AEMCA-PCP ALS Medical Directives -
Study Guide Questions and Actual
Answers.
Indication(s) for Medical Cardiac Arrest - Answer Non-Traumatic cardiac arrest
Conditions for CPR - Answer Alt LOA, Performed in 2 minute intervals
What are the 2 shockable rhythms? - Answer V-Fib and pulseless V-Tach
Conditions for Medical TOR - Answer Greater than or equal to 18y/o; Altered LOA; Arrest not
witnessed by EMS AND No ROSC AND no defibrillation delivered
How many times can you Analyze in a Medical Cardiac Arrest? - Answer 4
Consider very early transport after the 1st analysis in the following settings: - Answer
Pregnancy assumed to be greater than or equal to 20 weeks gestation, hypothermia, airway
obstruction, suspected PE, Medication overdose/toxicology, other known reversible cause of
arrest not addressed
Indications for Trauma Cardiac Arrest? - Answer Cardiac arrest secondary to sever blunt or
penetrating trauma
Conditions for a Trauma TOR - Answer Greater than or equal to 16 y/o, altered LOA, HR=0,
RR=0, no palpable pulses AND no defibrillation delivered AND monitored HR=0 OR monitored
HR >0 with the closest ED Greater than or equal to 30 min transport time away.
Minimum age for defibrillation - Answer 30 days old
If a patient is in cardiac from FBAO and the foreign body is removed and your pt remains in
cardiac arrest how do you proceed? - Answer Initiate management as a medical cardiac arrest
What is the age of a neonate? - Answer Less than 30 days old
What does APGAR stand for? - Answer appearance, pulse, grimace, activity, respiration
When do you perform an APGAR test? - Answer 1 minute after delivery & 5 min after delivery
, How do you treat a neonatal pt presenting w HR=79 bpm? - Answer For 30 seconds: Provide
positive pressure ventilation (BVM) using room are
How do you treat a neonatal pt presenting w HR=57 bpm? - Answer For 30 seconds:
Administer chest compressions; provide positive pressure ventilation (BVM) using 100% oxygen
Indications for ROSC - Answer Patient with return of spontaneous circulation (ROSC) after the
resuscitation was initiated
Conditions for 0.9% NaCl fluid Bolus (ROSC) - Answer Greater than or equal to 2 years old;
hypotension; chest auscultation is clear
Contraindication for 0.9% NaCl fluid bolus (ROSC) - Answer Fluid overload; SBP > or equal to
90mmHg
Consider optimizing ventilation and oxygenation by: - Answer Titrating oxygen to 94-98%;
avoid hyperventilation and target ETCO2 to 30-40 mmHg with continuous waveform
capnography (if available)
Max rate and volume of NaCl infusion in a patient >2 year to <12 years old following a ROSC?
What volume do you reassess at? - Answer Max Rate: 10ml/kg. Max Volume: 1,000mL.
Reassess every 100mL.
Max rate and volume of NaCl infusion in a patient 12 years or older following a ROSC? What
volume do you reassess at? - Answer Max Rate: 10ml/kg. Max Volume: 1,000mL. Reassess
every 250 mL.
Indication(s) for Cardiac Ischemia Medical Directive - Answer Suspected cardiac ischemia
Conditions for ASA (Cardiac Ischemia) - Answer Greater than or equal to 18 years old;
Unaltered LOA; Able to chew and swallow
Conditions for Nitroglycerine (Cardiac Ischemia) - Answer Greater than or equal to 18 years
old; Unaltered LOA; HR= 60-159 bpm; Normotension; Prior Hx of Nitro use OR IV access
What BP range is considered normotensive? - Answer Systolic blood pressure greater than or
equal to 100mmHg
Study Guide Questions and Actual
Answers.
Indication(s) for Medical Cardiac Arrest - Answer Non-Traumatic cardiac arrest
Conditions for CPR - Answer Alt LOA, Performed in 2 minute intervals
What are the 2 shockable rhythms? - Answer V-Fib and pulseless V-Tach
Conditions for Medical TOR - Answer Greater than or equal to 18y/o; Altered LOA; Arrest not
witnessed by EMS AND No ROSC AND no defibrillation delivered
How many times can you Analyze in a Medical Cardiac Arrest? - Answer 4
Consider very early transport after the 1st analysis in the following settings: - Answer
Pregnancy assumed to be greater than or equal to 20 weeks gestation, hypothermia, airway
obstruction, suspected PE, Medication overdose/toxicology, other known reversible cause of
arrest not addressed
Indications for Trauma Cardiac Arrest? - Answer Cardiac arrest secondary to sever blunt or
penetrating trauma
Conditions for a Trauma TOR - Answer Greater than or equal to 16 y/o, altered LOA, HR=0,
RR=0, no palpable pulses AND no defibrillation delivered AND monitored HR=0 OR monitored
HR >0 with the closest ED Greater than or equal to 30 min transport time away.
Minimum age for defibrillation - Answer 30 days old
If a patient is in cardiac from FBAO and the foreign body is removed and your pt remains in
cardiac arrest how do you proceed? - Answer Initiate management as a medical cardiac arrest
What is the age of a neonate? - Answer Less than 30 days old
What does APGAR stand for? - Answer appearance, pulse, grimace, activity, respiration
When do you perform an APGAR test? - Answer 1 minute after delivery & 5 min after delivery
, How do you treat a neonatal pt presenting w HR=79 bpm? - Answer For 30 seconds: Provide
positive pressure ventilation (BVM) using room are
How do you treat a neonatal pt presenting w HR=57 bpm? - Answer For 30 seconds:
Administer chest compressions; provide positive pressure ventilation (BVM) using 100% oxygen
Indications for ROSC - Answer Patient with return of spontaneous circulation (ROSC) after the
resuscitation was initiated
Conditions for 0.9% NaCl fluid Bolus (ROSC) - Answer Greater than or equal to 2 years old;
hypotension; chest auscultation is clear
Contraindication for 0.9% NaCl fluid bolus (ROSC) - Answer Fluid overload; SBP > or equal to
90mmHg
Consider optimizing ventilation and oxygenation by: - Answer Titrating oxygen to 94-98%;
avoid hyperventilation and target ETCO2 to 30-40 mmHg with continuous waveform
capnography (if available)
Max rate and volume of NaCl infusion in a patient >2 year to <12 years old following a ROSC?
What volume do you reassess at? - Answer Max Rate: 10ml/kg. Max Volume: 1,000mL.
Reassess every 100mL.
Max rate and volume of NaCl infusion in a patient 12 years or older following a ROSC? What
volume do you reassess at? - Answer Max Rate: 10ml/kg. Max Volume: 1,000mL. Reassess
every 250 mL.
Indication(s) for Cardiac Ischemia Medical Directive - Answer Suspected cardiac ischemia
Conditions for ASA (Cardiac Ischemia) - Answer Greater than or equal to 18 years old;
Unaltered LOA; Able to chew and swallow
Conditions for Nitroglycerine (Cardiac Ischemia) - Answer Greater than or equal to 18 years
old; Unaltered LOA; HR= 60-159 bpm; Normotension; Prior Hx of Nitro use OR IV access
What BP range is considered normotensive? - Answer Systolic blood pressure greater than or
equal to 100mmHg
