KERN COUNTY PROTOCOLS EXAM
QUESTIONS AND ANSWERS
Burn Center - Answers -Bakersfiled Memorial Hospital
Trauma-Red tier destination - Answers -Kern Medical
Trauma-yellow tier destination - Answers -All facilities
Orthopedic facilities - Answers -Bakersfield Memorial hospital, Adventist Bakersfield,
Kern Medical, MSW, Adventist Health Delano
Cardiac facilities - Answers -BMH, AHB, Heart
Neonatal Facilities - Answers -BMH, MSW, KM, AHB
Obstetrical Facilities - Answers -BMH, MSW, KM, AHB
Pediatric Facilities - Answers -BMH, KM
Sexual assault facility destination - Answers -AHB
Psych - Answers -All hospitals
Stroke Centers - Answers -BMH, KM, Mercy, MSW, AHB
Medical extremis facility - Answers -Closest facility
Medical Extremis Criteria - Answers -Any one of the following:
-unmanagable airway or respiratory arrest
-uncontrolled hemorrhaging w/ hypovolemic shock
-cardiac arrest
Serious signs and symptoms of bradycardia - Answers --CP
-SOB
-AMS
-fatigue
-weakness
-syncope
, -CHF
-hypotension
-ventricular escape rhythms
start TCP immediately if: - Answers --No response to atropine
-IV access cannot be quickly established
-patient is severely symptomatic
After TCP: - Answers --assess mechanical and electrical capture
-reassess perfusion
-give analgesics and sedation if not given prior to TCP
Trauma Extremis Criteria - Answers --Traumatic arrest
-unmanageable airway with inability to ventilate
Emergent pediatric criteria - Answers --Cardiac dysrhythmia
-poor perfusion
-severe respiratory distress
-cyanosis
-AMS
-status epilepticus
-BRUE under 1yo
Bypass closest and Transport to burn center when: - Answers --Partial or full thickness
burns to more than 10% TBSA
-Partial or full thickness burns that are circumferential to any part
-Partial or full thickness burns to hands, feet, face, major joints, perineum, or genitals
-electrical burns greater than 120 volts
-Chemical burns with greater than 5% TBSA
Lobby criteria - Answers --18yo+
-minor accompanied by an adult
-patient can sit unassisted
-no IV access
-not on a 5150 hold
-vitals:
~pulse: 50-120bpm
~SBP: 100-180
~DBP: under 120
~RR: 12-30
Determination of Death - Answers --Obvious Criteria
-pulseless and apenic for at least 10 minutes
-DNR or POLST
-Blunt trauma and in cardiac arrest prior to EMS arrival
QUESTIONS AND ANSWERS
Burn Center - Answers -Bakersfiled Memorial Hospital
Trauma-Red tier destination - Answers -Kern Medical
Trauma-yellow tier destination - Answers -All facilities
Orthopedic facilities - Answers -Bakersfield Memorial hospital, Adventist Bakersfield,
Kern Medical, MSW, Adventist Health Delano
Cardiac facilities - Answers -BMH, AHB, Heart
Neonatal Facilities - Answers -BMH, MSW, KM, AHB
Obstetrical Facilities - Answers -BMH, MSW, KM, AHB
Pediatric Facilities - Answers -BMH, KM
Sexual assault facility destination - Answers -AHB
Psych - Answers -All hospitals
Stroke Centers - Answers -BMH, KM, Mercy, MSW, AHB
Medical extremis facility - Answers -Closest facility
Medical Extremis Criteria - Answers -Any one of the following:
-unmanagable airway or respiratory arrest
-uncontrolled hemorrhaging w/ hypovolemic shock
-cardiac arrest
Serious signs and symptoms of bradycardia - Answers --CP
-SOB
-AMS
-fatigue
-weakness
-syncope
, -CHF
-hypotension
-ventricular escape rhythms
start TCP immediately if: - Answers --No response to atropine
-IV access cannot be quickly established
-patient is severely symptomatic
After TCP: - Answers --assess mechanical and electrical capture
-reassess perfusion
-give analgesics and sedation if not given prior to TCP
Trauma Extremis Criteria - Answers --Traumatic arrest
-unmanageable airway with inability to ventilate
Emergent pediatric criteria - Answers --Cardiac dysrhythmia
-poor perfusion
-severe respiratory distress
-cyanosis
-AMS
-status epilepticus
-BRUE under 1yo
Bypass closest and Transport to burn center when: - Answers --Partial or full thickness
burns to more than 10% TBSA
-Partial or full thickness burns that are circumferential to any part
-Partial or full thickness burns to hands, feet, face, major joints, perineum, or genitals
-electrical burns greater than 120 volts
-Chemical burns with greater than 5% TBSA
Lobby criteria - Answers --18yo+
-minor accompanied by an adult
-patient can sit unassisted
-no IV access
-not on a 5150 hold
-vitals:
~pulse: 50-120bpm
~SBP: 100-180
~DBP: under 120
~RR: 12-30
Determination of Death - Answers --Obvious Criteria
-pulseless and apenic for at least 10 minutes
-DNR or POLST
-Blunt trauma and in cardiac arrest prior to EMS arrival
