Lee County Common Treatment Guidelines - Universal Care

Question 1

Age Classification: Infant

Answer 1

1month - a year

Question 2

Age Classification: Adult

Answer 2

> 13 years

Question 3

Age Classification: Neonate

Answer 3

birth - 1 month

Question 4

Age Classification: Pediatric

Answer 4

1 - 13 years

Question 5

For purposes of admission, Lee Health considers any patient less than 18 to be

Answer 5

Pediatric

Question 6

For purposes of Trauma Alert, an
adult is ______ years and above
pediatric is _______ years and below

Answer 6

16
15

Question 7

The General Action Response includes:

Answer 7

Review dispatch information
Consider the need for additional resources

Question 8

Evaluate and ensure scene safety is part of which General Action?

Answer 8

Scene Arrival and size-up

Question 9

Using appropriate body substance isolation (BSI) is part of which General Action?

Answer 9

Scene Arrival and size-up

Question 10

Use appropriate personal protection equipment (PPE) is part of which General Action?

Answer 10

Scene Arrival and size-up

Question 11

Determine number and location of persons involved versus patients is part of which action?

Answer 11

Scene arrival and size-up

Question 12

Consider the need for additional resources is part of which TWO actions?

Answer 12

Response and scene arrival and size-up

Question 13

Patient Approach includes which TWO actions?

Answer 13

Determine mechanism of injury (MOI) and/or nature of illness (NOI)
If appropriate, begin triage and initiate mass incident (MCI) procedures - RAMP triage

Question 14

General Impression - sick vs not sick includes:

Answer 14

Appearance
Work-of-Breathing
Circulation to skin

Question 15

Assessing Mental Status includes:

Answer 15

Awake/Alert
Response to verbal stimuli (RVS)
Response to painful stimuli (RPS)
Unconscious/Unresponsive

Question 16

C-A-B, D-E Assessment stands for:

Answer 16

Circulation Status
Airway Status
Breathing Status
Disability Status
Exposure

Question 17

Circulation Status checks for:

Answer 17

Central and Peripheral pulses
Major Hemorrhage
Skin - color, temperature, condition

Question 18

Airway status check: if airway is compromised or obstructed…

Answer 18

proceed to airway, ventilation, oxygenation management guideline

Question 19

Breathing status includes:

Answer 19

work-of-breathing
respirations -present or absent, irregular or regular, rate & quality
Auscultate lung sounds

Question 20

Gross motor/sensory function checks for:

Answer 20

moves all extremities?
focal loss/defect?
eyes?
facial symmetry?

Question 21

Disability status includes:

Answer 21

Defibrillation
Gross Motor/sensory function
blood glucose
cervical motion restriction

Question 22

Evaluate illness or injury, remove clothing as necessary
Medic alert bracelets or identification
These are part of which assessment?

Answer 22

Exposure

Question 23

What does SAMPLE stand for?

Answer 23

Signs/symptoms
Allergies
Medications
Pertinent Medical History
Last Oral Intake
Events Leading to Present Illness or Injury

Question 24

What does OPQRST stand for?

Answer 24

Onsent
Provocation and Palliation
Quality
Region, Radiation, or Referred
Severity
Timing

Question 25

When conducting a physical exam on an adult, it goes from _____ to _____?

Answer 25

Head - to - Toes

Question 26

When conducting a physical exam on a pediatric go from _____ to ____?

Answer 26

Toes - to - Head

Question 27

Sample History and Physical exam steps

Answer 27

-SAMPLE / OPQRST History -Conduct physical exam -Conduct a focused, detailed or ongoing systems exam -Assess Vital Signs -Non-invasive monitor assessment -Collect and transport documentation related to patient's history

Question 28

Assessing Vital Signs includes:

Answer 28

Pulse Blood Pressure Respirations Skin color, temp and condition Capillary Refill

Question 29

Non-Invasive Monitor Assessment includes

Answer 29

Cardiac - limb lead monitoring & 12 lead Blood Pressure Capnography Pulse Oximetry Blood Glucose Temperature

