Emergency Medical Protocols and Procedures, Exams of Nursing

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complete solutions.

SNHD Protocols 241fuly answered

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Sexual assault victims less than 13 years of age shall be transported to what hospital? - ANSWER- Sunrise Hospital Which of the following describes heat exhaustion? - ANSWER- Elevated Body Temperature Cool, moist skin Weakness Anxious tachypnea Nothing contained in these protocols shall be construed to expand the scope of practice of any licensed Attendant beyond that which is identified in the Clark County EMS Regulations and the protocols. - ANSWER- True When is cervical stabilization not performed? - ANSWER- * Penetrating trauma to the head and/or neck with no evidence of spinal injury

• Injuries where placement of the collar might compromise patient assessment, airway management, ventilation and/or hemorrhage control *Patients in cardiac arrest What protocols must be followed in the specific sequence noted? - ANSWER- General assessment How much does the head represent in a child patient in the rule of 9s - ANSWER- 18% During childbirth, if a limb presents, how should the mother be placed? - ANSWER- Left lateral recumbent position How deep are compressions in the infant victim? - ANSWER- 1.5 inches Sexual assaults victims between the ages of 13 and 18 can be transported to what hospital? - ANSWER- Sunrise Hospital UMC Hospital Patients with a possible spinal injury found in motor vehicles should not be asked if they are able to exit the motor vehicle on their own - ANSWER- False Which of the following are contraindications for a traction splint? - ANSWER- *Pelvic fracture or instability *Knee, lower leg, or ankle instability

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Which of the following are considered obvious signs of death? - ANSWER- *Body decomposition *Decapitation *Incineration *Transaction of thorax Which of the following constitute an approved SNHD DNR? - ANSWER- *Form *Wallet Card *Medallion Should oxygen be withheld from a patient in respiratory distress? - ANSWER- No The Pediatric Patient Destination protocol is used for: - ANSWER- Patients less than 18 years of age Circumferential burns meets criteria to be transported to a burn center. - ANSWER- True How fast does a motorcycle need to be traveling when it crashed to be considered for the Trauma Field Triage Criteria? - ANSWER- 20mph What level trauma center is St. Rose Siena? - ANSWER- 3 Step 1 of the Trauma Field Triage Criteria assess or measures what? - ANSWER- Vital Signs For cardiac arrest patients who are pregnant, manual CPR is recommended - ANSWER- True If a pediatric patient has a heart rate of less than 60bpm then CPR should be initiated - ANSWER- True For a suspected narcotic overdose, how much Naloxone can be administered intranasally? - ANSWER- 2 - 4mg Orthopedic devices cannot be left in place during interfacility transfer. - ANSWER- False What level trauma center is UMC? - ANSWER- 1 If cardiac arrest is witnessed by EMS or CPR in progress and patient is unresponsive with no pulse, begin Continuous Cardiac Compressions (CCC). - ANSWER- True

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Sexual assault victims that are more than a 50 mile radius from UMC or Sunrise hospital must be transported to UMC or Sunrise Hospital - ANSWER- False Transport the patient to the nearest appropriate facility How many proximal long bone fractures places a patient in Step 2 of the Trauma Field Triage Criteria? - ANSWER- 2 How much does one arm represent in an adult patient in the Rule of 9s? - ANSWER- 9% A patient with burns that involve the face, hands, feet, genitalia, perineum, or major joints meets criteria to be transported to a burn center. - ANSWER- True At what temperature does sweating generally disappear? - ANSWER- 104 F When notifying the staff of an approved alcohol or drug abuse facility, contact should be made via a recorded phone patch through the FAO at 702- 382 - 9007 - ANSWER- True How far away should defibrillation pads be placed from a pacemaker or pulse generator? - ANSWER- 1 inch What is the purpose of the protocol manual? - ANSWER- Provide guidance to all prehospital care providers and emergency department physicians within the Clark County EMS System. How long can Postpartum Eclampsia/Pre-Eclampsia present after childbirth? - ANSWER- up to 6 weeks What level trauma center is UMC? - ANSWER- 1 Sexual assaults victims between the ages of 13 and 18 can be transported to what hospital? - ANSWER- Sunrise UMC When transporting a patient to a remote outpatient emergency department, telemetry contact does not have to be made - ANSWER- False How much does a leg represent in a pediatric patient in the rule of 9s? - ANSWER- 14 What are appropriate triage methodologies that can be used when patients exceed available resources? - ANSWER- START SMART

