La County Test Questions With Complete Solutions
`Crush Injury Correct Answers Crush Syndrome—is a
reperfusion injury as a result of traumatic rhabdomyalysis
Prolonged compression greater than four hours (i.e. Traumatic
Crush patient trapped waist deep in trench)
Suspicion of hyperkalemia
Treatment: Ref. 1273 Crush Injury/Crush Syndrome
Pain management:
Adult: 2-‐12 mg SIVP, titrate to pain relief
Pediatric: 0.1 mg/kg, SIVP (see Color Code Drug Doses/LACo
Kids)
Normal Saline 20 mg/kg IV bolus Adult & Pediatric
Fluid resuscitation—hydrate prior to release of compressive
force to minimize hypovolemia and dilute cellular toxins
Albuterol
Adults: 5 mg via continuous mask nebulization
Pediatric: (see Color Code Drug Doses/LACo Kids)
Less than 1 y.o. - 2.5 mg
1 y.o. or older - 5.0 mg
Calcium Chloride
Adults: 1 gram SIVP over 1 min
Pediatrics: (see Color Code Drug Doses/LACo Kids)
20 mg/kg SIVP over 1 min, max single dose 500 mg
Sodium Bicarbonate
Adult: 1 mEq added to 1L NS, run IV wide open prior to
extrication
Pediatrics: (see Color Code Drug Doses/LACo Kids)
1 mEq added to 1L NS, administer 20 mL/kg IV
,2 min seizure treat and transport? Correct Answers Status
Epilepticus - make base contact
Active Seizures - Ref. LACo Drug Cards - Midazolam
Adult
2-‐5 mg SIVP at 1 mg/min; titrate IVP dose to suppress seizure
activity, may repeat dose every 3-‐5 min PRN
5 mg IM/IN, may repeat dose ONE time in 5 minutes
Maximum total dose 10 min
Pediatric
0.1 mg/kg SIVP at 1 mg/min, titrate IVP dose to suppress
seizure activity
0.1 mg/kg IM/IN
May repeat IV/IM/IN dose ONE time PRN to a maximum total
dose of 5 mg
11-‐year-‐old female pt cuts her hand at the mall, she received
first aid, she does not want transport, what can/should you do?
Correct Answers Treat and release. Not required to AMA.
Ref. 832 Treatment/Transport of Minors
Procedures II.A—A minor child (excluding children ≤ 12
months of age who is evaluated by EMS personnel and
determined not to be injured, to have sustained only minor
injuries, or to have illnesss or injuries not requiring immediate
tratment or transportation, may be released to:
1. Self (consideration should be given to age, maturity,
environment and other factors that may be pertient to the
situation)
Ref. 834 Patient Refusal of Treatment or Transport - Policy III.B
—EMS personnel should not require patients released at scene
to sign the release (AMA) section of the EMS Report Form, as
, this implies that the patient is at significant risk by not utilizing
the EMS system for treatment and/or transportation.
12 lead shows STEMI, pt goes unconscious en route to
destination, transport patient to? SRC is 15 min away, MAR is
5, SRC diversion due to STEMI 10min away, MAR diversion.
Correct Answers Ref. 513 Policy VI—In general, patients with
a STEMI 12-‐lead ECG, (including hypotensive patients with
signs and symptoms consistent with cardiogenic shock) shall be
transported to the most accessible open SRC if ground transport
is 30 minutes or less regardless of service area boundaries.
Ref. 513 Policy IX—The SRC may request diversion of STEMI
patients for any of the following conditions:
The hospital is unable to perform emergent percutaneous
coronary intervention because the cath lab staff is already fully
committed to caring for STEMI patients in the Cath lab. STEMI
patients should be transported to the most accessible open SRC
regardless of ED diversion status.
The SRC experiences critical mechanical failure of essential
cath lab equipment.
SRC is on diversion due to internal disaster.
