SCCO EMS EXAM Flashcards
Chest compressions shall be performed at a rate of ____ beats per minute
110
The primary for conducting a hospital report (ringdown) for trauma alerts, STEMI Alerts and Stroke Alerts is via
EMS Command 92
Life support can be withheld or discontinued by emergency medical service personnel for a pulseless and/or apneic patient with a valid DNR directive
TRUE
If a person at a traffic accident scene state that they are a physician and wish to maintain care or the patient, the prehospital personnel shall request proper identification to confirm they are a DO/MD
TRUE
If a competent patient wishes to leave the ambulance during transport, they may only do so after arrival to the closest ED
False
A pediatric trauma alert may be transported to following centers:
Valley medical center
Stanford university medical center
EXCEPT/NOT AT: Regional medical center
All the following hospital may receive patients that meet “Stroke Alert” Criteria
El Camino Hospital of Los Gatos
Kaiser Santa Clara
O’Connor Hospital
EXCEPT/NOT AT: Palo Alto Veterans Association Hospital
A 26 year old male with an arrow that has fully penetrated his left forearm, distal to the elbow meets trauma alert criteria
FALSE
Major auto deformity greater than 12 inches on occupant site or greater than 18 inches any other site is considered trauma alert criteria
TRUE
ALS level patients may be transferred to BLS personnel during declared mass casualty incidents and disaster situations
TRUE
The EMS Duty Chief may serve in the following capacities
Supervision, regulation, and management of contracted system providers
Allocation of county-wide medical resources to include non-contracted ambulance providers, state medical mutual aid requests and management, non-traditional use of alternate care facilities
Authorizing emergency policy changes necessary to assist in the mitigation of the incident
EXCEPT: The EMS Duty Chief has authority over local jurisdiction on incidents
Dispatches by county communications shall be only valid authorization for air resource operation at the scene of an emergency in santa clara county
TRUE
A system ID badge expires on the same date as one’s professional medical credential
TRUE
Physician scene request and response, which statement is true?
A physician may be requested to the scene when a surgical extrication is required due to the inability to extricate a patient from their environment
If a hypoglycemic patient that can self administer is allowed to take a second tube of oral glucose after ___ minutes if there is no change in the patient’s condition
15 minutes
What are indications for the use of a mechanical tourniquet in Santa Clara County?
An uncontrolled extremity hemorrhage in an adult/pediatric patient
The use of clear text/ plain english has replaced the use of radio codes
TRUE
If an emergency button is accidentally activated, the unit must acknowledge the dispatcher with:
“No further assistance is needed”
Providers are required to notify the EMS duty chief of a level A variance:
Immediately
When responders transport a patient from the scene of a hazardous materials incident, which of the following information is to be provided to the routine patient notification report?
Chemical name, decontamination methods used on-scene, DOT reference number, and any appropriate treatment information
Which of the following is authorized to refuse medical care?
Minors legally authorized to consent
Life support can be withheld or discontinued by EMS of a pulseless and apneic patient who has exercised his/her right to die under End-of-Life Option Act
TRUE
A physician on the scene of a 911 call can do all the following
Relinquish patient care to prehospital personnel
Assist in patient care and the prehospital patient care would remain under the direction of the EMS Medical Director
Manage patient care and accompany the patient in the ambulance
EXCEPT: provide medical direction to prehospital personnel
All the following are criteria for “In-Extremis” patients
Breech presentation or protruding limbs during a delivery
Uncontrollable hemorrhage despite intervention from providers
Uncontrollable airway where the provider is unable to ventilate the patient adequately despite intervention
EXCEPT: altered level of consciousness following a traumatic injury
Patients that are in cardiac arrest that have a BLS airway meet “In-Extremis” criteria
FALSE
If a patient that has a valid DNR, dies in their home during medical treatment, who has the responsibility for disposition of the deceased?
The fire department or police department (if present)
What is the impact speed of a motor vehicle crash necessary for mechanism of injury criteria for a trauma alert
Impact speed of 40 mph or greater
Patients with partial thickness burns greater than 5% of the total body surface area are considered to have met major burn criteria
FALSE
What is required of a BLS crew to transport a patient with red lights and sirens?
