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General Protocols > General Protocols > Flashcards

General Protocols Flashcards

1
Q

In what order should you attempt to contact medical direction for ALS level 2 orders?

A

1 medcom
2 telephone
3 relay of information via dispatch

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1
Q

What are some organic causes of behavioral emergencies that should be treated?

A

hypoglycemia
Hypoxia
Poisoning

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1
Q

When using any type of physical restraint you should?

A

Constantly monitor and observe patient to prevent injury
Place patient on ECG monitor and pulse ox
Carefully rationale for the use of restraints

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1
Q

With the violent/impaired patient it may be necessary for law enforcement to execute?

A

Involuntary certificate for examination

Baker Act FS 394.463

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1
Q

When is it imperative for the paramedic to attempt to have a female police officer accompany rescue to the hospital?

A

Cases of possible rape

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1
Q

Baker Act is?

A

Authorization of certain medical care for a person who poses a threat to self or others

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1
Q

Incapacitated persons law allows for?

A

Examination and treatment of incapacitated persons in emergency situations who are not capable of informed consent

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1
Q

CISM is?

A

Comprehensive, integrated, multicomponent, systematic program for crisis intervention

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1
Q

What is the purpose of CISM?

A

To provide education, support, assessment, and intervention for emergency service personnel who are exposed to or effected by critical incidents

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1
Q

CISM was formulated and standardized by the?

A

International crisis incident stress foundation

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1
Q

To be on the CISM team you must have completed?

A

3 of the core ICISF courses

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1
Q

How quickly is the broward CISM team designed to respond to a request for CISM?

A

Max of 2 hours

24 x 7 x 365

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1
Q

Small group CISM defusing is recommended for?

A

Within 12 hours after incident

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1
Q

Small group CISM debriefing is for?

A

12 to 72 hours past critical incident

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1
Q

Types of CISM services provided by broward CISM team?

A 
Pre event planning
Strategic planning and assessment
Individual intervention
Small group defusing
Small group debriefing
Crisis management briefing
Family crisis intervention
Organized consultation
Assessment of organizational needs
Development and recommendation for coordination and delivery of services
Pastoral/spiritual crisis intervention
Referral and follow up
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1
Q

Types of critical incidents?

A 
Pediatric death or injury
Multiple youth fatalities
Events with sever operational challenges
Line of duty death or injury
Officer involved shooting
Off duty death, suicide, injury or homicide
Events with multiple or mass casualties
Prolonged events with loss of life
events when victims are known
Events with excessive media interest
Any event that could perceivably cause emotional impact
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1
Q

What information should be supplied when requesting CISM?

A

Agency name
Type of incident
Number of members involved
Call back number

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2
Q

EMT or paramedic shall withhold or withdrawal DPR upon?

A

Presentation of an original or completed copy of DNRO

Presentation of observation of DNRO device on patient

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3
Q

DNRO form number?

A

1896

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3
Q

DNRO forms must be signed by?

A

Physician and patient

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3
Q

If a patient is incapable of signing a DNRO who may sign it?

A

Health care surrogate
Court appointed guardian
Person acting pursuant to a durable power of attorney

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3
Q

How may a person be identified for verification of a DNRO?

A

License
Other photo identification
From a witness in the presence of the patient

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3
Q

If using a witness to identify patient of DNRO what must be documented in the PCR?

A

Full name of witness
Address and telephone
Relationship

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3
Q

What care during transport will you not provide to a patient with a DNRO?

A

Pulmonary or cardiac resuscitation

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3
Q

EMS providers shall provide what care to DNRO patients?

A

Comforting
Pain relieving
Any care short of CPR

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3
Q

Who may at anytime revoke a DNRO?

A

Whomever signed it

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4
Q

How may a DNRO be revoked?

A

In writing
Physician destruction
Failure to present
Orally expressing a contrary intent

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5
Q

Who may determine a patient is dead/non salavagable?

A

EMT or paramedic

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5
Q

4 presumptive signs of death?

A

Unresponsive
Apnea
Pulseless
Fixed dilated pupils

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5
Q

4 conclusive signs of death?

A

Injuries incompatible with life
Tissue decomposition
Rigor mortis of any degree with warm air temp
Liver mortis of any degree

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5
Q

Liver mortis is?