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What is the ideal scene time for a patient having a stroke? - ANSWER- Less than 10 minutes Verbal instructions from friends or family members constitute a valid DNR/POLST. - ANSWER- False Describe a dystonic reaction - ANSWER- *Involuntary muscle movements or spasms of the face, neck, and upper extremitites *Typically an adverse reaction to drugs such as Haloperidol In patients in which the ability to ventilate cannot be established, where shall the patient be transported to? - ANSWER- The nearest emergency department Step 3 of the Trauma Field Triage Criteria assess or measures what? - ANSWER- Mechanism of injury A patient who meets step 1 of the Trauma Triage Field Criteria, must be transported to what level trauma center? - ANSWER- Level 1 Level 2 Which of the following describes heat exhaustion? - ANSWER- *Elevated body temperature *Cool, moist skin *Weakness *Anxious tachypnea A patient may be placed in an Emergency Room waiting if which of the following criteria are met? - ANSWER- *Did not receive any parenteral medications during EMS transport except a single dose of a narcotic and/or an anti-emetic. *In the judgment of the Paramedic/EMT-P, does not require continuous cardiac monitoring. *Is left with a verbal report to hospital personnel. *Can maintain a sitting position without adverse impact on their medical condition. *Normal vital signs. How much intrusion needs to be present on any other site of the vehicle to be considered for the Trauma Triage Field Criteria? - ANSWER- 18 If there is any question regarding patient viability, to include potential hypothermia, rescutiation will be initiated - ANSWER- True If a telemetry physician's order cannot be carried out, what must occur? - ANSWER- *Indicate on the prehospital care record the reason why the order could not be carried out

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• The provider must immediately notify the OEMSTS. *Indicate on the prehospital care record the time of the order *The provider must immediately notify the telemetry physician as to the reason the order cannot be carried out. *Indicate on the prehospital care record what was ordered. For a patient to be transported to an approved alcohol and drug abuse facility, the respiratory rate must be between what range? - ANSWER- 12 - 20 What is the definition of a patient? - ANSWER- *An individual that has contact with the EMS system *A complaint or mechanism suggestive of potential illness or injury *Obvious evidence of illness or injury *An individual or informed 2nd/3rd party caller requests evaluation for potential illness or injury Which of the following are associated with a grand mal seizure? - ANSWER- *Loss of consciousness *Incontinence *Oral trauma What is status epilepticus? - ANSWER- *Two or more seizures successively without an intervening lucid period *Seizure lasting over 5 minutes How much does the groin represent in an adult patient in the Rule of 9s? - ANSWER- 1% During cardiac arrest, how often are pulse checks performed? - ANSWER- Every 2 minutes If a patient requires manual ventilatory assistance, then how many attendants should attend to the patient? - ANSWER- 2 What needs to be submitted to the Southern Nevada Health District after a drowning incident? - ANSWER- Submersion Incident Report Form Stuck clothing should be removed from a burned patient. - ANSWER- False All patients in cardiac arrest or in whom the ability to adequately ventilate cannot be established should be transported to the closest facility. - ANSWER- True What does the Parkland Burn Formula define - ANSWER- How much fluid is given over 24 hours for a burned patient

