EMT Exam: Recognizing Normal Cardiovascular Findings

By Arthur Hsieh

For the purposes of the EMT exam, you can use yourself as a “normal” picture when it comes to cardiovascular findings. Your normal resting pulse should be strong, regular, and pumping at about 60–100 beats per minute while at rest. You should be able to easily find this pulse by checking your radial artery on the thumb side of your wrist.

While you’re feeling the pulse, get a sense of how the skin looks and feels.mYour skin should have a normal, warm temperature; and is dry. That’s because your skin, an organ of the body, is being adequately perfused. Now, skin can be cooler to the touch when it’s cool outside or a little sweaty, but it should return to its normal look and feel within a matter of minutes.

Your blood pressure should be roughly around 120 mm Hg or less systolic and about 80 mm Hg or less diastolic when measured at the distal bicep region of the arm. Many people have blood pressures that are higher than normal (hypertension) but live with that pressure. On the other hand, athletes and other fit folks often live with much lower BP.

In general, having a lower-than-normal BP is much better than having high BP.

Tightly connected to the cardiovascular system is the respiratory system; what happens in one is often reflected in the other. Under normal conditions, the patient’s respiratory rate should be about 12 to 20 breaths per minute without any major effort. When things start to go wrong with the cardiac system, the respiratory system tries to compensate for the issue.

A 73-year-old female complains of chest tightness and difficulty catching her breath. Her blood pressure is 140/90 mm Hg, her pulse rate is 90, and her respiratory rate is 18 breaths per minute. Her skin is pale, warm, and dry; and her oxygen saturation level is 95 percent. Which of the following actions is appropriate?

  • (A)Lay her supine with her legs slightly elevated.

  • (B)Place her in a position of comfort.

  • (C)Administer high-flow oxygen with a nonrebreather mask.

  • (D)Ventilate her with a bag-valve mask.

The correct answer is Choice (B). While she may be experiencing a medical condition, her vital signs appear to be within normal limits. Keeping her comfortable will help reduce her anxiety and lower body stress. The modified Trendelenberg position, represented by Choice (A), isn’t necessary, as her blood pressure isn’t low.

Her oxygen saturation level is normal, and she appears to be breathing normally; oxygen administration, Choice (C), is not indicated. She is breathing well on her own, so manual ventilations, Choice (D), aren’t necessary.