A

Purple discoloration of skin

Does not blanch with pressure

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6
Q

Which patients require full ALS resuscitation unless they have injuries incompatible with life or tissue decomposition?

A

Hypothermia
Barbiturate overdose
Electrocution

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7
Q

Who is excluded in death in field protocol unless EMS personnel make contact with medical direction?

A

Children

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7
Q

What must be obvious in children death in the field for resuscitation not to be started?

A

Prolonged death

Or cases in which unexpected death has occured

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8
Q

A trauma victim who doe snot meet determination of death criteria may be determined to be dead if patient is?

A

Pulseless and apenic with asystole(confirmed in 2 leads)

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9
Q

A trauma victim who does not meet determination of death criteria and is pulseless and apenic with asystole in 2 leads may be determined to be dead if they have either?

A

Blunt trauma arrest

Prolonged extrication time where no resuscitative measure can be initiated prior to extrication

Arrest from primary brain injury or with no brain stem reflexes, arrest from multiple injuries

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10
Q

What amount of time is considered blunt trauma arrest?

A

15 minutes

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11
Q

What is required in determination of death in trauma arrest with prolonged extrication time?

A

Additional rhythm assessment followed by at least one reassessment after 15 minutes

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12
Q

If there is a delay in presentation of DNRO you should?

A

Start CPR

May be terminated with direction from medical control

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13
Q

What must be completed for a paramedic to terminate resuscitation?

A

Order from medical control

BLS and ALS treatments have been attempted without restoration of circulation or breathing

Advanced airway

IV medications and counter shocks

Persistent asystole ECG patterns present and no reversible causes

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13
Q

What must be attached to EMS report for death in the field?

A

ECG rhythm

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14
Q

Advanced airway in death in the field you must?

A

Verify by 2 paramedics
Leave in place
Confirm recorded on EMS report

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15
Q

Improperly placed advanced airway should be?

A

Left in place

Reported to appropriate personnel

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16
Q

Purpose of rehab protocol?

A

To examine and evaluate the physical and mental status of emergency workers working on an emergency incident or a training exercise and determine which treatment if any is necessary

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16
Q

It is recommended that a rehab area be utilized at all working incidents to provide?

A

A staging area for all on scene personnel

An immediate source of personnel for rescue or aid

Area for recovery and rehab of emergency workers

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17
Q

Where should a rehab area be located?

A

Away from environmental hazards

Readily accessible to rescue personnel for transport and supplies

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18
Q

What else will be located at the rehab area?

A

Air truck

Canteen service

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18
Q

In large incidents?

A

Multiple rehab areas may be necessary

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18
Q

If a specific location has not been assigned by the IC for rehab who will designate it?

A

The rehab officer

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18
Q

Rehab should be far enough away from the incident to allow for rescue personnel to?

A

Remove SCBA

Be afforded mental rest from the stress and pressure of the emergency operation or training evolution

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19
Q

The rehab officer shall secure all necessary resources required to staff and apply area. These items include?

A

Fluids
Food(3 or more hours)
Medical equipment
Other(cool zone and warming zone equipment)

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20
Q

Firefighters shall be evaluated by rehab when they have?

A

Used 2 SCBA bottles and/or 30 minutes of strenuous activity

SCBA failure

Weakness/dizziness, chest pain, muscle cramps, nausea/vomiting, AMS, difficulty breathing, other stress related symptoms

At the discretion of the IC, rehab officer, safety officer, CISM coordinator, company officer

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20
Q

A medical evaluation form shall be completed on who?

A

All personnel entering the rehab area and before they return to emergency work

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20
Q

Examinations of emergency workers in the rehab area will be conducted at what intervals?

A

10 minute intervals

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20
Q

Emergency worker rehab examination should include?

A 
GCS
Pupil response
Vitals
ECG
Lung sounds
Skin condition
Signs and symptoms
Oral temp
Pulse ox to include carboxyhemoglobin sat
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20
Q

How long must emergency workers who enter rehab rest prior to returning to work?

A

15 minutes

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20
Q

At no time should a emergency workers pulse exceed?

A

180

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21
Q

What is the normal resting pulse of an emergency worker?

A

100

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22
Q

What is the normal working pulse of an emergency worker?

