LOYOLA EMS SYSTEM ENTRY QUESTIONS AND VERIFIED 100% CORRECT ANSWERS

LOYOLA EMS SYSTEM ENTRY QUESTIONS AND VERIFIED 100% CORRECT ANSWERS "Who may not be released in the field in the event of school bus MVC? - CORRECT ANSWER Special needs children" "Any physician or nurse on scene must provide what? - CORRECT ANSWER Medical license and state issues ID" "Where should any possible stroke patient be transported to? - CORRECT ANSWER Nearest stroke center" "What must be left at hospital before leaving? - CORRECT ANSWER PCR" "What does the Illinois abandoned newborn infant act say? - CORRECT ANSWER Personnel must accept and provide all necessary care to an infant 30 says old or younger" "Who can call a patient death through med control? - CORRECT ANSWER Only ER physician" "Are living wills honored by EMS providers? - CORRECT ANSWER No" "What should you ask about when you have a patient with chest pain? - CORRECT ANSWER Use of viagra cialis or revatio in the past 36 hours before considering administration of nitro" "Adult initial dose of fentanyl under 65 y/o - CORRECT ANSWER 1mcg/kg not to exceed 100 mcg" "2nd dose of fentanyl under 65 y/o - CORRECT ANSWER .5mcg/kg not to exceed 50mcg" "First dose of fentanyl over 65 y/o - CORRECT ANSWER .5mcg/kg not to exceed 50mcg" "Second dose of fentanyl over 65 y/o - CORRECT ANSWER .25 mcg/kg not to exceed 25mcg" "Treatment of unstable bradycardia - CORRECT ANSWER .5 mg of atropine IV or 1mg ET tube May repeat every 3-5 minutes Max dose of 3 mg" "Treatment of unstable bradycardia if atropine does not work - CORRECT ANSWER Transcutaneous pacing at rate of 70 Consider sedation with versed 2 mg max dose of 10" "Adult intubation procedure - CORRECT ANSWER Benzocainex2 30 seconds apart Etomidate 0.6mg/kg not to exceed 40mg For post sedation versed 2mg every 2 minutes Max of 10mg" "Cyclic anti depressant overdose treatment - CORRECT ANSWER 1L NS bolus with 8.4% sodium bicarbonate 1meq/kg" "Beta blocker or calcium channel blocker overdose - CORRECT ANSWER 1mg glucagon Slow IVP Repeat x1 If no success consider pacing" "Organophosphate poisoning or SLUDGEBAM - CORRECT ANSWER Administer atropine 2mg rapid IVP every 3 minutes no max dose" "What is the distance a level 1 trauma center has to be for you to be able to transfer to level 2 - CORRECT ANSWER 25 minutes" "Dose for epi in peds - CORRECT ANSWER 1:10,000 0.1 ml/kg IV/IO Or 1:10,000 0.5 ml/kg ET Every 3-5 minutes" "Zofran dose in person less than 40kg - CORRECT ANSWER .1 mg/kg slow IV" "What form of zofran do you not give pediatrics - CORRECT ANSWER ODT" "Pediatric atropine dose - CORRECT ANSWER 0.02 mg/kg may repeat x1 Not to exceed 0.5mg" "Cardioversion jewels for pediatric - CORRECT ANSWER 1 J/kg May repeat at 2 J/kg" "Dose for adenosine in pediatric - CORRECT ANSWER 0.1 mg/kg not to exceed 6 0.2 mg/kg not to exceed 12" "Pediatric SVT ranges - CORRECT ANSWER Over 220 1 year or less Over 180 1-15 years old" "Pediatric drug assisted intubation - CORRECT ANSWER 0.05 mg/kg versed Not to exceed 0.2 mg/kg total Max of 10mg" "Pediatric shock fluid bolus - CORRECT ANSWER 20ml/kg If no response may repeat 2 for max of 60ml/kg" Radio Reports - CORRECT ANSWER 1) Name and vehicle # of provider, destination and ETA Indicate if desired destination is the nearest by travel times and any reason from going to another hospital 2) Patient age, sex and weight 3) LOC and orientation 4) Chief complaint and severity 5) Signs - GCS, Pulse, BP, Respirations, Skin, Pupils, and lung sounds 6) History - SAMPLE 7) Clinical findings - pertinent negatives and positives, Cincinnati prehospital stroke scale if applicable" "Triple Zero - CORRECT ANSWER Decapitation Rigor Mortis without hypothermia Profound dependent lividity Decomposition Mummification Incineration Frozen state" "Cardiac Patient with Chest Pain - Time Sensitive! - CORRECT ANSWER BLS Procedure 1) Adult initial Medical Care Contact Medical controls prior to administration of baby aspirin - give 4 81 mg tablets chewed and swallowed If patient has physical prescribed nitro and had not taken