Probation Test 4 & 5

Front 1

BLS providers can only assist patient with taking their own perscribed Nitro provided the pt's BP is at least what?

Back 1

100

Front 2

Two Contraindications of Nitro?

Back 2

BP less than 100, pt has taken ED meds

Front 3

Pediatric pt's that present with loud cough mimicing bark of a seal?

Back 3

Croup

Front 4

Pt with chest pain, you should administer _______ PO chewed or swallowed if not taken during previous 24 hours or pt has known allergy?

Back 4

Aspirin 324mg

Front 5

If pt presentation is atypical and protocol treatment may not be in best interest for pt or any situation where EMS is not sure about best treatment for pt?

Back 5

contact medical control

Front 6

What is dose of Albuterol?

Back 6

2.5mg

Front 7

What is dose of Atrovent?

Back 7

500mcg

Front 8

A pt with Asthma/copd that presents with resp distress and suspected wheezing, adminster what combination one time only?

Back 8

Albuterol and Atrovent

Front 9

How many additional albuterol treatments via NEB can bls provider administer?

Back 9

1 additional

Front 10

Pt has medical hx of asthma, w/o signicant cardiac hx and still presents with resp distress and is in extremis you should administer?

Back 10

Epi 1:1000 0.3mg IM via auto injector

Front 11

Pt is equal to or greater than 8, with BGL of less than _____, and displays signs and symptoms of hypoglycemia, administer oral glucose 24gm PO if pt is concious enough to swallow.

Back 11

70

Front 12

If narcotic overdose is suspected administer?

Back 12

Narcan 2mg IN

Front 13

Pt presents with severe anaphylactic reaction with associated hypoperfusion and/or resp distress, proceed to following treatment?

Back 13

Epi-Pen auto injector adult 0.3mg IM

Front 14

Stroke centers?

Back 14

7, 8, 13

Front 15

What radio channel can you contact poison control?

Back 15

Channel H-11 or call 1-800-222-1222

Front 16

General indications of referral to burn center are pt's with _____ or _____.

Back 16

2nd or 3rd degree burns

Front 17

Consider activation of the ______ for a pt involved in an unusual extrication, prolonged crush injury, or possible field amputation.

Back 17

GO TEAM

Front 18

_________ is a limb and life-threatening condition seen when perfusion pressure falls below tissue pressure in a closed anatomical space.

Back 18

Compartment Syndrome

Front 19

What is the cut-off age to take a child trauma/medical pt to Childrens?

Back 19

Greater than 15

Front 20

When does the PDOA protocol not apply to the trauma pt that is pregnant?

Back 20

When pt is 20 weeks or greater in gestation except in instances where there is apparent lividity or rigor mortis.

Front 21

When you need to contact medical control which hospitals are medical control hospitals?

Back 21

Each hospital will serve as their own medical control.

Front 22

When you have a pediatric pt and need to contact medical control what hospital would you utilize?

Back 22

Hospital 2 (childrens)

Front 23

AVPU stands for?

Back 23

Alert, verbal, painful, unresponsive

Front 24

Normal vital signs for adult?

Back 24

Resp (12-20) Pulse (60-100) BP (90-140)

Front 25

To inquire about pertinent past medical hx use?

Back 25

S - Signs/Symptoms
A - Alleriges
M - Medications
P - Past medical hx
L - last oral intake
E - Events leading up to

Front 26

To effectively maintain awareness of changes in pt's condition, repeated assessments should be performed?

Back 26

5 minutes for unstable, 15 minutes for stable

Front 27

For trauma alert or burn pts _____, transport to a trauma or burn facility capable of handling adult pt's. Pt's ______ years of age should be transported to Childrens.

Back 27

Greater than 15 (adult size), less than 15.

Front 28

Sexual assault pt's less than 18 should go to?

Back 28

Childrens

Front 29

How many priority levels are there?

Back 29

3

Front 30

What determines priority level?

Back 30

1 - unstable
2 - potentially unstable
3 - stable

Front 31

What are the trauma facilities?