A

Less than 120

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22
Q

Carbon monoxide for non smokers will be?

A

5%

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23
Q

Carbon monoxide for smokers will normally be?

A

Less than 8%

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24
Q

Carbon monoxide of more than what indicates moderate CO inhalation?

A

12%

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24
Q

Carbon monoxide reading of more than what indicates severe carbon monoxide inhalation?

A

25%

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25
Q

A body temp above what is abnormal in rehab?

A

100.6

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26
Q

Emergency workers can return to manpower when?

A

Presentations are normal

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27
Q

How quickly should workers presentations return to normal in rehab?

A

Within 15 minutes

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28
Q

What should be done if a team members HR exceeds 110?

A

Oral temp should be taken

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28
Q

If a emergency workers HR exceeds 110 and oral temp is greater than 100.6 you should?

A

Not permit member to wear protective equipment

Treat for heat stress and monitor for worsening conditions

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29
Q

Emergency responders will receive ALS treatment and transport if presentations are abnormal for more than?

A

15 minutes

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29
Q

Emergency workers presenting with what will immediately receive ALS treatment and transport?

A

Chest pain
Difficulty breathing
AMS

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30
Q

Abnormal presentations in emergency worker rehab include?

A 
Sp02 below 92%
HR greater than 120 for 15 minutes
CO levels above 25%
BP above or below workers normal levels
Symptoms of heat stroke
Oral temp greater than 100.6 of more than 15 minutes
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31
Q

Any emergency worker with CO levels of more than 8 but less than 15 should?

A

Be given opportunity to breath ambient air for 5 minutes

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32
Q

After giving emergency worker with CO level above 8 but less than 15 minutes 5 minutes to breath ambient air what should you do if CO level is still higher than 8%?

A

Give oxygen via mask until below 5%

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33
Q

No worker can leave rehab area until CO level is less than?

A

8%

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33
Q

Prior to the emergency worker taking anything orally he should?

A

wash his hands and face

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34
Q

What is the minimum amount of oral hydration for emergency worker rehab?

A

Minimum 1 to 2 quarts over 15 minute period

Water than full strength electrolyte

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35
Q

What type of substances should be avoided in hydration of emergency workers?

A

Caffeine

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36
Q

How much fluid shall members hydrate with while SCBAs are being changed?

A

8 ounces

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37
Q

What type of foods should be avoided in rehab incidents over 3 hours?

A

Fatty and salty foods

Soups, broths or stews digest much faster than sandwiches and fast food

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38
Q

Emergency workers assigned to rehab shall?

A

Enter and exit as a group

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39
Q

What shall be documented by the rehab officer on his check in/out sheet?

A

Crew designation
Number of crew members
Time of entry and exit

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39
Q

Crews should not exit the rehab area until?

A

Authorized to do so by the rehab officer

Vitals within normal limits

Minimum of 15 minutes of rest and hydration

Absense of abnormal signs and symptoms

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39
Q

Rehab officer shall deny return to duty of emergency worker if?

A

Vomiting, diarrhea, heat exhaustion in less than 72 hours

Large skin wounds/rash

Insulin dependent diabetic not eaten in past 4 hours

Wheezing or congested lungs

Respirations below 8 or above 40

Pulse above 120 or irregular

Sp02 below 92%

SpCO above 8 after oxygen

Oral temp above 101 or below 90

Systolic BP above 160 or below 100

Dizziness

Need for transport

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39
Q

Consider transport of emergency worker to hospital if has any of the following for 20 minutes

A 
Respirations less than 8 or more than 40
Pulse rate over 120
Sp02 less than 92%
SpCO greater than 8 after oxygen
Oral temp above 101 or below 90
Systolic BP above 160 or below 100
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39
Q

transport emergency worker to hospital immediately if?

A 
Irregular pulse
AMS
Symptoms of heat stroke
Significant head injury
SOB
Chest pain
Severe headache
SpCO above 25%
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39
Q

Where should you attempt to take a emergency worker with SpCO above 25%?

A

Hospital with hyperbaric chamber

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39
Q

What personnel will have a PCR completed on them?

A

ALS treatment and transport

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40
Q

What shall be completed on each firefighter or emergency worker who is not routinely returned to emergency operations?

