# EMT-P CBT question feedback



## ExpatMedic0 (Jul 31, 2008)

I am still waiting for my results, Ill post them up on that other thread when I get them but man I had some crazy questions. I know its against NREMT policy to discuss the test questions directly, so I wont do that but here is a vague overview of what through me off.

I had all these trauma questions involving airway and breathing, most of them would have needed some sort of intubation, chest decompression, cric, ect... but Oxygen or cspine always seemed to be in the choices along with the most invasive als answers.... it really threw me for a loop. I wasn't sure if they wanted me to identify the problem they where describing and the ultimate ALS intervention for it... or if I was suppose to just say o2 every time?

for example say the guy has JVD absent lung sounds on the left side and .... maybe hes got a sucking chest wound also. I can see they are painting me the picture of a tension p. But then it might say what will you do for this guy, a. oxygen, b. rapid transport c. needle the chest d. occlusive dressing.

what the hell, I would all of it... so then I start thinking well whats going to kill him first maybe I should needle the chest... but then again oxygen first bls before als? It dosent say needle the chest "immediately"

on another one some guy has cardiac tamponade and it list pericardial synthesis as a treatment, even though I am pretty sure thats not in any paramedic's scope of practice.... am I suppose to select that treatment to show the question I have identified the issue and know the solution?

another example(not the exact question) would be a guy with a broken mandible non responsive but breathing and a bunch of facial trauma, but they dont state if he has a head injury, or if his oral and nasal airways or patent enough any type of intubation and it would give me some things to do like, nasal intubation, RSI, cric, and 02... I guess I would cric him if the facial trauma made any type of intubation unlikely, or nasal intubate if he didn't have a head injury or mid facial trauma, or skull fracture... but it doesn't say, and with the MOI it makes it unclear! of course he gets o2 but clearly he needs more so am I looking at these questions the wrong way?


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## mikeylikesit (Jul 31, 2008)

First one would be relieve the tension in the thoracic cavity. second question i would ask myself... If the patient is still breathing with a patent airway (if not stated it is assumed) then all i would give him is O2.


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## Ridryder911 (Aug 1, 2008)

You should had been taught that tension pnuemos are considered an airway obstruction ( remember we have an upper & lower airway). Just alike opening the airway, it does no good administering oxygen if one is not able to breathe.. 

Hence the correct answer is to immediately relieve the tension pnuemo... Treat the cause and then the effect... 

You can thank me.. I think I wrote that one..

R/r 911


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## Guardian (Aug 1, 2008)

Yea, and you learn that clever little phrases like "bls before als" is just a bunch of crap.  There is a right way to treat someone and and wrong way.  Sometimes you need ALS intervention first.


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## Jochempeiper (Aug 25, 2008)

From what I have heard, I don't like the way that the NREMT-P test works(from what I've heard). In Virginia we get our card, and training through the Virginia Office of EMS. So it is only good IN Virginia, and nowhere else, I would have to take the whole NREMT-B class and test out in order for me to use my EMT out of state


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