EMR – Operations — Quick Review

At the start of a shift, an EMR checks the automated external defibrillator. Which finding requires immediate action before the unit is placed back in service?

An EMR discovers that the suction unit produces weak suction during the morning equipment check. What is the most appropriate first action?

During a vehicle check, an EMR notices that the bag-valve-mask reservoir bag has a small tear along one seam. Which consequence is most directly associated with using this device in the field?

An EMR is checking the oxygen cylinder at the start of a shift and the pressure gauge reads 400 psi. The agency sets the safe minimum for going in service at 500 psi. Which action is most appropriate?

An EMR performs a weekly check of the cervical collars stored on the unit. One rigid collar is cracked along the chin support, and there is no replacement collar in that size. What is the correct course of action?

After treating a patient who required multiple pairs of gloves and several gauze pads, what is the EMR’s responsibility regarding supplies before the next call?

When checking medication inventory at the start of a shift, an EMR finds a unit-dose oral glucose preparation with an expiration date of last month. What should the EMR do?

An agency uses a sealed tamper-evident bag system for controlled medications. At the start of a shift, an EMR notices the seal on a bag is broken even though the count sheet shows the full quantity. Which action is most appropriate?

During restocking after a call, an EMR realizes the agency’s replacement stock of an emergency injectable medication has been stored at a temperature above its labeled storage range. Which action is most appropriate?

An EMR crew responds to a mutual aid event and uses supplies drawn from a neighboring agency’s unit. On returning to their home station, they find their own unit’s inventory is now below minimum levels. Who bears primary responsibility for restocking the home unit?

Which component is essential to include in every patient care report completed by an EMR?

An EMR makes an error while writing a paper patient care report. What is the correct way to correct the mistake?

An EMR cares for a patient who refuses to provide a name or date of birth. How should the EMR handle the documentation requirement?

A patient care report is a legal document. Which practice best protects the EMR if the report is later reviewed in a legal proceeding?

An EMR responds to a scene where an alert, oriented adult patient is assessed, has no apparent illness or injury, and refuses further evaluation. Which documentation practice best protects the EMR and the agency?

An EMR arrives on scene and finds an unconscious adult patient with no family present, who cannot consent to care. Under which legal principle may the EMR proceed with treatment?

A competent adult patient tells an EMR that they do not want treatment and asks the crew to leave. What must the EMR do before honoring this refusal?

An EMR begins treating a patient at the scene of a collision and then leaves to assist another patient without ensuring that equally or more qualified personnel have assumed responsibility for the first patient. This action most accurately describes which legal concept?

For a plaintiff to establish negligence against an EMR in a civil case, which four elements must all be proven?

A 14-year-old is found alone, with no parent present, experiencing a severe allergic reaction with signs of anaphylaxis. The teen states they do not want treatment. Which legal principle allows the EMR to proceed with care despite the objection?

An off-duty EMR witnesses a sudden cardiac arrest in a restaurant and is in a state with a Good Samaritan law. Which statement most accurately describes the EMR’s legal position?

After a call, an EMR’s friend who is a nurse at the receiving hospital asks about the patient who was just brought in. The patient is not the nurse’s assigned patient. How should the EMR respond?

An EMR is involved in a call that draws significant media attention, and a reporter contacts the agency asking for details about the patient’s condition. Which response is most appropriate?

An EMR responds to a call involving a 7-year-old child with multiple bruises in various stages of healing and a caregiver who gives inconsistent explanations. What is the EMR’s legal obligation?

An EMR transports an elderly patient who has multiple pressure ulcers, appears severely malnourished, and lives with an adult child who is the sole caregiver. Which type of mandatory report is most appropriate?

A competent adult patient tells an EMR that she was sexually assaulted by an acquaintance earlier that evening. She is alert and oriented and refuses transport. Which action best respects both her autonomy and the EMR’s legal duties?

An EMR assists a patient who sustained a gunshot wound to the thigh. The patient is alert, refuses to identify who shot him, and refuses transport. After providing care and documenting refusal, the EMR’s next mandatory action is to:

Which personal habit most directly supports long-term physical resilience for an EMR who works rotating shifts?

An EMR notices a coworker who has become increasingly withdrawn, calls in sick frequently, and jokes about not caring about the job anymore. These signs most likely indicate:

Which of the following best describes a proactive approach to managing cumulative occupational stress for an EMR?

An EMR has responded to several pediatric cardiac arrest calls over the past month. She reports disturbed sleep, difficulty concentrating at work, and intrusive mental images of the scenes. The most appropriate next step is to:

A formal group debriefing session after a critical incident is best conducted by:

Which of the following events would most likely meet the threshold for activation of a critical incident stress management response for an EMS crew?

