1. You've been called to respond to a workplace incident. Your unit is the first to arrive, when you enter the office, you see a man on the floor, not moving. You call out and he doesn't answer. What steps would you take to assess the patient?

S2. You arrive at a call for a child with a bee allergy. They have been stung and no EpiPen has been administered, despite one being prescribed. What actions should an EMT take?

S3. Your unit is first to arrive at the scene of a witnessed cardiac arrest in a grocery store. A first aider has been continuing CPR for about 4 minutes. What should an EMT do next?