2 Prehospital Equipment

Question 1

`4 basic questions regarding efficacy of EMS equipment:

Answer 1

1. Does it do the job?
2. Is it safe?
3. Can it be applied to the field environment?
4. Can it be used effectively by prehospital personnel?

Question 2

Exposure to hazardous material or biologic or chemical weapons of mass destruction requires more protective equipment. Minumum PPE for such exposure include:

Answer 2

a high-efficiency particulate air filter mask the filters 99.97% of airborne particles 0.3 um in diameter
(or an acceptable alternative for the purpose, such as M95 military gas mask),
googles, gloves, and protective clothing

protective clothing should be nonabsorbent and puncture resistant

Question 3

some urban EMS providers wear soft body armor as a standard part of the uniform. Although each service must consider such variables as comfort, heat, weight, and cost, for EMS providers, _______ is optimal

Answer 3

a combination of ballistic/stab protection

Question 4

most important factor in surviving a cardiac arrest

Answer 4

early defibrillation

Question 5

AEDs are designed only to shock the following rhythms:

Answer 5

ventricular fibrillation
very fast ventricular or supraventricular tachycardias (usually >180 bpm)

Question 6

remarks on biphasic defibrillators

Answer 6

these defibrillate and cardiovert at lower energy levels and thus decrease myocardial injury

Question 7

TRUE or FALSE
prehospital 12L ECG showing STEMI leads to reduced door-to-balloon time and reduced mortality

Answer 7

TRUE

Question 8

simplest devices for airway management after manual airway maneuvers

Answer 8

oropharyngeal and nasopharyngeal airways

These basic airway adjuncts usually are paired in the field with a simple bag-valve mask device for ventilation and will work quite well together.

Question 9

Combitube is used for adults and adolescents that are:

Answer 9

> 48 inches tall or age >14 y/o

Question 10

Which of the following may not prevent aspiration:
A. Combitube
B. LMA
C. King LTS-D

Answer 10

LMA

Combitube and King-LTS-D prevent/minimize aspiration

Question 11

Which of the following will still allow ventilation even if inadvertently placed in trachea:
A. Combitube
B. LMA
C. King LTS-D

Answer 11

Combitube and King-LTS-D

LMA can cause respiratory obstruction if incorrectly placed

Question 12

Which of the following cannot be used if gag reflex are present:
A. Combitube
B. LMA
C. King LTS-D

Answer 12

all three

Question 13

other features of King-LTS-D

Answer 13

has port for gastric decompression tube

Question 14

TRUE or FALSE
Supraglottic airways may decrease hands-off time during resuscitation, but there is limited prehospital evidence to suggest that any advanced airway offers a neurologic survival benefit compared to simple bag-valve mask use

Answer 14

TRUE

Question 15

the “gold standard” for airway management in all patients

Answer 15

endotracheal intubation
and is especially used in patients in whom the other airway adjuncts are not satisfactory

the majority of ALS systems use endotracheal intubation as the airway of choice for patients in respiratory failure or with an unprotected airway

Question 16

Guidelines for cervical spine clearance in the field

Answer 16

absence of neck pain, tenderness, or discomfort
age between 11 and 65 y
no altered sensorium
no intoxication
no distracting injuries

Question 17

remarks on spinal immobilization in the field

Answer 17

the first person to assess the patient should immobilize the cervical spine immediately,
and if necessary, simultaneously perform a modified jaw thrust to open the airway.
*Manual stabilization of the neck is not released until the patient has been transferred and securely strapped to a board.
The responder may also clear the spine in the field.

Question 18

TRUE or FALSE
Once the patient is well secured to the board, the collar does not add a significant amount of stabilization and actually can be removed without compromise of the spine

Answer 18

TRUE
however, it is often left in place for added protection.

For adequate immbilization, the patient needs to be strapped on the backboard and secured with head blocks and head straps

Question 19

TRUE or FALSE
Soft cervical collars are not adequate or appropriate for prehospital care.

Answer 19

TRUE

Question 20

If the patient is sitting in a car after an accident and is stable from respiratory and circulatory standpoints, what is the sequence of spinal immobilization?

Answer 20

a **short spine board* and rigid cervical collar are first used to get the patient out of the vehicle safely and onto a long spine board

Question 21

If the patient is sitting in a car after an accident and the situation is critical (patient’s condition or the threats of hazard), what is the sequence of spinal immobilization?

Answer 21

the patient can be extricated more rapidly using only the cervical collar.
After applying the cervical collar, the patient is carefully rotated out and slid onto the waiting long board

Question 22

other remarks on spinal immobilization and clearance

Answer 22

Immobilization on a rigid board produces midline cervical pain and tenderness, so examination and radiographs should be performed promptly on arrival

In general, patients should not be removed from immobilization until the spine has been cleared clinically and radiographically

Question 23

preferred device for stabilization of femur fractures

Answer 23

femoral traction splint

Question 24

traction splints for the tibia should be reserved for the

Answer 24

angulated or displaced
otherwise, an air splint or a pillow splint would suffice

Question 25

simplest stabilization method for the pevlis

Answer 25

a sheet wrap, applied aroun the patient at the level of the trochanter and fastened with a clamp or hemostat