Maryland Medical Protocols Als Provider Review

Front 1

If a Maryland State EMS provider is unable to obtain on-line medical consultation for a patient who has a life-threatening injury, what steps must be taken by the EMS provider?

Back 1

Documentation, additional narrative, mark the “exceptional call” on PCR,
and notify local EMS supervisor immediately.

Front 2

EMS providers that need guidance from the poison control center should also
ensure that?

Back 2

Approved base station is on-line to give medical consultation.

Front 3

Which of the following protocols requires you to: Notify the consulting
physician via radio immediately, if an error is discovered, prior to arrival at
the hospital.

Back 3

Protocol Variation Procedure

Front 4

Any act or failure to act in practice or judgment, involving patient care that is
not consistent with established protocol, whether or not it results in any
change in the patient’s condition, requires you to:

Back 4

Notify your supervisor and local medical director within 24 hours.

Front 5

When consulting for medication orders, the on-line physician orders you to
give a medication that you believe would endanger the patient’s life, what is
the correct course of action that needs to be taken?

Back 5

Immediately notify consulting physician as to the reason you cannot care
out the order, document on MAIS, notify local EMS jurisdiction of the
incident.

Front 6

Which of the following protocols requires you to document on the patient care
report what was ordered and the time?

Back 6

Inability to carry out physician order.

Front 7

Which of the following protocols requires you and the consulting physician to
immediately notify the State EMS Medical Director (via SYSCOM) of an
incident, In addition, the provider must fax documentation of the rationale of
the incident within 24 hours to the State EMS Medical Director?

Back 7

Physician orders for extraordinary care not covered by Maryland Protocol.

Front 8

Under the Physician orders for extraordinary care not covered by Maryland
Protocol, protocol, what criteria MUST be present for Prehospital providers to
proceed with an order:

Back 8

Both consulting physician and provider must agree that patient’s condition
and extraordinary care are not addressed elsewhere in protocol, and that
procedure is absolutely necessary to maintain life of patient, provider must
feel capable of performing care as directed by consulting physician.

Front 9

What are the four ways you can assess a patient’s mental status?

Back 9

Alert, Verbal, Painful, Unresponsive

Front 10

If a patent airway cannot be established, what course of action MUST be
taken?

Back 10

Transport to nearest appropriate hospital-based emergency department.

Front 11

Based on the pulse oximetry readings, what general patient care is indicated?

Back 11

SpO2 94-100% - monitor, supplemental 02 for comfort via NC
SpO2 91-93% -monitor, hi flow o2 via NRB
SpO2 86-90% -Hiflow 02 via NRB or BVM
SpO2 <85% -02 via BVM, ETT if indicated

Front 12

Hyperventilation of head injury patients is indicated when they have signs of
herniation such as unequal pupils, posturing, or paralysis: or who is
manifesting a rapidly decreasing GCS: or with online medical consultation.
What are the following rates of hyperventilation in accordance with the
general patient care protocol:

Back 12

Adult -20 breaths per minute
Child -30 breaths per minute
Infant -35 breaths per minute

Front 13

If patient’s age is > 12 yo, provide

Back 13

1 breath every 5 seconds

Front 14

Patients from birth up to those who have not reached their 12th birthday who
are symptomatic with poor perfusion with a pulse of less than 60 BPM or
should:

Back 14

Ventilate for 30 seconds, if pulse less than 60 BPM, start CPR

Front 15

Patients greater than 1 year but who have not reached their 12th birthday, is
symptomatic with poor perfusion and the pulse is absent, begin CPR. If pulse
is greater than _______ bpm, continue assessment.

Back 15

60bpm

Front 16

If a patient presents with any blunt traumatic mechanism which could cause
cervical spine injury and meets ANY of the following criteria, complete
Spinal Immobilization should occur.

Back 16

-Decreased LOC/ or altered mental status
-Distracting injury
-midline spinal pain/tenderness
-under influence of drugs/alcohol
-focal neuro deficit
-s/s new paralysis

Front 17

Priority_________: Non-emergent condition, requiring medical attention
but not on an emergency basis.

Back 17

3

Front 18

Priority_________: Less serious condition yet potentially life-threatening
injury or illness, requiring medical attention but not immediately
endangering the patient’s life.

Back 18

2

Front 19

Priority_________: Does not require medical attention.

Back 19

4

Front 20

Priority_________: Critically ill or injured person requiring immediate
attention: unstable patients with life-threatening injury or illness.

Back 20

1

Front 21

In the event of a multiple casualty incident, the ____________technique
will be instituted for rapid tagging and sorting of patients into priority
categories for both treatment and transport.

Back 21

START/JumpSTART triage

Front 22

What does DCAP-BTLS stand for?

Back 22

deformities, contusions, abrasions, punctures, bruising, tenderness, lacerations, swelling

Front 23

All priority ____ patients require on-line medical consultation.

Back 23

1

Front 24

True / False: When utilizing the START/JumpSTART, providers may perform
all skills and administer medications within the protocol.

Back 24

True

Front 25

True / False: Medevac patients with indications for specialty referral center
should be flown to the appropriate type of specialty center if not more than 10
- 15 minutes further than the closest trauma center.

Back 25

true

Front 26

The ALS Provider-patient relationship is established when the ALS provider
initiates patient assessment and:

Back 26

-ALS drugs administered
-ALS procedure performed
-ALS assessment/provider judgement

Front 27

True / False: BLS providers have the right to decline the transition of patient
care. When consensus between the providers cannot be gained.

Back 27

True. a consult is required

Front 28

List 5 things that must be documented on your Patient Care Report, when
dealing with a suspected abuse/neglect patient.

Back 28

-pt/caregiver statements
-abnormal behavior
-condition of environment
-name and time of SS/police notification
-Name of receiving provider

Front 29

If patient is having a seizure, what are three treatments are important to
consider:

Back 29

-Airway
-Protect pt/do not restrain
-Stop seizure- what caused it?

Front 30

Midazolam may be administered without a consult for patients with active
seizures _______ _____ increments slow IV push over one to two minutes to
a max dose of _____ for adults. A patient over the age of ______, the dose is
reduced by _____%. Additional doses up to a max of _____, ALS providers
must obtain medical consultation.

Back 30

1-2mg increments, max 5mg w/o consult, 10mg with consult

Front 31

Pediatric Midazolam, if child has been seizing for greater than ___ minutes.
What is the dose of Midazolam for a pediatric patient?

Back 31

0.1 mg/kg, maximum of 5mg

Front 32

Other than IV, what other route can Midazolam be administered to pediatric
patients?

Back 32

IM/IN/IO

Front 33

________________________ can cause altered mental status but is not
commonly a cause of total unresponsiveness to pain.

Back 33

Alcohol/ETOH

Front 34

In the altered mental status protocol, treatments include initiation of IV LR
fluid therapy ____ ml/kg bolus, titrated to a systolic pressure of _____ mmhg.

