NREMT Emergency Medical Technician (EMT) Cognitive ExamAirway, Respiration & VentilationHard
A 72-year-old female is experiencing sudden onset of difficulty breathing, chest pain, and a feeling of impending doom. She has a history of recent surgery. Her skin is cool, pale, and clammy. Lung sounds are clear bilaterally. Which condition should the EMT suspect?
- APneumonia
- BPulmonary embolism
- CAcute myocardial infarction
- DCongestive heart failure
Show answer & explanationAnswer & explanation
Correct answer: B. Pulmonary embolism
The sudden onset of dyspnea, chest pain, a feeling of impending doom, and a history of recent surgery (a risk factor for DVT leading to PE) with clear lung sounds is highly suggestive of a pulmonary embolism. The clear lung sounds help differentiate it from conditions like CHF or pneumonia which would typically have abnormal lung sounds.
Why the other options are wrong
- A. Pneumonia would typically present with a cough, fever, and localized crackles or rhonchi, which are not described.
- C. While chest pain is present, the clear lung sounds and 'impending doom' with recent surgery point away from a primary AMI as the cause of respiratory distress.
- D. CHF typically presents with crackles/rales in the lungs due to fluid buildup, which are absent here.
Pulmonary Embolism (PE)
A blockage in one of the pulmonary arteries in your lungs, most often caused by blood clots that travel to the lungs from the legs (deep vein thrombosis).
- Symptoms include sudden dyspnea, chest pain, tachycardia, hemoptysis, and feeling of impending doom.
- Risk factors include recent surgery, prolonged immobility, oral contraceptives, cancer.
- Lung sounds are often clear initially.
Memory trick: Sudden chest pain, clear lungs, and a recent knife? Think clot!