PHECC Emergency Medical Technician (EMT) Written Exam (Ireland)

What is the correct initial sequence for the primary survey when assessing an emergency patient according to the PHECC Clinical Practice Guidelines?

• ADanger, Response, Send for help, Airway, Breathing, Circulation
• BAirway, Breathing, Circulation, Disability, Exposure
• CResponse, Airway, Danger, Breathing, Circulation
• DDanger, Airway, Breathing, Response, Circulation

When assessing patient responsiveness using the AVPU scale, how is a patient classified who opens their eyes and localises a painful stimulus, but does not respond to verbal commands?

• AAlert
• BResponsive to Voice
• CResponsive to Pain
• DUnresponsive

Which of the following is the most clinically accurate method for assessing capillary refill time in an adult patient, and what is its normal limit?

• ACompress the nail bed of a finger for 5 seconds at heart level; normal is less than 2 sec…
• BCompress the forearm skin for 2 seconds above heart level; normal is less than 3 seconds
• CCompress the nail bed of a finger for 2 seconds at heart level; normal is less than 2 sec…
• DCompress the palm of the hand for 5 seconds below heart level; normal is less than 1 seco…

Under PHECC guidelines, which clinical presentation is a primary indication for an EMT to check a patient's blood glucose level?

• AAn acute onset of chest pain radiating to the left arm
• BAn altered level of consciousness or suspected stroke
• CIsolated musculoskeletal trauma to a lower extremity
• DA mild allergic reaction with localized urticaria

How should an EMT correct an error made while writing a paper Patient Care Report (PCR) in Ireland?

• AObscure the error completely using correction fluid or heavy scribbling
• BDraw a single line through the error, write the correction beside it, and initial it
• CDiscard the PCR and start a new one to ensure a clean record
• DErase the error thoroughly using a pencil eraser and write over it

A trauma patient opens their eyes only in response to a painful stimulus, utters incomprehensible sounds, and withdraws from pain. What is their Glasgow Coma Scale (GCS) score?

• A6
• B8
• C10
• D12

When examining a patient's pupils, what does the term 'consensual light reflex' refer to?

• ABoth pupils dilating when a light is shone into one eye
• BThe pupil constricting only when the patient looks at a close object
• CThe pupil of the opposite eye constricting when light is shone into the other eye
• DThe pupil of the illuminated eye constricting while the opposite pupil remains dilated

In Ireland, pre-hospital practitioners use the IMIST-AMBO format for clinical handovers. What does the 'M' stand for in this acronym?

• AMedications administered
• BMedical history of the patient
• CMechanism of injury or illness
• DMental state of the patient

Which of the following findings is indicative of orthostatic (postural) hypotension when reassessing a patient's vital signs from a supine to a standing position?

• AA systolic blood pressure drop of at least 10 mmHg and a heart rate increase of 10 bpm
• BA systolic blood pressure drop of at least 20 mmHg or a diastolic drop of at least 10 mmHg
• CA diastolic blood pressure increase of 20 mmHg with no change in heart rate
• DA heart rate drop of 20 bpm with a corresponding blood pressure increase

What is the primary difference in the focus of the secondary survey between a critical trauma patient and a stable medical patient?

• AA critical trauma patient receives a rapid head-to-toe examination, whereas a stable medi…
• BA critical trauma patient receives a focused exam, whereas a stable medical patient recei…
• CA secondary survey is only performed on trauma patients and is completely omitted for all…
• DA secondary survey is performed during transport for medical patients but must be complet…

What is the recommended oxygen flow rate and reservoir bag state when administering oxygen via a non-rebreather mask (NRB) to a hypoxic patient?

• A5-8 litres per minute (L/min) with the reservoir bag partially collapsed on exhalation
• B10-15 litres per minute (L/min) with the reservoir bag remaining at least two-thirds full…
• C1-4 litres per minute (L/min) with the reservoir bag completely flat during inhalation
• D6-10 litres per minute (L/min) with the reservoir bag inflating only when the patient cou…

When performing oropharyngeal suctioning on an adult patient, what is the maximum duration for a single suction attempt, and when should suction be applied?

