According to Pediatric Basic Life Support (PBLS) guidelines by the American Heart Association (AHA), when a child becomes unresponsive due to foreign body airway obstruction (FBAO), the immediate next step is to begin chest compressions. This is done before checking the airway or giving breaths because the airway is presumed obstructed. The compressions may dislodge the object.
After 30 compressions, open the airway and check for visible objects. If none are seen, attempt rescue breaths.
This protocol reflects the high risk of complete airway blockage in children with sudden collapse following a choking episode.
References:
AHA PALS and BLS Provider Manual (2020), Pediatric FBAO Algorithm
NREMT Cognitive Exam Blueprint - Pediatric Airway Obstruction
National EMS Education Standards (2011) - Pediatric Emergencies

The correct answers are A. Provide left uterine displacement and E. Perform compressions at a depth of at least two inches.
Key Concept: Cardiac Arrest in Late Pregnancy
At #20 weeks gestation (30 weeks in this case):
The enlarged uterus compresses the inferior vena cava (IVC) when the patient is supine This reduces venous return and cardiac output, worsening resuscitation effectiveness Why A is correct (Left uterine displacement):
The uterus should be manually displaced to the left side
This relieves pressure on the IVC and improves circulation during CPR
NREMT/AHA-aligned guidance states:
"Manual left uterine displacement should be performed in pregnant patients during resuscitation." Why E is correct (Compression depth):
CPR in pregnant patients follows standard adult CPR guidelines
Compression depth should be at least 2 inches (5 cm)
"Perform high-quality chest compressions at a depth of at least 2 inches." Why the other options are incorrect:
B). Avoid using AED# Incorrect - AED is safe and indicated in pregnancy
"Defibrillation should not be withheld in pregnant patients."
C). Request a helicopter# Not a priority during active cardiac arrest - resuscitation comes first D). Upper half of sternum# Incorrect - compressions are performed on the center of the chest (lower half of sternum) Exact Extracts (NREMT/AHA-aligned references):
"Perform manual uterine displacement in late pregnancy during CPR."
"Use standard CPR compression depth and rate."
"Defibrillation is safe in pregnancy and should not be delayed."
Clinical Priority Summary:
In a pregnant cardiac arrest patient, the EMT should perform standard high-quality CPR while relieving uterine pressure on major vessels, making A and E the correct answers.
References:
NREMT EMT Education Standards - Cardiology & Resuscitation
American Heart Association (AHA) Guidelines for CPR and ECC
NREMT National Continued Competency Program (NCCP)

The correct answer is D. Ventricular tachycardia.
When an AED states "shock advised," it means the device has detected a shockable rhythm, which includes:
Ventricular fibrillation (VF)
Pulseless ventricular tachycardia (VT)
Among the answer choices, the only shockable rhythm listed is ventricular tachycardia.
Why this is correct:
AEDs are specifically programmed to identify rhythms that benefit from defibrillation. According to NREMT and AHA guidelines:
"Shockable rhythms include ventricular fibrillation and pulseless ventricular tachycardia." Why the other options are incorrect:
A). Asystole: This is a non-shockable rhythm (flatline). Treatment is CPR and medications, not defibrillation.
B). Atrial fibrillation: This is typically a perfusing rhythm and is not treated with AED shocks in cardiac arrest.
C). Pulseless electrical activity (PEA): Also a non-shockable rhythm; treated with CPR and addressing underlying causes.
Exact Extracts (NREMT-aligned EMT educational references):
"AEDs will advise a shock only for ventricular fibrillation or pulseless ventricular tachycardia."
"Asystole and pulseless electrical activity are non-shockable rhythms." Clinical Priority Summary:
A "shock advised" message always indicates a shockable rhythm, and the only correct option given is ventricular tachycardia, making D the correct answer.
References:
NREMT EMT Education Standards - Cardiology & Resuscitation
American Heart Association (AHA) Guidelines for CPR and ECC
NREMT National Continued Competency Program (NCCP)

The correct answer is B because this patient has multiple major suicide risk indicators : he is directly expressing suicidal intent, he is living alone , has just lost his job , has no support , and expresses hopelessness by saying he sees no purpose in living. In EMS behavioral-emergency assessment, statements suggesting self-harm must be taken seriously, and patients with these risk factors should be considered high risk . EMS educational guidance includes assessing whether the patient has said or done anything indicating possible risk of suicide or violence to self .
Authoritative public health sources also identify social isolation/loneliness , unemployment , and hopelessness/depression-related distress as important suicide risk factors. That makes this patient high risk even before knowing a detailed method or timeline.

The correct answer is C. Bradycardia.
In pediatric patients, it is critical to distinguish between respiratory distress and respiratory failure.
Respiratory distress includes early compensatory signs such as:
Intercostal retractions
Audible wheezes
Tachypnea
These findings indicate that the child is still attempting to compensate and maintain adequate oxygenation.
Respiratory failure, however, represents a late and life-threatening stage where the child can no longer maintain adequate oxygenation and ventilation.
Bradycardia is a key late sign of respiratory failure in infants and children and indicates severe hypoxia and impending cardiac arrest.
According to NREMT-aligned educational material:
"Bradycardia in pediatric patients is often the result of hypoxia."
"Late signs of respiratory failure include decreased mental status and bradycardia." Why the other options are incorrect:
A). Intercostal retractions: Early sign of respiratory distress (increased work of breathing) B). Audible wheezes: Indicates airway narrowing, typically seen in distress D). Tachypnea: Early compensatory mechanism to improve oxygenation NREMT guidance emphasizes:
"Increased work of breathing and abnormal breath sounds are signs of respiratory distress, not failure." Exact Extracts:
"Bradycardia in pediatric patients is usually caused by hypoxia."
"Late signs of respiratory failure include bradycardia and decreased mental status."
"Retractions and tachypnea are signs of respiratory distress."
References:
NREMT EMT Education Standards - Airway, Respiration & Ventilation
NREMT National Continued Competency Program (NCCP) - Pediatric Respiratory Emergencies Standard EMT Text (aligned with NREMT): Airway Management and Pediatrics