Medical Scenarios

Explore medical scenarios, BLS care, and interactive quizzes to enhance your training!

Indications:

  • Injuries suggestive of intentional harm (e.g., burns in patterns, various stages of healing).
  • Malnutrition or extreme lack of cleanliness.
  • Bulging fontanels or altered mental status in infants.

BLS Care:

  • Stabilize and treat injuries.
  • Discourage patient from washing if sexual abuse is suspected.
  • Document:
    • Statements made by patient/caregiver.
    • Abnormal behavior from patient/caregiver.
    • Environmental conditions.
    • Time law enforcement or social services were notified.
  • Report suspected abuse to appropriate authorities (law enforcement or social services).

Quiz:

Which of the following is a key indication of abuse or neglect?

What should you do if sexual abuse is suspected?

What must be documented in suspected abuse cases?

Who should you notify in suspected abuse cases?

Indications:

  • Mild Agitation: Agitated but cooperative.
  • Moderate Agitation: Irrational behavior that poses risk to self or others.
  • Severe Agitation: Physically violent.

BLS Care:

  • Maintain scene safety and call law enforcement if necessary.
  • Use verbal de-escalation and emotional support (e.g., SAFER Model):
    • Stabilize the situation.
    • Assess the crisis.
    • Facilitate resources (e.g., family, police).
    • Encourage action for their best interest.
    • Recovery/referral to professional care.

Quiz:

Which symptom characterizes severe agitation?

What is the first priority in cases of agitation?

The SAFER Model includes:

What should you do if verbal de-escalation is unsuccessful?

Indications:

  • Mild Symptoms: Localized swelling and itching.
  • Moderate Symptoms: Hives or mild wheezing.
  • Severe Symptoms: Acute swelling of mucosa, respiratory compromise, hypotension.

BLS Care:

  • For mild or moderate symptoms:
    • Administer epinephrine auto-injector (0.3 mg IM) in the lateral thigh.
    • If wheezing/bronchospasm: Use albuterol inhaler (2 puffs) or nebulized albuterol. Repeat once within 30 minutes if needed.
  • For mild symptoms with known life-threatening history:
    • Epinephrine auto-injector (0.3 mg IM) in lateral thigh.

Quiz:

What is the appropriate dose of an epinephrine auto-injector for adults?

What should be administered for wheezing during an allergic reaction?

What is the first step for a mild allergic reaction?

When should you repeat an albuterol treatment?

Indications:

  • Mild Symptoms: Localized swelling and itching.
  • Moderate Symptoms: Hives or mild wheezing.
  • Severe Symptoms: Acute swelling of mucosa, respiratory compromise, hypotension.

BLS Care:

  • For mild or moderate symptoms:
    • Epinephrine (BLS) IM injection:
      • <5 years old: 0.15 mg.
      • ≥5 years old: 0.3 mg.
    • Albuterol:
      • <2 years old: 1.25 mg nebulized.
      • ≥2 years old: 2.5 mg nebulized.

Quiz:

What is the epinephrine dose for a child under 5 years old?

What is the correct nebulized albuterol dose for children under 2 years old?

What symptoms indicate a moderate allergic reaction in children?

What should you do if a child develops wheezing after allergen exposure?

Indications:

  • Acute severe illness after allergen exposure with:
    • Urticaria (hives) or mucosal swelling.
    • Respiratory compromise or hypotension.
    • GI symptoms (e.g., abdominal pain, diarrhea).

BLS Care:

  • Administer epinephrine auto-injector:
    • Adult: 0.3 mg IM lateral thigh.
    • Pediatric: 0.15 mg IM (<5 years); 0.3 mg IM (≥5 years).
  • Repeat every 5 minutes (up to 3 doses) for persistent symptoms.
  • Use albuterol (BLS) nebulized for bronchospasm.

Quiz:

How many doses of epinephrine can be administered in severe anaphylaxis?

What is a hallmark symptom of anaphylaxis?

What is the pediatric epinephrine dose for children 5 years or older?

What is the preferred site for epinephrine administration?

Indications:

  • Blood glucose less than 70 mg/dL or greater than 300 mg/dL.
  • Altered mental status, suspected diabetes, or unresponsiveness.

BLS Care:

  • Check blood glucose.
  • If blood glucose < 70 mg/dL:
    • Administer oral glucose (10-15 grams) between gum and cheek.
    • Repeat dose if no improvement after 10 minutes.
  • If blood glucose > 300 mg/dL:
    • Provide supportive care and transport.

