LA County Test Questions and Answers
Treatment for respiratory distress with RR <8. - Answer-Ref. 806
If suspected, narcotic OD with hypoventilation, administer naloxone 2 mg IM/IN prior to venous access or advanced airway
Adult: 0.8-‐2 mg IVP, titrate to adequate RR/TV or 2 mg IM/IN
Pedi...
LA County Test Questions and
Answers
Treatment for respiratory distress with RR <8. - Answer-Ref. 806
If suspected, narcotic OD with hypoventilation, administer naloxone 2 mg IM/IN prior to
venous access or advanced airway
Adult: 0.8-‐2 mg IVP, titrate to adequate RR/TV or 2 mg IM/IN
Pediatric: 0.1 mg/kg IV/IM/IN
May repeat PRN
814—downtime > 20 min = terminate resuscitation - Answer-Ref. 814 Policy II.B—the
base hospital physician may pronounce death with it is determined that further
resuscitative efforts are futile. Patients without ROSC after 20 minutes of resuscitative
efforts by EMS personnel should be considered candidates for termination of
resuscitation. Exceptions may include hypothermia or patients who remain in, or whose
rhythm changes to, ventricular fibrillation or pulseless ventricular tachycardia.
SOB with pink frothy sputum, CHF—1st line drug of respiratory distress of cardiac
origin? - Answer-Ref. 806 Respiratory Distress: Basilar Rales - Cardiac Origin (adults
only)
Nitroglycerin SL
SBP ≥ 100 = 0.4 mg (1 puff or 1 tablet)
SBP ≥ 150 = 0.8 mg (2 puffs or 2 tablets)
SBP ≥ 200 = 1.2 mg (3 puffs or 3 tablets)
May repeat two times in 3-‐5 min based on repeat BP
Consider CPAP if available; max pressure 10 cmH2O
Car hit pole, driver and passenger in a vehicle that has passenger space intrusion -
driver self extricated, transport passenger to? - Answer-TC per 506 Trauma Criteria
Policy I.L—Passenger space intrusion of greater than 12 inches into an occupied
passenger space, or greater than 18 inches into any unoccupied passenger space
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. - Answer-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.
Of following what can you do in LACo? Needle T. - Answer-Ref. LACo ALS Skill Sheet -
Needle Thoracostomy (Chest Decompression)
Locate the landmarks for placement of the needle on an anatomical or live model: 2nd
intercostal space, mid clavicular line of the affected side
Cleanse site with an antiseptic solution
Insert needle perpendicular to chest wall at level of the superior border of the 3rd rib.
(Needle should meet resistance when 3rd rib is reached)
Move needle up along the 3rd rib until the needle tip is at the level of the 2nd intercostal
space
Slowly advance the needle into the thoracic cavity until the tip of the needle enters the
pleural space
Indications (S/S of a tension pneumothorax)
Progressive dyspnea
Decreased or absent unilateral breath sounds
Hypotension
Decreased LOC
Neck vein distention (if no hypovolemia)
Difficulty ventilating patient through an ETT
Tracheal deviation (late sign)
Treatment for pediatric patient with swollen vocal chords. - Answer-Ref. 1249
Treatement Protocol: Respiratory Distress - Stridor
If severe respiratory disress and croup suspected
Epinephrine (1:1,000) via hand held-‐nebulizer (HHN)
Pediatric: (see Color Code Drug Doses/LACo Kids)
Less than 1 y.o. - 2.5 mg diluted with 5 mL NS via HHN ONE time, hold for HR greater
than 200 bpm
1 y.o. or older - 5 mg diluted with 5 mL NS via HHN ONE time, hold for HR greater than
200 bpm
Ref. 1249 Treatement Protocol: Respiratory Distress - Wheezing
If deteriorating respiratory status:
Epineprhine 0.01 mg/kg (1:1,000) IM, maximum single dose 0.3 mg for patient weight
30 kg or greater (see Color Code Drug Doses/LACo Kids)
If suspected anaphylaxis, treat by Ref. 1242
Mom delivers a healthy baby where do you transport? Perinatal with EDAP or Perinatal
with NICU. - Answer-Ref. 511 Policy II—Perinatal patients who have delivered prior to
arriving at health facility should be transported to the most accessible perinatal center
which is also an EDAP (consider perinatal center with NICU)
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