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Old Officer study material > 2021 EMS Protocols > Flashcards

2021 EMS Protocols Flashcards

0
Q

Who is authorized to make changes to protocols?

A

the medical director for palm beach county fire rescue.

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1
Q

What are the goals of the protocols?

A

to provide rapid assessment, stabilization, and transportation to the appropriate care facility.

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2
Q

Who is allowed to deviate from the protocols?

A

Ems captains and Trauma hawk Personnel

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3
Q

In mutual aid circumstances whose protocols should be followed?

A

The transporting agency.

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4
Q

Oxygen is to be administered only when?

A

maintain sp02 of 95% all patients

90% for COPD and asthma.

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5
Q

ET tubes shall be confirmed how? 3 methods.

A

visualization
esophageal intubation detector (if available)
continuous EtCo2

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6
Q

Ventilatory rates are the following?

A 
Adults- Pulse 1 q6
             No pulse 1 q10        
             ICP 30-35mmhg        
Pediatrics     Pulse 1 q3
                      No Pulse 1 q6
                      ICP- 30-35mmHg
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7
Q

EtCO2 monitoring will be performed on which pts?

A 
Respiratory distress
AMS
Sedated / pain medication
seizure pts
ketamine pts
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8
Q

how will etco2 be monitored in that are not unresponsive?

A

etco2 nasal cannula device

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9
Q

which pt’s are required to have a 12 and 15 lead performed?

A

chest, Arm, neck, back, jaw, shoulder, epigastric pn or discomfort
palpitations
syncope, lightheadness, general weakness, fatigue
SOB, CHF, or hypotension
unexplained diaphoresis or nausea.

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10
Q

12 lead cables will remain on the pt until when?

A

turned over the ED staff when transporting.

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11
Q

12 leads will be repeated how often?

A

q 10min

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12
Q

Which pt’s shall have a BGL checked?

A 
Diabetics
AMS
seizure
stroke
syncope, 
lightheadedness, 
dizziness
poisoning
cardiac arrest
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13
Q

A complete set of v/s consists of what and done how often?

A 
Pulse,- Rate rhythm quality
Respirations-Rate and Quality
Temp
Pulse ox
BP- cap refill
ETC02
BGL

Priority 3 - at least 2 sets
Priority 2- q 5min.

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14
Q

Adult hypotension is defined as?

A

systolic BP> 90.

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15
Q

When should manual BP’s be taken?

A

Initially and to confirm any abnormal or significant change in an automatic BP.

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16
Q

Pt’s that have not reached puberty shall be classified as how?

A

pediatric pts.

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17
Q

When should an IO be done?

A

For serious medical pts where IV access cannot be obtained

2 attempts or 90 sec.

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18
Q

A king airway is for use in which pts?

A

pediatric pts 2yr and above.

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19
Q

When using the Hand Tevy method, what is used for the PRIMARY reference point?

A

age

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20
Q

What type of pts’ meeting trauma alert criteria transported by AIR to St. mary’s?

A

Pregnant (visibly pregnant or by hx of gestation >20wks)

21
Q

All intubated interfacility transfers must be ______ and ______ by the sending facility.

A

paralyzed and sedated.

22
Q

If the sending facility physician refuses to administer paralytics for a trauma transfer then what?

A

Crew must contact the EMS Captain and follow the advanced A/W protocol, and accompany pt to the receiving facility.

23
Q

What type of alerts go by air if ground transport is greater than what time?

A

40mminutes:
Decompression Sickness
STROKE
STEMI

24
Q

Stroke pt with transport times greater than 20 min go where?

A

depends- if all other criteria are met;
1. transport time to comprehensive is > 20 min
2. onset time < 2hr
3. no tpa exclusions
4. no severe headache
Primary center, if not all met, comprehensive center.

25
Q

Pediatric pts are age what?

A

less than 18.

26
Q

Where do decompression CO, H2S and CN poisonings go?

A

Hyberbaric chamber @ st mary’s hospital.

27
Q

Where are psychiatric pts transported?

A

stable- closest facility

unstable- closest ED for stabilization.

28
Q

What are the criteria for someone to request a “Free Standing” ED?

A

Stable Patients
informed if admitted they will be transferred.
sign “Emergency Transport Disclaimer”

29
Q

What are the Air Transport time criteria?

A

STEMI / Stroke >40min
Trauma > 25min
Extrication >15min
Response time >10min

30
Q

When can air transport NOT be used?

A

Pt weighing > 500lbs or 227kg
Pt that cannot lay supine
combative and cannot be physically restrained
Hazmat contaminated pts

31
Q

What does MICCR stand for?

A

Minimally Interrupted cardio-cerebral resusitation

32
Q

Cardiac arrest pt’s with the use of a “Lucas” device will be placed on what?

A

Scoop stretcher and elevated 15 degrees.

33
Q

All IVP medications for an arrest are followed by what?

A

10ml saline Flush

34
Q

Termination efforts can be done when?

A 
EMS captain OS
persistent asystole for 15 min
Etco2< 10mmHg
No hypothermia
1 defibrillation @ 360j.
500ml NS
All ALS interventions have been completed and reversible causes 
             addressed.
Social support group is in place for family if needed.
35
Q

What is considered a “SECONDARY” arrest?

A

CHF, drowning, FBAO, OD, Hanging, lightning strike- DC current., Trauma, CN, 3rd Trimester pregnancy

36
Q

What Etco2 level must be maintained in cardiac arrest?

A

at least 10mmHg

37
Q

What is the “optimal” Etco2 level in cardiac arrest?

A

20mmHg.

38
Q

When does a ResQpod get placed?

A

all cardiac arrest patients that are greater than 1yr old.

39
Q

What are the contraindications for the “ResQpod”

A

Pt less than 1 yr old
Pt’s with a pulse
Cardiac arrest due to trauma
during passive oxygenation

40
Q

Compressions should continue in cardiac arrest until when?

A

the defibrillator os charged and ready to deliver energy

41
Q

If a rhythm converts back after electrical therapy was used what setting should be used ?

A

the setting that was successful in converting the rhythm.

42
Q

What is the sequence in an arrest?

A

compressions, rhythm check, defibrillation/ medication admin.

43
Q

What is the dose of MGSO4 in Torsades?

A

adults- 2g in 50 ml 60gtts wide open

pedi- 40mg/kg in 50ml 60gtts wide open

44
Q

primary and secondary arrest pt’s go to which facilites?

A

primary- STEMI facility

secondary- Closest faclility

45
Q

What are the steps for post resuscitation for pediatrics?

A

HR < 60: oxygenation and ventilation for 1 min
{30 sec for Neonate}
If HR remains <60 p 1min begin CPR
{30 sec for Neonate}
If HR remains<60 p CPR : Epi 1:10000 @ 0.01mg/kg q 3-5min

46
Q

What are the pediatric minimum BP’s?

A

Neonate: 60mmHg
Infant : 70mmHg
Child 1-10 Age x2 plus 70
Child >10 90mmHg

47
Q

Induced Cooling indications are?

A

Arrest pts who have ROSC and remain unresponsive to pain
Drowning w/ no suspected trauma
18 yrs and older

48
Q

Induced ICE contraindications?

A

Arrest due to trauma
Arrest due to non-traumatic hemorage
unable to secure airway with either ET or king airway
Pregnancy

49
Q

What are the fluid requirements for ICE?

A

30ml/kg to max of 2L in 500ml incriments

Renal/ dialysis, CHF- 500ml. repeat 1x for hypotension.

Old Officer study material (30 decks)

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