Arrival on scene to arrival at hospital is less than 10 minutes, emergent patient, immediately advise county communications and request county EMS event number
To isolate and deny entry the proper distance to keep everyone back is at least
100 feet away for small incidents
500 feet away for large incidents
Two ventilations shall be provided after 30 compressions
FALSE
Badges are property of the county of santa clara and shall be surrendered to the EMS agency upon separation from service with an authorized santa clara county ems system provider
TRUE
Only the 911 contracted ambulance provider is required to understand the life safety procedures
FALSE
Pediatric, a pediatric trauma patient is defined as unless otherwise specified in protocol as
Under 15 years old
A mass casualty with 15 patients requiring ambulance transport will be considered a
Level 2
When emergency radio traffic requires an immediate action such as an evacuation, shelter in place order, or eminent safety issue, this alert is issue
Warbler Zone
A personnel accountability report (PAR) is a safety check that includes confirmation that all members of a unit are accounted for and are safe at the time of PAR. Trainees and/or observers do not need to be included in PAR
FALSE
If a patient refusing care or transport by your unit, any assessment or treatment performed, and/or medical history obtained from the patient does not need to be documented
FALSE
Life support may be withheld or discontinued for individuals with fixed and dilated pupils
FALSE
Providers are allowed to take patients that meet major trauma victim criteria to out-of-county facilities per the patient’s request
FALSE
If a patient, who has a valid DNR, dies while being transported to the hospital, the following options exist:
Transport to the arranged destination equipped and prepared to maintain the deceased including notification of local law enforcement
Return to the point of departure as appropriate
Transport to the closest emergency of an acute care hospital
At what speed does a motorcycle crash meet mechanism of injury criteria for a major trauma victim
Greater than 20 mph
A patient that is determined to be “In-Extremis” shall be transported to
The closest hospital
If ALS level interventions are performed, care may not be transferred to a BLS unit
TRUE
All the following hospitals may receive patients that meet “STEMI Alert” criteria
El Camino Hospital of Mountain View
Stanford University Hospital
Kaiser San Jose
EXCEPT: Saint Louise Hospital
A first responder paramedic is on scene waiting for the arrival of an ambulance to transport a patient needing advanced life support. Due to low 911 system level, a BLS unit has been dispatched to the call, the first responder paramedic should:
Maintain patient care and accompany the patient to the hospital
If a patient has 4 points on the F.A.S.T stroke screening they are required to be transported to a comprehensive stroke center if the last seen well is less than 6 hours
FALSE
Loss or stolen identification badges shall be reported to the agency and a system variance report shall be submitted
TRUE
Patients may be identified as a major trauma victim or a minor trauma victim based upon the severity of the trauma
FALSE
“Emergency Traffic” shall be limited to the presence of eminently life threatening conditions and should not be used for the reporting traffic collisions, still alarms, and other events that do not immediately threaten safety
TRUE
⅘ on GFAST scale and not shown any normal signs for how many hours in order to transport to comprehensive stroke center
⅘ on GFAST & 6 hours no improvement = comprehensive stroke center
North trauma patient
Stanford
Eastern trauma patient
Regional
A physician on scene give more information than if they are giving online direction
FALSE
Pediatric trauma hospitals
Stanford/Valley Medical
Updated EMS policy notifications would be distributed as follows except for which medium
Paper copy sent to every EMS provider
A patient who is a major trauma patient can ask to go to a hospital that is out of county and the EMT will comply
FALSE
Adult Trauma Hospitals
Stanford, Valley Medical, Regional
Fire can transport when
Patient needs RLS transport and county EMS is not on scene for at least 18 minutes
Patient is in cardiac/respiratory arrest
STEMI/Stroke alert
Major Trauma Criteria
Needs rapid transport
Uncontrollable airway
EMS directors in an MCI can do all of the following except
Take jurisdiction of the local law enforcement
“In-Extremis” means
protruding limb, uncontrollable airway, unable to stop bleeding after use of tourniquet
Medical health operational area coordinator
For santa clara county is the public health officer and EMS director
Initial point of contact for all mutual aid requests
Delegate available resources for mutual aid
The operations director can during MCI
Change emergency procedures to mitigate the potential threat of the MCI