Back 34

20ml/kg titrated to 100mm/hg

Front 35

What three symptoms are indicative of a narcotic overdose?

Back 35

-Pinpoint pupils, Decreased RR/Drive, Decreased LOC

Front 36

Adult patients that you suspect of having a narcotic overdose are given
________________ via ____, _____, _____, and ______ (if available). The
dose is _____ given slowly, to a max dose of _____ mg.

Back 36

Naloxone (Narcan) 0.4-2mg IV/IO/IM/IN max 2mg-consult to repeat
: For pediatrics: If age-related vital signs and the patient’s condition indicate
hypo perfusion, administer fluid bolus of ____ ml/kg, followed by _____
ml/kg if the patient’s condition does not improve, you can give additional
boluses of _____ml/kg.
20ml/kg

Front 37

Pediatric dose of narcan is _____ mg/kg slow IVP/IO/IM/Intranasal, to a
maximum of _____ mg.

Back 37

0.1mg/kg max 2mg IV/IO/IM/IN

Front 38

Children that fall under the category of being volume sensitive include:

Back 38

Chronic Heart of Lung disease, neonates, Renal failure Pt’s

Front 39

What is the initial bolus of fluid for volume sensitive children- _______ ml/kg
LR IV/IO, second and subsequent doses of ______ ml/kg LR IV/IO may be
given.

Back 39

10ml/kg

Front 40

If a parent or guardian of a child or infant less than 2 years of age describes of
the following signs/ symptoms:_______________, Skin color change,
marked change in _______________ tone, ____________ or
______________ not associated with feeding or a witnessed foreign body
aspiration: What condition may you suspect even if the child is acting normal
upon your assessment?

Back 40

Flaccid muscle tone ,apnea, Cyanosis, choking or gagging w/o FBAO
suspect Apparent life-threatening event (ALTE)

Front 41

If a parent or guardian wants to refuse care or transport for a patient that meets
the ALTE protocol, what must be done prior to leaving the scene?

Back 41

Consult with a pediatric base station

Front 42

What does the acronym SAFER stand for?

Back 42

Stabilize, Assess, Facilitiate, Encourage, Refer

Front 43

Defibrillation is more important initially if the patient can be ventilated
without ________________________.

Back 43

Intubation

Front 44

The goal is to immediately ___________ as soon after CPR as possible.

Back 44

defibrillate

Front 45

If unable to initiate IV or perform endotracheal intubation within _____
minutes, continue with appropriate care and transport the patient as soon
possible to the appropriate hospital.

Back 45

5minutes

Front 46

What is the next appropriate treatment following a single shock?

Back 46

resume CPR immediately

Front 47

What four drugs can be administered down the pediatric or neonate ET tube?

Back 47

Epi, Narcan, Atropine, Lidocaine

Front 48

Narcan, Atropine (1mg/ml), and epinephrine (1:1,000) shall be diluted in
____ ml of lactated ringers for pediatric dosing via ETT

Back 48

5ml

Front 49

List common signs and symptoms of a patient experiencing bradycardia:

Back 49

CP, SOB, Hypotension, N&V, Decrease in LOC, CHF/Pulmonary Congestion, possible AMI

Front 50

What is the preferred treatment for a patient that is hemodynamically
unstable with bradycardia?

Back 50

Trans-cutaneous Pacing (TCP)

Front 51

What is the recommended dose of atropine for a patient with sinus
bradycardia?

Back 51

0.5-1mg q 3-5 minutes, max 0.04mg/kg

Front 52

True / False: Atropine should be used with caution in a second degree type
II block and a new third degree block with wide complexes.

Back 52

True, consult required

Front 53

If a bradycardic patient does not respond to TCP or atropine, what is the
next drug and dose you would consider?

Back 53

dopamine2-20 mcg/kg/min

Front 54

True / False: A patient who is bradycardic, in a third degree heart block with
ventricular escape beats can be treated with 150 mg of Lidocaine.

Back 54

True

Front 55

Do not delay TCP for what two interventions:

Back 55

Sedation and Atropine

Front 56

What 2 drugs can you consider giving to a patient in experiencing
discomfort from TCP?

Back 56

Morphine, 0.1mg/kg or midazolam 1-2mg

Front 57

According to the pediatric algorithm for pediatric patients with
bradycardia. Perform chest compressions if the pulse on the child is

Back 57

60bpm

Front 58

What is the pediatric dose/concentration of Epinephrine if given IV/IO?

Back 58

0.01mg/kg 1:10,000
What is the pediatric dose/concentration of Epinephrine if given ET?

0.1mg/kg 1:1,000

Front 59

How often can the Epinephrine be administered to the Pediatric patient?

Back 59

Every 3-5 minutes

Front 60

Hemodynamically unstable is defined as a systolic B/P of less than ____
in neonates, ____bpm for infants (<1 yr old), and less than ____

Back 60

systolic B/P for children greater than 1 yr old.
60, 70, 70+2xAge

Front 61

What is the pediatric dose of atropine? ________ via what route________

Back 61

0.02 mg/kg iv/io/ett

Front 62

What is the max single dose of atropine for a Child

Back 62

0.5mg

Front 63

How many times can atropine be repeated?

Back 63

atropine can be repeated once

Front 64

In a pediatric patient experiencing bradycardia, which drug do you administer
first?

Back 64

epinephrine before atropine

Front 65

True / False: You cannot use TCP for a pediatric patient experiencing
symptomatic bradycardia.

Back 65

False

Front 66

List the possible causes of bradycardia?

Back 66

-Hypoxia
-hypotension
-hydrogen(Acidosis)
-Hypo/hyperkalemia
-Hypoglycemia
-Tension
-Tamponade
-Toxins
-Trauma
-thrombus/embolism

Front 67

Start pacemaker at age appropriate heart rate:
Infant
Child
Adult

Back 67

120,100,80

Front 68

Is TCP indicated for an adult patient in a witnessed cardiac arrest?

Back 68

No

Front 69

What is the max dose for Epinephrine in a cardiac arrest?

Back 69

No max, 1mg 1:10,000 q3-5minutes

Front 70

To confirm that a patient is in asystole, what must you do?

Back 70

check 2 leads

Front 71

What is the sequence of joule settings when defibrillation is indicated in a
pediatric patient?

Back 71

2j/kg,4j/kg,4j/kg

Front 72

What is the dose of epinephrine given to a pediatric patient in pulseless VF,
V-tach, or asystole?
____ mg/kg (1:10,000) IV/IO or ET _____mg/kg (1:1,000) diluted in 5 ml

Back 72

0.01mg/kg 1:10 IV/IO or 0.1mg/kg 1:1 ETT diluted in 5ml LR or NS

Front 73

List the ten possible causes for a patient that is in pulseless electrical activity
(PEA)?