During a brief peer support session held shortly after a mass-casualty incident, a provider becomes tearful and states he is fine and does not need to talk. The peer support specialist’s best response is to:

Which physical symptom is commonly associated with an acute stress reaction in emergency responders immediately following a critical incident?

A provider who responded to a building collapse mass-casualty event reports that for the past four weeks she has avoided driving past the site, has nightmares about the event, and feels emotionally numb around family. These symptoms best correspond to:

An EMR is preparing to assist with wound care on a patient with active bleeding. Which personal protective equipment is minimally required for this task?

After removing gloves following patient care, an EMR’s correct next step to minimize pathogen transmission is to:

An EMR sustains a needlestick injury while caring for a patient whose HIV status is unknown. After washing the wound, the EMR’s immediate next step is to:

An EMR cares for a patient who is later confirmed to have active pulmonary tuberculosis. The EMR wore gloves and a surgical mask but not a fitted N95 respirator. Which follow-up action is most important?

Following a call involving a patient with suspected meningococcal meningitis, which providers are most likely to require post-exposure prophylaxis?

When providing a radio report to the receiving hospital, the EMR should transmit patient information in which order?

The primary purpose of using plain language instead of agency-specific radio codes in EMS communications is to:

An EMR attempts to contact medical direction by radio but receives no response. Which is the most appropriate next step?

An EMR is operating at a multi-agency mass-casualty incident. She is assigned to a treatment sector and needs to request additional resources. To maintain clear communication under the incident command structure, she should transmit her request to:

At a multi-vehicle crash scene with five patients, command is established. Which ICS position is responsible for tracking the status of all personnel and equipment assigned to the incident?

An EMR arrives on scene and is told to report to the medical group supervisor. Within the ICS structure, what does this indicate about the incident?

An EMR is assigned to a mass casualty incident and given a specific geographic area to work. What ICS organizational element describes this type of assignment?

During a large-scale emergency, the Incident Commander asks the EMR to relay all patient status updates through a single supervisor rather than reporting directly to command. This practice reflects which ICS principle?

At a structural collapse with multiple agencies responding, the fire chief and EMS supervisor share decision-making authority without a single Incident Commander. Which command structure is being used?

An EMR self-dispatches to a large wildfire evacuation without being requested by the Incident Commander. Which ICS principle does this action most directly violate?

When preparing to lift a patient on a stretcher, which body position best protects the EMR from back injury?

An EMR and partner carry a patient down a staircase in a stair chair. Which way should the EMR positioned at the lower end of the stairs face?

A patient weighing approximately 280 pounds needs to be moved from the floor to a stretcher. The EMR has one partner available. What is the most appropriate initial action?

During a move, one EMR calls out commands to coordinate lifting with a partner. Which term best describes this role, and why does it matter?

An EMR must move an unresponsive patient from a bathtub to the floor. The tub is narrow, and the EMR cannot get into a proper lifting stance. Which technique is most appropriate given the constraints?

When operating on foot at a roadway scene with a fuel leak, how should an EMR position themselves relative to the hazard and traffic?

After securing a patient in the patient compartment of an ambulance, what should the EMR do before the ambulance moves?

An EMR is acting as a spotter to guide an ambulance backing into a tight space. Which technique is correct?

While responding with lights and siren, the EMR riding as a passenger sees the ambulance approaching a red light without slowing. What is the safest action?

An EMR is working at a highway incident when a second collision occurs nearby. Place these actions in the correct order of priority: (1) move patients to a safer location, (2) alert the team to move away from the roadway, (3) reassess scene safety, (4) resume patient care.

A bystander asks an EMR to give a patient a prescription pain medication from the patient’s own bottle to relieve severe pain. The EMR’s protocols do not authorize this. What should the EMR do?

An alert adult patient refuses transport by the arriving ambulance crew. What is the EMR’s primary obligation in this situation?

An EMR is first on scene at a cardiac arrest. A valid Do Not Resuscitate (DNR) order recognized in that jurisdiction is present. What is the correct action?

Local protocols require an EMR to obtain online medical direction before assisting a patient with a prescribed metered-dose inhaler. The EMR cannot reach medical control due to poor radio coverage. What is the most appropriate action?

An EMR responding to a pediatric drowning finds a 7-year-old pulseless and apneic. A parent presents a notarized DNR signed by only one parent. State law in this jurisdiction requires both custodial parents to sign for a minor’s DNR to be valid. What should the EMR do?

