1. You arrive on scene with your partner Elija to a multiple vehicle accident where you are the 2nd ambulance to arrive. Scene size up indicates there are 7 patients in 3 cars all requiring extrication. In the first car is a 27 year old woman who is 32 weeks pregnant, conscious, and crying, a 12 year old girl who is screaming and complaining of back pain, and an 8 year old boy who has a facial laceration and open fracture of the tibia who is also conscious but breathing very shallow. In the second car is an 86 year old man who is slumped against the steering wheel with no pulse and has a piece of metal impaled through his head. In the third car are 3 teenagers 17 years of age. The two in the front seat are complaining of neck pain and appear to have an altered level of consciousness. Neither of them were wearing a seatbelt and both have contusions on their foreheads. In the back seat is the last occupant, a girl who said she was having a seizure and vomiting earlier so her friends were taking her to the hospital. She was wearing her seat belt and has no sign of injury. Who should be receiving treatment first?

2. The umbilical cord is wrapped tightly around the baby's neck and you have tried unsuccessfully to slip the cord over the head. What should your next course of action be?

3. The pediatric assessment triangle is composed of three elements:

4. You arrive on scene with your partner Emilio to find a woman who is having problems breathing. She is speaking in 1 or 2 word bursts and is on oxygen at 3 liters per minute. There is an ashtray next to her bed loaded with cigarette butts. She says her care taker called the ambulance and she does not want you there. She says she will allow you to take her vitals but then you have to leave. Her BP is 100/60 her pulse is 48 and her respirations are 18. She says she is 89 years old and has a pacemaker and is on high blood pressure medication. "I just want to be old, please leave", she says. What should you do?

5. You arrive on scene to find a man in his 20's lying in a pool of vomit. You can see that he is breathing at about 16 breaths per minute and the depth of respiration is adequate. He has a small laceration on his forehead. You try getting a response by calling "Hey man can you hear me?" but he does not answer. Your partner gives him a quick sternal rub and his eyes pop open along with a whimper under his breath and then they close again. You ask him to perform several motor functions but he does not comply. He does not answer any of your questions. This man has a GCS of what?

6. You have just arrived at the scene to find a 27-year-old female complaining of anxiety and breathing difficulties. Which of the following questions would be most appropriate to ask first?

7. According to the current AHA Guidelines how many milliliters of tidal volume should you deliver via BVM to an adult patient who is apneic?

8. Which of the following patients has adequate respirations?

9. What would be the correct sequence of treatment for a 76 year old female with a pulse of 142. The patient is also cyanotic around the lips and nail beds?

10. Your patient is an 18 month old boy who, as reported by his mother, is "acting strange". You arrive to find the child reclined in his mother's arms. "I don't know what's wrong with him," she says. "I came out of the bathroom and he started making odd sounds and had spit running out of his mouth." What is the first thing you should do?