Comprehensive and Detailed Explanation From Exact Extract:

Contraindications to CPAP(Continuous Positive Airway Pressure) include:

Hypotension: CPAP can reduce preload and worsen shock (BP < 90 systolic is a contraindication)

Respiratory rate too low: A rate of 10 is at the low threshold; CPAP requires spontaneous adequate effort

Active vomiting or nausea: CPAP increases aspiration risk

Crackles and hypoxia areindications, not contraindications, for CPAP. Pulse rate does not influence CPAP use directly.

Comprehensive and Detailed Explanation From Exact Extract:

Under HIPAA (Health Insurance Portability and Accountability Act), only designated personnel are authorized to handle inquiries regarding a patient’s Protected Health Information (PHI). The Privacy Officer is responsible for enforcing compliance with privacy regulations and addressing PHI access requests.

Shift supervisors or hospitals do not have the legal authority to release PHI unless specifically designated.

Comprehensive and Detailed Explanation From Exact Extract:

Compared to adults, pediatric patients have:

Aproportionately larger tongue, which increases the risk of airway obstruction

Alarger occiput, which causes natural neck flexion when lying supine, potentially occluding the airway

This anatomical difference is why EMS providers often use ashoulder rollinstead of a head tilt to maintain aneutral airwayin infants and toddlers.

Comprehensive and Detailed Explanation From Exact Extract:

Clavicle deformity suggests potential rib or thoracic trauma. Unequal chest rise may indicate a flail segment, pneumothorax, or hemothorax. Subcutaneous emphysema, the presence of air under the skin, is a classic finding in pneumothorax or tracheobronchial injury.

Occipital depression is not chest related; epigastric distension is a GI symptom; and jugular vein distention would suggest tension pneumothorax or cardiac tamponade, which are more advanced complications.

Comprehensive and Detailed Explanation From Exact Extract:

The patient’sexcessively high respiratory rate (RR 50),hypoxia (SpO₂ 89%), anddecreased mental status(drowsiness) indicaterespiratory failure, which is theinability to maintain oxygenation or ventilation.

Respiratory distress: Increased effort but adequate compensation

Respiratory arrest: Complete absence of breathing

Respiratory alkalosis: Possible early finding, but not a condition diagnosis

This patient is tiring and losing the ability to ventilate effectively — a hallmark of failure.

Comprehensive and Detailed Explanation From Exact Extract:

Altered mental status, combined withpale, cool, and clammy skin, is strongly suggestive ofhypoglycemia(low blood sugar). Hypoglycemia is especially dangerous in diabetics who take insulin or oral hypoglycemics. The body'sadrenergic responsecauses the "cool and clammy" presentation.

Hyperglycemia typically presents withwarm, dry skinand develops more slowly. EMTs shouldadminister oral glucoseif the patient can swallow.

Comprehensive and Detailed Explanation From Exact Extract:

The symptoms described areclassic for a stroke (CVA). Additional hallmark findings include:

Arm drift(motor weakness or hemiparesis)

Facial droop(Cranial nerve VII involvement)

Slurred speech(dysarthria or aphasia)

These form the basis of prehospital stroke assessment tools likeFAST:

Face drooping

Arm weakness

Speech difficulty

Time to call 911

Miosis (pupil constriction) and tremors are not associated with stroke in EMS context. Syncope is an isolated event and not a reliable CVA symptom.

Comprehensive and Detailed Explanation From Exact Extract:

In cases ofsexual assault, preservingevidence integrityis critical. Clothing or other forensic evidence must be placed inpaper bags. Plastic or non-breathable materials can trap moisture, promotingmold or degradation of evidencelike DNA or bodily fluids.

This approach follows chain-of-custody protocols used by law enforcement and medical facilities for handling forensic material.

Comprehensive and Detailed Explanation From Exact Extract:

In infants, improper insertion of an OPA (oropharyngeal airway) can stimulate the vagus nerve, leading to bradycardia or even complete airway obstruction. If cyanosis and bradycardia develop after OPA insertion, immediate removal and resumption of ventilations with a bag-valve mask is critical.

The OPA must be properly sized and inserted only in patients without a gag reflex. Ventilations alone often reverse vagally induced bradycardia.

Comprehensive and Detailed Explanation From Exact Extract:

Negligenceoccurs when an EMT:

Has aduty to act

Breaches that duty(e.g., by withholding basic care like warmth)

Causesharm or risk of harm

Establishescausation

The EMT’s failure to treat the patient with respect and dignity — even if the patient improved — still constitutesnegligence, especially if tied to a discriminatory or dismissive attitude.

Comprehensive and Detailed Explanation From Exact Extract:

Perfusionrefers to delivery of oxygen and nutrients to tissues. It depends on three essential components:

Patent airway: Ensures oxygen reaches lungs

Intact microcirculation: Capillary-level exchange must function

Sufficient blood volume: Maintains blood pressure and oxygen transport

Hypoxic drive relates toCOPD physiology, not perfusion.High alveolar pressure(like from CPAP) mayimpede venous return, and alow ventilation-perfusion ratiomeans poor oxygenation efficiency, which negatively affects perfusion.

Comprehensive and Detailed Explanation From Exact Extract:

Forpediatric BLS with two rescuers, currentAHA Guidelines (2020)recommend:

Two-thumb encircling hands technique: Most effective for infants; provides consistent depth and control.

Compression ratio of 15:2: Enhances ventilation without compromising perfusion.

Compression depth: 1/3 of chest or approximatelyone-half the chest's depth.

CPR begins ifpulse <60 bpm with signs of poor perfusion, not at 72 bpm. Rate of180/minis excessive; ideal rate is100–120/min.

Comprehensive and Detailed Explanation From Exact Extract:

The legal concept oftort negligencein EMS requires the plaintiff to establish four elements:

Duty to act

Breach of that duty

Damages (harm caused)

Causation— a direct link between the EMT’s action/inaction and the harm caused

Causation(often termed “proximate cause”) is the essential element that connects the EMT’s breach to the patient's injury or outcome. Abandonment, assault, and false imprisonment are otherintentional torts, but not core elements of proving negligence.

Comprehensive and Detailed Explanation From Exact Extract:

Mechanism of Injury (MOI)assessment is a cornerstone of trauma care. It helps providers determine:

Extent of injury: High-speed collisions, falls from height, or penetrating trauma suggest internal injuries even if external signs are limited.

Need for additional resources: MOI may indicate the necessity ofALS backup,air transport, ortechnical rescue.

MOI cannot determine a patient’smedical historyor guarantee survival predictions. Thedestination facilitydepends on multiple factors including triage protocols, vital signs, and local trauma system regulations.

Comprehensive and Detailed Explanation From Exact Extract:

Albuterol, a commonbeta-2 adrenergic agonistused 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.