Back 31

4 (medstar), 5 (howard), 8 (George Washington)

Front 32

What hospital has a hyperbaric chamber?

Back 32

Hospital 8 (George Washington)

Front 33

What are the hospital codes?

Back 33

1 - United Medical
2 - Childrens
4 - Medstar
5 - Howard
7 - Georgetown
8 - George Washington
10 - Providence
12 - Sibley
13 - Washington Hospital Center
14 - Walter Reed
15 - Veterens

Front 34

In order for an ALS provider to transfer care pt must be?

Back 34

Stable with complaints that would be cared for at BLS level.

Front 35

A minor pt may refuse care if he/she is?

Back 35

Married, parent, or is currently pregnant.

Front 36

Contraindications for aero medical evac?

Back 36

Cardiac arrest, hazmat pt, or pt that is violent or erratic behavior

Front 37

Contraindications with AED?

Back 37

trauma arrest, pt with fully obstructed airway, hazardous enviroments

Front 38

Indications for AED?

Back 38

Pt in cardiac arrest, ages 1-8 use pedi pads

Front 39

What is normal SPO2?

Back 39

96-100%

Front 40

Should you include SPO2 as a vital sign?

Back 40

Yes

Front 41

King LT-D airway device should be used on ______ pt's without a gag reflex.

Back 41

Unconcious

Front 42

What are three contraindications use the combitube?

Back 42

Pt's with gag reflex, esophageal disease, or ingested caustic substance

Front 43

What is clinical indication for use of carbon monoxide detector?

Back 43

Pt's with smoke inhalation or inhaltion of other hydrocarbon. Used on FF's in incident rehab.

Front 44

Reading of ____ indicates mild carbon monoxide inhalation.

Back 44

Greater than 12%

Front 45

Reading of ____ indicates severe carbon monoxide inhalation.

Back 45

Greater than 25%

Front 46

What type of class medication is Tetracaine?

Back 46

Local anesthetic for eye.

Front 47

What is dose of tetracaine?

Back 47

Adult and Pediatric 1-2 drops per eye.

Front 48

What is the clinical indications for IN medication admin?

Back 48

Pt without IV access requiring urgent medication

Front 49

What is the dose and the route in which a BLS provider can administer Narcan and can a BLS provider establish IV access?

Back 49

2mg IN only

Front 50

When can a BLS provider establish IV access?

Back 50

If they have completed the module.

Front 51

What is the clinical indication when using the Blood Glucose analysis?

Back 51

Pt's with suspected hypoglycemia (diabetic emergencies, change in mental status, bizarre behavior)

Front 52

If pt's blood glucose level is ____, administer oral glucose, 24g if concious.

Back 52

70

Front 53

What is informed consent?

Back 53

When a competent pt or guardian is informed of the potential benefits and risk of a process or procedure, alternatives to that procedure, and the possible consequences related to each.

Front 54

What is expressed consent?

Back 54

Written or verbal request to be evaluated and treated.

Front 55

What is implied consent?

Back 55

What a patient is unable to express consent because of Altered LOC or severe distress

Front 56

In order to allow a pt to refuse care and/or transport you must conduct three assessments first, what are they?

Back 56

Legal competence, mental competence, medical or situational competence.

Front 57

When using O2 on an adult pt, the dosage should be ____ for BVM, ___ via NRB mask, or _____ via NC.

Back 57

Greater than 15lpm for BVM, 12-15lpm via NRB, 2-6lpm via NC

Front 58

What are indications for use of 02?

Back 58

Cardiac or respiratory arrest, trauma, dyspnea, suspected hypoxemia, cardiac related chest pain

Front 59

When administering O2 what is an adverse reaction?

Back 59

May induce respiratory drive in some COPD pt's

Front 60

What are if any contraindications listed for use of O2?

Back 60

none

Front 61

Members shall administer supplemental O2 in order to maintain SPO2 level of at least?

Back 61

Greater than 96%

Front 62

______ is an odorless, tasteless, colorless gas prodcued from incomplete combustion?

Back 62

Carbon Monoxide

Front 63

Where do most CO posionings occur?

