ICEMA PROTOCOL TEST QUESTIONS & ANSWERS
What size gauge/needle do you use for needle cricothyrotomy? - Answer -10-16
Needle cricothyrotomy procedure ? - Answer -- Absolute contraindication: Transection
of the distal trachea.
- Monitor EtCO2 and wave form capnography.
- Monitor pulse oximetry.
- Contact base hospital if unable to ventilate adequately and transport immediately to
the closest hospital for airway management.
If patient transfer of care and patient offloading from the ambulance gurney exceeds 25
mins what happens to the hospital? - Answer -It is documented and tracked as APOD
(ambulance patient offload delay)
APOD unusual event procedures for immediate offloading criteria: - Answer -- Stable
V/S
- Alert and Oriented
- No ALS interventions in place
- Is not on a Welfare and Institutions Code (WIC) 5150 hold
When is vascular access clinically indicated (8100) ? - Answer -- Administration of IV
medication(s), or
- Administration of IV fluid bolus or fluid resuscitation.
- In the judgement of the attending paramedic the patient's condition could worsen and
either (a) or (b) noted above may become necessary prior to arrival at the receiving
hospital ED.
- Discontinue ECG monitoring before removing the patient from the ambulance if there
are no clinical indications for cardiac monitoring.
8010 IFT Guidelines "What not to do" - Answer -- Paramedics may not transport a
patient with IV drips that are not in the EMT-P scope of practice.
- EMT-Ps may not transport patients with blood or blood products.
8010 IFT Guidelines "What to do" - Answer -- Monitor peripheral lines delivering fluids
in any combination/concentration of NS, LRs or dextrose and water.
- Transport intravenous solution with added medication(s) as follows:
- Lidocaine
-Dopamine
-Magnesium sulfate
- Monitor and administer medications through a pre-existing vascular access.
- Monitor heparin lock or saline lock.
- Monitor IV solutions containing potassium < or = 40 mEq/L
- Monitor thoracostomy tubes to water or dry sealed drainage.
- Monitor nasogastric tubes.
, -
6010 EMT-P Responsibilities - Answer -- Notify BH that a physician has requested to
take over patient.
- Maintain control of drugs and equipment from the LALS or ALS unit. Inform the
physician of drugs and equipment available.
- Offer assistance to MD, but only perform procedures that are withing the ICEMA scope
of practice.
- Document on EPCR and obtain physician signature.
6030 Child Abuse/Neglect required information: - Answer -- Name of person making
report.
- Name of child
- Present location of child
- Nature and extent of the abuse/neglect
- Location where incident occurred, if known.
- Other information as requested.
6040 Organ Information - Answer -- When EMS field personnel encounter an
unconscious adult patient for whom it appears death is imminent, a reasonable search
of the patient's belonging should be made to determine if the individual carries
information indicating status as an organ donor. This search shall not interfere with
patient care or transport.
- No search is to be made by EMS field personnel after the patient has expired.
6070 Care of Minors in the field and when BH contact is required before leaving the
scene: - Answer -- Minors under the age of nine (9) whose parents or guardians are
refusing care.
-Minors who in the opinion of EMS field personnel, do not require treatment or transport.
Assess and Refer criteria (8130) - Answer -The patient must meet all of the following
criteria:
- Parent or guardian is on scene if the patient is under 18 years of age (unless legally
emancipated)
- Has a GCS of 15 or GCS is at patient's baseline.
- Exhibits no clinical evidence of:
ALOC
Alcohol or drug ingestion that impairs decision making capacity.
Abnormal or labored breathing or SOB
CP/discomfort of any kind
Hypoxia as indicated by low oxygen saturation
Significant tachycardia
Serious hemorrhage
What size gauge/needle do you use for needle cricothyrotomy? - Answer -10-16
Needle cricothyrotomy procedure ? - Answer -- Absolute contraindication: Transection
of the distal trachea.
- Monitor EtCO2 and wave form capnography.
- Monitor pulse oximetry.
- Contact base hospital if unable to ventilate adequately and transport immediately to
the closest hospital for airway management.
If patient transfer of care and patient offloading from the ambulance gurney exceeds 25
mins what happens to the hospital? - Answer -It is documented and tracked as APOD
(ambulance patient offload delay)
APOD unusual event procedures for immediate offloading criteria: - Answer -- Stable
V/S
- Alert and Oriented
- No ALS interventions in place
- Is not on a Welfare and Institutions Code (WIC) 5150 hold
When is vascular access clinically indicated (8100) ? - Answer -- Administration of IV
medication(s), or
- Administration of IV fluid bolus or fluid resuscitation.
- In the judgement of the attending paramedic the patient's condition could worsen and
either (a) or (b) noted above may become necessary prior to arrival at the receiving
hospital ED.
- Discontinue ECG monitoring before removing the patient from the ambulance if there
are no clinical indications for cardiac monitoring.
8010 IFT Guidelines "What not to do" - Answer -- Paramedics may not transport a
patient with IV drips that are not in the EMT-P scope of practice.
- EMT-Ps may not transport patients with blood or blood products.
8010 IFT Guidelines "What to do" - Answer -- Monitor peripheral lines delivering fluids
in any combination/concentration of NS, LRs or dextrose and water.
- Transport intravenous solution with added medication(s) as follows:
- Lidocaine
-Dopamine
-Magnesium sulfate
- Monitor and administer medications through a pre-existing vascular access.
- Monitor heparin lock or saline lock.
- Monitor IV solutions containing potassium < or = 40 mEq/L
- Monitor thoracostomy tubes to water or dry sealed drainage.
- Monitor nasogastric tubes.
, -
6010 EMT-P Responsibilities - Answer -- Notify BH that a physician has requested to
take over patient.
- Maintain control of drugs and equipment from the LALS or ALS unit. Inform the
physician of drugs and equipment available.
- Offer assistance to MD, but only perform procedures that are withing the ICEMA scope
of practice.
- Document on EPCR and obtain physician signature.
6030 Child Abuse/Neglect required information: - Answer -- Name of person making
report.
- Name of child
- Present location of child
- Nature and extent of the abuse/neglect
- Location where incident occurred, if known.
- Other information as requested.
6040 Organ Information - Answer -- When EMS field personnel encounter an
unconscious adult patient for whom it appears death is imminent, a reasonable search
of the patient's belonging should be made to determine if the individual carries
information indicating status as an organ donor. This search shall not interfere with
patient care or transport.
- No search is to be made by EMS field personnel after the patient has expired.
6070 Care of Minors in the field and when BH contact is required before leaving the
scene: - Answer -- Minors under the age of nine (9) whose parents or guardians are
refusing care.
-Minors who in the opinion of EMS field personnel, do not require treatment or transport.
Assess and Refer criteria (8130) - Answer -The patient must meet all of the following
criteria:
- Parent or guardian is on scene if the patient is under 18 years of age (unless legally
emancipated)
- Has a GCS of 15 or GCS is at patient's baseline.
- Exhibits no clinical evidence of:
ALOC
Alcohol or drug ingestion that impairs decision making capacity.
Abnormal or labored breathing or SOB
CP/discomfort of any kind
Hypoxia as indicated by low oxygen saturation
Significant tachycardia
Serious hemorrhage
