Riverside Ems Protocol Review

Front 1

How long should you keep CE certificates?

Back 1

4 years after you receive them and they must be available for review.

Front 2

what fraction of your ce hours must be instructor based?

Back 2

1/2

Front 3

what fraction of your ce hours must be received from courses whose topics involve the medical management of patients within the scope of practice?

Back 3

2/3rd's

Front 4

what's the max number of ce's you can do each day?

Back 4

12 hours.

Front 5

What type of college classes count for ce credit and how many ce's per semester unit? and academic quarter?

Back 5

Any biological sciences (A&P, pathophysiology and phychology)
Academic semester: 15 per unit
Academic quarter: 10 per unit

Front 6

What is required for continuing accreditation of a paramedic in REMS?

Back 6

Valid State EMT-P License
ACLS card (valid within 30 days)
BLS card (Valid within 30 days)
Continued employment with an approved ALS provider
Skills Competency sheet
Attendance at all REMSA mandatory training sessions.

Front 7

How many hours of skills labs are required for re verification?

Back 7

Eight (8) hours of REMSA-approved skills labs on Performance Standards, to include all skills modules
required by REMSA.

Front 8

What is the correct call sign for units?

Back 8

BLS AMR - AMR UNIT#
ALS AMR - AMR Medic UNIT #
and if HT put an HT before it.

Front 9

What standard of care/courses must you have?
(5 things)

Back 9

approved initial training
CPR
PHTLS or ITLS
ACLS
PALS

Front 10

Who are the 7 Base Hospitals in Riverside County?

Back 10

1. Inland Valley Regional medical center(IVMC) - Wildomar
2. Riverside County Regional Medical Center (RCRMC) - MoVal
3. Riverside Community hospital(RCH) - Riverside
4. Desert Regional Medical Center - Palm Desert
5. Eisenhower Medical Center (EMC) - Rancho Mirage
6. John F. Kennedy Memorial Medical center (JFK) - Indio
7. Palo Verde Hospital (PVH) - Blythe

Front 11

Use of an Alternative ambulance: When can you use a bls ambulance?

Back 11

Use of a BLS ambulance will be exercised only when expeditious transport is deemed critical for the survival of
the patient and only when both the patient status and time criteria defined below are met.
The on Scene ALS crew will provide ALS personnel and equipment to care for patient transport.

Front 12

Use of an Alternative ambulance: What're the 4 critical criteria?

Back 12

a. Persons suffering from a fragile or unmanageable airway / airway compromise. (e.g. foreign body airway
obstruction (FBAO), bag-valve-mask (BVM)-assisted respirations, continuous suctioning)
b. Persons experiencing an acute myocardial infarction (AMI) as confirmed by diagnostic changes on a 12-
lead EKG.
c. Persons showing rapidly deteriorating vital sign and/or deteriorating mental status.
d. Persons meeting critical trauma patient (CTP) criteria AND who show signs of respiratory, circulatory, or
neurological compromise as defined in 2.c. above.

Front 13

Use of an Alternative ambulance: if the patient meets one of the 4 critical criteria and the als transport unit is not on scene you shall ask the ETA and then do what?

Back 13

1. if response time is outside of the contract dispatch center will query eta of bls units
2. if response time is greater than 10 minutes more than the bls ambulance. The bls ambulance will be dispatched
( The ALS transporting unit will continue its response. Both transporting units will respond to the incident.
Upon arrival of the first unit, the Incident Commander should consider canceling the ambulance still en
route. )

Front 14

who is designated as the primary "First response agency" within their jurisdiction?

Back 14

A fire suppression agency

Front 15

who is responsible for medical management of an individual?

Back 15

The highest level of REMSA authorized responder is responsible.

Front 16

What're the required functional positions under the medical group on an MCI?

Back 16

1. Triage unit leader - triages and directs movement of patients
2. Medical Communication Coordinator - others
3. Treatment Unit Leader - supervises personnel assigned to treat patients in the three treatment areas
4. Ambulance Coordinator - manages ambulance staging and dispatches ambulances
5. Patient Transportation unit leader - responsible for the coordination of patient transportation and the maintence of records

Front 17

Under MCI what does the Med comm unit leader do?

Back 17

maintains communication with the base hospital. responsible for reporting location, mechanism and approximate number of patients (by category immediate delayed etc). requests hospital availability and determining patient transportation and destination decisions.

