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SNHD EMT EMS PROTOCOLS Complete Solutions Graded A+

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SNHD EMT EMS PROTOCOLS Complete Solutions Graded A+ Pediatric Oral Glucose Indication - Glucose 60mg/dL Newborn Oral Glucose Indication - Glucose 40mg/dL Pediatric pulse rate for cardiac arrest - 60bpm Pediatric Narcan Dose and Route - 2-4mg intranasal What age is considered pediatric for sexual assault victims? - 18 years old During an internal disaster by a hospital - that hospital should be bypassed unless the patient is in cardiac arrest or adequate ventilation cannot be established Mild, Moderate, and Sever signs of allergic reactions (Peds & Adults) - Mild- Skin reaction Moderate- skin reaction w/ some respiratory involvement but the patient can still maintain good tidal volume and air exchange Severe- Respiratory difficulty Who should you never use Narcan on? - Newborns Pediatric Patients with altered mental status- it is important to not excuse____ causes - Drugs, alcohol, or diabetes Should narcan be administered before or after advanced airway procedures? - Before A pediatric patients HR is less than 60bpm, what now? - Immediately begin CPR Pediatric Rule of 9's - Head - 18% BSA Pediatric Rule of 9's - Arms - 9% BSA Each Pediatric Rule of 9's - Legs - 14% BSA Each Pediatric Rule of 9's - Anterior Trunk - 18% BSA Pediatric Rule of 9's - Posterior Trunk - 18% BSA Pediatric Rule of 9's - Groin - 1% BSA Life resuscitating treatment includes - Chest compressions Defibrillation Assisted ventilations Prior to transfer who is responsible for notifying the reciveiving staff of reason, patient condition, and ETA? - The physician to the receiving physician Criteria a patient must meet in order to be transported to a drug and alcohol rehab facility (vs an emergency room) - BP: 90-180/60-100 Pulse: 60-120 Respiratory Rate: 12-22 Blood Glucose: 60-250 GCS: 14 Spo2: 94% or 90% for a smoker No Medical Complications No signs of trauma No suspected head trauma Approval of physican or mediacal staff prior to transport When resuscitation efforts are terminated what should you do with medical interventions? - leave them in place When can you transport or move a body w/o permission from the coroners office? - Never Indication for manual cervical stabilization - Midline cervical tenderness Focal neurologic deficit AMS Drug or alcohol intoxication Painful or distracting injury Contraindications of manual cervical stabilization - -Penetrating trauma to head or neck w no evidence of spinal injury -When cervical collar might impede the patient's airway or ventilation - Patient in cardiac arrest Where to apply tourniquet - proximal to injury site Contraindications to a traction splint - Pelvic fracture/instability, knee, lower leg, or ankle instability What medications can an EMT-B administer for an uncontrolled nose bleed? (Medication, dose, and route) - Oxymetazoline or Phenylephrine, 2 sprays per nostril, Intranasal How to evaluate posterior blood loss? (Epistaxis) - Examine the posterior pharnyx At what point does sweat generally disappear? (Body temp) - 104 degrees F Any pregnant patient should be placed in what position? - left lateral recumbent What medication, dose and route is used to treat a suspected opiate overdose? - Narcan, 2-4mg, intranasal Waiting Room Criteria Blood Pressure - 100-180 Systolic 60-100 Diastolic Waiting Room Criteria HR & RR - 60-100 HR 10-20 RR Waiting Criteria Pulse Oximetry - 94% Waiting Room Criteria AxO - x4 Important notes for stoke documentation - Last known time of normal & a witness name and number if available Normal Live Birth Delivery Steps - 1. Puncture Amniotic Sac 2. Deliver the Head 3. Suction Nose and Mouth 4. Deliver Shoulders 5. Deliver rest of the body 6. Clam and Cut Cord 7. Repeat per # of births 8. Deliver Placenta The reason burns to extremities are so dangerous - Potential vascular compromise secondary to tissue swelling How to treat a burn to the extremity? - Elevate extremity What to never apply to burns - Ice, Ointment, Ice and Antiseptic How many burn center criteria does a patient need to meet? - 1 What body parts specifically are considered burn center criteria? - Face, hands, feet, genitals, perineum, and major joints All adult burn center criteria - 1. Second Degree Burns 10% BSA 2. Third degree Burns 3. Burns that involve the face, hands, feet, genitals, perineum, and any major joints 4. Electrical/Lightening Burns 5. Chemical Burns 6. Circumferential Burns 7. Inhalation Burns What are 6 types of burns? - Thermal, Chemical, Electrical, Radiation, Lightning, Inhalation Dose of aspirin for chest pain - 324mg Examples of erectile dysfunction drugs - Viagra, levitra, Cialis How to place a patient w limb presentation? - left lateral recumbent position How to place a patient w cord presentation? - Trendelenburg position slightly on the left side During a breech delivery - support body of baby during delivery Mild Hypothermia Criteria - 90-95 degrees F Moderate Hypothermia Criteria - 82-90 degrees F Severe Hypothermia Criteria - 82 degrees F What kind of drugs can elevate body temperature? - Cocaine, Amphetamines, and salicylates STEMI stands for - ST elevation myocardial infarction EMT-B treatment for STEMI - 324mg aspirin or patients dose of nitroglycerin Key Feature of heat cramps - Benign (not harmful) muscle cramps Key Feature of heat exhaustion - Altered mental status, hypotension, elevated temperture Key Feature of of heat stroke - Altered mental status and body temp 104% Field signs of preeclampsia - Change of vision, headache, and RUQ Abdomen pain examples of opiates - morphine, heroin, methadone, codeine, oxycodone Key signs of CHF - JVD Pink Frothy sputum (Pedal) Edema Bilateral rales Key signs of a grand Mal seizure - Loss of consciousness Incontinence Oral Trauma Key signs of focal seizures - -Only 1 part of the body affected -Not typically associated w loss of consciousness Hypotension is typically defined as _______ but ______ - A systolic BP 90, should be interpreted based on patients normal blood pressure Causes of hypovolemic shock (loss of blood and fluid apply) - Hemorrhage, trauma, etc Causes of cardiogenic shock - Heart failure, MI, Cardiomyopathy (disease that makes heart pump more difficult, and myocardial contusion (bruise of the heart muscle) Cause of disruptive shock (abnormal distribution of blood flow) - Sepsis, anaphylaxis, and neurogenic toxins Causes of obstructive shock (shock due to obstruction to a great vessel/heart) - Pericardial tamponade, pulmonary embolus, etc R.A.C.E stands for (Stroke score) - Rapid, Arterial, Occlusion, evaluation Lowest RACE score - 0 Highest RACE score - 9 RACE Score - Facial Palsy - 0- Absent

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