Back 63

At home

Front 64

Once carbon monoxide binds to the hemoglobin molecule, it can no longer do what?

Back 64

Transport O2

Front 65

What are the general indicatiors of carbon monoxide exposure?

Back 65

Victims rescued from or had a prolonged exposure to smoke, victims who have been exposed to carbon monoxide due to fault heating system, auto exhaust, or other sources of incomplete combustion.

Front 66

Whom should you contact if you need assistance in managing specific overdoses?

Back 66

Poison Control

Front 67

Cyanide is a cellular toxin - it halts respiration at the _____.

Back 67

Cellular level

Front 68

What are early signs and symptoms of cyanide exposure?

Back 68

Anxiety, vertigo, weakness, headache, tachypnea, nausea, dysnea, vomitting, tachycardia

Front 69

If you have a pt that has been stung/bitten by an insect/reptile/animal, should you bring it to the hospital?

Back 69

no

Front 70

If an anaphylactic reaction occurs as a result of a bite/sting you should?

Back 70

Follow the allergic reaction protocol.

Front 71

With an OB pt that is in labor, with delivery of a newborn being imminent, what is the most important decision to make with this pt?

Back 71

Whether to attempt delivery in the field or transport the pt to the hospital.

Front 72

What is the first step in the birthing process once the head presents?

Back 72

Suction the newborn's mouth then nose.

Front 73

Once delivery is accomplished, clamp the cord at ____ and _____ from the navel and cut between the clamps.

Back 73

6" and 8"

Front 74

When should you score the APGAR?

Back 74

1 minute and 5 minutes

Front 75

What is prolapsed cord?

Back 75

When the umbilical cord presents itself outside of the uterus while the fetus is still inside.

Front 76

What position should you place the mother in that has a prolapsed cord?

Back 76

Knee Chest position

Front 77

In the event the pt has experienced a miscarriage and if there is any question as to the approximate gestation of the fetus you should?

Back 77

Provide resusciatitive measures

Front 78

If there is a question as to whether the fetus is viable you should?

Back 78

Contact medical control

Front 79

When does the protocol trauma in pregnancy apply to the pregnant pt?

Back 79

When the pregnant pt is 20 weeks or greater in gestation

Front 80

According to the protocol trauma in pregnancy, what are the 2 instances where you would not resuscitate the pt?

Back 80

When there is apparent lividity or rigor mortis

Front 81

Hyperthermic reactions generally relate to _____, _____, or in severe causes, ______.

Back 81

Heat cramps, heat exhaustion, in severe cases heat stroke.

Front 82

What should you do if heat exhaustion or cramps are suspected?

Back 82

move pt to cool environment and obtain a temperture.

Front 83

If heat stroke is suspected where should you place cold packs on the pt?

Back 83

At the groin, under the armpits, and around the neck

Front 84

What is hypothermia defined as?

Back 84

Hypothermia is defined as a core temp below 95 F

Front 85

Pt with moderate to severe hypothermia may often present with signs and symptoms of?

Back 85

altered mental status and occassionally a decreased pulse, resp rate, and blood pressure.

Front 86

Pt's in cardiac arrest with suspected severe hypothermia shall not be considered dead until?

Back 86

Re-warming has been completed at a medical facility

Front 87

What protocol applies to pt's suffering from an accidental or intentional submersion in any liquid?

Back 87

Drowning/near drowning

Front 88

When transporting a pt that has been restrained you must transport that pt in what position?

Back 88

supine

Front 89

You should always make sure that MPD is summoned to all responses involving combative pt's? T or F?

Back 89

True

Front 90

When you have a violent psychiatric pt greater than 15 should they go to childrens?

Back 90

They should not be transported to childrens.

Front 91

Criteria for determining a pt PDOA shall include those that are pulseless/apneic with one or more of the following?

Back 91

Rigor mortis, dependent lividity, decomposition, traumatic injuries incompatible with life such as organ destruction of the brain/thoracic contents, incineration, submersion greater than 24 hours, valid out of hospital DNR order present, valid licensed physician on scene that orders resuscitation not to be attempted.

