NYS EMT-B Protocols (For protocol test and/or NYS EMT Exam) with Complete Solutions!!

Medical Control - ANSWER-- MD that can give any order on the scope of their practice -May control assist with questions regarding patient care or if there are complex medical conditions -Can help determine the most appropriate receiving facility Cardiac Arrest--Adult - ANSWER-- 30 compressions to 2 breaths via BVM (30:2) -Switch w/ partner every 2 minutes -Minimize interruptions of CPR -Use airway adjuncts as indicated -Apply AED, resume CPR after defibrillating Cardiac Arrest--Pediatric - ANSWER-30:2 for single rescuer 15:2 for two rescuer -Adult AED pads can be used if needed Foreign Body Airway Obstruction (FBAO)--Adults - ANSWER-- Rapid transport If conscious and can breathe, cough, speak: -encourage pt. to cough -transport in position of comfort/sitting -O2 administration If conscious and cannot breathe, cough, speak: -Airway maneuver -Heimlich Unconscious: -Remove airway obstruction if visible -Perform CPR FBAO--PEDS - ANSWER--Rapid transport If conscious and can breathe, cough, speak: -encourage pt. to cough -transport in position of comfort/sitting -O2 administration -Consider letting parent hold face mask 6-8in. from the child's face If conscious and cannot breathe, cough, speak: -Airway maneuver -Perform 5 chest thrusts alternating with 5 back blows Unconscious: -Remove airway obstruction if visible -Perform CPR Signs of Ineffective Breathing - ANSWER--Cyanosis -Visible retractions -Use of Accessory Muscles -AMS - RR < 10 bpm -Signs of Poor Perfusion Respiratory Arrest/Failure--Adult - ANSWER--Open airway and remove any visible airway obstruction by hand; insert adjunct if necessary -Suction if necessary -PPV with BVM -Ventilate every 5-6 seconds; each breath given over 1 second -SPO2 goal: 94% > Respiratory Arrest/Failure--Pediatric - ANSWER-Open airway and remove any visible airway obstruction by hand; insert adjunct if necessary -Suction if necessary -PPV with BVM -Ventilate every 3-5 seconds; each breath given over 1 second -SPO2 goal: 94% > Signs of Obvious Death - ANSWER--Body decompensation -Rigor Mortis -Dependent lividity -Injury not compatible with life (decapitation, burned beyond, recognition) *Resuscitation efforts may be held *Notify law enforcement AMS-- Adult and PEDS - ANSWER--can be caused by hypoglycemia --> check Blood glucose < 60 --> 1 unit dos of Oral glucose or carb source -Consider head injury -Non-accidental trauma (especially in PEDS) -Drug investigation -O2 therapy Oral Glucose Dos and Indication - ANSWER--15-24 grams; one tube -Conscious and can swallow on command ALTE/BRUE (Apparent Life Threatening Event/Brief Resolved Unexplained Events) - ANSWER--Episode in infant < 2 yrs. old -Apnea -Skin color change -Marked change muscle tone -Choking or gagging -Seizure ALTE/BRUE Treatment - ANSWER--Airway management -O2 -Blood glucose -Ongoing assessment Anaphylaxis - ANSWER--rapidly progressing, life threatening allergic reaction Anaphylaxis Treatment--Adults and PEDS - ANSWER--Position of comfort -Airway and 02 -EpiPen intramuscular (syringe may also be used as replacement **PEDS consideration: don't agitate child EpiPen Autoinjector Dos & Indication - ANSWER-Adults: 0.3 mg PEDS: 0.15 mg **Can also be used if pt. is in severe respiratory distress bc of allergen or for hypoperfusion -Bronchodilator -Increases BP, HR -Can use patients if they have -Can use EMS one as authorized Nebulized Albuterol - ANSWER--2.5 mg in 3mL (1-unit dos) -Give if pt is wheezing -Bronchodilator