Ems Flashcards
If it is impossible or innapropriate to obtain medical consultation you must
Document in narrative
Check exceptional call box
Notify ems jurisdiction who must notify state ems medical director within 5 days
Age groups
Newly born
Neonate
Infant
Toddler
Preschooler
School age
Adolescent
Newly born up to 1 hour
Neonate 1 hour to 28 days
Infant > 28 days to 1 year
Toddler 1 year-<2 years
Preschooler 2-4 years
School age 5-12 years
Adolescent 13-18 years
If an error or variance in procedure occurs you must
Notify consulting physician via radio ____
Notify local ems jurisdiction or program medical director within ____ of incident
QA officer must provide written notification within ___ days to ems jurisdiction, program medical director, miemss compliance officer, state medical director
Within ___ days of written notification, QA officer must initiate medical review comittee
Within ____ days QA officer must foward written results of medical review comittee to miemss compliance office and state medical director
If an error or variance in procedure occurs you must
Notify consulting physician via radio IMMIDIATELY AND AT HOSPITAL
Notify local ems jurisdiction or program medical director within 24 HOURS of incident
QA officer must provide written notification within 5 DAYS to ems jurisdiction, program medical director, miemss compliance officer, state medical director
Within 14 DAYS days of written notification, QA officer must initiate medical review comittee
Within 30 DAYS QA officer must foward written results of medical review comittee to miemss compliance office and state medical director
Inability to carry out physicians order must
Immediately notify dr and EMS jurisdiction
Ems program notify medical directors in 5 days
Initiate QA investigation within 14 days
Foward results of investigation to miemss compliance and state medical director within 30 days
Orders for extraordinary care must notify ems program medical director
As soon as practical after call
BVM for neonate
Bvm all ages greater than neonate
Neonate 1 every 3 seconds
Greater than neonate 1 every 5 seconds
Hyperventilate head injury Pt if
Signs and symptoms of hernia toon are present (posturing loss of pupillary response, dilation of one or both pupils, vomiting, hypotension, bradycardia, irregular respirations)
Rate of hyperventilation
Adult 13 or greator
Child 1-12 years
Infant less than 1 year
Adult 20 bpm
Child 30 bpm
Infant 35 bpm
Newly born protocol should be followed for patients that are ____
Within first hour of birth
When there is an MCI, the ____ call box must be checked
Exceptional call
Online medical direction should be obtained from local trauma center and specialty center when transport to specialty center would be ____ mins additional transport time
10-15
Pediatric START triage
Pediatric START TRIAGE
Respiratory rate <15 or >45 -> IMMEDIATE
Pediatric START TRIAGE
Nuero assessment- innapropriate p or u -> immediate
A,V, P -> delayed
Self prescribed Nitro can be given ___ times. It can be repeated so long as bp is greater than ___ mmhg and pulse is between ____-____
3 times
Greater than 90 mmhg
Pulse between 60-150 bpm
mild agitation
SAFER
Stabilize
Assess
Facilitate
Encourage
Recovery
Mild allergic reaction
Moderate allergic reaction
Mild localized swelling and itching at the site
Moderate hives and or mild wheezing
Anaphylaxis
Acute onset of severe illness after exposure to a known allergen with two or more of the following
Hives or acute swelling of mucosa
Respiratory symptoms
Hypotension
GI symptoms
ALTE Infant or child less than ___ years of age
2 years
Sepsis indications
Must meet at least two
Temp greater than 100.4
Hr greater than 100
RR greater than 25
Hypotension (systolic below 90)
Posterior cerebella assessment
Balance-sudden onset of loss of balence
Eyes- sudden vision loss
Take pt to stroke center within ____ hours from when it was last known well
22 hours
LAMS of 4 or greater
Transport to comprehensive or thrombectomy-capable primary stroke center
Pediatric with stroke (under 18)
Pediatric trauma center
Hand/foot presented place mom
Left lateral position
Feet or butt presents
Deliver body, support weight and insert V to open airway
Cord presents
Face down, butt up, wrap cord to keep moist
Universal algorithm for newly borns
Dry warm stimulate
Suction if non vigorous or airway obstruction
If apnea/gasping or hr less than 100 or central cyanosis -> ventilate for 1 min 40-60 bpm room air then connect to o2
If HR less than 60 after 30 seconds of BVM ->120 compressions per min with 3:1 compression ventilation
Consider transport to hyperbaric facility
Carboxyhemoglobin value greater than %25
Many more criteria
For burns greater than ____% body surface area, follow cold emergencies protocol
10%
All 3rd degree. and any 2nd degree burn greater than ___% must go to the burn center
10 %
Chemical burns should be transported to ____
Closest available hospital for decon
GCS
Eye opening
Spontaneously
To voice
To pain
No response
Motor response
To verbal
To painful
Flexion withdraw
Flexion abnormal
Extension
No response
Verbal
Oriented
Disoriented
Innapropriate words
Incomprehensible sounds
No response
Spinal motion restriction
Backboard with c collar
Acetaminophen contraindications
Hypotension
Head injury
Had it last 4 hours
Can’t swallow
Respiratory distress
Vomiting
Liver disease
Allergy
Less than 2 years
Acetaminophen dosages
Less than 2 not indicated
2-4 160
5-12 320
13 and above 640
Must contact base station for Pts who wish to refuse after administration of ____
Naloxone
If systolic drops more than ___mmhg or hr is less than ___ or greater than ___ bpm, obtain medical consult prior to administration of second dose
20
Less than 60
Greater than 150
Dosage of oral glucose
10-15 grams
Bls clinician may cancel als if they have obtained
Chief complaint
History
Vitals
No high risk chief complaint or other need for als monitoring or treatment exists
When do pts need to go to shock trauma for hyperbaric chamber.
Carboxyhemoglobin greater than 25%
Or
1 of these
Carboxyhemoglobin greater than 15%
Co monitor on aide bag activates
Ppm greater than 99 ppm
WITH one of these
History of LOC
Gcs 13 or less
Decline in Nuero functions
Pregnancy
Chest pain
Extremes in age
Discretion
Lams of 4 or 5 must go to
Comprehensive or thrombectomy capable stroke center
Shady grove, suburban
Washington hospital center, georgetown, GW