Front 92

When you have a PDOA whom should you request to investigate the scene and assume responsiblity of the deceased person?

Back 92

MPD

Front 93

Does DC honor the reciprocity DNR order?

Back 93

Yes

Front 94

What are the following interventions that may be provided to a pt who is wearing a DNR-CCo that is intact and has not been defaced to provide comfort or to alleviate pain?

Back 94

Clear airway, suction, O2, pain medications, control bleeding, make comfort adjustments

Front 95

Who can revoke the comfort care order at anytime?

Back 95

The pt or authorized decision maker/surrogate

Front 96

When ventilating a child with special needs if the child's condition improves there may have been a problem with the ventilator? true or false

Back 96

true

Front 97

A child with special healthcare needs will always present with age appropriate mentalities? true or false

Back 97

false

Front 98

What is the most common emergency with central lines in children?

Back 98

Blockage or obstruction of the line, complete or partial accidental removal or complete or partial laceration to the line.

Front 99

A good source of getting medical hx of the child's condition is to?

Back 99

Ask the caretaker

Front 100

If an in-dwelling catheter becomes completely removed you should attempt to reinsert the catheter and transport to the nearest hospital, true or false?

Back 100

false

Front 101

You should always bring the line with you to the hospital, true or false?

Back 101

true

Front 102

Children with gastrotomy tubes will not have complications due to destruction or dislodgement of the tube, true or false?

Back 102

false

Front 103

Are fire/ems personnel required to report cases of suspected child/elder abuse or neglect to the police agency responsible for the area which the call occured?

Back 103

Yes, you are required to report cases.

Front 104

Should you confront or become hostile to the parent or caregiver that you think may be the abuser?

Back 104

No, you should not confront the parent or caregiver.

Front 105

If you suspect that a pt is being neglected should you report the situation?

Back 105

Yes

Front 106

What is the purpose of having Mass Casualty Incident start and jumpstart triage?

Back 106

To provide structure to the triage and treatment of persons involved in a multiple or mass casualty incident or multiple pt scene.

Front 107

What is the definition of a multiple or mass casualty incident?

Back 107

An emergency scene that creates a number of pt's sufficient to significantly overwhelm available resources.

Front 108

What is considered a multiple casualty incident?

Back 108

Less than 9 pt's

Front 109

How many patients do you have to have to declare a mass casualty incident?

Back 109

Greater than 9

Front 110

What is the definition of triage?

Back 110

Process of sorting and categorizing pt's based on the severity of their symptoms

Front 111

Patients will be categorized into the four following groups, each group has a color designation to assist in rapid sorting of triaged pt's. What are the colors and titles?

Back 111

Red - immediate
Yellow - delayed
Green - minor
Black - deceased

Front 112

During a primary triage, providers should spend no less than what with each pt?

Back 112

30 seconds

Front 113

After the initial evaluation of incident rehab, members will be reassessed after a _____ rest period.

Back 113

20 minute

Front 114

Can members return to incident operations if their vital signs return to normal?

Back 114

Yes they can after 20 minutes

Front 115

What is the acronym that can be used for determining symptoms of a nerve agent poisioning?

Back 115

SLUDGEM + R + A

Front 116

What are the two chemicals most widely used in pesticides today?

Back 116

Organophosphate and Carbamale

Front 117

What is the two part antidote for emergent treatment for a nerve agent exposure?

Back 117

Atropine, 2-Pam Chloride

Front 118

What are serious forms of human anthrax?

Back 118

Inhalation, cutaneous, intestinal

Front 119

What poisioning symptoms may mimic pneumonia or food poisioning depending on rate of transmission?

Back 119

Ricin poisioning

Front 120

With acute radiation sydrome, can you use available radiation detection equipment to determine the presence of significant amounts of contamination on an individual?

Back 120

Yes you can

Front 121

If soapy water is readily available or easy to make, can you use it to decontaminate a victim?

Back 121

It may not be practical - the IC should make the decision.