A

EMS run report

Casualty report

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41
Q

How much water per hour should members consume in rehab?

A

1 quart per hour

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41
Q

A complete PCR shall be completed on in rehab?

A

Any member who receives treatment/transport

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41
Q

Standard dispatch for air rescue assignment?

A

1 rescue and 1 engine

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41
Q

HS should setup as to facilitate takeoffs and landings in which direction?

A

Into the wind

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41
Q

The approach and departure for air rescue HS should be clear of obstacles?

A

40 feet tall

Within 100 feet of HS

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41
Q

What is the minimum tailer rotor guard for air rescue at HS?

A

Minimum of 1

2 if available

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42
Q

Where should the marshaller stand on air rescue landings and takeoffs?

A

Outer edge of HS perimeter

Windward side

Back to wind

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43
Q

Who will have primary responsibility for marshaling duties?

A

Apparatus LT or captain

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44
Q

Who will maintain constant radio contact with helicopter and visual contact with marshaller?

A

Additional firefighter

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44
Q

Does the marshaller approach the aircraft?

A

No, remain vigilant at all times

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45
Q

What equipment shall a marshaller use?

A 
Helmet with chin strap
Goggles or visor down
Gloves
Full bunker gear
Flashlights with wands for night ops
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45
Q

When can you approach air rescue?

A

Only when given the all clear signal by crew members

All personnel approach air rescue must stay in constant contact with pilots field of vision at all times

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46
Q

What should not be used on air rescue HS?

A

Road flares
Spotlight or headlights shined at helicopter

Shinning lights or strobes may cause vertigo, night blindness or seizures in pilot

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46
Q

It is imperative that ground rescue do what prior to air rescue arrival?

A

Contact receiving facility

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47
Q

Which information needs to be relayed to air rescue?

A

Number of patients

Receiving facility

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48
Q

What is the minimum amount of backboard straps a patient should be secured with when transporting by air rescue?

A

3

Unless contraindicated by condition

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49
Q

Where should you place an additional backboard strap on unruly patients?

A

Over the knees

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50
Q

How many people will carry the stretcher to air rescue?

A

Minimum 4

1 must be a air rescue crew member

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51
Q

What must each person carrying stretcher to air rescue be wearing?

A

Helmet with face shield and chin strap

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52
Q

If using a stretcher to carry a difficult patient to air rescue what must be removed?

A

Pillows, sheets, mattress

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52
Q

What procedures are acceptable to delay transport when using air rescue?

A

Those used to maintain airway

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52
Q

What should you advise air rescue of when in route?

A

Additional equipment for difficult airway

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53
Q

Where should rescue crews remain until helicopter has manded?

A

At least 100 feet away or at incident site

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54
Q

No personnel should approach air rescue unless?

A

Cleared in by air rescue crew members

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55
Q

In the event that air rescue crews require assistance with patient care who will accompany patient during air transport?

A

Paramedic in charge

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56
Q

What is the minimum size of a HS?

A

100 x 100

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57
Q

What is the sequence information should be communicated to ER physician?

A 
Priority code and receiving facility
Rescue number/paramedic name
Patient age/sex
Patient complaint or major problem/time of onset
Assessment:mental status, ROM, pupils, skin,  BBS, BP, P, R, ECG, hemodynamic condition
GCS
MOI
Hx of illness, meds used, allergies
Treatment given
ETA
58
Q

Priority 1?

A

Critical

59
Q

Priority 2?

A

Serious

60
Q

Priority 3?

A

Stable

61
Q

Priority 4?

A

Admin traffic

62
Q

A critical patient is one who?

A

Presents with immediately life threatening illness or injury

63
Q

A serious priority patient is one who?

A

Presents with illness or injury requiring immediate medical intervention and that has potential to become life threatening if not treated promptly

64
Q

A stable patient is one who?

A

Presents with illness or injury not requiring immediate medical intervention or that is so easily managed that medical direction is not required

Also used for notification of impending patient arrival to facility

65
Q

A trauma alert is communicated via?

A

Fire dispatch

66
Q

A second trauma alert contact should be made?

A

Via medcom to hospital

67
Q

When communicating trauma alert you must include?

