Ems Flashcards
What is the dose of albuterol given via nebulizer?
2.5 mg
To effectively maintain awareness of changes in the patients conditions, repeated assessments are essential and should be performed?
Unstable patients every 5 minutes
Stable patients: every 15 minutes
In order to allow a patient to refuse care and/or transport you must conduct 3 assessments first what are they?
- Legal capacity to refuse care
- Mental capacity to refuse care
- Medical or situational capacity
What are the clinical indications fo using the aed?
- Patient in cardiac arrest (pulseless,apneic)
2. Age 1-8 use reduced energy pediatric pads
Sexual assault patients <18 years of age should be transported to?
H2 children’s national hospital center
What is the dose of atrovent given via a nebulizer?
500 mcg nebulized
If the patient is >8 years of age with a blood glucose level of ________________ and displays signs/symptoms of hypoglycemia, administer oral glucose 24-50 gm SL if the patient is conscious enough to swallow
<70 mg
What are the normal vital signs for an adolescent?
Respiration’s:12-24
Pulse: 60-100
Blood pressure: greater than 90
The current hospitals in d.c. identified as designated stroke centers are?
H5- Howard H7- Georgetown H8- GW H10- providence H12- sibley H13- Washington hospital center
What medication can be administered intranasal by all provider levels?
Narcan
Patients requiring artificial ventilation or assisted ventilations shall be ventilated with a bag a valve mask (bvm)__________________ supplemental oxygen?
100%
When the BLS provider contacts medical control which hospitals are medical control hospitals for patients being transported to them?j
Each hospital serves as its own medical control
A reading of _______________ indicates severe carbon monoxide inhalation
25 %
What does avpu stand for?
Alert,verbal,painful stimuli, unresponsive
In what position shall the patient never be placed in suspected cases of excited delirium?
Prone position
In general indications for a referral to a burn center apply to patients with a basically __________________ or _________________ burns
2nd or 3rd degree burns
For asthma and copd patients the cpap device is started at 10 cmH20 with an in line nebulizer?
False 5 cmh 20
Upon arriving at a receiving facility , EMS providers will not initiate new medical care once they cross the threshold of the facility?
True
When you have a pediatric patient and need to contact medical control what hospital would you utilize?
H2 children’s national hospital center
For thermal burns with suspected smoke inhalation, how should the oxygen be administered?
If smoke inhalation is suspected provide humidified air
What is the condition for precaution with oxygen?
Utilize the prescribed dose of a copd patient unless the patient is in severe respiratory distress, then 100% is required
To inquire about pertinent past medical history you may use the acronym?
Sample
What is the cutoff age to take a child with a major burn or major trauma to children’s hospital?
15 years old
If a patient with a medical history of asthma, and is extremis you should administer
Epinephrine 0.3 mg via auvi Q
On what channel can you contact poison control?
H11 or 1-800-222-1222
A patient with asthma/copd that presents respiratory distress with suspected bronchospasm/wheezing. How many times may all providers administer albuterol with atrovent via a nebulizer?
One time only for prehospital care
What hospital has a hyperbaric chamber?
H8 GW
When does the PDOA protocol not apply to the trauma patient that is pregnant?
Greater than 20 weeks of gestation except when there is apparent dependant lividity and rigor mortis
What hospitals are the major trauma centers inside the District of Columbia that are adult major trauma capable?
H4- medstar
H5- Howard university
H8- GW
If a narcotic (opiate) overdose is suspected with a GCS of less than 13, the BLS provider shall administer?
Naloxone (narcan) 2 mg intranasal. May repeat twice
A reading of _______________ indicates mild carbon monoxide inhalation
12%
Medical communications is a vital component of pre hospital care, medical communication with medical control or a receiving facility should be conducted for every ___________________ patient?
Priority 1 patient
The king airway may be considered the initial airway of choice in the cardiac arrest patient. The 3 contraindications are?
- Patients who are conscious or have a intact gag reflex
- Patients under 3ft in height
- Patient with known esophageal disease or ingestion of caustic substance
Narcan’s two indications are?
- Suspecting narcotic/opiate overdose
2. Altered mental status of unknown origin
An ALS provider may transfer care to bls provider even if a medication is given by the ALS provider as long as the patient is stable
True
When transmitting patient information _______________ include personnel or sensitive information?
False
Patients exhibiting signs of moderate to severe respiratory distress due to pulmonary edema or near drowning should be placed on what device?