Requests for medical health mutual aid into santa clara county
Incident command officer makes request
Gives information to EMS duty chief
If no resources are available then MHOAC coordinates region II resources for help
Immediate danger is defined as
Any threat or hazard that could reasonably be expected to cause immediate death or serious physical harm to a responder
If patient is determined as deceased
Discontinue resuscitative efforts
Cancel prehospital personnel en route
Provide appropriate care to bystanders
Complete PCR document reason for determination of death
Routine patient transport
Transported to routine emergency department unless EMS system surge, hospital diversion, or patient needs specialty care
Stroke comprehensive
El Camino, Good Sam, Regional, Stanford
Stroke primary
all except VA
STEMI
all except VA, El Camino, St, Louise
Patient transport special circumstances
EMS surge, MCI, diversion
DNR include
POLST for no CPR, DNR, DNR medallions, Durable Power of Attorney
Prehospital transfer of care information will include
full list of information, patient history, medical assessments, critical changes, treatments provided
BLS interfacility transport
Can transport: hospital to SNF/residence, doctors appointments, or dialysis
Emergent definition
Transported to nearest ED with red lights/sirens IF time from scene to ED is less than 10 minutes, contact county for event number
Emergent patient transportation less than 10 min
Contact 911 ALS assistance, if no one is available first arriving paramedic will ride to hospital with BLS crew
EMS duty chief
Liaison between agencies that are requested by IC commander
Delegate roles to ALS contractor supervisors
Fill in IC system
Delegate county health officer
Hazardous material procedure
Safety + isolate area/deny entry
Establish command, identify hazardous materials
Trained hazmat personnel were allowed to treat the area. EMS coordinate effort to provide hospital with pertinent information
Prehospital task force/ strike team type 1
5 ALS ambulances, EMT/paramedic, 1 strike team lead with separate vehicle
Strike team type 2
5 BLS ambulances with 2 EMTs, 1 strike team leader with separate vehicle
CAN report
Conditions
What is observed
Actions
What IC plans to do
Needs
What additional resources are needed
Risk refusal - turn down
Ems crew has determined that because of safety concerns they cannot take care of patient, EMS field supervisor completes system variance report
Turn down occurs because of
Violation of safe work practices
Environmental conditions
Individuals lacking qualifications or experience
Defective equipment being used
Assignment violates law of regulation, policies, or procedures
Personnel accountability report
Welfare check to verify safety/security of responders
Includes all EMS unit including ride alongs
Routine Medical Care Adult
Vitals
Glasgow coma scale
BP
RR
Pulse
Pulse ox
Temp
Glucose
ECG
Capnography
Neonate
0-4 months
Infant
1 month - 1 year
Child
more than 1 year old
Pediatric
less than 15 years old
Contact transmission of infectious disease control
Occurs through pathogens through skin, vomit, draining wounds, secretions (saliva, sweat, etc). Wear impermeable gown
Droplet transmission of infectious disease control
Occurs through inhalation or absorption of bodily/substance droplets (influenza, rhinovirus). Wear surgical mask/ face shields, impermeable gowns
Airborne transmission of infectious disease control
Occurs through inhalation or absorption of air that contains TB, measles, chickenpox. Wear N95/N100 respirator/impermeable gowns
Ventricular assist device VAD
VAD supplements cardiac ventricle in pumping blood to body
VAD assessment difficulties
Unable to palpate pulse, read BP, obtain pulse ox
EMS rely on consciousness, skin sign, cap refill
True or false: chest compressions are contraindicated in patients with VAD
True
Determination of death
Decapitation
Decomposition
Incineration
Obvious destruction of brain, lungs, heart
Rigor mortis
No pulse + PCR
Elected to end life via end of life agreement
Channel to speak through to medical
medic 92
Patient destinations: patient choice
Patient may be transported to requested facility as long as facility meets medical requirements, barring any EMS surge and hospital diversion
SCCO specialities psychiatric
El camino MV, Santa Clara valley MC EPS, PA VA hospital, Stanford
SCCO specialities burn
Santa Clara Valley Medical Center
Diversion
Only one hospital may be on ambulance diversion (red) at any given time in a diversion zone
May divert for 60 minutes per occurrence, but must allow for another 60 minutes before next diversion
Transfer of patient care may be
Paramedic to paramedic
Paramedic to ALS flight crew
Paramedic to BLS
Only in MCI activations
Prehospital personnel to hospital staff
Baseline vitals assessed every __ for stable
10 minutes
Baseline vitals assessed every ___ for unstable
5 minutes
VAD done at
only done at Stanford and Kaiser