A 
Rescue number/name
Name of receiving facility
Category(adult, pediatric, obstetrical)
Trauma alert criteria
Patients sex
Number of patients
ETA and by ground or air
68
Q

Who should receive proper evaluation, treatment, and transport to appropriate facility?

A

All patients of potential patients

69
Q

For a person to refuse medical care they must be presumed?

A

Competent

70
Q

In cases of refusal of care in minors attention should be given to signs of?

A

Child abuse

71
Q

What patients are able to refuse care?

A

Competent adults, emancipated minors or legal representative of a patient

72
Q

A competent patient is defined by the ability to?

A

Understand the nature and consequences of his actions by refusing medical care and/or transport

73
Q

A person is considered an adult if they are?

A

Over 18

Emancipated minor

74
Q

Emancipated minors are?

A

Self sufficient minors
Married minors
Minor in the military

75
Q

What patients are not able to refuse care?

A

Incompetent patients

76
Q

A person is considered incompetent and unable to refuse medical care of transport if?

A

The severity of the medical condition prevents the patient from making an informed rational decision regarding medical care

77
Q

A person may not refuse medical care if they have?

A 
Altered LOC
Suicide attempt
Severally altered vital signs
Mental retardation of deficiency
Not acting as a reasonable person would given the same circumstances
Younger than 18
78
Q

Under what principle may a person be treated and transported who is considered incompetent?

A

Implied consent

79
Q

Implied consent is?

A

What the reasonable individual person would consent to under the same circumstances?

80
Q

Under the refusal of care procedure you should determine that the individual is involved in the?

A

Incident

81
Q

When a patient is refusing care you should determine individual is refusing to allow for?

A

Proper evaluation
Necessary treatment
Necessary transport

82
Q

Unless a person specifically refuses you should complete what on all patients?

A

Complete physical exam

83
Q

What must you inform the patient who is refusing care of and make sure they completely understand?

A 
Potential consequences(loss of limb or life, irreversible sequalae) 
The explanation
84
Q

All measure should be taken to convince patient to consent including?

A

Enlisting help of friends and family

85
Q

If a patient fully refuses medical are the paitent or responsible party should?

A

Sign a refusal of care

86
Q

When a person signs a refusal of care what information should be provided?

A

Release is against medical advice
Release applies to this instance only
EMS should be requested again if necessary

87
Q

After a refusal of care is signed it must be?

A

Witnessed(legibly printed name, contact information, signature of witness)

88
Q

When can you combine refusal of care of multiple patients on 1 report?

A

When individuals refuse ALL assistance

Including proper evaluation

147
Q

What must be documented in refusal of care in multiple patients?

A

Name
Addresses
Witnesses

147
Q

When should medical direction be contacted for consultation in instances of refusal of care?

A

Low severity under 18
Patient who represents a significant risk to patient of EMS system
Patient who is not own legal guardian
Post seizure of administration of D50 or Narcan

148
Q

When a patient refuses to be transported to the closest appropriate facility this is considered?

A

Refusing transport

Contact local department supervisor

149
Q

What is the purpose of the mass casualty incident protocol?

A

Efficiently triage, treat, transport victims of MCI’s

150
Q

What should the officer of the first arriving unit do in MCI’s?

A

Establish command
Perform scene size up estimating number of victims
Request level 1-5 response
Identify staging area
Direct remaining crew and additional personnel arriving to initiate triage
Triage in accordance with START or JumpSTART

151
Q

Red ribbon means?

A

Immediate care is needed

151
Q

Yellow ribbon means?

A

Delayed care is needed

152
Q

Green ribbon means?

A

Ambulatory(minor injury)

152
Q

Black ribbon means?

A

Deceased(non-salavagable)

153
Q

Al walking wounded should be?

A

Located and directed to one location away from incident

154
Q

What opfficers need to be designated by command at MCI’s?

A

Triage
Treatment
Transport
Staging

155
Q

In MCI’s if suspected or known WMD event command should designate what officer to assist with decontamination, antidotes and treatment?

A

Medical intelligence officer

156
Q

When will trauma transport decision be made?

A

Secondary triage in treatment phase

157
Q

Who will medcom relay information to about hospital capabilities?

A

Transport officer or medical communications officer

158
Q

A strike team is a ?

A

Specific combination of the SAME KIND of resources with common communications and a leader

159
Q

A task force is?

