Kern County Protocols: Questions & Straightforward
Solutions
Burn Center Accurate Answer:- Bakersfiled Memorial Hospital
Trauma-Red tier destination Accurate Answer:- Kern Medical
Trauma-yellow tier destination Accurate Answer:- All facilities
Orthopedic facilities Accurate Answer:- Bakersfield Memorial hospital,
Adventist Bakersfield, Kern Medical, MSW, Adventist Health Delano
Cardiac facilities Accurate Answer:- BMH, AHB, Heart
Neonatal Facilities Accurate Answer:- BMH, MSW, KM, AHB
Obstetrical Facilities Accurate Answer:- BMH, MSW, KM, AHB
Pediatric Facilities Accurate Answer:- BMH, KM
Sexual assault facility destination Accurate Answer:- AHB
Psych Accurate Answer:- All hospitals
Stroke Centers Accurate Answer:- BMH, KM, Mercy, MSW, AHB
Medical extremis facility Accurate Answer:- Closest facility
Medical Extremis Criteria Accurate Answer:- Any one of the following:
-unmanagable airway or respiratory arrest
-uncontrolled hemorrhaging w/ hypovolemic shock
-cardiac arrest
Trauma Extremis Criteria Accurate Answer:- -Traumatic arrest
-unmanageable airway with inability to ventilate
Emergent pediatric criteria Accurate Answer:- -Cardiac dysrhythmia
-poor perfusion
, -severe respiratory distress
-cyanosis
-AMS
-status epilepticus
-BRUE under 1yo
Bypass closest and Transport to burn center when: Accurate Answer:- -
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 Accurate Answer:- -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 Accurate Answer:- -Obvious Criteria
-pulseless and apenic for at least 10 minutes
-DNR or POLST
-Blunt trauma and in cardiac arrest prior to EMS arrival
Termination of CPR Accurate Answer:- -No ROSC after 30 minutes of
CPR
-Persistent PEA with ETCO2 >20 or trending up
-Persistent shockable rhythm
-Paramedic Judgement
-Witnessed traumatic arrest if transport time >15 minutes
Transport Cardiac Arrests when: Accurate Answer:- -ROSC
-Hypothermia
Solutions
Burn Center Accurate Answer:- Bakersfiled Memorial Hospital
Trauma-Red tier destination Accurate Answer:- Kern Medical
Trauma-yellow tier destination Accurate Answer:- All facilities
Orthopedic facilities Accurate Answer:- Bakersfield Memorial hospital,
Adventist Bakersfield, Kern Medical, MSW, Adventist Health Delano
Cardiac facilities Accurate Answer:- BMH, AHB, Heart
Neonatal Facilities Accurate Answer:- BMH, MSW, KM, AHB
Obstetrical Facilities Accurate Answer:- BMH, MSW, KM, AHB
Pediatric Facilities Accurate Answer:- BMH, KM
Sexual assault facility destination Accurate Answer:- AHB
Psych Accurate Answer:- All hospitals
Stroke Centers Accurate Answer:- BMH, KM, Mercy, MSW, AHB
Medical extremis facility Accurate Answer:- Closest facility
Medical Extremis Criteria Accurate Answer:- Any one of the following:
-unmanagable airway or respiratory arrest
-uncontrolled hemorrhaging w/ hypovolemic shock
-cardiac arrest
Trauma Extremis Criteria Accurate Answer:- -Traumatic arrest
-unmanageable airway with inability to ventilate
Emergent pediatric criteria Accurate Answer:- -Cardiac dysrhythmia
-poor perfusion
, -severe respiratory distress
-cyanosis
-AMS
-status epilepticus
-BRUE under 1yo
Bypass closest and Transport to burn center when: Accurate Answer:- -
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 Accurate Answer:- -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 Accurate Answer:- -Obvious Criteria
-pulseless and apenic for at least 10 minutes
-DNR or POLST
-Blunt trauma and in cardiac arrest prior to EMS arrival
Termination of CPR Accurate Answer:- -No ROSC after 30 minutes of
CPR
-Persistent PEA with ETCO2 >20 or trending up
-Persistent shockable rhythm
-Paramedic Judgement
-Witnessed traumatic arrest if transport time >15 minutes
Transport Cardiac Arrests when: Accurate Answer:- -ROSC
-Hypothermia