max dose, and if systolic bp is above 100, administer NTG 0.4 mg SL If patient is unstable, initiate expeditious transport" "Adult Pulmonary Edema - CORRECT ANSWER Patient Assessment - place patient in High Fowlers position if systolic bp is greater than 100 mg, may need to deliver supplemental oxygen - can administer 0.4 mg SL of NTG" "Narcan (naloxone) 2 mg IN - CORRECT ANSWER If indicated by decreasing sensorium and pinpoint pupils, depressed respirations and possible history of opioid/synthetic opioid ingestion" "Cholinergic Drug overdose - CORRECT ANSWER D U M B B E L S" SAMPLE - CORRECT ANSWER signs and symptoms allergies medicine past pertinent details last oral intake events leading up" "OPQRST - CORRECT ANSWER onset, provocation, quality, radiation, severity, time" "Steps to patient assessment - CORRECT ANSWER Scene safety/PPE/BSI ABCs A&Ox4 ALS backup? Focused history Detailed physical" "Do we honor living wills/surrogates? - CORRECT ANSWER No, just DNRs" "Components of a valid DNR? - CORRECT ANSWER Name Physician name and signature effective date explicitly labeled DNR Evidence of consent" "Signs of a triple zero patient - CORRECT ANSWER NEED: non-breathing, pulseless, asystolic One or more: decapitation rigor mortis without hypothermia dependent lividity decomp putrification frozen incineration" "Suspected cardiac patients with heart pain - CORRECT ANSWER Initial medical care Pt must be able to swallow 4x81 g baby aspirin (324 g) check BP, systole must be >100 mmHg before nitroglycerin (prescribed)" "Acute asthma/COPD - CORRECT ANSWER initial medical care Inhaler (check 6Rs) and find out last time of dosage begin transport neb 2.5 mg Albuterol in 3mL" "Seizures/status epilepticus - CORRECT ANSWER Clear and preserve airway Protect from injury Position on side, baseline vitals Blood glucose (if less than 60 administer glucose) transport" "Stroke - CORRECT ANSWER limit scene time and do c-spine if trauma suspected baseline vitals protect airway Assess Cincinnati stroke scale Ask onset" "Chronic renal failure (dialysis pts) - CORRECT ANSWER DONT take BP on same arm as shunt or fistula control any obvious bleeding" "Heat emergencies - CORRECT ANSWER Move pt to cool environment (do not massage muscles) Can give fluid if awake, alert, and gag reflex Put cool packs to lateral chest wall, groin, axilla, carotid arteries, temples, behind knees check blood glucose" "Specialty transport - CORRECT ANSWER Ask med control" "Glasgow Coma Scale (GCS) - CORRECT ANSWER " "Ophthalmic emergencies - CORRECT ANSWER General: assess pain, check visual acuity, elevate head Chem splash: irrigate with saline Penetration: Do not remove object or irrigate, stabilize object and transport (patch both eyes no matter what)" "Burn injuries - CORRECT ANSWER Evaluate extent of burn using Rule of 9s Apply wet dressing for local pain relief Leave blisters alone Cover pt with dry sheets and blanket to maintain body temp during transfer Use high flow O2 if needed Remove chemicals if possible" "Taser weapon injuries - CORRECT ANSWER Scene safety and BSI Assess mental status Stabilize if needle in vulnerable place, remove carefully otherwise Control bleeding and cover with dry dressing" "Musculoskeletal injuries - CORRECT ANSWER immobilize and splint, check PMS (pulse, motor, sensation) Elevate and apply cold pack" "Amputation - CORRECT ANSWER Stabilize with bulky dressing, tourniquet, wrap part in saline gauze and seal away with name" "Emergency childbirth - CORRECT ANSWER check heart rate after delivery >100, check color 60-100 continue ventilations for 1-2 min and reassess <60 chest compressions for 30 seconds, 3:1 ratio" "Emergency childbirth complications - CORRECT ANSWER High flow O2 and GO Place in Trendelenburg if cord is prolapsed, cover cord with moist dressing and keep warm" "Peds age groups - CORRECT ANSWER Newborn: 24 hours or less neonate: 1 month or less infant:1 year and less toddler: 1-5 years under 15 is a peds" "Peds respiratory arrest - CORRECT ANSWER initial medical care Airway maneuver, maintain C-spine