Intro To Pt Protocols And Standing Orders

Question 0

True or False: the current field protocol and standing order manual will supersede any and all prior patient care protocol manuals?

Answer 0

True

Question 1

The patient care protocols and standing orders outlined in the manual are intended to serve as _____________ .

Answer 1

Guidelines

Question 2

Yes or No: are the protocols meant to substitute for sound paramedic judgement?

Answer 2

No, they are guidelines.

Question 3

It is __________ that any deviation from these protocols are included and well documented in the EMS patient care report and brought to the attention of the _______ _________ on duty ASAP.

Answer 3

Mandatory

EMS Supervisor

Question 4

Some protocols require contact with_____________?

Answer 4

Online medical control

Question 5

True or False: It is important that all therapies and interventions be administered randomly.

Answer 5

False, in sequence.

Question 6

In the rare event of loss if radio contact between the __________ and ________ ___________ ____________, these protocols must be followed __________.

Answer 6

Ambulance
Base station hospital
Exactly

Question 7

The protocols are considered to be a _____________ process.

Answer 7

dynamic

Question 8

hypertensive parameter?

Answer 8

Systolic BP >220

Diastolic BP >110

Question 9

Hypotensive parameter

Answer 9

Systolic bp <100

Question 10

Tachycardia (adult) parameter

Answer 10

Heart rate >100 bpm

Question 11

Bradycardia parameter (adult)

Answer 11

Heart rate <60 bpm

Question 12

Tachypnea parameter (adult)

Answer 12

Respiratory rate >24 breathes per min

Question 13

Hemodynamically Stable parameter

Answer 13

Pt does NOT have hypotension,tachycardia, or evidence of impaired generalized perfusion (delayed capillary refill,etc)

Question 14

Hemodynamically Unstable parameter

Answer 14

Pt HAS hypotension, tachycardia, or evidence of impaired generalized perfusion

Question 15

Neonate/newborn def

Answer 15

<28 days old

Question 16

Infant def

Answer 16

> or = to 28 days old and <1 yr old

Question 17

Child def

Answer 17

> or = to 1yr old and <8 y/o

Question 18

Pediatric def

Answer 18

Age < or = to 16 y/o OR wt <40kg

Question 19

Adult def

Answer 19

Age >16 y/o OR wt > or = to 40kg

Question 20

EMT-B skills allowed are:

Answer 20

Spinal motion restriction
Bandaging splinting dressing
Cardiopulmonary resuscitation 
Oropharyngeal nasopharyngeal airway
Oral suctioning
Oxygen administration
Automatic external defibrillator
Blood glucose assessment
Pulse oximetry
Emergency childbirth
Traction splints
Albuterol nebulizers
Intramuscular 1:1000 epinephrine
Oral glucose

Question 21

Paramedic skills allowed are:

Answer 21

Orotracheal intubation
King tube airway device
Naloxone Narcan intramuscular or intravenous
End-tidal CO2 monitoring
Peripheral IV access
Diphenhydramine IM or IV
Dextrose 50% Ivy
All medications authorized in this protocol manual
Pleural decompression (needle thoracostomy)
Transthoracic external cardiac pacing
External jugular venous cannulation
Intraosseous access
Four lead cardiac rhythm interpretation
Manual defibrillation/synchronized cardioversion
12 lead cardiac acquisition

Question 22

Texas DSHS defines the minimum advanced life support ambulance as:

Answer 22

Including all BLS equipment
plus IV equipment IV fluids
Intubation equipment
Dextrose 50%

Question 23

Texas DSHS defines the minimum mobile intensive care unit ambulance as:

Answer 23

All ALS supplies and equipment
Plus cardiac monitor/ defibrillator
And medications

Question 24

All patients with an emergency life-threatening condition as deemed by paramedic assessment should be transported to:

Answer 24

Closest appropriate hospital

Question 25

In the event of a mass casualty incident incident commander or his or her designee should contact:

Answer 25

The local receiving hospitals as soon as possible

Question 26

What is the trauma criteria for Driscoll Children’s Hospital?

Answer 26

Nonpenetrating pediatric trauma patients less than 14 years old

Question 27

The term that defines patients who are in the category of “major trauma patients”

Answer 27

Trauma code

Question 28

The purpose of the trauma code is for:

Answer 28

The efficient and effective care of the trauma patient who may require a multidisciplinary approach to care

Question 29

The term trauma alert defines patients who are:

Answer 29

Those who have sustained a transfer of force or injury sufficient to be a threat to limb or life but does not at the time of field triage qualify as a trauma code patient

Question 30

True or false: when calling report to trauma hospital advise the receiving facility of the type of trauma activations you would like to begin

Answer 30

False. Do not request one of the activations only give the patient report as you would for any patient

Question 31

Why do you notify the receiving hospital of a trauma as soon as possible?

Answer 31

So that the trauma team can be activated

Question 32

Level one trauma code activation criteria:

Answer 32

Traumatic arrest
Sufficient facial trauma as to compromise the airway
Signs of hemodynamic instability
• respiratory rate 30
• systolic BP < 90
• Head injury and a GCS 15%(2nd 3rd) or resp distress
Transfer Pts receiving blood to maintain vital signs
Pelvic instability with hypotension

Question 33

Level two trauma alert activation criteria:

Answer 33

Pelvic instability
Flail chest
Open or depressed skull fx
Ejection from a vehicle
Falls >20 feet adults and >10 feet in children
Pregnant trauma patients > 20 weeks gestation with injuries/pain

Question 34

Diaphoresis is an ___________ sign

Answer 34

Ominous.

Diaphoreses signifies sympathetic nervous system response, catecholamine release

Question 35

What are the fundamental components to standard of care?

Answer 35

1. the patient benefits from early medical interventions
2. The patient defines the emergency
3. EMS is an extension of the medical care into the field and not merely a mode of transportation to the hospital

Question 36

Under standard of care components the first one: the patient benefits from early medical interventions; what are they?

Answer 36

A. The early and aggressive application of oxygen therapy
B. The early use of defibrillation
C. The early protection of in-line C-spine stabilization
D. The early initiation of definitive therapies

Question 37

Vital signs should be taken on code 3 transports every how many minutes?

Answer 37

5

Question 38

Vital signs should be taken on code 1 transports every ____ minutes?

Answer 38

15

Question 39

With a load and go patient the following interventions should be done prior to transport if possible:

Answer 39

• BLS, airway and ventilation procedures
• intubation if it can be accomplished rapidly
• defibrillation
• spinal motion restriction
• Control of gross external hemorrhage with direct pressure
• occlusion of open chest wounds
• 12 lead EKG if indicated

Question 40

Rapid transport is indicated for:

Answer 40

• Adult and pediatric trauma code patients
• Head injury or suspected stroke with GCS <10
• suspected aortic aneurysm
• suspected ectopic pregnancy, fetal distress, abruptio placenta, or uterine rupture
• patients with significant abdominal pain or G.I. bleeding and unstable vital signs