• AApply suction only upon insertion of the catheter; maximum 5 seconds
• BApply suction continuously during both insertion and withdrawal; maximum 30 seconds
• CApply suction only upon withdrawal of the catheter; maximum 15 seconds
• DApply suction for 20 seconds before ventilating the patient for 5 seconds

Which of the following describes the correct method to measure an oropharyngeal airway (OPA) prior to insertion in an adult patient?

• AFrom the tip of the nose to the tragus of the ear
• BFrom the center of the patient's incisors to the angle of the jaw
• CFrom the corner of the patient's mouth to the earlobe
• DFrom the tip of the chin to the thyroid cartilage

Which of the following clinical findings is an absolute contraindication to the insertion of a nasopharyngeal airway (NPA) by an EMT?

• AAn active gag reflex in a semi-conscious patient
• BSuspected basilar skull fracture or severe mid-face trauma
• CA history of mild epistaxis (nosebleeds)
• DUnresponsiveness due to an opioid overdose

Under PHECC CPGs, which size of the i-gel supraglottic airway is indicated for an adult patient weighing between 50 kg and 90 kg?

• ASize 3 (Yellow)
• BSize 4 (Green)
• CSize 5 (Orange)
• DSize 2.5 (Grey)

When assessing the placement of an i-gel supraglottic airway in a cardiac arrest patient, which monitoring method is the gold standard to confirm ventilation?

• AChecking for condensation in the tube of the i-gel
• BAuscultating equal breath sounds bilaterally over both lungs
• CWaveform capnography showing a persistent carbon dioxide trace
• DObserving visible bilateral chest rise with each ventilation

What is the correct dose and route of nebulised Salbutamol for an adult patient experiencing a severe asthma attack under PHECC EMT CPGs?

• A2.5 mg administered via nebuliser
• B5 mg administered via nebuliser
• C0.5 mg administered via intramuscular injection
• D10 mg administered via nebuliser

A patient with a history of Chronic Obstructive Pulmonary Disease (COPD) is in moderate respiratory distress. What is the target oxygen saturation (SpO2) range for this patient?

• A94% - 98%
• B88% - 92%
• C90% - 95%
• D98% - 100%

During bag-valve-mask (BVM) ventilation of an unresponsive adult patient who is in respiratory arrest but has a pulse, at what rate should ventilations be delivered?

• A1 breath every 3 to 4 seconds (15-20 breaths per minute)
• B1 breath every 5 to 6 seconds (10-12 breaths per minute)
• C1 breath every 8 to 10 seconds (6-8 breaths per minute)
• D2 breaths every 15 seconds (8 breaths per minute)

Which of the following is a sign of inadequate ventilation when utilizing a bag-valve-mask (BVM) on an unresponsive patient?

• AA soft, compressible feel to the bag during compression
• BSymmetrical bilateral chest rise and fall during inhalation and exhalation
• CAn increasing heart rate that stabilizes within normal limits
• DAbsence of breath sounds upon auscultation and flat capnography waveform

An adult asthma patient in severe respiratory distress suddenly stops breathing and becomes unresponsive. What is the EMT's immediate priority action?

• AAssemble a nebuliser with Salbutamol and attempt to hold it over the patient's mouth
• BPerform a head-tilt chin-lift maneuver, insert an OPA, and begin bag-valve-mask ventilati…
• CImmediately perform chest compressions at a rate of 100-120 per minute
• DApply pelvic and spinal immobilization in case the collapse caused trauma

What is the primary clinical advantage of using a pocket mask with an oxygen inlet for patient ventilation compared to mouth-to-mouth ventilation?

• AIt delivers a lower volume of air, which prevents gastric distension
• BIt delivers a higher oxygen concentration (up to 50%) when connected to an oxygen supply…
• CIt eliminates the need to perform a head-tilt chin-lift maneuver
• DIt allows the practitioner to stand further away from the patient's face

A conscious adult patient is choking on a piece of food. They can speak, cough weakly, and are making a high-pitched wheezing sound. How should the EMT manage this patient?

