Scope of Practice Flashcards
What type of calls require a paramedic to ride instead of an AEMT?
Cardiac-related chest pain, respiratory distress, stroke/CVA, AMS
All of these patients require a 12-lead.
Should obtaining a 12-lead delay transport?
No
How can a paramedic give a copy of an EKG to the receiving hospital?
Via static/printed strip or electronic transmission
Do EKGs need to be uploaded to a run report?
Yes
How quickly should an EKG be obtained?
As soon as possible - do not delay transport.
Which EKGs should be transmitted to the receiving hospital?
Any, but especially, chest pain or cardiac-related complaints.
Should an AEMT acquire a 12-lead?
AEMTs may acquire and transmit a 12-lead, but they cannot interpret or make any care decisions based on that 12-lead.
Once a 12-lead has been obtained, a medic should ride the call - the only time this may not happen is on a BLS unit.
Are medics required to take all calls if a 12-lead has been aqcuired?
Yes
How many IV attempts are allotted per provider?
Attempts should be limited to 3 per provider
Should an AEMT attempt IV access via an EJ?
No - this is a medic skill ONLY
Should a paramedic attempt IV access via an EJ?
Yes - EJs are within the scope of a paramedic only
What type of fluids should be initiated on trauma patients?
Warm fluids
How should IV piggyback drugs be mixed?
100mL D5W with 60gtts tubing
WITH THE EXCEPTION of Dopamine and Epi drips
What medications cannot be piggybacked with D5W?
Dopamine and Epinephrine
What patients should receive an IV?
Only patients in need of medication administration or fluid resuscitation
Can an AEMT ride with isolated hypoglycemia calls where D50/D10 has been administered?
Yes - provided the patient is stable
Can an AEMT ride with ATBX that have been infusing for over 30mins?
Yes - provided the patient is stable
Can an AEMT ride with fluids that have been given via IV pump for over 30 mins?
Yes - provided the patient is stable
Can an AEMT ride with fluids at infusing at an ALS level?
No - this is paramedic only
If time permits, what shall be placed on all intubated patients?
NG/OG tube
All intubated patients MUST have what piece of equipment hooked to monitor for maintenance and assessment?
ETCO2, continuous capnography
Should initial intubation attempt be video or direct?
Video - unless there is excess fluid that cannot be cleared with suctioning or there are technical issues with device
After how many failed attempts should a crash or alternate airway be considered?
After two failed attempts
For all patients on a vent, what medication shall be maintained?
Sedation
What are the approved sedation medications for patients on a vent?
Ketamine or Versed per the RSI protocol dosages if indicated for maintenance
If a patient is on a vent, can paralytics be administered?
If needed, paralytics may be used per the RSI protocol dosages.
What weight is considered to be under pediatric protocols?
Less than 60kg or 132lbs in total body weight
What age is considered to be under pediatric protocols?
Less than 13 years of age
What safety protocol should be established before administering pediatric dosages of any medication?
6 Rights, or double-check with secondary confirmation method
What is a quick reference for age/size considerations in peds?
Pedi tape / length-based tape / Broselow tape
Where should pediatric patients with significant traumatic injuries be transported?
Vanderbilt Children’s Hospital
Where should pediatric patients with critical medical illness be transported?
Vanderbilt Children’s Hospital or Centennial Children’s Hospital
Where should pediatric patients with non-critical illnesses be transported?
Closest appropriate facility
Where should pediatric patients with non-illnesses in need of immediate stabilization be transported?
Closest appropriate facility
When should blood draws be performed?
When possible, blood draws should be obtained on all STEMI, sepsis, and stroke alerts. Obtained no greater than 10min PTA at hospital. Initials and time written on each tube.
