Universal Guidelines

Question 1

On Scene Disputes

Answer 1

Not mentioned in PCR.
Must contact MCP for dispute resolution.
Separate written report if dispute is unresolved.

Question 2

Scene Times-General Instructions-

Answer 2

Kept to a minimum unless: Trauma- c-spine prior to transport.
Nontraumatic CPR is exception.

Question 3

Neonate

Answer 3

Birth to 28 days

Question 4

Pediatric

Answer 4

Medical: less than 37kg (81 pounds)
Trauma: under 14 years old

Question 5

Adult

Answer 5

Medical: 37kg (81 pounds) or greater
Trauma: older than 14 years old

Question 6

Interfacility Transfer

Answer 6

SHOULD THE PATIENT DECOMPENSATE DURING TRANSPORT, EMS PROVIDERS SHALL ASSUME ALL PRIMARY CARE RESPONSIBILITIES with assistance from accompanying staff.

Question 7

Transport of Pt’s with Blood Products

Answer 7

If allergic reaction signs, immediately stop infusion and initiate a normal saline infusion (using new tubing). Reaction usually happens within 10ml of infusion

Question 8

General Medical Treatment- B.S.I.

Answer 8

Mask on patient. MANDATORY TO ADD N95 OR SCBA if using CPAP, BVM, or nebulizer

Question 9

ABC order. Airway

Answer 9

ET tube or supraglottic are advanced airways of choice. Advanced airway if GCS < 8.

Question 10

ABC Order. Breathing

Answer 10

Rate, depth, pattern. Pulse ox to 94%. COPD to 90%

Question 11

ABC Order. Circulation

Answer 11

LOC and mental status.
Cap refill in pedi.
Hypotension <90 adult or <70 + (2x age) pedi.
12 lead on any patient who may have cardiac cause.
Cardiac related treat in order: Rate, Rhythm, Blood Pressure

Question 12

Cardiac Arrest

Answer 12

C.A.B.

Compressions, Airway, Breathing.

Question 13

IV access, Fluids, Medications

Answer 13

Follow medication administration with 10-20mL bolus

Question 14

LBRT

Answer 14

LBRT doses may be utilized in lieu of calculating pediatric doses per protocol.

Question 15

Universal Care Guidelines- Trauma

Answer 15

Rapid transport. Patients should be approached and assessed utilizing Primary, Secondary, and Reassessment Surveys.

Question 16

Primary Survey- Trauma

Answer 16

Rapidly identify life threatening injuries. Done within two minutes of contact. THE PRIMARY SURVEY IS ONLY INTERRUPTED FOR AIRWAY OBSTRUCTION OR CARDIAC ARREST.
STEPS: C-spine, ABC, control hemorrhage, assess AVPU scale

Question 17

Secondary Survey-Trauma

Answer 17

Completed enroute to facility for critical or within 5 minutes of primary for noncritical.
STEPS: vitals (HR, BP, Resp, SP02), BP done manually. SAMPLE, head to toe, GCS/RTS, bandage/splint, obtain vascular access

Question 18

Reassessment Survey- Trauma

Answer 18

Every five minutes for critical.
STEPS:
Repeat primary, repeat vitals and GCS, reassess all injuries/interventions

Question 19

Fluid Therapy

Answer 19

Adults: 500ml NS if BP <90. May repeat once.
Pedi: per LBRT. May repeat once.
If IV access cannot be obtained after 2 attempts in 90 seconds, consider IO.

Question 20

Authority for Control of Medical Services at an Emergency Scene

Answer 20

If pt’s Dr is on scene, follow order unless it conflicts with protocols. Contact OLMCP. Let OLMCP know about any decisions made. Keep communication open between OLMCP and on scene physician.

Question 21

Disaster Response

Answer 21

“Disaster Response Mode”. For hurricanes, tornadoes, etc.

Crews may treat and release. Consult supervisor for life threatening situations.

Question 22

Expired Medication

Answer 22

Use ONE YEAR after expiration date.