Front 18

What is S.T.A.R.T? (MCI)

Back 18

It's the system that allows first responders to triage patients in 60 seconds or less based on ventilation, perfusion and mental status.

Front 19

What qualifies as a deceased patient in an MCI?

Back 19

No Ventilation present even after attempting to position airway.

Front 20

What qualifies as a immediate patient in an MCI?

Back 20

Ventilation is present only after positioning the airway or
respirations over 30 per minute
Pulse / cap refill over 2.
Mental status depressed patients fails to follow simple commands

Front 21

What qualifies as a delayed patient in an MCI?

Back 21

any patient that does not fit in immediate or minor

Front 22

What qualifies as a minor patient in an MCI?

Back 22

These patients are separated from the general group at the start of the triage by requesting those who can walk to go to an assigned area

Front 23

What qualifies as an MCI?

Back 23

When there are 5 or more patients requiring transport or when it's deemed necessary by Incident command.

Front 24

What shall Med com communicate in their initial contact to the hospital in an MCI?

Back 24

1. It should identify itself as Medcom
2. Name and location for MCI bed availability
3. ETA to closest hospital and trauma center to establish a point of reference
4. Description of special circumstances
5. Number of patients and request for MCI bed availability

Front 25

What shall Med com communicate in their second contact to the hospital in an MCI?

Back 25

1. Receiving bed availability from the BH
2. Current patient count by patient status (immediate, delayed or minor)
3. Transportation destination considerations (peds, burn and trauma)

Front 26

What shall Med com communicate in their third and subsequent contact to the hospital in an MCI?

Back 26

1. Triage tag #
2. PAtient status
3. Chief Complaint
4. Patient Info
5. Hospital Destination
6. Ambulance company and unit id
7. Off scene time
Transporting ambulance shall contact facility as soon as possible with other patients details.

Front 27

When can a patient be restrained?

Back 27

1. When the patient is a danger to himself or others.
2. When a patient is transported as a 5150
3. When the patient is transported under arrest.

Front 28

When restraining a patient that is a danger to himself or others how should you restrain him or her?

Back 28

use the minimum restraint necessary.

Front 29

When restraining a patient that is transported as a 5150 how should you restrain him or her?

Back 29

1. transport them using four point wrist and ankle restraints
2. take the original, complete, signed 5150 form with
3. Transport the patient as clinically indicated
NOTE: Law enforcement should follow because they're legally responsible for the patient during transport

Front 30

When restraining a patient that is transported under arrest how should you restrain him or her?

Back 30

same as any other but MUST NOT BE HANDCUFFED and law enforcement must follow up
I repeat do not allow handcuffing.

Front 31

What can you use for restraints and what must be checked?

Back 31

1. Use only REMSA approved neoprene or nylon webbing with velcro.
2. Distal circulation must be assessed at least every 15 minutes
3. Restraints may not interfere with assessment or care of patient
4. Patient must be transferred via low or high fowlers position
5. Fully Document the use of restraints!

Front 32

Can you restrain a patient that's supine or prone?

Back 32

NO NEVER
Also never restraint a patient on a spine board

Front 33

What must you place on alternative medications that are obtained? (alternative medication column)

Back 33

red sticker!

Front 34

What should you do if you use an alternative drug?

Back 34

notify REMSA duty officer immediately and follow with written notification within 72 hours.

Front 35

What patient is considered pediatric in regards to the Universal patient protocol?

Back 35

14 or younger.

Front 36

Oxygen rates: for Nasal Cannula, NRB and BVM

Back 36

NCL: 2-6LPM
NRB: 10-15 LPM
BVM: 10-15 LPM

Front 37

How should you hand off to another provider? (4 letter pneumonic)

Back 37

Situation, Background, Assessment, Recommendation

Front 38

What pulse oximetry must I maintain?

Back 38

94% or higher?

Front 39

What 5 things must be c-spined?

Back 39

1. Neck or upper thoracic pain
2. New onset neurological deficits
3. High risk mechanism of injury
4. Altered level of consciousness with distracting pain or influence of alcohol/drugs
5. atypical presentation, circumstance, or provider uncertainty.

Front 40

At what age can peds patients be intubated or a king airway placed?

Back 40

if the patient appears to be 8 years of age or older.

Front 41

True or false, Capnography is mandatory following a king airway placement

Back 41

TRUE

Front 42

What type of chamber should be used for pediatric iv fluids administration?

