9 free EMT practice questions: Medication & Supply Inventory

Epinephrine auto-injectors expire sooner than other medications: Checking expiration dates is part of every supply check, and epinephrine auto-injectors do have a shelf life. Nothing here says these devices are expired or close to it. The problem is the strength on the unit, not the date.

The 0.3 mg strength may be given only by an advanced provider: Some medications on a unit are limited to advanced providers. Epinephrine auto-injectors are not one of them. An EMT can give either the 0.3 mg or the 0.15 mg auto-injector to a patient in anaphylaxis.

Two auto-injectors would be needed for every adult patient: The 0.3 mg dose can look small, and stacking two devices sounds like a way to reach an adult dose. The 0.3 mg auto-injector is already the full adult dose. One device gives an adult the whole dose. Some adults do need a repeat dose later, and each repeat is another full 0.3 mg dose, not half of one.

Delivery of low-flow oxygen to an adequately breathing patient: Low-flow oxygen for a patient who is breathing adequately comes from the nasal cannula. The unit still has nasal cannulas.

Measurement of the oxygen saturation of an adequately breathing patient: Oxygen saturation is measured with a pulse oximeter. Which masks are stocked has nothing to do with the pulse oximeter.

Ventilation of a patient whose breathing is inadequate: A patient whose breathing is inadequate gets ventilated with a BVM, and the BVMs are still on the unit.

Pediatric pads are unnecessary, because adult pads fit every patient: Adult pads can be used on a child when nothing else is available. Pediatric pads exist to lower the energy delivered to a child under 8 years old or under 55 pounds. A station that covers an elementary school needs to be ready for those children.

The defibrillator may not be used on a child until pediatric pads arrive: Pediatric pads are preferred for a child, but they are not required to shock. Guidelines say to use adult pads instead of holding back the shock. Waiting for pediatric pads delays lifesaving care for a child in cardiac arrest.

Pediatric pads are needed only for patients under 1 year of age: Pediatric pads are not only for infants. The cutoff is 8 years old or 55 pounds, well past the first year of life.

Continue using them until they expire; replacement is not needed until after expiration: Using the auto-injectors right up to the expiration date is fine when the replacements are already on the way. The drug is at full strength until that date, and pulling it early wastes good stock. The problem is the second half of option A, waiting until after expiration to replace them. Waiting leaves a gap where the truck carries expired auto-injectors or none at all.

Inspect them for visible changes and use them if they appear normal: Looking at the auto-injectors is a real check you have to do. You look through the window for discoloration or particles. Cloudy or brown epinephrine gets pulled no matter what the date is. Looking at the drug cannot tell you its strength, because epinephrine breaks down chemically before it changes how it looks. Inspection and the expiration date are two separate checks, and one does not replace the other.

Discard them immediately and report the supply shortage to administration: Throwing out a medication right away is right when the medication is already expired, damaged, discolored, or recalled. These auto-injectors are good for 4 more weeks. Throwing them out now leaves the truck with no epinephrine and creates the shortage you would be reporting.

Recap the bottle, add a desiccant packet, and return it to service with a note to monitor: A desiccant packet and a tight cap prevent moisture damage. That's why the packet and the cotton are in the bottle in the first place. Once the tablets have absorbed water and started to break down, drying the air around them cannot undo the damage or bring back the strength. Returning the bottle to service with a note also leaves a bad drug on the truck. The next person to use the bottle may never read the note.

Use the tablets for patients who refuse liquid medication; discard them if the patient declines: Matching the form of a medication to what a patient will take is real clinical thinking, like chewable versus swallowed. The form has nothing to do with whether the drug is safe to give. Damaged medication is off limits for every patient, no matter what the patient prefers. Discarding the tablets only when a patient declines still means giving damaged aspirin to any patient who accepts.

Assume the discoloration is from normal storage and use the bottle until the expiration date passes: The expiration date is the usual reason to pull stock, and checking dates is part of the same rig check that caught this bottle. The printed date assumes the drug was stored right: sealed, dry, and within its temperature range. This bottle was not stored that way. Moisture can ruin a drug well before the printed date.

Strap the cylinder to the stretcher frame with the patient straps: A strong strap seems like it should hold a cylinder. Securing a tank to the stretcher is only allowed with a commercially made device built for that purpose. The question says the unit has no such device. Patient straps are made to hold a patient, and the stretcher itself moves in and out of the ambulance.

Lay the cylinder on the floor behind the airway seat, out of the walkway: Laying the cylinder on the floor out of the walkway keeps people from tripping on it. Tripping is not the main danger. A tank that is not secured becomes a projectile in a crash, wherever the tank starts out in the compartment.

Stow the cylinder in the outside compartment with the extrication tools: Moving the cylinder to an outside compartment keeps the cylinder away from the crew. The rule to secure tanks with fixed clasps or housings applies wherever they are carried. Loose extrication tools in the same compartment can also damage the cylinder's valve and gauge.

Place it in service, since the gauge reads full: The gauge reading of 2,000 psi tells you how much oxygen is inside. The collar stamp is what tells you when the cylinder was last tested. A cylinder can read 2,000 psi and still be overdue for the test that shows it can safely hold that pressure.

Crack the valve to confirm it holds pressure: Cracking the valve is a real step. Cracking the valve clears debris from the opening before the regulator goes on. Holding pressure for a few seconds on the station floor is not the test the collar stamp records.

Keep it as the backup and use the newer one: The backup is the cylinder you reach for with a second patient or a long transport. Moving the overdue cylinder to backup keeps it on the ambulance. You still end up depending on the overdue cylinder, just later.

Top off the sterile water and leave it in place: Topping off the water keeps the same used bottle in the oxygen line for the next patient. Humidifier equipment is used on one patient only. The bottle is what has to be replaced, not just the water.

Empty and air-dry the bottle before the next patient: Emptying and air-drying is how reusable equipment gets handled. A single-use humidifier does not go back into service after any cleaning step. This bottle has already been used on a patient, so it gets replaced.

Keep the bottle for the next transport over 1 hour: The 1-hour rule tells you whether to use a humidifier at all. The rule does not tell you how many patients one bottle can serve. A second long transport means a second patient, and that patient gets a new bottle.

There is no concern, since one size fits all adult patients: One size does not fit all adults. Adult necks vary in size, and a single collar size cannot properly fit every one of them.

Cervical collars are not required equipment on an ambulance: Cervical collars are standard spinal motion restriction equipment. They should be on the ambulance in the right sizes.

The concern only applies if a pediatric patient is anticipated: The problem is not only with children. Even among adults, one collar size cannot fit the full range of neck sizes you will see.