• APerform immediate abdominal thrusts (Heimlich maneuver)
• BEncourage the patient to continue coughing and monitor them closely
• CDeliver 5 back blows followed by 5 chest thrusts
• DAttempt to perform a blind finger sweep to remove the food

What is the correct sequence of physical maneuvers for a conscious infant with a severe foreign body airway obstruction (FBAO) under PHECC guidelines?

• A5 abdominal thrusts, followed by 5 back blows
• B5 back blows, followed by 5 chest thrusts
• CImmediate blind finger sweep, followed by BVM ventilations
• D5 chest thrusts, followed by 5 abdominal thrusts

Under what clinical condition should an EMT consider using humidified oxygen instead of standard dry oxygen therapy?

• ADuring short-duration transport of a patient with mild asthma
• BWhen administering high-flow oxygen for a patient in cardiac arrest
• CDuring long-term oxygen therapy (typically > 30 minutes) to prevent airway drying, or in…
• DFor any patient presenting with hyperventilation syndrome

What is the correct compression-to-ventilation ratio for adult CPR when performed by either one or two rescuers, before an advanced airway is placed?

• A15:2
• B30:2
• C30:1
• D15:1

When performing CPR on a child or infant with two rescuers present, what is the correct compression-to-ventilation ratio under PHECC guidelines?

• A30:2
• B15:2
• C15:1
• D5:1

What is the recommended depth and rate of chest compressions for an adult patient in cardiac arrest?

• AAt least 4 cm at a rate of 80-100 compressions per minute
• B5 cm to 6 cm at a rate of 100-120 compressions per minute
• CAt least 7 cm at a rate of 120-140 compressions per minute
• D3 cm to 4 cm at a rate of 100-120 compressions per minute

What safety precaution must the EMT take prior to delivering a shock with an Automated External Defibrillator (AED)?

• APerform ventilations while the shock is being delivered to support oxygenation
• BEnsure all persons are clear of the patient, and no one is touching the patient or bed
• CCover the patient's chest with a dry towel to prevent skin burns
• DHold the AED pads firmly against the patient's chest during the discharge

Under the PHECC EMT Clinical Practice Guidelines, what is the authorized dose, route, and administration method of Aspirin for a patient with suspected Acute Coronary Syndrome (ACS)?

• A75 mg orally, swallowed with a glass of water
• B300 mg chewed, to be dissolved in the mouth before swallowing
• C600 mg chewed, to be swallowed immediately
• D150 mg chewed, administered only if the patient has no history of ulcers

Which of the following represents a contraindication to the administration of Glyceryl Trinitrate (GTN) by an EMT for a patient with suspected cardiac chest pain?

• AA systolic blood pressure of 110 mmHg
• BA heart rate of 95 beats per minute
• CThe use of sildenafil (Viagra) or other erectile dysfunction medications within the last…
• DA history of previous coronary artery bypass graft (CABG) surgery

What are the four links in the out-of-hospital Chain of Survival as recognized in resuscitation guidelines?

• AEarly Access, Early CPR, Early Defibrillation, Early Advanced Care
• BScene Safety, Patient Assessment, Transport, Hospital Care
• CAirway Management, Ventilation, Defibrillation, Post-Resuscitation Care
• DFirst Aid, EMT Care, Paramedic Care, ICU Admission

Under PHECC guidelines, in which scenario is an EMT permitted to withhold or terminate CPR without a direct medical order?

• AWhen the patient has been in cardiac arrest for more than 15 minutes before EMS arrival
• BWhen the patient presents with signs of death inconsistent with life, such as rigor morti…
• CWhen family members request that resuscitation efforts be stopped because of the patient'…
• DWhen the patient is unresponsive and has a documented history of terminal oncology

Which of the following pairs of cardiac arrest rhythms are classified as shockable by an Automated External Defibrillator?

• AAsystole and Pulseless Electrical Activity (PEA)
• BVentricular Fibrillation (VF) and Pulseless Ventricular Tachycardia (VT)
• CAtrial Fibrillation (AF) and Sinus Bradycardia
• DAsystole and Ventricular Fibrillation (VF)

Immediately following the delivery of a shock from an AED, what is the correct next action for the resuscitation team?