and preserve airway BVM if not breathing Check for cardiopulmonary compromise Check for obstruction" "Peds respiratory distress with tracheostomy tube - CORRECT ANSWER Administer high flow O2 per trach collar Suction and reassess airway Remove inner cannula or insert ET tube into stoma BVM if needed" "Peds seizures - CORRECT ANSWER Preserve airway Protect from injury Roll pt on side and record blood glucose levels Febrile seizures: remove clothes to cool, use cool cloth and fan child" "Peds heat emergencies - CORRECT ANSWER Record initial assessment Assess for environmental risks to pt and self and relocate if needed" “Patient needing restraint must be restrained in what position - CORRECT ANSWER Semi Fowlers" "Any patient under what age is considered a minor? What can they not do? - CORRECT ANSWER 18, they cannot consent for themselves unless child abuse is suspected" "What is an emancipated minor? - CORRECT ANSWER Patient between the ages of 16-18 that have demonstrated ability and capacity to manage own affairs and live independently of parents or guardians." "When can a minor consent for themself or their child? - CORRECT ANSWER When they are pregnant married or have a living child." "When can a parent not refuse treatment of child? - CORRECT ANSWER Parents may not withhold consent for life saving treatment When suspicion of abuse or neglect exist Life or limb threatening limb or injury Incompetent adult guardian" "Uninjured children in school bus MVC can be released in the field to.... - CORRECT ANSWER Parent or qualified school official" "When should nearly expired drugs be exchanged? - CORRECT ANSWER At least 60 days prior to expiration" "Loyola EMS requires how much system approved CE? - CORRECT ANSWER 120 hours" "How many hours will be awarded for make up quizzes? - CORRECT ANSWER 1.5 hours" "In the event of an exposure what do you do? - CORRECT ANSWER Complete Loyola EMS communicable disease exposure form which is part of the exposure carepak" "Personnel may be suspended for many reasons including... - CORRECT ANSWER Unauthorized use or removal of narcotics drugs or supplies" "What should be communicated at beginning of radio report? - CORRECT ANSWER Closest and desired hospitals along with ETAs" "What should be obtained and relayed for any patient with altered mental status? - CORRECT ANSWER Blood glucose" "Patients with nausea receive what? - CORRECT ANSWER 4 mg zofran slow IVP or ODT 1 dose only" "When is it acceptable to discontinue ALS care? - CORRECT ANSWER Never" "When can pediatric drug dosing exceed adult dosing? - CORRECT ANSWER Weight based IV fluid bolus versed or narcan" "Symptomatic bradycardia treatment if atropine and pacing do not work - CORRECT ANSWER Dopamine 5-10 mcg/kg/min IVPB" "Stable adult SVT treatment - CORRECT ANSWER 6mg adenosine followed by rapid 10cc flush If no response 12mg If no response 12mg" "Unstable adult SVT treatment - CORRECT ANSWER Sedate with 2mg versed every 2 minutes up to 10 mg Cardiovert at 100J If no change repeat at recommended energy If no change refer to cardiogenic shock SMO" "When should induction of hypothermia be used? - CORRECT ANSWER When ROSC patient remains unconscious and unresponsive Is able to maintain systolic above 90mmhg Pt is untubated Presumed cardiac etiology for arrest" "What is he age etomidate should not be used? - CORRECT ANSWER 15" "Adult acute asthma protocol - CORRECT ANSWER Albuterol 2.5mg or xponenex 1.25mg Repeat as necessary If no response and in severe distress administer epinephrine 1:1,000 0.3mg IM If older than 50 or cardiac disease call med control" "Adult anaphylaxis with signs of hypoperfusion - CORRECT ANSWER IV/IO fluid bolus 200ml increments Administer epi 1:10,000 0.5mg slow IVP Or 1:1,000 1mg ET Or 1:1,000 0.5 mg IM y repeat every 5 minutes Administer Benadryl 50mg slow IV/IO Consider albuterol/xopenex and dopamine" "Adult anaphylaxis without signs of hypoperfusion - CORRECT ANSWER Administer Benadryl 50mg IM or slow IVP Administer epi 1:1,000 0.3mg IM may repeat once after 15 minutes Contact medical