Back 42

A volume control chamber should be used.

Front 43

True or false, Capnography is mandatory following an ET tube placement

Back 43

True

Front 44

if you're suctioning the trachea and have thick secretions what can you do?

Back 44

you can introduce 3cc's of normale saline.

Front 45

What can you give for a patient tht's conscious and needing an IO? and why?

Back 45

You can give Lidocaine 2% slow IO push over a minute for IO infusion pain on a conscious patient. You should wait a minute before infusing fluids.

Front 46

When must you submit a STEMI 12 lead?

Back 46

when you're equipped to do so and it must be sent to the STEMI BH. You should include the machine identified stemi and paramedic identified STEMI

Front 47

When must you contact a single REMSA Base Hospital? (out of the ordinary calls)

Back 47

You must contact for sexual assault (or law enforcement ok to book"
ALTE (apparent life-threatening event)

Front 48

Who must you contact for a critical trauma?

Back 48

A trauma center

Front 49

Who must you contact for a stemi?

Back 49

A stemi BH

Front 50

How often should vitals be repeated (3 options)

Back 50

5 minutes for unstable patients
15 minutes for apparently stable patients during the first hour of care
30 minutes for apparently stable patients following the first hour of care.

Front 51

What is the dose of Activated charcoal for an adult and is it a BH order?

Back 51

yes it requires a BH order. and it is 50g once (lower doses available for kids but also a BH order)

Front 52

When is adenosine considered a BH order?

Back 52

only for peds under 36kg

Front 53

What is the correct dose of adenosine for an adult?
does it require BH orders?

Back 53

12mg (one time). No base station order required for the initial dose but you will need to make contact for additional doses.

Front 54

when giving a drug what should you do before giving it? (if possible)

Back 54

have another person verify the dose.

Front 55

What info do you need to determine a dosage?

Back 55

you need patients age, weight and height.

Front 56

What is the correct dose of albuterol 0.083% ?

Back 56

2.5mg for all patients including all peds. May repeat as clinically indicated

Front 57

What is the correct dose of amiodarone for adults (initial and secondary dose)

Back 57

Initial: 300mg
Secondary: 150mg

Front 58

What is the correct dose of ASA (Aspirin) for an adult?

Back 58

324mg

Front 59

What is the correct dose of Calcium chloride? 10% solution? what does it require?

Back 59

1g in 10ml's. It requires a BH order.

Front 60

What is the correct dose for Dextrose 50%?

Back 60

25G in 50 ml's no Base station order required.

Front 61

Does calcium chloride require a base station order?

Back 61

YES

Front 62

How many times can you give adenosine without a base station order?

Back 62

just once

Front 63

What is the correct dose of Diphenhydramine?

Back 63

50mg may be given IV/IO or IM

Front 64

What is the correct dose of EPI 1:1000 IM for an adult?

Back 64

0.3mg IM (need BH for additional doses)

Front 65

What is the correct dose of EPI 1:10000 for adult IV?

Back 65

1mg

Front 66

What is the correct dose of glucagon?

Back 66

1mg

Front 67

What is the correct dose of Glucose gel?

Back 67

1 tube

Front 68

What is the correct dose of Ipratropium bromide (Atrovent)

Back 68

0.5mg must call BH for additional doses

Front 69

IS a BHO (Base hospital) required for Lidocaine?

Back 69

Yes anytime you use it excluding for conscious IO pain.

Front 70

When is it ok to give lidocaine without a BHO?

Back 70

when you're doing a conscious IO.

Front 71

What is the correct initial dose for Lidocaine 2%?

Back 71

100mg but it still requires BHO.

Front 72

What is the correct repeat dose for Lidocaine 2%?

Back 72

50mg but it requires BHO.

Front 73

When does Mag Sulfate NOT need a BHO?

Back 73

when dealing with Eclampsia or giving ECLAMPSIA IM.

Front 74

What is the correct dose of MAgnesium sulfate?

Back 74

2g in 4ml

Front 75

What is the correct dose of Magnesium sulfate for adults dealing with eclampsia issues? IV

Back 75

5g in 10ml IV (NO BHO needed) cannot repeat without BHO

Front 76

What is the correct dose of Magnesium sulfate for adults dealing with eclampsia issues? IM

Back 76

1.25g in 2.5ml you may repeat up to 4x

Front 77

What is the correct dose of Midazolam (versed) for an adult? (supplied in 5mg/1ml) IV

Back 77

2.5mg (0.5 ml) (must call base to repeat)

Front 78

What is the correct dose of Midazolam (versed) for an adult? (supplied in 5mg/1ml) IM

Back 78

5mg in 1mL (must call base to repeat)

Front 79

What is the correct dose of Midazolam (versed) for an adult? (supplied in 5mg/1ml) in relation to CPAP?

