6 month test Flashcards
1
Q
When do DNR forms expire?
A
Never
2
Q
What is required for DNR form?
A
Original or copy (with original signature). On yellow paper with black “DNR” written, patient identification and signed by doctor.
3
Q
Can a DNR be revoked?
A
Yes
4
Q
How can a DNR be revoked?
A
In writing, destruction or failure to present form or verbally.
5
Q
4 signs of presumptive death?
A
Pulseless
Unresponsive
Apneic
Fixed and dilated pupils
6
Q
4 conclusive signs of death?
A
Rigor mortis
Liver mortis (lividity, blood pooling down)
Tissue decomposition
Injuries incompatible with life
7
Q
Can time of death be called on pediatrics?
A
Yes, only in cases of prolonged death
8
Q
When can trauma patients be pronounced?
A
Pulseless and apneic with asystole in 2 leads with blunt trauma arrest, extrication time >15min or arrest from primary brain injury
9
Q
Can resuscitation be stopped once started?
A
If DNR is presented or doctors orders
10
Q
When do FF’s need to go to rehab?
A
After 2 bottles or 30 min
SCBA failure
Chest pain, weakness, dizzy etc
Officer discretion
11
Q
Minimum rehab time?
A
15min
12
Q
What is required if presentation in rehab is abnormal for more than 15min?
A
ALS treatment
13
Q
What is abnormal rehab spo2?
A
<94%
14
Q
Rehab abnormal HR?
A
120+ bpm
15
Q
Rehab abnormal CO?
A
More than 8% but less than 15% (give 5 min to bring down
16
Q
What CO level requires immediate transport?
A
25%
17
Q
Abnormal rehab temp?
A
> 100.6
18
Q
Minimum dispatch for rescue
A
1 Engine and 1 Rescue
19
Q
Who has the final say for pilot landing
A
Pilot in charge
20
Q
How far away do obstacles need to be?
A
Anything 40+ feet need to be 100+ feet away
21
Q
How must you approach helicopter?
A
In pilots field of vision and in low crouch
22
Q
When can you approach a helicopter
A
When the all clear is given
23
Q
What must be worn when approaching a helicopter?
A
Full PPE
24
Q
Can you use road flairs for helicopters?
A
No
25
Minimum size for helispot?
100 x 100
26
Who is able to refuse care?
Competent person, 18+ yo or emancipated minor
27
Who is unable to refuse care?
Suicidal
AMS
Severely altered vitals
Mentally retarded
Not acting reasonable
< 18yo
28
MCI levels
1= 5-10
2= 11- 20
3= 21- 100
4= 101 -1000
5= 1000+
29
What are MCI priorities
Red, Yellow, Green and Black
30
What is assessed in MCI?
RPM= Respirations, Pulse and Mentation
31
What signs classify patient RED?
Resp 30+, no radial pulse, unable to follow commands
32
Classify as black?
No breathing despite opening airway
33
Jump start triage black?
No resp no pulse, no resp with pulse after 5 breaths
34
During MCI, Ped not breathing with pulse but resumes breathing after 5 vent. What color?
Red
35
MCI, Ped cap refill >2sec and no radial, what color?
Red
36
What equipment is needed for Ped cric?
14g, 15mm adapter from small tube and 10cc
37
What angle do you insert needle cric?
45 degrees
38
What solution is used prior to performing cric?
Provodine iodine swab
39
What is age cutoff for needle cric?
<12 yo
40
What is the age cutoff for safe haven of newborns
7 days
41
What questions should be asked of parent during safe haven event?
Only medically pertinent questions
42
What needs to be done immediately after safe haven event?
Create a run , complete report, transport, notify of a Safe Haven
43
When do you notify LEO in a safe haven event?
In case of obvious abuse
44
Red trauma criteria
Airway- assistance required
Circulation- BP <90, No radial pulse
Fractures- Multiple long bone fractures
Burns- 2-3rd degree burns > 15%BSA
High voltage
Amputations
Penetrating injury head, neck or torso
GCS < 12
Exhibits paralysis
45
If patient does not meet trauma criteria what can you do?
Paramedic judgement
46
Blue trauma alert
Airway sustained resp >30
Sustained HR of >120
Fractures single long bone Fx site due to MVA or fall greater than 10ft
Injuries- major degloving, Avulsion >5in, GSW to extremities
MOI- Ejection from vehicle or deformed steering wheel
Age- 55 or older
47
Pediatric red trauma criteria
Airway- assisted or intubated
Motor response- AMS, Paralysis
Weak or no carotid/femoral pulse
Systolic <50
Any open bone fx,multiple fx sites, multiple dislocations
Major soft tissue disruption
Burns- 10% or greater
Penetrating trauma head, neck, torso
48
Pediatric Blue criteria
Size red or purple 11kg
Amnesia or reliable history of LOC
Only carotid or femoral pulses present
SIngle bone Fx
49
What is the fall height for level 2 trauma
Adult = 12ft
Ped= 6ft
50
MVA criteria for level 2 trauma?