Quiz:

What is the recommended treatment for blood glucose <70 mg/dL?

What is the appropriate response if hyperglycemia (>300 mg/dL) is detected?

How soon should oral glucose be repeated if the patient shows no improvement?

What blood glucose level is considered hypoglycemia?

Indications:

  • Blood glucose less than 70 mg/dL or greater than 300 mg/dL.
  • Altered mental status, suspected diabetes, or unresponsiveness.

BLS Care:

  • Check blood glucose.
  • If blood glucose < 70 mg/dL:
    • Administer oral glucose (10-15 grams) between gum and cheek.
    • Repeat dose if no improvement after 10 minutes.
  • For neonates (<28 days): blood glucose < 40 mg/dL requires immediate transport after care.

Quiz:

What blood glucose level is considered critical for neonates (<28 days)?

What is the initial treatment for a pediatric patient with blood glucose <70 mg/dL?

If a pediatric patient does not respond to initial oral glucose, what is the next step?

What is the priority for neonates with blood glucose <40 mg/dL?

Indications:

  • Active seizure or postictal state.
  • Altered mental status or history of epilepsy.

BLS Care:

  • Protect the patient from injury.
  • Do not restrain the patient or insert anything into the mouth.
  • After the seizure stops:
    • Check blood glucose. If <70 mg/dL, treat per hypoglycemia protocol.
    • Monitor airway and breathing.

Quiz:

What is the first action to take during an active seizure?

What should you do after the seizure stops?

What protocol should be followed if blood glucose is <70 mg/dL after a seizure?

Should anything be inserted into the patient’s mouth during a seizure?

Indications:

  • Suspected infection with at least two of the following:
    • Temperature >100.4°F or <95.9°F.
    • Heart rate >100 bpm.
    • Respiratory rate >25.
    • Hypotension (SBP <90 mmHg).

BLS Care:

  • Place the patient in a position of comfort or supine if hypotensive.
  • Check blood glucose and treat hypoglycemia if needed.
  • Provide oxygen as needed.
  • Transport and notify the receiving facility of a "Sepsis Alert".

Quiz:

Which of the following is a sign of sepsis?

What position should a hypotensive patient with suspected sepsis be placed in?

What is an important action during transport of a sepsis patient?

What vital sign abnormality should prompt a suspicion of sepsis?

Indications:

  • Sudden onset of:
    • Blurred vision, slurred speech, or facial droop.
    • Arm weakness or dizziness.
    • Severe unexplained headache.

BLS Care:

  • Perform Cincinnati Prehospital Stroke Scale:
    • Facial droop: Ask the patient to smile.
    • Arm drift: Have the patient hold both arms out.
    • Speech: Assess for slurred or incorrect words.
  • Position the patient with head elevated at 30 degrees.
  • Check blood glucose. If <70 mg/dL, treat per hypoglycemia protocol.
  • Transport to the appropriate stroke center and notify as “Stroke Alert.”

Quiz:

What is a common sign of a stroke?

What tool is used to assess for stroke in the field?

What position should a stroke patient be placed in during transport?

What is the priority notification for a stroke patient during transport?

Indications:

  • Transient loss of consciousness (fainting).

BLS Care:

  • Place the patient in a supine position with feet elevated.
  • Monitor airway, breathing, and circulation.
  • Assess for underlying causes (e.g., hypoglycemia, stroke).
  • Transport if abnormal findings are present.

Quiz:

What is syncope?

What position should a patient be placed in if they faint?

Which protocol should be used if a syncope patient has abnormal findings on the Cincinnati Stroke Scale?

What is the next step if a syncope patient does not regain consciousness promptly?

Indications:

  • Signs of inadequate blood flow, such as:
    • Cool, clammy skin or delayed capillary refill (>2 seconds).
    • Altered mental status or hypotension (based on age-related vital signs).

BLS Care:

  • Place the patient supine with legs elevated.
  • Monitor airway and vital signs.
  • Transport to the closest appropriate facility.

Quiz:

What is a sign of hypoperfusion in a pediatric patient?

What is the recommended BLS action for pediatric shock?

What is the appropriate frequency for monitoring vital signs in pediatric shock?

Which vital sign is most critical to assess in pediatric shock?