During a daily equipment check, an EMR finds that the portable suction unit cannot generate adequate vacuum pressure. What is the correct next step?

An EMR checks a bag-valve-mask device before a shift and finds a tear in the mask cushion that prevents a complete seal during testing. What action is required?

An AED was used to deliver a shock earlier in the shift and afterward passed its self-test indicator. What is the most thorough post-use action?

An EMR completes a call and returns to quarters. Which action should be taken first regarding the equipment used during the call?

During a daily equipment check, an EMR finds that the automated external defibrillator displays a service or maintenance indicator. What is the correct response?

An EMR notices that several pairs of nitrile gloves from the supply bag have passed their printed expiration date. Which action is most appropriate?

While restocking after a call, an EMR discovers that the unit’s oral glucose has been used and there is no replacement available in the station supply room. What is the best next step?

An EMR is conducting a shift inventory check and finds that the oxygen cylinder reads 200 psi. The agency’s policy states the minimum acceptable pressure before cylinder replacement is 500 psi. Which statement best explains why this policy exists?

Which of the following best describes the primary purpose of a patient care report completed by an EMR?

An EMR makes an error while completing a handwritten patient care report. What is the correct way to handle the mistake?

A patient refuses to give their name at the scene. How should the EMR document this on the patient care report?

After transferring patient care to arriving EMS personnel, an EMR completes the patient care report. Which finding should be recorded even if it seems minor or unrelated to the chief complaint?

An EMR provides care that is later questioned, and the patient care report from that call is subpoenaed. Which statement about the report is accurate from a legal standpoint?

An EMR arrives on scene and asks a conscious, alert adult patient for permission to provide care, and the patient says yes. This represents which type of consent?

An EMR arrives to find an unconscious adult with no family present and begins assessment and care. Which legal concept allows the EMR to treat this patient?

A competent adult patient tells the EMR they do not want to be treated and do not want to go to the hospital. What must the EMR do to legally honor this refusal?

An EMR begins care on a patient and then stops providing care before transferring responsibility to another equally or more qualified provider. This situation most closely describes which concept?

To establish negligence against an EMR in a civil case, which four elements must generally be proven?

An off-duty EMR witnesses a sudden cardiac arrest in a shopping mall. Which factor is most likely to determine whether the EMR has a legal duty to act?

An EMR is treating a 15-year-old who is alone and has a minor laceration. The patient asks the EMR not to call their parents and consents to wound care. Which statement best applies to this situation?

After a call, a neighbor of the patient asks the EMR what was wrong with the patient. What is the appropriate response?

An EMR responds to a call involving a public figure. A reporter arrives on scene and asks for details about the patient’s condition. The most appropriate response is to:

Which of the following represents an appropriate disclosure of patient information without the patient’s written authorization?

An EMR posts a story on social media about an unusual call, changing the patient’s name but including the specific neighborhood, date, injury type, and other identifying details. Which statement best describes this action?

An EMR responds to a call involving a child with multiple bruises in various stages of healing and a caregiver who gives an inconsistent explanation. Which action is most appropriate?

An EMR treats a patient with a gunshot wound who declines transport and signs a refusal. What is the EMR’s obligation regarding the gunshot wound itself?

Which action best protects an EMR from injury when lifting a patient who is too heavy to lift alone?

An EMR who routinely works overnight shifts begins experiencing difficulty sleeping during the day, irritability, and difficulty concentrating. These findings are most consistent with:

When approaching a scene where a patient is reported to be violent, which is the MOST appropriate initial action for the EMR?

Which of the following is the BEST long-term strategy for an EMR to maintain psychological wellness over a career in emergency services?

An EMR is dispatched to a suspected clandestine drug manufacturing site. On arrival, the air has a strong chemical odor and there are visible chemical precursor containers outside the structure. The EMR should:

Which of the following events would MOST likely qualify as a critical incident for emergency responders?

A defusing session following a critical incident is BEST described as:

Two weeks after working a mass casualty incident, an EMR reports recurring nightmares about the event, avoiding driving past the scene, and feeling emotionally numb around family. The EMR’s partner should:

Which statement BEST describes the purpose of a Critical Incident Stress Management (CISM) program?

An EMR who responded to a fatal pediatric drowning begins experiencing physical symptoms including headache, nausea, and trembling immediately after the call ends. These signs are MOST consistent with:

When should an EMR don gloves during patient care?

