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Free NREMT practice questionsFree EMT practice questions · Patient Treatment and Transport

1 free EMT practice questions: Non-Traumatic Musculoskeletal Disorders

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Question 1 of 1

A 68-year-old patient with chronic lower back pain calls EMS during a flare-up. The patient has a clear history of mechanical back pain from degenerative disc disease, denies trauma, and is neurovascularly intact with normal strength. What is the most appropriate action?

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Correct answer · Assess for red flags, position for comfort, and transport non-urgently if none are found

This patient has a flare-up of chronic mechanical back pain, with no sign of a spine injury. The patient denies any trauma and is neurovascularly intact with normal strength. With no mechanism of injury and a normal motor and sensory exam, nothing points to damage to the spinal cord or the nerve roots. Spinal motion restriction would not help this patient. Spinal motion restriction would only add pain and keep a patient with degenerative disc disease stuck in one position. Assess for red flags, position the patient for comfort, and transport non-urgently.

Why the others are wrong

Assume spinal precautions are needed for all back pain and apply full C-spine immobilization: Immobilizing every back pain patient comes from older teaching that restricted the spine until an injury was ruled out. This patient denies trauma and has a normal neuro exam. Those two findings already answer the spine injury question. Applying the old rule anyway skips the assessment you just did.

Immobilize the patient as a precaution because of the patient's age: Older patients do have a higher risk of fractures from minor falls and bumps. This patient reports no mechanism at all, only a flare of chronic pain. Age alone, without trauma or abnormal exam findings, is not a reason to immobilize.

Advise the patient to stay home and rest; do not transport unless pain is severe: Some chronic pain flares are mild enough to manage at home. This patient called 911 during the flare, and nothing in the question says the pain is minor. The crew does not get to decide alone that a patient who called for help stays home. The decision not to transport belongs to the patient and medical direction.

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