Back 79

1mg (0.2mL) (must call base to repeat)

Front 80

What is the correct dose of Morphine Sulfate? (supplied in 10mg/1ml) IV for an Adult?

Back 80

5mg(0.5ml)

Front 81

What's the correct dose of Nitroglycerin (tablet or spray)

Back 81

1 tablet or spray (0.4mg) (may repeat twice prior to base contact at 3-5 minute intervals)

Front 82

What's the correct dose of Nitroglycerin (paste)

Back 82

1g (1 inch) (comes in 1g/1inch packets)

Front 83

What is the correct fluid bolus for an adult?

Back 83

250ml's (1 bolus) (may repeat as clinically indicated)

Front 84

What is the correct dose of Ondansetron (IV)

Back 84

4mg

Front 85

What is the correct dose of Ondansetron (ODT)

Back 85

4mg

Front 86

What is the correct dose of sodium Bicarb? (adults)

Back 86

50 mEq and it does not require a BHO order

Front 87

What is the correct dose of Verapamil? (adults)

Back 87

5mg in 2ml (needs a BHO)

Front 88

What is the correct dose of Diazepam for adults?

Back 88

2.5mg's

Front 89

When must you contact a BH in regards to ama?

Back 89

Any refusal involving a non-emancipated minor (refusal must be made by parent, or guardian or parental designee)
Any refusal involving a patient in custody.
any refusal indicated als treatment
Any pt that has had als treatment and is refusing transportation
Any patient that would benefit from BH Contact

Front 90

When should you not attempt resuscitation? (9 items)

Back 90

1. MCI patient that's apneic despite airway maneuvers
2. Apneic and pulseless with rigor and lividity
3. decapitation
4. decomposition or incineration
5. separation of brain, heart or lungs from body
6. total abdominal evisceration
7. complete transection of torso
8. A valid signed DNR/POLST or medallian
9. Blunt trauma arrest with continous asystole or PEA at a rate less than 10

Front 91

Can you discontinue pediatric arrest without BH contact?

Back 91

NO you must receive a Base hospital physician order.

Front 92

What 6 criteria must be present to discontinue resuscitation?

Back 92

1. Patient is medical
2. Unwitnessed arrest
3. No bystander CPR
4. No shock delivered
5. A minimum of 2 rounds were given
6. Continuous asystole or PEA at a rate less than 10

Front 93

In regards to shock treatment position what should you do?

Back 93

Position patient supine to meet physiologic requirements avoid trendelenburg or elevating legs for shock.

Front 94

What 3 things must be present to suspect tension pneumothorax?

Back 94

1. Progressively worsening respiratory distress/apnea
2. Unilateral decreased or absent breath sounds on the affected side
3. Hypotension (BP less than 90 with signs of poor perfusion) (this includes cardiac arrest (PEA by presenting rhythm)

Front 95

Where should you transport the blunt trauma arrest patient?

Back 95

They should be transported to the closest PRC (prehospital receiving center).

Front 96

Where should you transport the penetrating trauma arrest patient to?

Back 96

They should go to the closest trauma center if it's no more than 10 minutes further than the closest PRC. if it is they should go to the closest PRC.

Front 97

How much time should you try to limit for patients that meet the trauma triage criteria?

Back 97

10 minutes or less

Front 98

A patient with suspected traumatic brain injury will display signs of increased ventilatory rate and or unequal fixed and dilated pupils and extensor posturing / no motor response what should you ventilate adults at? child? Infant?

Back 98

Adult: 20 breaths per minute
Child: 25 breaths per minute
Infant: 30 breaths per minute

Front 99

When should you remove an impaled object?

Back 99

when it's interfering with the airway and or chest compressions

Front 100

What should you do with an impaled object?

Back 100

stabilize it?

Front 101

What type of treatment should be done for a flail chest and what should you avoid?

Back 101

Assist with ventilations (DO NOT ATTEMPT TO STABILIZE the flail segment by sandbagging, splinting, and or swathing)

Front 102

How should you dress a pneumothorax?