A

A GROUP of resources with common communications and a leader

159
Q

Level 1 MCI?

A

5 - 10 patients

159
Q

Level 2 MCI?

A

11 - 20 patients

160
Q

Level 3 MCI?

A

21 - 100 patients

160
Q

Level 4 MCI?

A

101 -1000 patients

160
Q

Level 5 MCI?

A

Over 100 victims

161
Q

Who do triage, treatment, and transport branch officers report to?

A

Medical branch

162
Q

Who does medical communications coordinator report to?

A

Transport officer

163
Q

Staging officer reports to?

A

Command

164
Q

How many triage tags should each MCI kit have?

A

50

165
Q

When does secondary triage happen?

A

Treatment phase

166
Q

Who is responsible for coordination of victims and maintenance of records relating to victim identification, injuries, mode of transport, and destination?

A

Transport officer

167
Q

White vest?

A

Command

168
Q

Blue vest?

A

Medical officer

169
Q

Yellow vest?

A

Triage officer

170
Q

Red vest?

A

Treatment

171
Q

Green vest?

A

Transport

172
Q

Green striped vest?

A

Medical communication coordinator

172
Q

Blue striped vest?

A

Med supply

172
Q

Orange vest?

A

Staging

172
Q

When do you remove a ribbon of a MCI victim?

A

Once you have completed and attached a triage tag in secondary triage

172
Q

When do you determine priority of transport in MCI’s?

A

Treatment phase

173
Q

What does RPM stand for?

A

Respirations
Perfusion
Mental status

173
Q

What should you do once you have encounter a red in the START assessment?

A

Stop, dont proceed any further

Tag red

174
Q

What problems should be managed during triage of MCI?

A

Only life threatening problems such as airway and major bleeding

175
Q

During triage of an adult if respirations are more than 30 you should?

A

Tag red

176
Q

During adult triage if a patient is not breathing you should?

A

Open airway

Remove obstruction if seen and assess for respirations

177
Q

If adult victim is not breathing after opening airway and removing obstruction you should?

A

Tag black

178
Q

If during adult triage patient has respirations less than 30 and radial pulse you should?

A

Assess mental status

179
Q

If during adult triage patient has respirations less than 30 but no radial pulse you should?

A

Tag red

180
Q

If during adult triage patient has radial pulse and respirations less than 30 but does not follow commands is disoriented or unconscious you should?

A

Tag red

181
Q

When do you control major bleeding in triage assessment?

A

While assessing perfusion

182
Q

Who is responsible for maintaining status information(# of victims, hospital readiness to accept victims) in MCI’s?

A

MRCC(medical resource coordination center)

183
Q

How do you check for a person mental status in triage?

A

Check the victims ability to follow simple commands

Check orientation to time, person, place

184
Q

What color tag should you prioritize a patient who has respirations under 30, radial pulse and is oriented x3?

A

Green

185
Q

When would you prioritize a MCI victim as yellow?

A

Depending on victims injuries if they don’t qualify for any red tags

186
Q

When should you use the JUMPstart triage assessment?

A

Patients younger than 8

Patients with anatomical or physiological features of a child

187
Q

For the JUMPstart assessment of respirations when should you move on to the perfusion assessment?

A

Respirations between 15 and 45

188
Q

During JUMPstart assessment you should tag red if respirations are?

A

Under 15

Over 45

189
Q

If patient is not breathing during JUMPstart assessment you should?

A

Open airway
Remove obstruction
Assess breathing

190
Q

If a patient is not breathing after opening airway or removing obstruction in the eJUMPstart assessment you should?

A

Check a radial pulse

191
Q

If a victim is not breathing but has a radial pulse or pedal pulse in the JUMPstart assessment you should?

A

Provide 5 ventilations

Approx 15 seconds

192
Q

If spontaneous respirations resume after giving 5 breaths to a victim who was not breathing with a radial pulse you should?

A

Tag red

193
Q

If victim is still not breathing after giving 5 breaths in JUMPstart assessment you should?

A

Prioritize black

194
Q

When assessing perfusion in the JUMPstart assessment when should you move on to mental status?

A

When there is a peripheral pulse

195
Q

When should you tag a victim red in the perfusion portion of the JUMPstart assessment?