28-‐year-‐old pt in active labor complaining of vaginal
bleeding goes to? Correct Answers Ref. 511 Policy I -
Transport to the most accessible perinatal center
A. patients who appear to be in active labor, whether or not
delivery appears imminent
808 Mandatory Base Contact: Pleuritic CP vs Isolated Hip Fx
Correct Answers Chest Pain or discomfort—Ref. 808 Section I
- Base Hospital Contact Required
`Crush Injury Correct Answers Crush Syndrome—is a
reperfusion injury as a result of traumatic rhabdomyalysis
Prolonged compression greater than four hours (i.e. Traumatic
Crush patient trapped waist deep in trench)
Suspicion of hyperkalemia
Treatment: Ref. 1273 Crush Injury/Crush Syndrome
Pain management:
Adult: 2-‐12 mg SIVP, titrate to pain relief
Pediatric: 0.1 mg/kg, SIVP (see Color Code Drug Doses/LACo
Kids)
Normal Saline 20 mg/kg IV bolus Adult & Pediatric
Fluid resuscitation—hydrate prior to release of compressive
force to minimize hypovolemia and dilute cellular toxins
Albuterol
Adults: 5 mg via continuous mask nebulization
Pediatric: (see Color Code Drug Doses/LACo Kids)
Less than 1 y.o. - 2.5 mg
1 y.o. or older - 5.0 mg
Calcium Chloride
Adults: 1 gram SIVP over 1 min
Pediatrics: (see Color Code Drug Doses/LACo Kids)
20 mg/kg SIVP over 1 min, max single dose 500 mg
Sodium Bicarbonate
Adult: 1 mEq added to 1L NS, run IV wide open prior to
extrication
Pediatrics: (see Color Code Drug Doses/LACo Kids)
1 mEq added to 1L NS, administer 20 mL/kg IV
,2 min seizure treat and transport? Correct Answers Status
Epilepticus - make base contact
Active Seizures - Ref. LACo Drug Cards - Midazolam
Adult
2-‐5 mg SIVP at 1 mg/min; titrate IVP dose to suppress seizure
activity, may repeat dose every 3-‐5 min PRN
5 mg IM/IN, may repeat dose ONE time in 5 minutes
Maximum total dose 10 min
Pediatric
0.1 mg/kg SIVP at 1 mg/min, titrate IVP dose to suppress
seizure activity
0.1 mg/kg IM/IN
May repeat IV/IM/IN dose ONE time PRN to a maximum total
dose of 5 mg
11-‐year-‐old female pt cuts her hand at the mall, she received
first aid, she does not want transport, what can/should you do?
Correct Answers Treat and release. Not required to AMA.
Ref. 832 Treatment/Transport of Minors
Procedures II.A—A minor child (excluding children ≤ 12
months of age who is evaluated by EMS personnel and
determined not to be injured, to have sustained only minor
injuries, or to have illnesss or injuries not requiring immediate
tratment or transportation, may be released to:
1. Self (consideration should be given to age, maturity,
environment and other factors that may be pertient to the
situation)
Ref. 834 Patient Refusal of Treatment or Transport - Policy III.B
—EMS personnel should not require patients released at scene
to sign the release (AMA) section of the EMS Report Form, as
, this implies that the patient is at significant risk by not utilizing
the EMS system for treatment and/or transportation.
12 lead shows STEMI, pt goes unconscious en route to
destination, transport patient to? SRC is 15 min away, MAR is
5, SRC diversion due to STEMI 10min away, MAR diversion.
Correct Answers Ref. 513 Policy VI—In general, patients with
a STEMI 12-‐lead ECG, (including hypotensive patients with
signs and symptoms consistent with cardiogenic shock) shall be
transported to the most accessible open SRC if ground transport
is 30 minutes or less regardless of service area boundaries.
Ref. 513 Policy IX—The SRC may request diversion of STEMI
patients for any of the following conditions:
The hospital is unable to perform emergent percutaneous
coronary intervention because the cath lab staff is already fully
committed to caring for STEMI patients in the Cath lab. STEMI
patients should be transported to the most accessible open SRC
regardless of ED diversion status.
The SRC experiences critical mechanical failure of essential
cath lab equipment.
SRC is on diversion due to internal disaster.
28-‐year-‐old pt in active labor complaining of vaginal
bleeding goes to? Correct Answers Ref. 511 Policy I -
Transport to the most accessible perinatal center
A. patients who appear to be in active labor, whether or not
delivery appears imminent
808 Mandatory Base Contact: Pleuritic CP vs Isolated Hip Fx
Correct Answers Chest Pain or discomfort—Ref. 808 Section I
- Base Hospital Contact Required