> 15min extrication time
Rollover
Death of an occupant
Major intrusion
Ejection from bike
51
What is speed criteria for Pedestrian vs Vehicle
Adult >15mph
Ped >6mph
52
Age criteria for level 2 trauma
55+
53
What are the medication criteria for level 2
Anti-platelet and anti cougulant
54
GCS eye response score
4- spontaneous
3- Verbal
2- Pain
1- None
55
GCS verbal response score
5 oriented
4 Confused
3 Inappropriate
2 Garbled
1 None
56
What is GCS motor response score
6 obeys
5 localizes
4 Withdraws
3 Flexion
2 Extension
1 None
57
What is the RACE assessment for the face?
Facial droop
58
What is the RACE assessment for arm function?
Arm drift 10 seconds
59
What is the RACE assessment for leg function?
Lift leg for 5 seconds
60
What is the RACE assessment for gaze and head?
Check for deviation
61
RACE assessment for aphasia?
Give a command (make a fist ie.)
62
What is the RACE assessment for agnosia?
Have a patient name an object and show use
63
What RACE score is a stroke alert?
Anything greater than 0
64
What is added to the race score if deviation, agnosia, aphasia are present?
"A "symbol
65
What does adding "A" symbol to RACE score mean?
High possibility of large vessel occlusion
66
How and for how long do you mix the Cyanokit?
Rocking motion for 30 seconds
67
What is required for the delivery of a Cyanokit?
A dedicated line
68
Over how long do you infuse Cyanokit?
15 min
69
When do you not use an NPA?
Patients with frontal head or midfacial injuries (poss basilar fractures)
70
How to measure an NPA?
Nostril to earlobe
71
How to insert an NPA?
Bevel to the septum
72
How to measure an OPA?
Corner of mouth to earlobe
73
How long can you suction a patient?
10 seconds
74
How do you measure a rigid suction catheter?
From the earlobe to the corner of the mouth
75
What direction is your incision done for a cric?
1st Vertically
2nd Horizontally
76
How to assess for tension penumothorax?
Absent sounds to affected side
Poor ventilation
Tracheal deviation
JVD
Decreased Spo2 or EtCo2
77
When would JVD not be present in tension pneumo?
Severe hemorrhage
78
Where do you perform a needle decompression
2nd or 3rd intercostal space
79
What needle is used foro chest decompression?
3 1/2 inch 14 gauge needle
80
At what heart rate do you set the lifepak before pacing?
70-80 bpm
81
How do you check the effectiveness of pacing
Check for a pulse on the carotid or femoral or brachial
82
Why do you check a pulse on Right side during pacing?
Because of muscle twitching
83
What do you do if you have no mechanical pulse during pacing?
Treat as Asystole/PEA
84
What do you do immediately after pacing?
Print a continuous rhythm strip
85
Where can you place pads for pacing?
- anterior and posterior to the heart
or - Upper right, left midaxillary (lateral to the left nipple)
86
For how long do you flush chemicals or foreign bodies from the eye?
20 min
87
Max volume you can administer intranasal?
1 ml per nostrile
88
What locations can you perform an IO?
Proximal tibia
Proximal humerus
89
What must be recorded when applying a trauma tourniquette?
Time of application
90
What is an emancipated minor?
Completely self sufficient, married or in military
91
What is age cutoff for trauma
16
92
What is the age cutoff for medical?
18yo
93
What is a newborn?
Patient just born
94
What is a neonate?
Patient is less than 6 weeks (1 month)
95
What is an infant?
Under 1 year
96
What is a child?
1 year to puberty
97
What is adolescent?
Child that has reached puberty
98
What determines a trauma alert?
1 red or 2 blue criteria
99
What Sat do you give support to?
less than 94%
100
What are signs of tube confirmation
ETco2, Visualized, Neg epigastric, and positive lung sounds
101
What is BP cutoff for Morphine?
90 systolics
102
How is nitrous given?
Self-administered
103
What is normal Etco2 range?
35-45
104
What is done if you cant visualize FBAO?
Intubate, if unable to cric
105
In what position do we place respiratory patients
Fowlers
106
What is first line drug for asthma patients
Albuterol
107
When can you use atrovent
With any albuterol dose
108
How many epi doses are in the ACLS asthma?
2
109
What is the asthma epi dose?
1:1000 .3mg IM
110
What is the asthma Mag dose?
2gm in 50 ml over 5-10 min
111
What is CPAP peep for asthma
2.5- 5
112
What is asthma ALS-2
Repeat Epi