Back 73

-Hypoxia
-hypotension
-hydrogen(Acidosis)
-Hypo/hyperkalemia
-Hypoglycemia
-Tension
-Tamponade
-Toxins
-Trauma
-thrombus/embolism

Front 74

Is sodium bicarbonate indicated for an adult patient in cardiac arrest? If so,
what is the dose? ________, ________________

Back 74

Yes, w/ consult, 1meq/kg

Front 75

True / False: Lidocaine (1mg/kg) can be given to a patient who has a return
of spontaneous circulation following cardiac arrest.

Back 75

true

Front 76

True / False: Patients with chest pain may take own RX of nitroglycerin, up
to three doses.

Back 76

True

Front 77

True / False Nitroglycerin is contraindicated for 48 hours, for any patient
who has taken any erectile dysfunction drug or pulmonary anti-hypertensive

Back 77

True

Front 78

If a patient B/P drops more than _____ mmhg after administration of
Nitroglycerin, you must obtain medical consult before further administration.

Back 78

20mm/hg systolic

Front 79

If a patient does not have a RX or a previous HX of NTG use what must be
done prior to administration of the drug?

Back 79

Initiate IV access

Front 80

What is the maximum dose of Nitroglycerin for an adult with chest pain?

Back 80

1.2mg- 3 doses of 0.4mg SL

Front 81

What is the dose of Morphine Sulfate that may be administered following
consultation with medical control? What route can be used?

Back 81

0.1mg/kg SLOW IVP

Front 82

Is a consult necessary when administering Aspirin 324 or 325mg PO to a
patient that you suspect is having an MI?

Back 82

No

Front 83

What are the two criteria a patient must meet before you can consider
treatment of hyperkalemia?

Back 83

Known renal failure/hx of dialysis tx or Crush syndrome. Must have bradycardia w/ prolonged QRS

Front 84

What are the contraindications for calcium chloride?

Back 84

Must be used in setting where Hyperkalemia, Ca channel blocker OD or Hypocalcemia is strongly suspected
may not be used when pt takes digoxin and is in suspected Ca channel blocker OD

Front 85

If the patient has a combination ICD and Pacemaker, deactivating the ICD
_________ or ____________ deactivate the pacemaker.

Back 85

May or May not

Front 86

Consult a pediatric base station for children (who have not reached their
_____ birthday) with an ICD device delivering shock therapy or
_________________.

Back 86

<18y.o. delivering shocks or malfunctioning

Front 87

True / False: Suctioning of a new born child is only indicated when the infant
is not vigorous after birth.

Back 87

true

Front 88

In the universal algorithm for newly born, what are the first four treatments
that must be accomplished?

Back 88

Dry, warm, position, stimulate

Front 89

If the new born is apneic or is gasping for air and heart rate is less than 100,
what is the most appropriate treatment?

Back 89

ventilate with BVM, 40-60 breaths /min

Front 90

Begin new born resuscitation with a heart rate less than _______ bpm.

Back 90

60bpm

Front 91

Premature infants born less than 32 weeks will likely require ongoing ___
ventilations due to the immature lungs.

Back 91

32 weeks

Front 92

List four possible causes of a new born with a decreased level of function:

Back 92

hypothermia
hypoglycemia
Resp depression
Hypovolemia

Front 93

Always suction the _________ before the ___________, in a new born.

Back 93

Mouth before the nose

Front 94

Treatment of Premature Ventricular Contractions are indicated in:

Back 94

-PVC’s in the presence of cardiac symptoms that are:
near the T wave
Multi-focal
Sequential or closely coupled
OR
-Runs of or pulsed VT
-After conversion from VT/VF

Front 95

What is the drug/dose/route used to treat symptomatic PVC’s?

Back 95

Lidocaine, 1-1.5mg/kg IV/IO, max of 3mg/kg

Front 96

True / False: Medical consultation is not needed to treat PVC’s in an
asymptomatic patient.

Back 96

False, must consult to treat PVC’s in asymptomatic PT

Front 97

Inclusion criteria for patients with Acute Coronary Syndrome (ACS) and has
one of the following in a Diagnostic quality 12 lead ECG:

Back 97

Anterior, Inferior, lateral: ST elevation
greater than 1 mm in two or more contiguous leads and QRS complex
is narrower than 0.12 seconds.
OR
1mm elevation in 2 limb leads
AND
b. QRS complex is narrower than 0.12 seconds.
OR
1.5-2mm+ elevation in 2+ precordial leads
OR
New Left BBB: If patient has in his/her possession a previous ECG
with narrow QRS to demonstrate that the wide complex is a NOS

Front 98

True / False: If patient meets the above STEMI criteria, than they are
classified as a priority one patient and you must do a consult.

Back 98

True

Front 99

True / False: You must consult with any base station for children less than 15
years old with ST elevation.

Back 99

False, Must consult with pediatric base station

Front 100

Sudden Infant Death Syndrome is one of the leading causes of death in infants
ages ______-_______, and seems to peak a ___ to ___ months of age.

Back 100

1-12months. peaks at 2-4 months

Front 101

For SIDS patients, you should pay special attention to the condition of the
infant, including the presence of _____________ or ______________ and to
the preservation of the ________________, including any _______________
and the condition of the room.

Back 101

marks or bruising, preserve environment, including linens

Front 102

What are some signs and symptoms that a patient with tachycardia may
present with?

Back 102

-CP
-SOB
-Hypotension
-Decreased LOC
CHF/AMI

Front 103

If your adult patient has a heart rate greater than ____, and is hemodynamically
unstable, you should do what?

Back 103

150bpm, Synchronized Cardiovert

Front 104

If an infant has a heart rate of greater than_____ and is hemodynamically
unstable, you must prepare for immediate synchronized Cardioversion.

Back 104

220bpm

Front 105

What is the minimum heart rate for an unstable child need to be for you to
consider synchronized Cardioversion?

Back 105

180bpm

Front 106

A patient in SVT, you first choice would be to? ________________________

Back 106

Valsalva maneuvers

Front 107

What is the drug used to treat SVT, and what are the doses? __________________

Back 107

Adenosine, 6mg rapid IVP, 12mg, 12mg, max of 30 mg

Front 108

What drug do you consider for a patient experiencing signs and symptoms of
atrial fibrillation or atrial flutter?

Back 108

diltiazem 10-20 mg over 2 minutes

Front 109

You have a stable adult patient with a wide complex tachycardia of uncertain
type, what would be your first drug of choice?

Back 109

Lidocaine

Front 110

What is the dose of the drug used in number 122?

Back 110

1-1.5mg/kg, then 0.5-0.75 mg/kg

Front 111

If your patient became hypotensive after administering diltiazem, what drug
and dose could you administer? __________________dose ______________

Back 111

Calcium chloride, 500mg slow IVP

Front 112

What is the joule setting for a pediatric patient in SVT?

