BK 33 EMS

Question 1

EMT & PM’s can:

Answer 1

Determine death in the field

Question 2

Base hospital Physicians can:

Answer 2

Pronounce death based on information provided by PMs in the field

Question 3

If pt has rigor & lividity only, can EMTs & PMs determine death?

Answer 3

Only after performing assessment to confirm absence of respirations, cardiac, and Neuro functions

Question 4

Auscultate ones for how long?

Answer 4

Minimum of 30 seconds

Question 5

Auscultate apical pulse for how long?

Answer 5

Minimum of 60 seconds

Question 6

Palpate carotid pulse for how long on adults?

Answer 6

Minimum 60 seconds

Question 7

Palpate brachial pulse on infants for how long?

Answer 7

Minimum 60 seconds

Question 8

What neuro assessment shall be done?

Answer 8

Check pupillary response with penlight to determine fixed and dilated; check and confirm unresponsive to painful stimuli

Question 9

EMS personnel may determine death if a patient is in asystole after how long?

Answer 9

20 minutes

Question 10

What other criteria is needed to determine death if a patient is in asystole?

Answer 10

Patient is 18 years or greater greater, Arrest not witnessed by EMS, no shockable rhythm identified at any time during resuscitation, no ROSC at any time and no hypothermia

Question 11

What is ROSC?

Answer 11

Return of spontaneous circulation

Question 12

Patients who have not achieved ROSC after 20 minutes of quality on scene resuscitation should be considered for transport if:

Answer 12

Arrest witnessed by EMS personnel persistent VF/VT rhythm after 3 shocks

Question 13

Responsibility for medical management rests with who?

Answer 13

Most medically qualified person on scene

Question 14

Authority for crime scene management rests with who?

Answer 14

Shall be vested with law enforcement

Question 15

What are the forms EMS must honor in the field?

Answer 15

Prehospital DNR
POLST (Physician Orders for Life-Sustaining Treatment)
State EMS Authority-approved DNR Medallion

Question 16

In addition to no respiration, pulse or neuro response, EMT’s & PM’s may determine death:

Answer 16

1. Decapitation
2. Massive crush injury
3. Penetrating or blunt injury with evisceration of the heart, lung or brain
4. Decomposition
5. Incineration
6. Pulseless/Non-breathing with extrication time greater than 15 minutes
7. Penetrating trauma
8. Blunt trauma without organized ECG activity
9. Pulseless, non-breathing victims of MCI
10. Drowning greater than 1 hour
11. Rigor mortis
12. Lividity