A

When there is no peripheral pulse

196
Q

When assessing mental status in a victim with the JUMPstart assessment you should tag red if?

A

Only responding to pain

Unconscious

197
Q

If a victim is alert or responds to verbal stimuli in the JUMPstart assessment?

A

Assess for further injuries and prioritize as yellow or green

198
Q

When do you assess infants who are developmentally unable to walk with the JUMPstart assessment?

A

Either during initial triage or in the green area if carried out by a non rescuer

199
Q

If an infant does not fulfill the criteria of a red victim and has no other outward signs of significant injury they may be triaged as?

A

Green

200
Q

What information should be obtained if possible form the 911 caller?

A 
Nature of emergency
Location of incident
Call back number
Number of patients
Severity of illness/injury
Name of caller
201
Q

Who should be immediately notified if on scene personnel recognize a need for other emergency agencies?

A

Dispatch

202
Q

Who should be notified as soon as possible of trauma alert patients?

A

Dispatch and trauma center

203
Q

Who should dispatch immediately transfer the trauma alert information to supervisor on duty?

A

Dispatch using the word trauma alert

204
Q

When is a rescue helicopter to be used for trauma alert patients?

A

If transport by ground will be more than 20 minutes

205
Q

When can you use rescue helicopter to transport level 2 trauma alert patients?

A

If transport by ground is more than 30 minutes

206
Q

Use air rescue if a trauma alert patient extrication is going to be more than?

A

20 minutes

207
Q

Who should pre-alert trauma center when a patient is going to be transported by air rescue?

A

Ground crew

208
Q

How many lanes should be obstructed for air rescue to land on a roadway?

A

Minimum of 3

209
Q

Components of a trauma alert assessment?

A 
Airway
Circulation
BMR
Cutaneous
Long bone fracture
Patients age
Mechanism of injury
209
Q

Airway red?

A

Active ventilatory assistance due to injuries causing ineffective or labored breathing beyond administration of oxygen

210
Q

Circulation red trauma alert?

A

Lacks radial pulse with sustained HR above 120 or BP less than 90

211
Q

Trauma alert BMR red?

A

4 or less GCS motor assessment
Presence of paralysis
Suspicion of spinal cord injury
Loss of sensation

212
Q

Trauma alert cutaneous red?

A

2nd or 3rd degree burns over 15% of BSA
Electrical burns regardless of surface calculation from high voltage/direct lightening
Amputation proximal to wrist or ankle
Any penetrating injury to head, neck, torso(excluding superficial wounds where depth can be determined)

212
Q

Trauma alert longbone fracture red?

A

Signs of 2 or more lone bone fractures

212
Q

Trauma alert red GCS?

A

Less than 12

Paramedic judgement

212
Q

Trauma alert airway blue?

A

30 or greater

213
Q

Trauma alert circulation blue?

A

Sustained HR of 120 or greater

214
Q

Trauma alert BMR blue?

A

BMR of 5 on GCS

215
Q

Trauma alert cutaneous blue?

A

Soft tissue loss from either a major de gloving injury, flap evulsion greater than 5 inches, sustained gunshot wound to extremity of body

216
Q

Trauma alert long bone fracture blue?

A

Signs and symptoms of single long bone fracture resulting from motor vehicle accident or fall from an elevation of 10 feet or greater

217
Q

Trauma alert age blue?

A

55 or greater

218
Q

Trauma alert MOI blue?

A

Ejected from motor vehicle

Impacted steering wheel causing deformity

219
Q

What age is considered pediatric when referring to trauma alerts?

A

15 or under

219
Q

Pediatric trauma alert airway red?

A

Active ventilatory assisstance

220
Q

Pediatric trauma alert consciousness red?

A 
Altered mental
Lethargy
Drowsiness
Inability to follow commands
Unresponsive to voice or painful stimuli
Suspicion of spinal cord injury with or without presence of paralysis or loss of sensation
220
Q

Pediatric trauma alert circulation red?

A

Faint or non palpable carotid or femoral pulse

Systolic BP less than 50

220
Q

Pediatric trauma alert long bone fractures red?

A 
Evidence of open long bone
Multiple fracture sites
Multiple dislocations(except for wrist or ankle)
221
Q

Pediatric trauma alert cutaneous red?