Back 112

0.5, 1, 2 j/kg

Front 113

What is the dose of adenosine for a pediatric patient? _____-_____ mg/kg

Back 113

0.1-0.2 mg/kg

Front 114

If calculated joule setting is lower than synchronized Cardioversion device is
able to administer, what should you do?

Back 114

synchronized cardiovert at the lowest joule setting

Front 115

What is the pediatric dose/route of Lidocaine for a child in VT?

Back 115

1mg/kg, then 0.5 mg/kg IV, IO, ETT

Front 116

What do you do with a person that has a valid “DNR-A” form?

Back 116

Full care until Arrest

Front 117

What do you do with a person that has a valid “DNR-B” form?

Back 117

Palliative care until arrest

Front 118

List the acceptable forms of DNR in the state of Maryland?

Back 118

molst or Medical alert bracelet/insert
MD or out of state DNR/MOLST form
Direct orders from MD-onscene
Orders via sys com from MD

Front 119

What area of the body does frostbite usually affect first?

Back 119

Feet/toes, then nose, ears, fingers

Front 120

The frost-bitten skin will initially appear: ______________________, than
turns: _______________________________________________________.

Back 120

cold, white, waxy, then turns black and blue

Front 121

True/ False You must rub affect frost-bitten areas in order to start the
rewarming process.

Back 121

False

Front 122

Protect the patient with frost bite from further _______ loss.

Back 122

Heat

Front 123

What drug could you consider for a patient that has frost bite?

Back 123

Morphine, 0.1mg/kg IV/IM/IO

Front 124

Patients with severe hypothermia have many of the same symptoms as
patients that are in mild to moderate hypothermia. List one symptom that
differentiates a patient from mild/moderate hypothermia and severe
hypothermia? ___________________________________________________

Back 124

Lack of shivering is a sign of severe hypothermia.

Front 125

Rough handling of a hypothermic patient could cause what problem?

Back 125

cardiac arrest

Front 126

True/ False If you have a patient that is pulseless, apneic, and you suspect is
hypothermic, the patient should be resuscitated. (Does not have injuries
incompatible with life)

Back 126

True, pt is dead once warm and sad

Front 127

How should you re-warm a patient with hypothermia?

Back 127

passively, with a warm environment and heated 02 if available

Front 128

True / False You should consider longer medication intervals with a
hypothermic patient, only after medical consultation.

Back 128

true-double the time between doses

Front 129

How many shocks with an AED can you administer to a hypothermic patient
without medical consultation?

Back 129

One

Front 130

List some common signs and symptoms of depressurization syndrome?

Back 130

history of diving or altitude chamber use. Headache, nausea,vomiting, tingling in extremities, seizures, coma, death

Front 131

True / False Aeromedical transport is not indicated for a patient with
depressurization syndrome.

Back 131

False

Front 132

Can you transport a patient exposed to a hazardous material by air?

Back 132

No

Front 133

It is essential that the EMS provider in charge notify _______________ and
___________________of a hazardous materials event in which there may be
consultation and transport.

Back 133

EMRC/SYSCOM and Recv Facility

Front 134

Triage and _______________________ if indicated for a hazardous materials
exposure.

Back 134

Decontaminate

Front 135

Heat Cramps:

Back 135

moist, clammy, skin, dehydrated, cramping, possible N&V, normal to slightly elevated temp.

Front 136

Heat Exhaustion:

Back 136

weakness, dizziness, N&V, elevated body temperature

Front 137

Heat Stroke:

Back 137

Any of the previous with Alteration in mental status

Front 138

True / False You give electrolyte-rich fluid to a patient that you suspect of
having a heat related problem.

Back 138

True

Front 139

What two treatments should be given to a patient you suspect of having heat
stroke?

Back 139

Active cooling and IV fluid

Front 140

Initiate fluid therapy of _______________ ml/kg bolus and titrate to a systolic
pressure of _________________ mmhg, for a patient with a heat related
emergency.

Back 140

20ml/kg, 100mm/hg

Front 141

For near-drowning patients, abdominal thrusts are:

Back 141

contraindicated unless FBAO is present

Front 142

True / False All near-drowning victims should be transported even if they
appear uninjured or appear to have recovered.

Back 142

True

Front 143

True / False Overpressurization symptoms are often occur rapidly making
assessment easier.

Back 143

False

Front 144

What must you do prior to starting an IV in a burned area of skin?

Back 144

Consult

Front 145

Patients presenting with nausea and/or vomiting due to underlying injury,
medical condition, active motion sickness, or medication side
effect/complication may be administered _________________. The Adult
dose is ______mg slow IV over ________minutes or _______mg IM.

Back 145

Zofran, 4mg over 2 minutes

Front 146

What is the proper way to transport a patient you suspect of having
eclampsia?

Back 146

Left Lateral Recumbent

Front 147

Describe what you must do with a cord only presentation, during child birth?

Back 147

Support head with v formation of fingers, keep pressure off cord and monitor cord pulse

Front 148

During child birth, if the head will no come out of the vagina, what must you
do to keep the infants airway open?

Back 148

insert fingers in v formation to support mouth and nose

Front 149

Suctioning a infant after birth should be done how?

Back 149

Mouth then Nose

Front 150

Heavy vaginal bleeding is a sign of what?

Back 150

Injured placenta

Front 151

What can you do for post-partum bleeding?

Back 151

uterine massage from pubis to umbilicus

Front 152

Should you attempt to remove conceptual products out of the vagina if there is
heavy bleeding?

Back 152

No

Front 153

What are some signs and symptoms of non-traumatic hypoperfusion?

Back 153

Hypotension
tachycardia
diaphoresis
weakness
decreased LOC/AMS
SOB
decreasing PP
Dilated pupils

Front 154

In a non-traumatic hypoperfusion patient, if the lungs are clear you can initiate
what?

Back 154

fluid therapy, 20 ml/kg, to a systolic of 100 mmhg

Front 155

If rales are present in a patient with non-traumatic hypoperfusion, can you
give IV fluid, and if so, how much?

Back 155

Yes, 250-500ml

Front 156

What is your first drug of choice for a patient with non-traumatic
hypoperfusion?

Back 156

dopamine, 2-20 mcg/kg/min

Front 157

What is the appropriate fluid bolus for a volume sensitive pediatric patient,
with non-traumatic hypoperfusion?

Back 157

10 ml/kg, followed by 10 ml/kg

Front 158

What is the maximum dose of LR that you can administer for an adult patient
without medical consultation?

Back 158

2,000ml

Front 159

If a baby’s feet/butt present first, what should you do?

Back 159

deliver body, support weight, v to open airway

Front 160

List some common signs and symptoms associated with an absorption
overdose?

Back 160

N and V
ABD pain
diarrhea
tachycardia
AMS
Dyspnea

Front 161

For suspected organophosphate poisoning in an adult, what drug must be
considered?