control if older than 50 or cardiac disease Consider bronchodilator for wheezing" "Unexplained syncope treatment - CORRECT ANSWER 200mL IV bolus Narcan 1mg IV/IN Repeat 0.5 mg every 2 minutes" "What to obtain for suspected stroke - CORRECT ANSWER Last known normal" "If patient has abnormal Cincinnati where do they go? - CORRECT ANSWER Closest stroke center" "When in a trauma do you always transport to closest? - CORRECT ANSWER If no airway" "Child involved MVC age considerations - CORRECT ANSWER Birth to 2 years or 20 pounds rear facing seat 2-4 or 65 pounds front facing toddler seat Booster seat 4-8 years or 4 foot 9 Seat belt from 8-15 or taller that 4 foot 9" "Prolonged extrication without serious injury is not sufficient reason for - CORRECT ANSWER SCT/CCT" "Avoid what to eye injury? - CORRECT ANSWER Pressure" "Thermal burns <10% treatment if occurred with in 15 minutes - CORRECT ANSWER Cool burned area with water or NS for no longer than 5 minutes" "Burn <10% dressing type - CORRECT ANSWER Wet may be applied for pain relief" "Burn >10% dressing type - CORRECT ANSWER Dry sterile dressing" "Taser injuries to face - CORRECT ANSWER Stabilize prongs and transport" "Long bone fix with displacement and spasm - CORRECT ANSWER Consider versed 2mg every 2 minutes up to 10mg" "Care of amputated part - CORRECT ANSWER Wrap in saline moistened gauze and put in plastic bag" "What not to do with amputated part - CORRECT ANSWER Immerse in NS or water" "Pediatric seizures - CORRECT ANSWER Versed 0.1 mg/kg IV Versed 0.2 mg/kg IN Max dose of 10mg" "Dose for narcan in pediatrics - CORRECT ANSWER Less than 20 kg or less than age 5 0.1 mg/kg Greater than 20kg and age of 5 then 2mg" "Anaphylaxis in peds - CORRECT ANSWER Benadryl 1mg/kg More than local reaction then administer epi 1:1,000 Less than 10kg 0.1 mg/kg Between 20kg and 10kg 0.2 mg/kg Over 20kg 0.3 mg/kg For signs of hypoperfusion administer fluid bolus Administer epi 1:10,000 0.1 mg/kg every 3 min." "Patient Assessment - CORRECT ANSWER 1) Scene safety/BSI/PPE 2) Initial assessment: Airway and C spine established and maintained, Breathing assessed and assisted if needed (lung sounds) Circulation (pulse and hemorrhage), Disability AVPU 3) History and Physical Exams: SAMPLE (signs and symptoms, allergies, medications, past oral intake, last oral intake/last menstrual period, and events leading up to condition), Vital signs, Rate pain on scale 1-10 4) Detailed physical exam 5) Ongoing assessment - reassess ABCDs" "Respiratory Assessment - CORRECT ANSWER Target oxygen saturation = 94-98%, 92% if COPD in cases of adequate rate depth/minimal distress/mild hypoxia/SpO2 92-94% --> Low FiO2 in cases of adequate rate/depth, moderate/severe distress and SpO2 of less than 92%, --> High FiO2 In cases of inadequate rate/depth with moderate/severe distress or instability --> High FiO2 by BVM ventilation" "Pain Management - CORRECT ANSWER BLS/ALS = zofran out 4 mg tab or 4 mg slow IV 1 dose only" "Outline for streamlined communication for BLS Calls - CORRECT ANSWER 1. Name and vehicle number of provider 2. patient age and gender 3. Chief complaint/ MOI 4. SOP being followed 5. Any deviation from SOP/unusual circumstances 6. ETA" "Load and Go situations - CORRECT ANSWER applies if circumstances demand hospital care for patient stability - some procedures in SOPs may be omitted or abbreviated" "Power of Attorney for Healthcare - CORRECT ANSWER POLST/DNR only valid if WRITTEN and signed by patients attending practitioner" "Living Will/Srrogates - CORRECT ANSWER Living wills may NOT be honored by EMS providers - begin or continue treatment No situations in which surrogate can directly give instructions to EMS providers - begin or continue treatment" "Validity of POLST/DNR Order - CORRECT ANSWER Name of patient, Resuscitation orders must say "Do Not Resuscitate" or "withhold treatment", 3 signatures required - evidence of consent, signature of a witness, and signature of attending practitioner If patient is NOT in cardiac or respiratory arrest, begin Adult Initial Medical Care"