2023 AF Emergency Medical Services Protocols Questions with Correct Solutions

AF EMS embraces two fundamental concepts in establishing a standard of care: - 1) The emergent patient benefits from immediate medical interventions, and timely definitive treatment. 2) Early and aggressive treatment modalities will be updated continually based upon published prehospital data (evidence based medicine) True or False Parent/Guardian consent may not be required for minors who present with complaints related to pregnancy, sexually transmitted diseases, mental health and/or substance abuse? - True Suspected Physical/Sexual abuse - Contacting OLMD is a legal requirement. Signs of abuse: Psychological characteristics physical signs of abuse signs of neglect inappropriate dress pain, itching, bleeding, bruising in genital area reports of recurrent urinary tract infections AMA - Against Medical Advice Patient has a life threatening injury/illness but refuses treatment, contact OLMD, have them speak to patient. If the patient still refuses document patient release as AMA Contraindications to Conducted Electrical Weapon or Taser Probe removal - 1) Probes localised to face; tissues above the level of the clavicles; the breast, groin or hand. 2) Suspicion that the probe may be imbedded in a blood vessel, joint or bone. BLS Termination of Resuscitation Criteria - -Unwitnessed arrest -Patient is greater than 18 years -Arrest NOT related to hypothermia, possible drug overdose or possible carbon monoxide or cyanide toxicity. -Airway has been effectively managed -Atleast 20 mins of high quality CPR have been performed. -3 AED analyses have been performed WITHOUT shock advised. -EtCO2 value is 10mmHg despite effective CPR -Medical Direction approves termination of resuscitation and pronounces time of death True or False You can use multi dose vials or anaesthesia - False If IV extravasation occurs: - -Stop Infusion -Connect syringe to IV catheter and attempt to withdraw fluids -Remove IV catheter, immobilize extremity, and elevate above heart level -Apply heat pack to area True or False If IO extravasation/infiltration occurs, you should stop the infusion and remove the catheter. - False Do not attempt to remove, secure in place. What kind of patients are most at risk for respiratory failure and should be treated aggressively? - Patients w/ AMS, Lethargy, increasing EtCO2/ continued hypoxia Mild Pain Control - Acetaminophen 500mg PO x2 AND/OR Meloxicam 15mg PO x1 Moderate to Severe Pain - Fentanyl 400mcg OTFC buccal x1 OR Fentanyl 100mcg IN x1 SBP MUST be 100mmHg, naloxone readily available Ketamine 50mg IN, repeat q20 PRN x1, max 100mg What individuals are at an increased risk of CNS depression following narcotic adinistration? - Elderly patients, narcotic naive patients, patients w/ head injuries and those who are intoxicated. When is Ketamine the preferred analgesic? - When SBP is 90 What are the 5 H's? - -Hypovolemia(IV/IO Access, fluids) -Hypoxia (High Flow O2) -Hydrogen Ions (Acidoses)(BVM Ventilation) -Hyper/Hypo-kalemia (Patient History) -Hypothermia (Exam, Temperature) What are the 5 T's? - -Toxins: Naloxone or other Tx -Tamponade, Cardiac/ CVA: Trauma/ Pt History -Tension Pneumothorax: Exam/ Breath sounds, Needle Decompression -Thromosis, Coronary: Pt History, EKG -Thrombosis, Pulmonary: Pt History Signs/ Symptoms of Bradycardia - Dizzy, lightheaded, syncope, chest pain Acute CHF Hypotension, Shock, AMS What is a maneuver you can do for patients who are tachycardic? - Vagal Maneuver: have pt attempt to blow plunger out of a 10ml syringe for 5-10 seconds. Hyperlipidemia - blood condition of abnormally high fat levels (cholesterol and triglycerides) When is NTG contraindicated? - Suspected right sided MI SBP 100mmHg Viagra or Levitra has been used in last 24 hours Cialis in last 48 hours When should you consider using a PEEP valve? - When using BVM on pts w/ hypoxia Max dose : 10cmH2O If CPSS exam is positive, BGL 50 AND onset of symptoms within 6 hours you should - Initiate stroke alert and transport to stroke center What is critically important when treating stroke patients? - "Last known well time" Helps determine pt treatment options and direct or transport Minor, rapidly improving or completely resolved stroke like symptoms could be indicative of - A TIA; pt just be transport for evaluation as TIAs often prelude CVAs Todd's paralysis - Brief period of unilateral paralysis immediately after a seizure. (Usually lasts 30 mins to 36 hours) LVO Stroke - Large Vessel Occlusion According to the Airborne Pathogens protocol, do NOT utilize a nebulized medication or CPAP unless - A HEPA filter can be attached True or False Pain medication is not contraindicated for patients with abdominal pain - True Medications should be limited to parenteral to limit PO intake