Back 161

Atropine 2-4mg IV or IM Q5-10 minutes

Front 162

For suspected organophosphate poisoning in an pediatric, what drug must be
considered?

Back 162

Atropine 0.02 mg IV or IM Q5-10 minutes

Front 163

Can you receive medical direction from the poison control center?

Back 163

no, must have consulting facility online as well

Front 164

What is the adult dose of activated charcoal?

Back 164

1.0 gm/kg

Front 165

What is the only type of activated charcoal that we can give?

Back 165

without sorbitol

Front 166

If you patient is having a dystonic, extrapyramidal, or mild allergic reaction,
to an ingested poisoning, what drug must you consider?

Back 166

Benadryl 25-50mg or 1mg/kg, max of 25mg

Front 167

If your patient is having a suspected beta-blocker overdose, you should
consider what drug?

Back 167

Glucagon, 1mg IVP q5-10 minutes

Front 168

If your patient is having a suspected calcium channel blocker overdose, you
should consider what drug?

Back 168

Calcium Chloride 0.5-1g slow IVP

Front 169

Calcium chloride is contraindicated in a calcium channel blocker overdose if
the patient is taking what?

Back 169

Diltiazem

Front 170

If your patient is having a suspected organophosphate overdose, you should
consider what drug?

Back 170

Atropine
2-4mg q5-10minutes, 0.02mg/kg q5-10

Front 171

If your patient is having a suspected tricyclic overdose, you should consider
what drug?

Back 171

sodium bicarbonate 1meq/kg

Front 172

What is the pediatric dose of Glucagon, for a patient that weighs less than
25kg?

Back 172

0.5mg ivp

Front 173

List 6 signs and symptoms of an inhalation poisoning?

Back 173

N & V
diarrhea
dyspnea
seizures,
AMS
Burns to face & airway/Stridor/Ashy sputum

Front 174

True / False Pulse oximetry may not be accurate for a toxic inhalation.

Back 174

True

Front 175

List 4 unique signs/ symptoms for a patient with an injection overdose.

Back 175

Local pain
puncture wounds
local edema
metallic/rubbery taste

Front 176

A patient with a snakebite you can apply cold packs for relief of
_______________ only.

Back 176

Ice packs

Front 177

If the snake is dead, and it is practical should you take the snake with you to
the hospital?

Back 177

Yes

Front 178

For suspected narcotic overdose, you should consider use of?

Back 178

Narcan 0.4 to 2.0 mg

Front 179

What is the pediatric dose of Narcan? ___________________________

Back 179

0.1mg/kg max 0.4-2mg

Front 180

presentation of stimulant toxicity

Back 180

Chest pain, HTN, anxiety, SVT, agitation, seizures, hyperthermia

Front 181

Supraventricular Tachycardia (SVT) may resolve with the administration of
_____________. Treating SVT due to stimulant toxicity with ____________
will not work since the substance causing the SVT will still be in the system
and cause refractory SVT after the ____________ has worn off.

Back 181

Midazolam may resolve stimulant based SVT. Adenosine will not as the stimulant will still be present in the Pt’s bloodstream.

Front 182

The adult pain scale (0-10), what is the number signifies the least amount of
pain?

Back 182

0

Front 183

List the indications for pain management drugs?

Back 183

Moderate or severe pain, as a palliative measure

Front 184

What are the two acceptable routes to administer morphine?

Back 184

IV, IM

Front 185

What is an allergic reaction? _____________________________________

Back 185

Localized or systemic exaggerated immune response to a foreign substance

Front 186

For a moderate to severe allergic reaction, what is the dose of epi?

Back 186

1:1,000, 0.01 mg/kg IM up to a max of 0.3mg, may repeat up to 3 doses
for severe symptoms, Q5 minutes

Front 187

What is the dose of diphenhydramine for an adult? Can it be repeated?

Back 187

25-50mg slow ivp, can repeat with consult

Front 188

True /False: Patients with moderate to severe respiratory distress may require
high flow oxygen via NRB, CPAP, or BVM while receiving medication via a
nebulizer.

Back 188

true

Front 189

For adult anaphylactic shock with hypotension or sever airway/respiratory
distress, what is the dose of epi that may be given?

Back 189

1:10,000 0.01 mg/kg, IVP, maximum single dose of 1mg

Front 190

True / False You may give a patient with a mild allergic reaction,
epinephrine 1:1,000 0.3mg IM.

Back 190

True

Front 191

What is the dose of Epi for a pediatric patient having a mild allergic reaction?

Back 191

1:1,000 0.01 mg/kg IM

Front 192

For an asthma/COPD patient you need to consider medical consultation for
patients greater than ______ years old, or patients with _______________
history.

Back 192

45y.o. or with cardiac Hx

Front 193

When are you required to start an IV on a patient having asthma/COPD
symptoms?

Back 193

P1 or P2 or with Cardiac Hx

Front 194

A patient having asthma or COPD you should administer what dose of EPI?

Back 194

1:1,000 0.01 mg/kg IM

Front 195

What is the dose of terbutaline _____ mg via ______ route

Back 195

0.25mg IM

Front 196

When is medical consultation required for a pediatric patient in the
asthma/COPD protocol?

Back 196

congenital/chronic heart or lung disease

Front 197

List the symptoms of a pediatric patient who is experiencing Croup?

Back 197

stridor, decreasing LOC, resp distres, barkish cough

Front 198

What is the single symptom that will change your diagnosis from croup to
epiglottitis?

Back 198

Drooling

Front 199

For severe Croup, if respiratory distress is so severe that respiratory arrest is
imminent: Administer __________________ then you administer
_______________ AND 2.5 ml of ______________________ via nebulizer.

Back 199

0.01mg/kg 1:1 Epi IM, 0.5mg/kg Dexmethasone PO/IV, then 2.5ml Epi 1:1 via NEB

Front 200

All patients who receive nebulized Epinephrine must be transported by an
_______________ life support unit to the ___________________ medical
facility.

Back 200

ALS transport to nearest facility

Front 201

List the significant signs and symptoms that will help you make a diagnosis of
CHF/APE:

Back 201

Hx of CHF/COPD, orthopnea, JVD, HTN. A-fib,cardiac drug/beta blocker Rx, dyspnea

Front 202

Patients can be classified into 4 stages of respiratory distress. List and
describe the four stages?

Back 202

Asymptomatic-Dyspnea on exertion
Mild - dyspnea resolving with low Fi02 supplemental 02
Moderate- O2 sat less then 93%, elevated BP
Severe, Severe dyspnea, hypoxia, Bp above 180

Front 203

When should you consider the use of CPAP?

Back 203

Mild to moderate Resp distress with hx/ suspicion of CPH/APE
Pt must be alert

Front 204

Perform 12-lead ECG and in the face of an ___________________ wall MI
with posterior wall extension MI, consider lowering the ___________ dose of
NTG.