An EMR is exposed to a patient’s blood when it splashes into their eyes during a procedure. The FIRST action should be:

An EMR is stuck by a needle used to inject a patient whose HIV and hepatitis status are unknown. After immediate wound care, the NEXT most important step is:

Which personal protective equipment combination is appropriate when caring for a patient with suspected active pulmonary tuberculosis?

An EMR provides mouth-to-mask ventilation to a patient later confirmed to have meningococcal meningitis, and no barrier device was available at the time. The exposure pathway of GREATEST concern is:

When transmitting a radio report to the receiving hospital, which element should the EMR include FIRST?

The term ‘relay’ in radio communications refers to:

An EMR is giving a radio report on a 58-year-old male with chest pain. Which statement represents proper radio technique?

During a mass casualty incident, communications become chaotic because multiple units are transmitting simultaneously. The BEST way to address this is:

An EMR arrives at a scene where the patient has no pulse. After beginning CPR, the EMR radios dispatch. Which radio report component is MOST time-sensitive and should be communicated first after unit identification?

In the Incident Command System, who has overall authority and responsibility for managing an incident?

An EMR arrives first at a multi-vehicle crash involving 15 patients. No ICS structure has been established yet. The EMR’s FIRST action should be:

At a large structure fire with multiple casualties, an EMR is assigned to the treatment area. A bystander who has been helping carry patients asks the EMR directly where to take the next patient. Following ICS principles, the EMR should:

When preparing to lift a patient on a stretcher, which foot position best protects the EMR’s lower back?

Which action is most important for preventing lower back injury when lifting a heavy patient from the floor?

Two EMRs must move an unresponsive patient from a narrow hallway to the living room before the ambulance crew arrives. The patient is on the floor and there is no room to place a stretcher. Which technique is most appropriate?

An EMR is preparing to move a conscious, cooperative patient from the floor to a chair using a squat lift. At which point in the lift should the EMR exhale?

During an emergency move of a patient suspected of having a spinal injury, the EMR does not have a cervical collar or immobilization device available. Which manual technique best limits cervical movement during the drag?

A patient who weighs about 300 pounds must be moved from a second-floor bedroom down a narrow staircase. Which step should the EMR take FIRST before beginning the move?

When riding as a passenger in the patient compartment of an ambulance, what must an EMR do to reduce the risk of injury during a sudden stop?

Which action should an EMR take when approaching an emergency scene where law enforcement has not yet secured the area and a bystander reports an active threat?

An EMR is on scene assisting with patient care when a second ambulance arrives and parks with its engine running near the entrance of an attached garage. Which hazard does this situation create that the EMR must recognize?

At a motor vehicle collision scene, the EMR is directing traffic about 50 feet from the crash while awaiting the ambulance. Oncoming traffic is approaching at highway speed. What is the safest positioning for the EMR?

Upon arriving at a residential structure fire to assist with bystander triage, the EMR notices that the wind has shifted and smoke is now blowing toward the staging area. What is the MOST appropriate immediate action?

An EMR arrives on scene before the transporting ambulance and finds a responsive adult patient in respiratory distress. Which intervention is clearly within the EMR’s scope of practice?

An EMR is caring for a patient at a sporting event when a physician bystander approaches and begins directing the EMR to perform interventions outside the EMR’s scope of practice. What should the EMR do?

An EMR is the first responder to a cardiac arrest. The patient’s family states that a valid Do Not Resuscitate (DNR) order exists but cannot locate the paperwork. What should the EMR do?

After completing care and transferring a patient to the transporting crew, the EMR should document which minimum set of information on the patient care report?

An EMR is providing care at a mass gathering event under a medical director’s standing orders. A patient presents with signs of anaphylaxis and the EMR’s kit contains an epinephrine auto-injector. The event’s protocol authorizes epinephrine administration for confirmed anaphylaxis. Which criterion must be met before the EMR administers the epinephrine?

An EMR picks up an AED at the start of a shift and finds that the status indicator shows a fault or failure signal rather than a ready signal. What should the EMR do?

While inspecting a bag-valve-mask (BVM) device before a shift, the EMR finds that the pop-off valve vents at very low pressure during a test squeeze and cannot be closed or overridden. What is the most appropriate action?

An EMR checks a portable oxygen cylinder at the start of a shift and finds it reads 200 psi. Agency policy sets a minimum service pressure of 200 psi before a cylinder must be exchanged. What should the EMR do?

After assisting with an anaphylaxis call, the EMR used one of the two epinephrine auto-injectors the first-responder kit is required to carry. When restocking, the EMR finds that only one replacement auto-injector is available, and it is not expired. What is the MOST appropriate action?