• APerform a pulse check to see if the rhythm has returned to normal
• BResume chest compressions immediately, starting with a 30:2 cycle
• CUse the AED to analyze the cardiac rhythm again
• DDeliver 2 rescue breaths and check for normal breathing

Under what circumstance is compressions-only CPR recommended for a layperson or an off-duty practitioner?

• AFor all pediatric cardiac arrests to maximize perfusion
• BWhen the rescuer is unwilling or unable to perform rescue breaths
• CDuring a drowning or asphyxial cardiac arrest
• DOnly when an advanced airway has been successfully placed

A cardiac arrest patient achieves Return of Spontaneous Circulation (ROSC). If the patient is unresponsive but breathing normally, how should they be positioned for transport under CPGs?

• AIn a flat supine position to optimize spinal alignment
• BIn the recovery position (lateral recumbent position)
• CIn a semi-Fowler's position (head elevated 30 degrees)
• DIn the prone position to prevent airway obstruction

What is the correct first-line intervention for an EMT when managing an active, severe external hemorrhage from a extremity wound?

• AApply a tourniquet proximal to the wound immediately
• BApply direct pressure to the wound using a sterile dressing
• CElevate the limb above the level of the heart
• DLocate and compress the nearest arterial pressure point

Where should a combat application tourniquet (CAT) be applied to control severe arterial bleeding from a lower leg wound, and what must be documented?

• ADirectly over the knee joint; document the patient's blood pressure
• B5-7 cm proximal to the wound (above the injury), avoiding joints; document the time of ap…
• CDistal to the wound to trap the blood; document the date of application
• DDirectly over the wound site; document the name of the medic

When applying a commercial pelvic splint (such as a SAM Pelvic Sling) to a patient with a suspected pelvic fracture, what is the correct anatomical landmark for its placement?

• AAround the patient's waist, at the level of the umbilicus
• BAround the pelvis, at the level of the greater trochanters of the femurs
• CAround the upper thighs, below the groin crease
• DAround the lower abdomen, at the level of the iliac crests

Which of the following is a key clinical principle when applying an extrication cervical collar to a trauma patient?

• AThe collar is a definitive spinal immobilizer and allows manual stabilization to be disco…
• BThe collar must be sized correctly based on the distance from the chin to the thyroid car…
• CThe collar should be applied as tightly as possible to restrict all movement of the head
• DThe collar is only indicated if the patient has a normal level of consciousness and no ne…

Under PHECC guidelines, in which situation is the use of a scoop stretcher preferred over a standard long spine board for patient movement?

• AFor a patient requiring rapid extrication from a motor vehicle
• BFor rapid transfer of a patient with a suspected pelvic or hip fracture from the ground t…
• CFor a patient requiring continuous CPR during transport
• DTo immobilize a patient with a suspected cervical spine injury during long-distance trans…

A patient with a traumatic head injury presents with a rising systolic blood pressure, a decreasing heart rate (bradycardia), and irregular, shallow respirations. What is this clinical triad called and what does it indicate?

• ABeck's Triad; indicates cardiac tamponade
• BCushing's Triad; indicates severe intracranial pressure (ICP)
• CVirchow's Triad; indicates deep vein thrombosis
• DCushing's Triad; indicates hemorrhagic shock

What is the correct pre-hospital management for an open pneumothorax (sucking chest wound)?

• AApply a sterile gauze dressing secured tightly on all four sides
• BApply an occlusive chest seal dressing, secured on three sides or utilizing a built-in on…
• CPack the wound with hemostatic gauze and apply a pressure bandage
• DInsert a gloved finger into the wound to relieve the trapped air

Using the Rule of Nines, what is the estimated Total Body Surface Area (TBSA) of burns in an adult patient who has sustained partial-thickness burns to their entire anterior chest and abdomen?

• A9%
• B18%
• C27%
• D36%

What is the priority intervention for an EMT when caring for a patient who has sustained a liquid chemical splash to both eyes?

• AApply dry sterile dressings over both eyes and transport immediately
• BIrrigate the eyes continuously with large volumes of clean water or normal saline for at…
• CAttempt to neutralize the chemical using a mild vinegar or baking soda solution
• DInstill antibiotic eye drops and instruct the patient to keep their eyes closed