Back 204

Inferior, consult for NTG

Front 205

NTG dose for Asymptomatic CHF:

Back 205

None

Front 206

Mild symptoms:

Back 206

0.4mg q3-5minutes, max 1.2mg

Front 207

Moderate/Severe symptoms:

Back 207

0.4mg + 1in Paste, continue SL NTG to reduce systolic by 20 percent

Front 208

True / False You can administer nitroglycerin to a patient that has a
prescription or a previous history of nitroglycerin use.

Back 208

True

Front 209

When do you need to consult for use of nitroglycerin?

Back 209

Inferior or Posterior MI

Front 210

When can you put an inch of nitro paste on a patient?

Back 210

Moderate/severe CHF

Front 211

If blood pressure is low, you should consider medical fluid boluses followed
by _____________________.

Back 211

Dopamine 2-20mcg/kg/min

Front 212

List the three parts of the Cincinnati Prehospital Stroke Scale?

Back 212

Facial drop/ palsy
Arm drop
Speech slurring

Front 213

If the patient is a candidate for fibrinolytic therapy and can be delivered to a
hospital within __________ hours of sign/symptom onset, transport the
patient to the ______________________________________________. If
one is not available within ____ minutes then go to the nearest hospital.

Back 213

Stroke center w/in 3.5 hrs of onset. if not available w/in 30 minutes then go to local hospital.

Front 214

Consult with the nearest designated stroke center ASAP to allow for
______________________________.

Back 214

Team prep

Front 215

True / False You do not have to consult when treating a suspected stroke
patient that is hypotensive.

Back 215

False

Front 216

If a child presents with a suspected stroke, you need to consult with whom?

Back 216

Local and pediatric base station

Front 217

What position should you transport a child that you suspect is having a stroke?

Back 217

Head elevated 30 degrees.

Front 218

The contraindications for Acetaminophen are:

Back 218

Persistent vomiting, allergy, admin in past 4 hours, head/internal bleeding

Front 219

The indication and dose for Activated Charcoal is

Back 219

Poisoning by mouth (consult to admin)
1g/kg

Front 220

True/False: Adenosine has a 10 second half-life.

Back 220

true

Front 221

A contraindication for giving Adenosine is

Back 221

Known hypersensitivity

Front 222

The peak effect occurs for Albuterol Sulfate is

Back 222

in 30-120 minutes

Front 223

Medical direction is required before administering Albuterol Sulfate to the

Back 223

Pregnant pt or one with a cardiac Hx

Front 224

Pediatric Acetaminophen: 3-5 years of age ________

Back 224

1 unit dose (160mg)

Front 225

Adult Aspirin: _____mg or _____mg chewed

Back 225

324or 325mg

Front 226

Adult Calcium Chloride

Back 226

0.5-1g

Front 227

Pediatric Adenosine: ______ mg/kg to ______ mg/kg ______ IV/IO bolus,
maximum initial dose of 6 mg, maximum second or third dose 12 mg.

Back 227

0-1-0.2 rapid IVP

Front 228

Pediatric Acetaminophen: Less than ___________: Not Indicated

Back 228

3years old

Front 229

Pediatric Acetaminophen 7-9 years: __________________

Back 229

3 unit doses, 480mg

Front 230

Pediatric Albuterol Sulfate: Ages less than two years: ______
Age two or older: _______ by nebulized aerosol

Back 230

1.25mg, 2.5mg

Front 231

Adult Adenosine: ________ rapid IVP bolus followed by a _________.

Back 231

6mg,12,12, rapid followed by flush

Front 232

Pediatric Calcium Chloride: _________

Back 232

20mg/kg

Front 233

Adult Atrovent: __________

Back 233

500mcg

Front 234

Adult Albuterol Sulfate: _________

Back 234

2.5mg repeated once

Front 235

Pediatric Atropine Sulfate: _________

Back 235

0.02mg/kg

Front 236

______________: contraindicated for known systemic fungal infection.

Back 236

Dexmethasone

Front 237

______________: contraindicated for a patient currently taking Digoxin with
suspected calcium channel blocker overdose.

Back 237

Calcium chloride

Front 238

______________: Single administration ONLY, 500 ug (2.5 ml) by nebulized
aerosol connected to 6-8 lpm of oxygen in combination with Albuterol 2.5mg.

Back 238

Atrovent/ipatropium

Front 239

Pediatric Dextrose: If less than 2 months of age Administer __________ IV/IO.

Back 239

5-10ml/kg of D10

Front 240

Adult Dextrose: Administer _______________ IV (1 ampule of 50% solution)

Back 240

25g (50ml D50)

Front 241

_______________ for Pediatric: Administer 20 mg/kg (0.2 ml/kg) slow IVP/IO
(50 mg/min) Maximum dose 1 gram or 10 ml.

Back 241

Calcium chloride

Front 242

_______________ Pediatric: Ages 1 year but less than 2 years: 250 ug (1.25 ml)
by nebulized aerosol.

Back 242

Atrovent

Front 243

Pediatric Dextrose: If greater than 2 years of age – Administer ______________

Back 243

1-2ml/kg d50

Front 244

Pediatric Albuterol Sulfate: Age 2 and older: ___________by nebulized
aerosol.

Back 244

2.5mg repeated once

Front 245

Pediatric Dextrose If greater than 2 months but less than 2 years of age –
Administer _______________

Back 245

2-4ml/kg D25 IV

Front 246

Adult Dopamine: Administer ____________ IV drip titrated to BP of 100
systolic or medical consultation

Back 246

2-20mcg/kg/min

Front 247

Pediatric Diphenhydramine: Administer ____________ slow IVP/IO/IM

Back 247

1mg/kg

Front 248

Adult______________: 1:1,000, 0.01mg/kg IM max. single dose 0.5 mg

Back 248

Epinepherine

Front 249

Pediatric ____________: Contraindicated for patients less than 12 years of age

Back 249

Diltiazem

Front 250

Pediatric ____________: Administer 1 mg/kg slow IV/IO or IM Maximum
single dose 25 mg.

Back 250

Diphenhydramine

Front 251

Adult Dexamethasone: Administer _________

Back 251

10mg IV/PO

Front 252

Pediatric Dopamine: Administer _______ ug/kg/min IV drip titrated age
specific BP or medical consultation selected BP: initial infusion rate 2-5 ug/kg/min.

Back 252

2-20

Front 253

Adult Diltiazem: For patients older than _____ years of age or borderline blood
pressure, consider initial bolus _______ mg administered IV over 2 minutes.

Back 253

50y.o. consider initial 5-10mg

Front 254

_________________Indication and/or recurrent seizures due only to nerve
agent or organophosphate exposure.

Back 254

Midazolam/Diazepam

Front 255

Pediatric Epinephrine: Administer _______ mg/kg (0.1 ml/kg) of 1:10,000
IVP/IO repeat every 3 – 5 minutes.

