An AEMT is managing a 64-year-old male in cardiac arrest. Bag-valve-mask ventilations produce minimal chest rise due to severe facial trauma and a thick beard preventing an effective mask seal. Which advanced airway intervention is within the national scope of practice for an AEMT to secure the airway?
Answer and explanation
Correct answer: D
Supraglottic airway insertion is within the national AEMT scope of practice to establish an advanced airway; endotracheal intubation and surgical or needle cricothyrotomies are Paramedic-level procedures.
An AEMT is dispatched to a residential home for a 58-year-old female with a long-term tracheostomy who is experiencing severe respiratory distress caused by thick, inspissated mucous secretions. Which suctioning intervention is authorized within the AEMT scope of practice?
Answer and explanation
Correct answer: C
AEMTs are educated and authorized to perform tracheobronchial suctioning of an already intubated or tracheostomy-dependent patient using sterile technique; replacing an outer cannula or jet ventilation is outside scope.
According to national EMS clinical guidelines, for an adult medical patient presenting with mild-to-moderate respiratory distress without signs of shock, carbon monoxide toxicity, or chronic hypercapnia, supplemental oxygen should be titrated to achieve a target pulse oximetry saturation of _____
Answer and explanation
Correct answer: C
Standard prehospital clinical guidelines specify titrating supplemental oxygen to an SpO2 of 94% to 98% for patients in respiratory distress to prevent both hypoxemia and the hyperoxic risks of excessive oxygenation.
A 62-year-old male reports retrosternal chest pressure radiating to his left shoulder that began 1 hour ago while gardening. Vital signs are blood pressure 138/84 mmHg, heart rate 76 beats/min, and respirations 16 breaths/min. During history gathering, the patient states he took tadalafil 36 hours ago for erectile dysfunction. Which pharmacological action must the AEMT take regarding nitroglycerin administration?
Answer and explanation
Correct answer: D
Nitroglycerin is strictly contraindicated within 48 hours of taking tadalafil (or 24 hours for sildenafil/vardenafil) due to the risk of life-threatening refractory hypotension from synergistic vasodilation.
An AEMT is managing an unresponsive 68-year-old female in pulseless electrical activity (PEA). High-quality CPR is ongoing and a supraglottic airway is in place. Two attempts at peripheral IV access have failed due to vein collapse. According to national standards, what is the most appropriate vascular access route to establish next, and which medication dose is indicated within the AEMT scope?
flowchart TD
A[Adult Cardiac Arrest: PEA] --> B[High-Quality CPR & Bag-Valve Ventilation]
B --> C{Peripheral IV Feasible?}
C -->|No: 2 Failed Attempts| D[Establish Intraosseous Access]
D --> E[Administer Epinephrine 1 mg 1:10,000 IV/IO]
C -->|Yes| E
Answer and explanation
Correct answer: D
Intraosseous access is within the AEMT scope when peripheral IV access is unsuccessful, and epinephrine 1 mg (1:10,000) IV/IO is indicated every 3-5 minutes for cardiac arrest; amiodarone and central lines are Paramedic-level.
True or False: Under the National EMS Scope of Practice Model, an AEMT is authorized to operate automated and semi-automated external defibrillators and apply mechanical CPR devices, but performing manual synchronized electrical cardioversion and transcutaneous cardiac pacing requires Paramedic-level licensure.
Answer and explanation
Correct answer: A
Automated/semi-automated defibrillation and mechanical CPR devices are within the AEMT scope; manual defibrillation, synchronized cardioversion, and transcutaneous pacing require Paramedic-level certification.
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