Symptom based protocols

Question 1

minor who has married, entered the armed services of the United States, become employed and self-subsisting, or has otherwise become independent from the care and control of his/her parent,

Answer 1

Emancipation

Question 2

Only the following patients can be treated and released, and only if they are (blank) years or older, less than (blank) and an emancipated minor (see below), or less than(blank) years of age in the custody of a legal guardian.

Answer 2

18

Question 3

What defines symptomatic HTN?

Answer 3

BP > 200 + one of the following: HA, N/V, blurred vision, CP, resp. difficulty

Question 4

What defines hyperglycemia & hypoglycemia.

Answer 4

> 400mg/dL; 70mg/dL

Question 5

Administer O2 to correct hypoxia to (blank).

Answer 5

95%

Question 6

Groups with Atypical AMI Presentations

Answer 6

Elderly
Females
Diabetics
Chronically Hypertensive Patients

Question 7

What are the triggers for proceeding to Cardiogenic Shock protocol?

Answer 7

Cardiac CP, Dyspnea + SPB < 80, SBP 80 - 100 + HR > 120, skin changes, altered mental status

Question 8

What are the triggers for proceeding to the CHF protocol?

Answer 8

RR > 24, SBP > 100

Question 9

What are the H’s & T’s?

Answer 9

Hypovolemia, hypoxia, hydrogen ions (acidosis), hypo/hyperkalemia, hypothermia
Toxins (OD), Tamponade (Cardiac), Tension Pneumo, Thrombus, Trauma

Question 10

For a cardiac arrest without an advanced airway, ventilations may be performed either:

Answer 10

30:2 ; asynchronous at 10/min

Question 11

In the presence of adrenal insufficiency, resuscitation may be unsuccessful without the administration of …

Answer 11

Steroids

Question 12

Not all hypotension will lead to (blank).Not all hypotension needs to be (blank).

Answer 12

Shock; treated in the field

Question 13

What are the SIRS criteria?

Answer 13

Temp > 38 (100.4) or < 36 (96.8)
Elevated HR
Elevated RR (PaCO2 < 32mmHg)

Question 14

What is the age cut-off for push dose epi?

Answer 14

16

Question 15

What types of shock will push dose epi be used to treat?

Answer 15

Cardiogenic & Distributive

Question 16

what is the push dose epi, dose?

Answer 16

5-20mcg IVP 0.5 - 2mL of a 10mcg/mL solution every 2 - 5 min

Question 17

What is the treatment options for cardiogenic shock?

Answer 17

cardiogenic - fluids & push dose
bradycardia - atropine and pacemaker

Question 18

what is the treatment for distributive shock

Answer 18

Sepsis - fluids, push dose
Anaphylaxis - epi
Neurogenic - fluid, push dose

Question 19

what is the goal for on scene time involving trauma patients following extrication?

Answer 19

< 10 mins

Question 20

T/F: all pregnant trauma patients should be transported to the NEAREST adult trauma center regardless of where they are supposed to deliver.

Answer 20

True

Question 21

If rhythm is ventricular fibrillation or ventricular tachycardia, DEFIBRILLATE IMMEDIATELY AT

Answer 21

360J biphasic equivalent

Question 22

Lidocaine may be substituted for amiodarone at:

Answer 22

1.5 mg/kg IVP, IO

May repeat 0.5 - 0.75 mg/kg IVP, IO in 3-5 minutes if still in VF/VTach

Question 23

Endotracheal (ET) administration of drugs is acceptable but not preferable. (Blank) cannot be given ET. ET administration is (blank) the normal dose with (blank) NS flush afterwards.

Answer 23

Amiodarone; double; 10 ml

Question 24

In Cardiac Arrest Consider the following
In the setting of renal failure/ESRD,

Answer 24

management of hyperkalemia early in resuscitation.

Question 25

For preexisting metabolic acidosis or tricyclic antidepressant overdose,
Administer

Answer 25

Sodium Bicarbonate (1 mEq/mL)
1 mEq/kg IVP, IO

Question 26

For hypovolemic arrest,
Administer

Answer 26

Normal Saline
1 Liter Fluid Bolus Chilled saline may be used if available.

Question 27

I’m cardiac arrest, After 30 minutes, consider

Answer 27

termination of resuscitative efforts

Question 28

For bradycardia administer

Answer 28

Atropine (AtroPen)
1 mg IVP, IO
If no response to initial measures, repeat
Atropine (AtroPen)
1 mg IVP, IO every 3 - 5 minutes up to a Total of 3 mg.

Question 29

For bradycardia Consider External Pacing if

Answer 29

patient is unstable on initial assessment or if remains symptomatic (Hypotension, altered mental status, syncope, shock, etc) after attempting atropine

Question 30

Begin pacing at a

Answer 30

rate of 60 - 80 with current output at 20 mA. Increase current output every 10 seconds until either cardiac (electrical and mechanical) capture occurs or maximal output is reached

Question 31

When pacing, For sedation, consider administration of

Answer 31

Midazolam (Versed)
2 - 5 mg IVP, IM, IN, IO if blood pressure allows.

Question 32

If rhythm is Torsades de Pointes then give

Answer 32

Magnesium Sulfate
2 gm IVP, IO diluted in at least 10 mL normal saline over 10 - 15 minutes.

Question 33

If the patient is to be cardioverted and does not have an altered level of consciousness, administer

Answer 33

Midazolam (Versed)
2 - 4 mg IVP, IO, IM until patient’s speech slurs or a Total of 8 mg is given.