LCCTG Medical Guidelines Flashcards
What is the guideline age for an adult?
13yo+ or puberty
What is the guideline age for a pediatric?
1-13yo
What is the guideline age for an infant?
1month-1 year
What is the guideline age for a neonate?
birth-1 month
Lee Health considers any patients less than _____ to be pediatrics?
18yrs
Trauma alert criteria adult age is what?
16yo+
What are the six medication “rights”?
Patient Drug Dose Route Time Documentation
How many intubation attempts are allowed?
two
Which method of laryngoscopy is preferred?
Video
The passing of a tube past what landmark constitutes an intubation attempt?
beyond the teeth
What should be inserted with all advanced airways?
gastric tube
Proper ventilation consists of adequate what?
Tidal volume
Rate
PEEP increases what?
Functional residual capacity
What is the range for PEEP?
5-15cm H2O (5, 7.5, 10, 12.5, 15)
Tight lung pt PEEP setting is typically?
5cmH2O
Wet lung pt PEEP setting is typically?
7.5-15cmH2O
PEEP greater than 15 can result in what?
increased intrathoracic pressure causing decrease in venous return and cardiac output
Two contraindications for PEEP?
Cardiac arrest
Gross hypotension
Apneic nasal oxygenation at what setting has been shown to improve O2 saturation in apneic pt’s during advanced airway placement?
NC @ 15 lpm
What two monitoring devices are required for all advanced airway pt’s?
capnography
pulse oximetry
FBAO on a conscious obese/pregnant pt requires what initial intervention?
Chest thrusts
FBAO on a conscious child requires what intervention
Abdominal thrusts
FBAO on a conscious infant requires what intervention?
5 backslaps + 5 chest thrusts
When is the use of pt restraints authorized?
When the pt’s behavior may jeopardize the safety of pt or crew.
What shall be assessed and how often, on restrained pt’s?
PMS x 10 minutes
How does one assess distal perfusion in the restrained pt?
Distal pulses
cap refill<2 sec
How many sets of restrained pt PMS assessment are required regardless of short transport time?
2
To what facility are sepsis alert pt’s transported?
Any facility
What is a simple extremity fracture? (SEFx)
isolated, closed, fracture below the knee or elbow without neuromuscular compromise or surgical need
In a child what joint dislocation is not considered a simple fracture?
elbow dislocation
Adults with a high probability for general medical surgical intervention shall be transported to what facility?
any
Oncology pt’s with a fever of _____ or greater shall be transported to what facility?
Lee Memorial NCH Fawcett Bayfront Sarasota Memorial North Port ER
Pt’s with a hazmat exposure shall be taken to what facility?
any, post decon
Pt’s with high likelihood of hyperbaric oxygen need shall be taken to what facility?
any
Venomous snakes/spider bites shall be taken to what facility?
Lee Memorial
Any Collier facility
Mammal and marine bites shall be taken to what facility?
any
Lee county comprehensive stroke center?
Gulf Coast
Lee county Primary stroke center?
Lee Memorial
Healthpark
Lee County STEMI facility?
Gulf Coast
Healthpark
What is the ground transport time cutoff for Priority 1 pt’s?
30 minutes
Who may request air transport?
Any on scene first responder
What three pt categories are forbidden from air medical transport?
CPR in progress
Haz mat (regardless of decon)
P3 pt’s
What is the minimum size for LZ’s?
100’ x 100’ (day or night)
How shall LZ’s be illuminated?
4 corners with strobes or steady burn light source
What should the LZ report include?
surface type
wind direction/speed
hazards
What shall the LZ controller say over the radio if the LZ becomes unsafe during takeoff/landing?
Abort, abort, abort
AO x 4=?
person
place
time
situation
Emancipated minor?
16-18yo
married
enlisted
court declaration of emancipation
Can a DNR be a photocopy?
Yes
Who’s signatures must appear on a DNR
Pt
Physician
How does one verify that pt identity corresponds with pt DNR?
photo ID
witness
How may a DNR be revoked?
in writing
destruction of document
failure to present
orally expressing contrary intent
What are the five presumptive signs of death?
unresponsive apneic pulseless absence of heart sounds fixed pupils
What are the five conclusive signs of death?
injuries incompatible with life tissue decomposition rigor mortis livor mortis algor mortis (cold)
What three conditions require resuscitation efforts in the absence of injuries incompatible with life?
hypothermia
OD
electrocution
Maternal resuscitations of ____ weeks or more will not be terminated in the field.
24
A paramedic may terminate resuscitation efforts provided the following criteria are met:
appropriate ALS/BLS interventions with no change
Absent heart tones x 60 seconds
Persistent V fib, PEA, asystole
What two pulseless cardiac rhythms require medical direction for discontinuation of resuscitation efforts?
PEA
V fib
Level 1 MCI pt #?
6-10 transports
Level 2 MCI pt #?
11-20 transports
Level 3 MCI pt #?
21-100 victims
Level 4 MCI pt #
101-1000 victims
Level 5 MCI pt #?
1000+ victims
Who does the rehab supervisor report to?
IC
ISO
How many sets of abnormal vital signs does an emergency worker need before being moved to the medical treatment area?
2
What symptoms present in the emergency worker require transport to the ER?
CP SOB Dizziness AMS Nausea
What is the required temp to be released from rehab?
=100.6
What is the required HR to be released from rehab?
<100bpm
What is the required respiratory rate to be released from rehab?
12-20/min
What is the required BP to be released from rehab?
<160/100
What is the pulse oximetry required to be released from rehab?
> 91% RA
What is the CO level required to be released from rehab?
<10% of baseline
Adult Rescue breathing rate/seconds?
every 5-6 seconds
Adult Rescue breathing rate/min?
10-12
Adult CPR ratio?
30:2
Pediatric Rescue breathing rate/seconds?
every 3-5 seconds
Pedi Rescue breathing rate/min
12-20/min
Pedi pulse rate requiring compressions?
<60, with signs of poor perfusion
Pedi CPR ration 1 rescuer
30:2
Pedi CPR with two rescuers
15:2
