MICN Class 800s 2026–2027 – Complete Study Guide,
CCEMSA Protocol Review & Practice Questions
EMTs and paramedics may **determine** death based on specific criteria set forth in this policy 814
TRUE
FALSE - correct answers -TRUE
Base hospital physicians may **pronounce** death based on information provided by the paramedics in
the field and guidelines set forth in this policy. - correct answers -814
EMS personnel may determine death in the following circumstances: - correct answers -In addition to
the absence of respiration, cardiac activity, and neurologic reflexes, one or more of the following
physical or circumstantial conditions exist:
-Decapitation
-Massive crush injury
-Penetrating or blunt injury with evisceration of the heart, lung or brain
-Decomposition
-Incineration
-Pulseless, non-breathing victims with extrication time greater than fifteen minutes, where no
resuscitative measures can be performed prior to extrication.
-Penetrating trauma patients who, based on the paramedic's thorough assessment, are found apneic,
pulseless, asystolic, and without pupillary reflexes upon the arrival of EMS personnel at the scene.
1
, -Blunt trauma patients who, based on a paramedic's thorough patient assessment, are found apneic,
pulseless, and without organized ECG activity (narrow complex supraventricular rhythm) due to
traumatic mechanism upon the arrival of EMS personnel at the scene.
-Pulseless, non-breathing victims of a multiple victim incident where insufficient medical resources
preclude initiating resuscitative measures.
-Drowning victims, when it is reasonably determined that submersion has been greater than one hour.
-Rigor mortis
-Post-mortem lividity
In atraumatic cardiopulmonary arrest: EMS Personnel may determine death if a patient is in asystole
after 20 minutes of quality cardiopulmonary resuscitation on scene and meets ALL of the following
criteria: - correct answers -1. Patient 18 years or greater
2. Arrest not witnessed by EMS personnel
3. No shockable rhythm identified at any time during the resuscitation
4. No ROSC at any time during the resuscitation
5. No hypothermia
814-The importance of on-scene resuscitation for medical cardiac arrest and the specific circumstance
when it is appropriate to transport patients with medical cardiac arrest with ongoing resuscitation. -
correct answers -Resuscitation should be continued on-scene until one of the following:
ROSC is confirmed with a corresponding rise in EtCO2Paramedics should continue to stabilize the patient
on scene for 5 minutes after ROSC and only initiate transport if ROSC is maintained.
Base physician determines further resuscitative efforts are futile
2
CCEMSA Protocol Review & Practice Questions
EMTs and paramedics may **determine** death based on specific criteria set forth in this policy 814
TRUE
FALSE - correct answers -TRUE
Base hospital physicians may **pronounce** death based on information provided by the paramedics in
the field and guidelines set forth in this policy. - correct answers -814
EMS personnel may determine death in the following circumstances: - correct answers -In addition to
the absence of respiration, cardiac activity, and neurologic reflexes, one or more of the following
physical or circumstantial conditions exist:
-Decapitation
-Massive crush injury
-Penetrating or blunt injury with evisceration of the heart, lung or brain
-Decomposition
-Incineration
-Pulseless, non-breathing victims with extrication time greater than fifteen minutes, where no
resuscitative measures can be performed prior to extrication.
-Penetrating trauma patients who, based on the paramedic's thorough assessment, are found apneic,
pulseless, asystolic, and without pupillary reflexes upon the arrival of EMS personnel at the scene.
1
, -Blunt trauma patients who, based on a paramedic's thorough patient assessment, are found apneic,
pulseless, and without organized ECG activity (narrow complex supraventricular rhythm) due to
traumatic mechanism upon the arrival of EMS personnel at the scene.
-Pulseless, non-breathing victims of a multiple victim incident where insufficient medical resources
preclude initiating resuscitative measures.
-Drowning victims, when it is reasonably determined that submersion has been greater than one hour.
-Rigor mortis
-Post-mortem lividity
In atraumatic cardiopulmonary arrest: EMS Personnel may determine death if a patient is in asystole
after 20 minutes of quality cardiopulmonary resuscitation on scene and meets ALL of the following
criteria: - correct answers -1. Patient 18 years or greater
2. Arrest not witnessed by EMS personnel
3. No shockable rhythm identified at any time during the resuscitation
4. No ROSC at any time during the resuscitation
5. No hypothermia
814-The importance of on-scene resuscitation for medical cardiac arrest and the specific circumstance
when it is appropriate to transport patients with medical cardiac arrest with ongoing resuscitation. -
correct answers -Resuscitation should be continued on-scene until one of the following:
ROSC is confirmed with a corresponding rise in EtCO2Paramedics should continue to stabilize the patient
on scene for 5 minutes after ROSC and only initiate transport if ROSC is maintained.
Base physician determines further resuscitative efforts are futile
2