Back 102

with an occlusive dressing (you can briefly remove to release pressure when indicated)

Front 103

How should I dress an evisceration?

Back 103

with saline soaked dressing

Front 104

should you fix grossly angulated extremity fractures?

Back 104

yes return them to anatomic position as clinically indicated use gentle traction.

Front 105

True or false you need to contact a BH for any fracture or dislocated with neuro and or vascular compromise

Back 105

True.

Front 106

For an amputation what should you do?

Back 106

rinse amputated body parts
wrap with saline soaked dressing and place in a bag
DO NOT PLACE directly on ice

Front 107

You may give MS IVO/IO or IM as long as what occurs?

Back 107

for pain associated with isolated traumatic injury to an extremity or the appendicular skeleton
the blood pressure is over 90 mmHG

Front 108

can you repeat Morphine sulfate doses without BHO?

Back 108

NO YOU MUST CONTACT FOR FURTHER ORDERS

Front 109

For patients with a traumatic injury what meds can you give with bh order? 4

Back 109

Calcium Chloride: (for suspected hyperkalemia associated with crush injuries)
Midazolam: For Anxiety associated with traumatic injury
Morphine Sulfate: for pain
Sodium Bicarb: for hyperkalemia associated with crush injuries

Front 110

What is cardiogenic shock involve?(2)

Back 110

arrhythmia or infarction

Front 111

What is Distributive shock involve? (3)

Back 111

anaphylactic, neurogenic, septic
(3)

Front 112

What is Hypovolemic shock involve? (4)

Back 112

hemorrhagic blood loss, burns, diarrhea, vomiting.

Front 113

What does obstructive shock involve?

Back 113

Embolism
Tamponade
Tension pneumo

Front 114

What is a first degree burn?

Back 114

superficial, red and sometimes painful

Front 115

What is a second degree burn?

Back 115

red, blistered, swollen and very painful

Front 116

What is a second degree burn?

Back 116

whitish, charred, or translucent, decreased sensation in the burned area.

Front 117

What is the adult rule of 9's in regards to burns?

Back 117

Head: 9%
Right Arm: 9%
Left Arm: 9%
Torso: 36%
Genitalia: 1%
Right Leg: 18%
Left Leg: 18%

Front 118

What is the adult rule of 9's in regards to burns?

Back 118

Head: 18%
Right Arm: 9%
Left Arm: 9%
Torso: 36%
Right Leg: 14%
Left Leg: 14%

Front 119

For thermal burns LESS than 20% what should you do?

Back 119

Cool with wet dressing
Follow with dry clean, non adherent dressing

Front 120

For thermal burns less than 20% what should you do?

Back 120

Apply Dry, Clean, non-adherent dressing

Front 121

What should you consider for electrical burns?

Back 121

Consider possibility of spinal trauma / need for spinal stabilization
treat related injuries

Front 122

What should you do for eye burns?

Back 122

flush contaminated eyes with saline for 15 minutes or more
check for contact lenses
patch the eyes

Front 123

What should you do for tar burns?

Back 123

cool with water
DO NOT REMOVE TAR
apply petrolatum gauze dressing

Front 124

What medical treatment may you give for burns?

Back 124

Fluid Bolus for significant burns
Morphine sulfate (may repeat once without BHO)

Front 125

How many times can you repeat your morphine sulfate dose for a burn injury? without a BHO

Back 125

you may repeat your dose once without a BHO.

Front 126

When should a burn patient be transported to the closest receiving center?

Back 126

when there is a potential airway compromise.
Airway compromise has priority over burns)

Front 127

When should a burn patient be transported to the Trauma center?

Back 127

When the burn patient meets Critical trauma patient criteria. Trauma has priority over burns

Front 128

In regards to burn when must BH contact be made?

Back 128

1. suspected inhalation injury
2. Burns involving face, hand, feets, genitalia, perineum or majory joints
3. High voltage electrical burns
4. Second degree burns greater than 10% BSA
5. Third degree burns

Front 129

What is a PDE5 inhibitor?

Back 129

any drug with fil on the end example viagra etc any sexually enhancement drug

Front 130

When do you need a BHO order for NTG?

Back 130

when you're going over the 3 initial doses or your patient has taken a PDE5 inhibitor (sexually enhancement drug)

Front 131

When should Morphine be given in regards to Acute Coronary Syndrome?