Back 255

0.01mg/kg

Front 256

Adult Diphenhydramine: Administer __________ slow IVP or IM

Back 256

25-50mg

Front 257

Adult Lidocaine with pulse: Administer ________ IVP bolus followed by 0.5-
0.75 mg/kg every 8 – 10 minutes as needed, up to 3 mg/kg.

Back 257

1-1.5mg/kg

Front 258

Adult Midazolam: ______mg/kg in _____ mg increments slow IV push over one
to two minutes per increment. Max single dose____5 mg.

Back 258

0.05mg/kg in 2 mg increments, max 5mg, 50 percent for greater then 59y.o.

Front 259

Pediatric Haldol: Child 6-11 years of age_______ IM or IV, Max of ____ mg.

Back 259

0.05mg/kg max 2.5mg

Front 260

Pediatric Narcan: Administer ______ mg/kg IVP/IM/Intranasal (if delivery
device is available), up to maximum initial dose of 2 mg, may be repeated

Back 260

0.1mg/kg

Front 261

_______________ Adult and Pediatric: KVO

Back 261

Lactated ringers

Front 262

Adult Haldol: Patient 15-69 years of age: ______ mg IM or IV

Back 262

5mg

Front 263

_______________ for volume sensitive children 10 ml/kg

Back 263

Fluid, lactated ringers

Front 264

_______________ Maximum dose of 2,000mL without medical consultation.

Back 264

Lactated ringers

Front 265

Adult Narcan: Administer________ mg IVP/IM/Intranasal (if delivery device is
available), repeat as necessary to maintain respiratory activity.

Back 265

0.4-2mg

Front 266

Pediatric Lidocaine with pulse:

Back 266

1mg/kg initial, 0.5mg/kg q8-10min, max 3mg/kg

Front 267

Pediatric_____________: 0.1 mg/kg slow IVP/IO/IM (1-2mg/min, max 5mg

Back 267

Morphine

Front 268

Adult ___________: 4 mg slow IV over 2 – 5 minutes 4 mg IM.

Back 268

Zofran

Front 269

Adult ____________: 0.4 mg SL

Back 269

NTG

Front 270

____________Should only be given after airway has been secured and
ventilations achieved

Back 270

Sodium Bicarb

Front 271

____________ generally . up to to 1 inch (1.25-2.50 cm) of the ointment is applied.

Back 271

NTG

Front 272

Pediatric _____________: Administer 1mEq/kg IVP/IO for patients less than 1 year of age, must be diluted (1:1) with LR

Back 272

Sodium Bicarb

Front 273

Never apply _________ to the eyeball or globe.

Back 273

Pressure

Front 274

When treating foreign objects NOT embedded in the eye, flush with
copious amounts of __________ from the bridge of the nose outward.

Back 274

Preferably sterile water, non-sterile water, Normal Saline, LR

Front 275

Injury to the eye orbits and the area around the eye, you must
__________and __________ the patient’s head and spine, apply cold packs if the
eyeball is not involved.

Back 275

stabilize w/ spinal protection

Front 276

When treating lacerations or injuries to the eyeball or globe, shield the
other eye to __________ movement, protect loss of fluids, __________ the
patient’s head and spine and elevate the head of the backboard to decrease
intraocular pressure.

Back 276

minimize movement, immobilize, elevate

Front 277

Impaled objects, __________ and __________ affected eyeball and
_________other eye to reduce movement

Back 277

stabilize and shield affected eyeball, and cover other eye

Front 278

Adults with an isolated eye injury can be given an __________ per Pain
Management protocol.

Back 278

Opiod

Front 279

List all five (5) indications for a referral to the hand/extremity trauma
center:

Back 279

Hand/forearm amputation, partial/ complete finger/thumb amputation, degloving crush injury to hand/forearm
injection injuries, compartment syndrome

Front 280

True/False Toe injuries from lawn mowers are not candidates for
re-implantation and should go to the local Emergency Department.

Back 280

True

Front 281

True/False Do not submerge amputated parts in water or expose them
directly to ice so they become frost bitten.

Back 281

True

Front 282

Initiate an IV of __________ at 20ml/kg bolus, and titrate to a systolic
pressure of __________mg Hg.

Back 282

Lactated ringers, titrate to 100mm/hg

Front 283

Consider additional boluses of fluid administration up to a maximum of
__________ ml without a medical consult.

Back 283

2,000

Front 284

True/False In pediatrics, for hypoperfusion, you can administer fluid
challenges of 20 ml/kg of LR, IV or IO.

Back 284

True

Front 285

How many fluid boluses can you administer before switching to a bolus
of 10ml/kg?

Back 285

2 then consult

Front 286

True/False: Trauma patient’s who have not reached their 15th birthday,
should be transported to a pediatric trauma center.

Back 286

True

Front 287

When hyperventilating a head injury patient, ventilate at a rate of:

Back 287

Adult-20, child-30,infant, 35

Front 288

True/False: While time, distance, and proximity are all factors to be
considered in the triage decision, the trauma decision three should be used to
determine who should be transported to the nearest appropriate trauma center and
when the transport should occur.

Back 288

True

Front 289

Maintain spine stabilization for ____________ trauma patients. Patients
with isolated _______________ trauma should not have spinal immobilization
performed.

Back 289

Blunt-Maintain
Isolated penetrating do not need spinal stabilization.

Front 290

True/False Healthcare providers are obligated by law to report cases of
suspected child or elder abuse and/or neglect to the local police authority or
protective services.

Back 290

True

Front 291

In order to make the patient feel more comfortable/secure, every attempt
should be made to have the patient talk to someone of the _________________.

Back 291

Same Gender

Front 292

Discourage victims from __________ (i.e. shower, washing, changing
clothes).

Back 292

Cleansing

Front 293

List the four indications for referral to a Specialty Spinal Center:

Back 293

15 years old or greater, S/s new para/quadriplegia, patent airway, hemodynamically stable

Front 294

True/False: For a spinal cord injury, initiate an IV LR fluid therapy
20mL/kg bolus, titrated to a systolic pressure of 100mg Hg.

Back 294

True

Front 295

List the four indications for referral of a pediatric spinal injury to a
Pediatric Trauma Center:

Back 295

15 years old or younger, S/s new para/quadriplegia, patent airway, hemodynamically stable

Front 296

True/False: If the closest trauma center is greater than ten (10) minutes
away, the trauma arrest should be taken to the closest Emergency Department?

Back 296

True

Front 297

If an adult trauma arrest is suspected (along with multi-system blunt or
abdominal trauma), bilateral ____________________ shall be performed.