(Cpap) continuous positive air pressure
When using oxygen (O2) on an adult patient the dosage should be ________________ for bvm _________________ via NRB mask, or __________________ via nasal cannula
Greater than or equal to 15 Lpm
12-15 Lpm
2-6 Lpm
What is implied consent
When a patient is unable to express consent because of altered mental status or severe distress
What would a provider do if a patient presentation is atypical and the protocol treatment may not be in the best interest for the patient or in any situation where the ems provider is not sure about the best treatment for the patient?
Contact medical control
If a patient presents with a severe anaphylactic reaction with associated hypo-perfusion and/or respiratory distress, proceed to the following treatment regimen?
Epinephrine auto injector adult: 0.3 in adults
0.15 in pediatrics
Insufficient respiratory effort includes what clinical findings
Less than 8 respiration’s per minute for adults, or below the normal limits for pediatrics.
Greater than 26 respiration’s for adults, or above the higher limits of normal for pediatrics.
No visible chest rise, pulse or less than 90%
In cpr pit crew position 3 is responsible for what 3 functions?
- Open and clears the airway
- Inserts appropriately sized king airway (per protocol) and continue ventilation’s
- Provides bvm at appropriately rate and depth
_________________ is a limb and life threatening condition seen when perfusion pressure falls below tissue pressure in a closed anatomical space in instances of long bone fractures, high energy trauma,crush injuries?
Compartment syndrome
All patients with an amputation should be transported to medstar? True or false
False
What are the aspirin contraindications?
- Hypersensitivity
2. Signs and symptoms of acute cva
In general patient care for a patient with chest pain, you should administer ______________ PO ( chewed or swallowed) if not taken during the previous 24 hours or has a known allergy?
Aspirin 324 mg
What determines priority level?
- Unstable patient
- Potentially unstable
- Stable patients
In cpr pit crew position 1 is responsible for what 3 functions
- Assess responsiveness and check pulse
- Initiates chest compressions immediately
- Alternates chest compressions with position 2
What are the hospital codes within the District of Columbia
H1- United medical center H2- children’s national medical center H4- medstar H5- Howard university H6- psychiatric institution of Washington H7- Georgetown H8- GW H9- children’s at United medical center H10- providence H12- sibley H13-Washington hospital center H15- veterans administration
Members shall administer supplemental oxygen in order to maintain sp02 level of at least____________
94%
Stable patients with isolated eye trauma should be transported to which hospital?
Howard university
What are the contra indications when using the aed?
- Traumatic cardiac arrest
- Patient with fully obstructed airway
- Hazardous environment
When delivering medication via a nebulize the liter flow rate should be set at?
10 Lpm
What are the contraindications for the resQpod?
- Patient under 8 years of age
- Cardiac arrest secondary to trauma
- Remove the device immediately with return of spontaneous circulation (rosc)
What is expressed consent
Written or verbal request to be evaluated and treated
The 3 contraindications for requesting aero medical evacuation of a patient includes?
- Patient in cardiac arrest
- Patient been exposed to hazardous materials
- Patient is combative and violent
Vital signs minimally consist of what procedures?
Respiration’s,pulse, blood pressure
Hospitals will designated personnel to assess patients brought by ems transport units with the goal of transferring care and releasing unit within _______________ of the patients arrival to the emergency department?
10 minutes
Consider activation of the _________________ for a patient involved in an unusual extrication, prolonged crush injury, or possible field amputation
Go team
What percentage of body surface area percent occupies each arm regarding burns in adults and children?
9%
List 4 signs and symptoms of carbon monoxide poisoning
Headaches Errors in judgment Confusion Loss of coordination Loss of consciousness Chest pain Cyanosis Seizures Irritability Vomiting
The first step of treatment for carbon monoxide poisoning is?
Remove patient from contamination if safe to do so
Use of pulse oximeter is a reliable tool for measuring O2 saturation with carbon monoxide poisoning?
No, pulse ox gives false readings
Whom should you contact if you need assistance in managing specific overdose?
Medical control or poison control
Cyanide is a cellular toxin it halts respiration at the?
Cellular level
What are some early signs and symptoms of cyanide poisoning?
Anxiety Headaches Tachypnea Tachycardia Vertigo Weakness Vomiting (nausea) Dyspnea
If you have a patient that has been bitten/stung by an insect,reptile, or animal that has caused injury to the patient, should you bring the living animal to the hospital with you?
No, never transport live animal/reptile to hospital
If an anaphylactic reaction occurs as a result of a bite or sting you should?
Administer epi in per protocol. Adult 0.3/ pediatric .15
Once the head emerges, suction the newborns mouth then nose to clear secretions. If the cord is wrapped around the newborns neck, what shall the provider attempt to unwrap from the neck?
Attempt to unwrap cord from around neck. If unable to do so, clamp cord at the 6 and 8 inch and cut in between