Back 131

It should be given refractory to NTG for chest discomfort and it may be repeated once as long as BP remains greater than 90 mmHG

Front 132

is NTG or ASA indicated for peds?

Back 132

NO!

Front 133

True or False BH contact must be made with a STEMI base hospital when a stemi is suspected?

Back 133

TRUE

Front 134

When should patients be transported to a Stemi Receiving Center?

Back 134

1. When the ECG machine reads **Acute MI* or **Acute MI suspected**
2. Paramedic interprets ECG as STEMI
3. STEMI BH interprets transmited ECG as STEMI or otherwise orders transport to a SRC

Front 135

When is Stemi BH contact mandatory?

Back 135

1. ETA from scene must be 30 minutes or less
2. STEMI BH must confirm/order transport to a SRC.

Front 136

What 4 things in regards to STEMI destination decision should be considered?

Back 136

1. Malignant dysrhythmias (vfib, tach and 2nd 3rd degree av block)
2. Contraindications to thrombolytics
3. Duration of symptoms
4. Hemodynamic instability (shock

Front 137

WHAT TWO THINGS MUST YOU NOT GIVE/DO TO VAD Patients?

Back 137

Do not perform compressions
Do not assist with or give Aspirin and or Nitroglycerin

Front 138

What is the first line treatment for preload dependant VAD patient?

Back 138

volume replacement. (provide treatment as directed by REMSA treatment protocols)

Front 139

Do you need to have a BH order for Synchronized cardioversion?

Back 139

No you only need a BHO when you're dealing with PEDS and SVT

Front 140

What's the treatment for SVT?

Back 140

Vagal/valsalva maneuvers
Adenosine (can only do once need an order for additional doses)
Synchronized Cardioversion

Front 141

What should you do when you have a pediatric patient with symptomatic bradycardia with pulses?

Back 141

You need to make BH contact.

Front 142

For a patient with symptomatic bradycardia when can you give Midazolam? and why?

Back 142

for amnesic effects prior to TCP

Front 143

What is proper TCP procedure?

Back 143

Begin at 20 mA and 70 bpm
Titrate in 5 mA increments to minimum current required to maintain capture
Increase in 10 bpm increments, up to 100 bpm maximum to gain adequate cardiac output and tissue perfusion.

Front 144

What do you increase the rate at for TCP? and to what max

Back 144

You start at 70 and you increase it by 10 bpm increments to a max of 100 bpm till you have signs of adequate tissue perfusion.

Front 145

When can you give morphine during TCP? and why?

Back 145

you can give it for discomfort during TCP as long as the BP's above 90.

Front 146

What is considered a low blood sugar for adults?

Back 146

80mg/dl or below

Front 147

What is considered a low blood sugar for PEDs?

Back 147

70mg/dl or below.

Front 148

What routes can you give glucagon?

Back 148

IM or SQ

Front 149

What routes can diazepam be given?

Back 149

IV/IO or IM (NOT IN!!)

Front 150

What routes can Midazolam be given?

Back 150

IV/IO/IN and IM

Front 151

What're two of the main standing order interventions for Symptomatic Bradycardia with pulses?

Back 151

Atropine and TCP starting at 20 mA and 70 BPM

Front 152

Cardiac Arrest: RULES regarding defibrillating

Back 152

Note that the protocol mandates resuming CPR immediately after defibrillating a shockable rhythm and continuing uninterrupted CPR for 2 minutes before analyzing a rhythm.

Front 153

What are the standing order medication for adults in cardiac arrest?

Back 153

epi, amiodarone and one dose of sodium bicarbonate.

Front 154

In a pediatric cardiac arrest what meds must you make BH contact for?

Back 154

Sodium Bicarb and Amiodarone

Front 155

True or false you must make BH contact in all cases of suspected stroke, CVA or possible TIA

Back 155

TRUE

Front 156

What routes can Ondansetron be given?

Back 156

IV, IO, IM or ODT

Front 157

Can you repeat Ondansetron dose? (zofran)

Back 157

no

Front 158

Pediatric administration of zofran requires BHO on what color and smaller on the Broselow tape?

Back 158

Yellow or smaller

Front 159

What route should EPI 1:1000 be given on an allergic reaction?

Back 159

IM or SQ (BHO required for repetition)

Front 160

What route should Diphenhydramine be given on an allergic reaction?

Back 160

IM or SLOW IV/IO push

Front 161

Can you give Albuterol during an allergic reaction without a BHO order?