Back 297

Needle decompression thoracostomy

Front 298

List the criteria for Category A trauma:

Back 298

GCS 13 or less
SYS bp <90mm/hg in adults, <60mm/hg in peds
RR less then 10 or greater then 28 or PT being ventilated

Front 299

List the criteria for Category B:

Back 299

2 or more proximal long bone Fx
amputation
chest wall instability
paralysis
mangled/pulseless extremity
skull fx
penetrating trauma proximal to elbow or knee

Front 300

List the criteria for Category C:

Back 300

High risk MOI

Front 301

List the criteria for Category D:

Back 301

Comorbid factors, age greater then 55 or less then 15, hx anti coag rx, burns, pregnant greater then 20 weeks
provider judgement

Front 302

True/False “Option A” is limited to (palliative) care only before arrest.

Back 302

False, that is option B

Front 303

True/False “Option B” is maximal (restorative) care only before arrest.

Back 303

False that is A-1

Front 304

True/False EMS providers should only request a second instrument (i.e.
bracelet when a form has already been presented), if there is reason to question
the validity of the first produced notification device.

Back 304

True

Front 305

True/False Treat out-of-state EMS/DNR orders as “Option A”?

Back 305

False, treat out of state as B

Front 306

True/False Oral DNR orders may be taken over a non-recorded phone line
from the patient’s physician?

Back 306

False, oral orders must go thru syscom

Front 307

True/False Revocation of an EMS/DNR order may be obtained by:
A-Physical cancellation or destruction of EMS/DNR order
B-The authorized decision-maker must destroy or withhold the EMS/DNR
Order devices.

Back 307

True

Front 308

List the seven indications EMS providers may pronounce the death.

Back 308

decomposition, rigor mortis, decapitation, dependent lividity, ALS- pulseless and apnea in MCI,
ALS- Pulseless/apnea w/ injuries incompatible with life
Termination of Resusitation

Front 309

An individual is dead if, based on ordinary standards of medical practice,
the individual has sustained either:

Back 309

Irreversible cessation of Respiratory or cardiovascular function
irreversible cessation of all brain function, including the Brain stem

Front 310

True/False All hypothermic patients’ fall into the presumed dead on
arrival.

Back 310

False

Front 311

True/False Only and EMT/P can access a Central Venous catheter/device
for life threatening emergencies ?

Back 311

True

Front 312

List the three potential adverse effects/complications from utilizing a bag
valve mask device:

Back 312

Gastric distention, vomiting, Increased ICP from Vagal stimulation

Front 313

True/False The King Airway is the first line advanced airway,
endotracheal intubation is the second line advanced airway?

Back 313

False, ETT is first line

Front 314

List the two indications for placing a gastric tube into a patient:

Back 314

intubated pediatric pt or signs of gastric dissension

Front 315

List the four contraindications for placing a gastric tube:

Back 315

esophageal varices, nasogastric deformity, esophageal surgery, suspected basillar skull fx

Front 316

List the four contraindications for placing a nasotrachael tube:

Back 316

PT on anticoagulants, airway/facial trauma, CSF leakage, skull Fx, patient less that

Front 317

List the eight potential adverse effects/complications for placing a
nasotrachael tube:

Back 317

epitaxis, esophageal intubation, facial trauma, R main stem intubation, increase in ICP, Pneumo/tension pneumo
inter cranial tube placement

Front 318

List the preferred site for needle decompression: _________________

Back 318

Second intercostal, mid clavicular

Front 319

List the five potential adverse effects/complications when performing
needle chest decompression:

Back 319

Intercostal injury, cause pneumo/hemo thorax, lung damage, cardiac injury, infection

Front 320

When performing direct laryngoscopy for an obstructed foreign airway
obstruction, you must first make sure

Back 320

pt must be unconscious, gcs less then 8

Front 321

When performing orotrachael intubation, you must confirm the placement
of the ET tube with a minimum of ___ devices:

Back 321

2

Front 322

What is the maximum length of time that you are allowed to suction in an
attempt to clear a tracheostomy ?

Back 322

10seconds

Front 323

List the contraindication for applying an AED:

Back 323

PT showing signs of life

Front 324

What is the joule setting during Cardioversion for symptomatic PSVT or
atrial flutter ?

Back 324

50j, 100j, 200, 300j, 360j

Front 325

What is the joule setting during Cardioversion for symptomatic atrial
fibrillation?

Back 325

Initial 200j, 200j, 300, 360j

Front 326

What is the joule setting during Cardioversion for symptomatic
tachydysrhythmias ?

Back 326

Initial 100j, 200j 300j 360j

Front 327

The correct joule setting for pediatric symptomatic
tachydysrthymias is

Back 327

0.5joules/kg, 1joule/kg, 2 joule/kg

Front 328

The correct joule setting for pediatric defibrillation in ventricular
fibrillation or pulseless ventricular tachycardia is:

Back 328

2 joules/kg,4 joules/kg,4 joules/kg

Front 329

True/False: Bag-valve-mask ventilation is the technique of providing
rescue breathing for patients with inadequate respiratory effort or cardiac arrest.

Back 329

True

Front 330

True/False The external jugular vein is utilized as the first attempt to
secure IV access.

Back 330

False, it is an option if needed

Front 331

If the adult blood glucose level is less than 70 mg/dl, then administer
_____grams of 50% dextrose.

Back 331

25grams (50ml D50)

Front 332

If unable to obtain IV access and the blood glucose level is 70 mg/dl, then

administer __________ (if over 25 kg) or 0.5 mg __________.

Back 332

1mg glucagon IM, glucagon IM

Front 333

If blood glucose is greater than__________, then administer __________

Back 333

300mg/dl administer Lactated ringers 10ml/kg

Front 334

If blood glucose is less than _____ mg/dl (adult or pediatric patient),
obtain medical consult for authorization before administering a second dose of
50% dextrose.

Back 334

40mg/dl

Front 335

When administering D10 % to a patient two months of age or less, you
must mix _____ part D50% with ____ parts LR.

Back 335

1 part D50 to 4 parts LR

Front 336

When administering D25 % to a patient greater than two months, but less
than two years of age, you must mix _____ parts D50% with _____ parts
LR. You will administer _____ ml/kg.

Back 336

1 parts d50 to 1 part LR, administer 2-4ml/kg

Front 337

The preferred site for an intraosseous access in a patient six years of age
or less is:

Back 337

1-5 cm distal to the tibial tuberosity on the anteromedial surface of the
tibia or medial surface of the distal tibia just proximal to the medial
malleolus.

Front 338

List the six contraindications for introaosseous access:

Back 338

Conscious patient with stable vital signs
Peripheral vascular access readily available
Suspected or known fractures in the extremity targeted for IO infusion
Previous attempt in the same bone
Cellulitis at the intended site of the procedure
Patient with known bone disorder
Prior knee or shoulder joint replacement

Front 339

How many attempts are you allowed for IO access within five minutes:

Back 339

2