Question 30

Impression - develop a triple differentiated impression of the case. Examples include:

Answer 30

-altered mental status: Hypoglycemia vs stroke vs organic brain syndrome -acute coronary syndrome: STEMI vs unstable Angina vs Pulmonary Emboli -Shoulder injury: fracture vs dislocation vs contussion

Question 31

Treatment: Adequate ventilation target

Answer 31

etCO2 35mmHg - 45mmHg; normal capnograph

Question 32

Treatment: Oxygenation target

Answer 32

SpO2 94% - 99%; normal plethysmograph

Question 33

Correct tension pneumothorax with pleural needle decompression Primary approach:

Answer 33

Anterior - 2nd or 3rd intercostal space, midclavicular line

Question 34

Correct tension pneumothorax with pleural needle decompression Secondary approach:

Answer 34

Lateral - 4th or 5th intercostal space, midaxillary line

Question 35

IO primary site for adults:

Answer 35

Proximal Humerus

Question 36

IO primary site for pediatrics:

Answer 36

Distal femur or Proximal Humerus

Question 37

Correct open pneumothorax with what?

Answer 37

appropriate vented occlusive dressing

Question 38

EMT's may start IVs in what two conditions?

Answer 38

Under the supervision of a credentialed Paramedic Upper extremity only

Question 39

IO approved insertion sites are:

Answer 39

Proximal Humerus, Proximal Tibia, Distal Femur and Distal Tibia

Question 40

First-line therapy for closed-system hypotension is:

Answer 40

crystalloid fluid resuscitation

Question 41

What is the preferred balanced-based isotonic crystalloid?

Answer 41

Lactated Ringer's

Question 42

Arrest compressible hemorrhages by:

Answer 42

Direct Pressure Pressure Dressing Tourniquet Use Rapid Transport Crystalloid fluid resuscitation to temporize physiology

Question 43

Any patient that receives IV or IO medications must have what?

Answer 43

A running crystalloid infusion **No medications will be given directly via medication port or saline lock

Question 44

Hypoglycemia Blood Glucose Target:

Answer 44

bG > 60mg/dL and < 300mg/dL

Question 45

How do you splint/immobilize suspected pelvic fractures?

Answer 45

With a commercial pelvic binder

Question 46

How do you splint/immobilize fractured/dislocated limbs?

Answer 46

natural or functional position, above and below the fracture site

Question 47

What do you do with angulated, isolated limb fractures/dislocations with neurovascular compromise?

Answer 47

manipulate/realign to restore distal circulation then splint/immobilize

Question 48

Body temp target:

Answer 48

98.6 F / 37 C

Question 49

What blood does not clot?

Answer 49

Cold blood

Question 50

What is Hibler's Method?

Answer 50

A combination of vapour tight layer and an additional dry insulating layer. Preserves body heat and mitigates Lethal Triad

Question 51

Provide what to unconscious patients?

Answer 51

corneal protection

Question 52

Clinical Priority 1

Answer 52

unstable ALS patient; requiring immediate emergent medical attention for a life and/or limb threatening illness/injury

Question 53

Clinical Priority 2

Answer 53

stable ALS patient; requiring medical attention but not immediately endangering patient's life

Question 54

Clinical Priority 3

Answer 54

BLS patient; requiring non-emergent medical attention

Question 55

Determining disposition refers to?

Answer 55

Mode of transportation (air, land, water..) Status - lights and sirens vs non-emergent

Question 56

How often do you Re-vital sign unstable patients?

Answer 56

Every 5 minutes

Question 57

Minimum time to re-vital sign stable patients?

Answer 57

Every 15 minutes

Question 58

A minimum of how many assessments are required for every patient transport?

Answer 58

2

Question 59

What is essential for good patient outcome?

Answer 59

Transfer of Care between non-transport and transport in accordance with the 01 October 2012 Medical Director's Transfer of Care MOU

Question 60

What is the goal of Universal Care?

Answer 60

To facilitate appropriate initial assessment and management of any EMS patient and link to appropriate specific guidelines and directed by the findings within the universal care guideline.