Back 161

yes and you can repeat as clinically indicated!

Front 162

When can you give Naloxone?

Back 162

For respiratory depression with suspected narcotic overdose

Front 163

What can you not exceed when giving Naloxone IM/IN?

Back 163

1ml per nostril for adults and 0.5ml for peds

Front 164

Can Naloxone be repeated as clinically indicated?

Back 164

yes! but do not exceed the max doseages

Front 165

What type of overdose should diphenhydramine be considered for?

Back 165

for suspected dystonic reaction. BHO required for repeat doses

Front 166

Overdose: Glucagon should be considered for what with BHO?

Back 166

For suspected beta blocker or calcium channel blocker overdose

Front 167

Overdose: Sodium Bicarbonate should be considered for what with BHO?

Back 167

Altered Mental status and or dysrhythmia with suspected cylic antidepressant overdose

Front 168

Overdose: Calcium chloride should be considered for what with BHO?

Back 168

Beta Blocker or calcium channel blocker overdose

Front 169

YOU MUST CONTACT A BH IN ALL NEONATAL RESUSCITATION (NEWBORN).

Back 169

YOU CAN DO BLS MEASURES BUT MUST Contact for ALS procedures.

Front 170

On a Neonatal resuscitation where should you place the pulse ox?

Back 170

it must be placed on right upper extremity (pre-ductal)

Front 171

When transporting a patient that is having behavior issues what should you do for treatment?

Back 171

apply 4 point restraints and spit sock as clinically indicated.
YOU MUST TRANSPORT in low to high Fowler's position

Front 172

Midazolam should be considered for what behavioral emergency? can it be repeated WITHOUT BHO? if so how many times?

Back 172

It should be considered for suspected excited delirium and it can be repeated ONCE without base station order.

Front 173

Respiratory distress: In regards to breathing treatments what can be given? and what can be repeated?

Back 173

You can give one treatment of albuterol and atrovent and you can repeat the albuterol without BHO but you must get a BHO to repeat atrovent.

Front 174

In what respiratory issue is CPAP not indicated?

Back 174

ASTHMA

Front 175

IF epiglottitis is suspected what should you do?

Back 175

you should not visualize the throat and position the patient upright and leaning forward to drain the secretions.

Front 176

What is Albuteral / atrovent indicated for?

Back 176

bronchospasm

Front 177

What is the procedure for CPAP

Back 177

Start at 5 cmh2) and slowly increase by 2.5 increments to a max of 15.
(20 can be done with BHO)

Front 178

Is cpap indicated on PEDS?

Back 178

NO!

Front 179

When CPAPing a patient BH contact is required if what happens?

Back 179

if the the systolic blood pressure falls below 90

Front 180

What is the correct dose of Midazolam for relief of anxiety in relation to CPAP?

Back 180

1mg must call for repeat doses. PEDS administration is not indicated and Patients blood pressure must be over 90

Front 181

IS NTG indicated for respiratory distress?

Back 181

yes especially if it involves or CHF is suspected.

Front 182

When applying NTG paste and the patients BP drops below 90 what should you do?

Back 182

remove and wipe away excess

Front 183

What is considered geriatric?

Back 183

any patient that looks to be 65 years or older.

Front 184

Ground ambulance is the primary means of transportation for what?

Back 184

destinations 30 minutes or less by code 3.

Front 185

Peds patients should be transported to a pediatric trauma center when?

Back 185

When they meet critical trauma guidelines.

Front 186

When should a pediatric patient Meeting Critical trauma guidelines go to the closest Trauma center?

Back 186

When the Peds trauma center is greater than 30 minutes away by ground.

Front 187

When should you consider HEMS for trauma patients?

Back 187

if the closest trauma center is over 30 minutes away by ground.

Front 188

On a trauma and the destination is questionable what should you do?

Back 188

Contact a trauma base and ask them.

Front 189

What's the primary site for IO? without BHO?

Back 189

Anterior Medial Aspect of the proximal tibia

Front 190

What's the Secondary sites for IO? with BHO?

Back 190

Distal Tibia or distal femur

Front 191

How can you verify IO placement?

Back 191

Sudden lack of resistance
Needle is freestanding without support
Aspiration of blood/marrow
Able to to flow 5-10ml of fluid and it flows

Front 192

How many IO attempts can be made without BHO?

Back 192

one attempt.