WITH COMPLETE QUESTIONS AND ANSWERS | SOUTHERN
NEVADA HEALTH DISTRICT | ADVANCED EMERGENCY
MEDICAL TECHNICIAN
Adult behavioral emergency differential - CORRECT ANSWERS-AMS differential; alcohol
intoxication; toxin/substance abuse; medication effect or overdose; withdrawal syndromes; depression;
bipolar; schizophrenia; anxiety disorder
Adult behavioral emergency Pearls - CORRECT ANSWERS-Law enforcement assistance should
be requested on all calls involving potential violent patients
Under no circumstances are patients to be transported restrained in the prone position
Recommended exam: mental status, skin, heart, lung, neuro
Consider all possible medical/trauma causes for behavior
Do not irritate the patient with a prolonged exam
EMS providers are mandatory reporters in regard to suspected abuse of any vulnerable person
Dystonic reaction - CORRECT ANSWERS-Condition causing involuntary muscle movements or
spasms typically of the face, neck, and upper extremities
Typically an adverse reaction to drugs such as Haloperidol (may occur with administration)
When recognized, administer Diphenhydramine 50 mg IM/IV/IO
SAFER - CORRECT ANSWERS-Stabilize the situation by containing and lowering the stimuli
Assess and acknowledge the crisis
Facilitate the identification and activation of resources (chaplain, family, friends or police)
Encourage the patient to use resources and take action in his/her best interest
Recovery or referral - leave patient in care of responsible person or professional, or transport to
appropriate facility
Adult Burns thermal exposure - CORRECT ANSWERS-1. General adult assessment
,2. Stop the burning process with water or saline; remove smoldering clothing and jewelry; do not
remove STUCK clothing
3. Ventilation management
4. Cover burned areas with dry sterile dressing; DO NOT USE any ice, lotion, ointment or antiseptic
Vascular access: IVF - NS or LR 500 mL fluid bolus if signs of hypoperfusion, or >20% BSA burn present;
contact medical direction at burn center for further drip rates or additional boluses
5. Cardiac monitor
6. pain management
7 consider smoke inhalation
8. Transport to closest appropriate burn care center: Sunrise Hospital or UMC Trauma Center
Adult Burn Chemical/electrical exposure - CORRECT ANSWERS-1. General adult assessment
2. Paramedic: Cardiac monitor
3. Eye involvement? continuous saline flush in affected eyes; flush with water or NS for 10-15 min
Remove jewelry, constricting items, and expose burned area
Identify entry and exit sites, apply sterile dressings
4. Vascular access: IVF - NS or LR 500 mL fluid bolus if signs of hypoperfusion, OR > 20% BSA burn
present; contact medical direction at burn center for further drip rates or additional boluses
5. Pain management PARAMEDIC
6. Transport to closest appropriate burn care center: Sunrise hospital or UMC trauma center
Adult Burn History - CORRECT ANSWERS-type of exposure (heat, gas, chemical); inhalation
injury; time of injury; past medical history and medications; other trauma; loss of consciousness;
tetanus/immunization status
Adult burn signs and symptoms - CORRECT ANSWERS-Burns, pain, swelling; dizziness; loss of
consciousness; hypotension/shock; airway compromise/distress; wheezing; singed facial or nasal hair;
hoarseness or voice changes
Adult burn differential - CORRECT ANSWERS-superficial (1st degree) - red and painful; partial
thickness (2nd degree) - blistering; full thickness (3rd degree) - painless/charred or leathery skin;
thermal; chemical; electrical; radiation; lightning
,Adult burn Pearl - CORRECT ANSWERS-burn patients are trauma patients; evaluate for
multisystem trauma
Assure whatever has caused the burn, is no longer contacting the injury (stop the burning process)
Recommended exam: mental status, HEENT, neck, heart, lungs abdomen, extremities, back, neuro
Consider early intubation with patients experiencing significant inhalation injuries
Potential CO exposure should be treated with 100% oxygen
Circumferential burns to extremities are dangerous due to potential vascular compromise secondary to
soft tissue swelling, elevate extremity
Burn patients are prone to hypothermia - never apply ice or cool burns; must maintain normal body
temperature
Patients meeting the following criteria shall be transported to the closest appropriate burn care center -
CORRECT ANSWERS-1. Second degree burns > 10% BSA
2. Any third degree burns
3. Burns that involve the face, hands, feet, genitalia, perineum, or major joints.
4. electrical burns including lightning injury
5. chemical burns
6. circumferential burns
7. inhalation burns
8. burn injury with concomitant trauma
Adult burns fluid resuscitation - CORRECT ANSWERS-Adults 13 years and above 500 mL NS or
LR bolus
Contact burn center medical direction for additional boluses or drip rates or if it is a prolonged transport
Adult burns Pearls (electrical) - CORRECT ANSWERS-Do not contact the patient until you are
certain the source of the electric shock has been disconnected
attempt to locate contact points (entry wound where the AC source contacted the patient; an exit at the
ground point) both sites will generally be full thickness
Cardiac monitor
, Attempt to identify the nature of the electrical source (AC vs DC), the amount of voltage and the
amperage the patient may have been exposed to during the electrical shock
Disposition for stable patients - CORRECT ANSWERS-Transported to the hospital of their
choice, if the patient has no preference the patient should be transported to the nearest appropriate
facility
Disposition for patients outside a 50 mile radius from the protocol designated transport destinations -
CORRECT ANSWERS-The licensee providing emergency medical care shall transport the
patient to the nearest appropriate facility
Waiting room criteria - CORRECT ANSWERS-Upon arrival in the ED, if transfer of care has not
occurred in accordance with NRS 450B.790, any patient, excluding patients on a legal psychiatric hold,
meeting ALL criteria may be placed in a waiting room
1. Normal vital signs
Heart rate 60-100
Respiratory rate 10-20
Systolic BP 100-180
Diastolic BP 60-110
Room air pulse ox > 94%
A&Ox4
2. Did not receive any parenteral medications during EMS transport except a single dose of analgesia
and/or an anti-emetic
3. In the judgment of the Paramedic, does not require continuous cardiac monitoring
4. Can maintain a sitting position without adverse impact on their medical condition
5. Is left with a verbal report to hospital personnel
Internal disaster - CORRECT ANSWERS-If a hospital declares internal disaster, that facility is to
be bypassed for all patients except patients in cardiac arrest or in whom the ability to adequately
ventilate has not been established
Operational exceptions may be initiated in regard to transport to hospitals on internal disaster.