Primary Assessment of the Unresponsive Patient - NREMT EMT Level

1. What should you do if no foreign body is visible but airway obstruction is suspected in an unresponsive patient?

   Begin CPR; check mouth before ventilations. CPR generates pressure to potentially dislodge obstructions, with visual checks ensuring safe ventilation attempts.

2. Which device is typically preferred for ventilating an unresponsive patient in primary assessment?

   Bag-valve mask (BVM) with high-flow oxygen. BVM delivers controlled positive pressure ventilation with supplemental oxygen, optimizing oxygenation in apneic patients.

3. What is the primary assessment priority order for an unresponsive patient?

   Airway, breathing, circulation (ABCs). Focusing on ABCs systematically identifies and addresses life-threatening issues in sequence during initial patient evaluation.

4. Which position is commonly used to help protect the airway in an unresponsive, breathing patient without trauma?

   Recovery position (lateral recumbent). This position facilitates drainage of secretions and reduces aspiration risk while maintaining airway openness without spinal concerns.

5. Which airway-opening maneuver is appropriate if no trauma is suspected in an unresponsive patient?

   Head-tilt, chin-lift. This method safely opens the airway by lifting the mandible forward, suitable when cervical spine injury is not suspected.

6. What is the target oxygen delivery device for an unresponsive patient who is breathing adequately?

   Nonrebreather mask at high flow. This device provides high-concentration oxygen to support adequate spontaneous breathing in critically ill unresponsive patients.

7. Which intervention is first-line for life-threatening external extremity bleeding in primary assessment?

   Apply a tourniquet. Tourniquets rapidly control severe bleeding by occluding arterial flow, prioritizing hemorrhage control in life-threatening situations.

8. Which immediate question determines if you should activate ALS and request additional resources early?

   Is the patient responsive or unresponsive. Determining responsiveness early identifies critical patients requiring prompt advanced life support and resource allocation.

9. What is the first action in the primary assessment of an unresponsive patient after scene safety?

   Check responsiveness (tap and shout). This initial step assesses the patient's level of consciousness to guide subsequent actions in the primary survey.

10. Identify the correct airway maneuver: unresponsive patient with suspected head or neck trauma.

    Jaw-thrust maneuver. Jaw-thrust avoids cervical spine movement, preserving alignment in patients at risk for spinal injury during airway management.

11. What breathing pattern is treated as not breathing in an unresponsive patient during primary assessment?

    Agonal gasps. Agonal respirations indicate inadequate breathing, necessitating treatment as absent breathing to initiate resuscitation protocols promptly.

12. What is the correct next step after finding an adult patient unresponsive and not breathing normally?

    Activate EMS, get AED, and check pulse. Immediate activation of emergency response and preparation for defibrillation are essential while confirming absence of pulse in potential cardiac arrest.

13. Identify the correct immediate action: unresponsive adult, not breathing normally, no pulse detected.

    Start CPR and use an AED as soon as available. Cardiac arrest protocol demands immediate compressions and defibrillation to restore effective heartbeat and circulation.

14. What mental status scale term applies to a patient who does not respond to verbal or painful stimuli?

    Unresponsive (AVPU: U). AVPU scale classifies lack of response to stimuli as unresponsive, indicating severe alteration in mental status requiring urgent intervention.

15. What is the immediate intervention if an unresponsive adult has no pulse?

    Start CPR and apply an AED as soon as possible. Absence of pulse indicates cardiac arrest, requiring immediate chest compressions and defibrillation to restore circulation.

16. What is the maximum time you should take to check an adult pulse during primary assessment?

    No more than $10$ seconds. Limiting the check to this duration prevents delays in starting CPR if no pulse is detected in a potentially arrest situation.

17. What is the correct action if you see a visible foreign body in the airway of an unresponsive patient?

    Remove it with a finger sweep. Manual removal of visible obstructions clears the airway immediately, preventing further compromise in unresponsive patients.

18. Which pulse site is preferred for an unresponsive infant during primary assessment?

    Brachial pulse. The brachial artery is the standard site for infants, as it is accessible and avoids potential neck manipulation in small patients.

19. Which pulse site should you check first in an unresponsive adult during primary assessment?

    Carotid pulse. The carotid artery provides a central pulse assessment, reliable for detecting circulation in unresponsive adults during rapid evaluation.

20. What is the correct action if an unresponsive patient is breathing and has a pulse but is vomiting?

    Suction the airway and position to protect the airway. Suctioning removes secretions, and proper positioning prevents aspiration, maintaining airway patency in vulnerable patients.

21. Identify the correct immediate action: unresponsive adult, not breathing normally, pulse present.

    Start rescue breathing and apply oxygen; recheck pulse. Rescue breaths support oxygenation in respiratory arrest, with oxygen supplementation and pulse monitoring to detect changes.

22. What is the immediate intervention if an unresponsive adult has a pulse but is not breathing normally?

    Provide rescue breathing and reassess pulse regularly. Presence of pulse with absent breathing requires ventilatory support to maintain oxygenation while monitoring for deterioration.

23. Which airway-opening maneuver should you use if trauma is suspected in an unresponsive patient?

    Jaw-thrust maneuver. This technique opens the airway without hyperextending the neck, minimizing risk of exacerbating spinal injuries in trauma cases.

24. What is the immediate circulation threat you must identify and control during primary assessment?

    Severe external bleeding. Controlling massive hemorrhage is critical to prevent hypovolemic shock and maintain circulation in the primary survey.

25. Identify the correct intervention: unresponsive patient with massive external bleeding from an arm.

    Apply a tourniquet proximal to the bleeding site. Proximal tourniquet placement effectively stems arterial bleeding, allowing rapid control in hemorrhagic emergencies.

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