A 
Major degloving injury
Major soft tissue disruption
Major flap evulsion
2nd or 3rd degree over 10%
Electrical burns
Amputation proximal to wrist or ankle
Penetrating injury to head, neck or torso
222
Q

Trauma alert consciousness blue?

A

Patient exhibits signs of amnesia

Loss of consciousness

223
Q

Pediatric trauma alert circulation blue?

A

Carotid or femoral pulse is palpable but radial or pedal are not
Systolic BP less than 90

224
Q

Pediatric trauma alert long bone fracture blue?

A

Signs and symptoms of sign long bone fracture

225
Q

Pediatric trauma alert weight blue?

A

Less than 11kg

Body length is equivalent to this weight on a pediatric weight based tape(33 inches)

226
Q

Adult fall height level 2 trauma alert?

A

12 feet

227
Q

Level trauma alert pediatric fall height?

A

6 feet

228
Q

What 4 things in vehicle accidents meet level 2 trauma alert?

A

Extrication time over 15 minutes
Rollover
Death of passenger in same compartment
Major intrusion into passenger compartment

229
Q

Ejection form bicycle meets what level trauma alert?

A

2

230
Q

What speed must a vehicle have been going that struck a pedestrian to call a level 2 trauma alert?

A

15 MPH for adults

5 MPH for pediatrics

231
Q

What does GCS measure?

A

Cognitive ability

232
Q

3 components of GCS?

A

Eye
Verbal
Motor

233
Q

Eye opening to verbal GCS?

A

3

234
Q

Eye opening to pain GCS?

A

2

235
Q

No eye opening GCS?

A

1

236
Q

Eyes open spontaneously GCS?

A

4

237
Q

Inappropriate words GCS?

A

3

238
Q

No verbal response GCS?

A

1

239
Q

Incomprehensible sounds GCS?

A

2

240
Q

Oriented verbal response GCS?

A

5

241
Q

Confused verbal response GCS?

A

4

242
Q

Extension to pain GCS?

A

2

243
Q

Withdrawal from pain GCS?

A

4

244
Q

No motor response GCS?

A

1

245
Q

Flexion to pain GCS?

A

3

246
Q

Obeys commands GCS?

A

6

247
Q

Localizing pain GCS?

A

5

248
Q

Highest possible GCS?

A

15

249
Q

Lowest possible GCS?

A

3

250
Q

Mild brain injury GCS?

A

13 or higher

251
Q

Moderate brain injury GCS?

A

9-12

252
Q

Severe brain injury GCS?

A

8 or less

253
Q

3 trauma centers in broward county?

A

North Broward
Broward
Memorial general

254
Q

2 pediatric trauma centers in broward?

A

Broward general

Memorial General

255
Q

Influenza and Tdap vaccinations are offered?

A

Annually

October through February

256
Q

What infectious diseases require a baseline screening?

A

TB, Hep A B C

Meningitis is covered under presumtive law but does not require baseline

257
Q

A non significant exposure is one that has?

A

Little to no risk of transmission of disease known at this time

258
Q

What must be done with all non significant exposures?

A

Fill out a infectious disease exposure report form incase of increased risk is documented

259
Q

Action or injury causes a significant exposure?

A 
Any body fluid
Through the skin
Eyes nose or mouth
Within 2 hours of shaving
Within 24 hours of scabs
260
Q

Who should a disease exposure form be submitted to?

A

Designated infection control officer

261
Q

A significant exposure worker should be transported for evaluation, testing, and treatment within?

A

2 hours

Preferably to a facility with rapid HIV testing if material was blood or body fluids

262
Q

What test should be preformed post exposure?

A

Rapid HIV
Acute hepatitis panel
RPR syphilis

263
Q

Who is a TB test performed on in a suspected airborne droplet exposure?

A

Source and worker

264
Q

Who do you not perform a TB test on in suspected TB exposure?

A

Worker with test less than 12 weeks prior

Worker with hx of positive skin test

265
Q

How quickly must a hospital notify an agency of increased risk of disease transmission if no exposure was report?

A

48 hours

266
Q

When will follow up testing occur for blood and body fluid exposure?

A

Week 6, 12, and 26

Testing after 1 year may be indicated for high risk exposures

General Protocols (1 decks)

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