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What are the approved Hypothermia Centers? - ANSWER- *Centennial Hills *Desert Springs *Henderson Hospital *Mountain View Hospital *St. Rose Siena *Southern Hills *Spring Valley *Summerlin *Sunrise *UMC *Valley What is recommended if hypoxia is the cause of the cardiac arrest? - ANSWER- Early ventilation If a drowning victim has foam in the airway, the foam should be suctioned out initially. - ANSWER- False What is the most common cause of bradycardia in a child? - ANSWER- Hypoxemia How fast does a vehicle need to be traveling immediately before a collision to be considered for Step 3 of the Trauma Field Triage Criteria? - ANSWER- 40MPH The Systolic BP Calculation of (Age In Years x 2)/70 can be used in patients up to what age? - ANSWER- 10 Adult pads may be used on children weighing more than how much? - ANSWER- 15kg Who should be present for patients requiring mechanical ventilation? - ANSWER- Trained personnel authorized to operate the equipment Patients sustaining burn injuries shall be transported in accordance with what protocol - ANSWER- Burn protocol How much does the posterior torso represent in an adult patient in the Rule of 9s? - ANSWER- 18% In order to quantify vaginal bleeding, a patient should be assessed for what? - ANSWER- Number of pads used per hour At what intervals is an APGAR score recorded? - ANSWER- *1 minute after birth *5 minutes after birth

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All patients with absent vital signs who do not have conclusive signs of death shall be treated with life-resuscitating measures unless EMS personnel are presented with a valid Do-Not-Resuscitate (DNR)/Physician Order for Life-Sustaining Treatment (POLST) Identification/Order. - ANSWER- True A remote outpatient emergency department can treat obstetric patients under how many weeks gestation? - ANSWER- 20 weeks How much does an arm represent in a pediatric patient in the rule of 9s? - ANSWER- 9 A patient may be placed in the ER waiting room if their heart rate is between what range? - ANSWER- 60 - 100 Hospitals that have declared internal disaster should be bypassed, except for patients presenting with what condition(s)? - ANSWER- * Inability to ventilate

• Cardiac arrest How should an EMT initiate Target Temperature Management after ROSC? - ANSWER- Ice packs to the axilla and groin Faxed, copied, or electronic versions of the DNR identification/POLST are not legal and valid - ANSWER- False How should Oxygen be delivered to patients with Smoke Inhalation? - ANSWER- 100% NRB Radio contact is not needed for all pediatric patients. - ANSWER- False When should defibrillation be attempted during a witnessed cardiac arrest? - ANSWER- Immediately What is a normal blood glucose reading in a newborn? - ANSWER- 40mg/dl What should occur if bleeding cannot be controlled through tourniquet application? - ANSWER- *Additional tightening of the tourniquet *Apply a second tourniquet Step 2 of the Trauma Field Triage Criteria assess or measures what? - ANSWER- Anatomy of Injury A patient can be alert and oriented x3 and be placed in the ER waiting room. - ANSWER- False Define moderate hypothermia. - ANSWER- 82 - 90F

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Radio contact should be established for what patients? - ANSWER- *All Trauma center patients *Code 3 returns *Need for telemetry physician *As indicated per protocol Which of the following describes heat cramps? - ANSWER- *Normal to elevated body temperature *Weakness *Muscle cramping A patient who meets step 2 of the Trauma Triage Field Criteria, must be transported to what level trauma center - ANSWER- *Level 1 *Level 2 A patient with a diastolic blood pressure between what range may be placed in an ER waiting room - ANSWER- 60 - 100 The administration of nitroglycerin is contraindicated for any patient who has used erectile dysfunction medications within the last 24 hours - ANSWER- false How much does the front represent in a pediatric patient in the rule of 9s - ANSWER- 18 A psychiatric patient without a potentially life threatening illness may be transported to a Remote Outpatient Emergency Department. - ANSWER- false When are pediatric protocols to be used? - ANSWER- On children who have not yet experienced puberty A DNR or POLST order shall be validated by confirming the patient's - ANSWER- *Age *Condition of identification form *Name How much does an arm represent in a pediatric patient in the rule of 9s? - ANSWER- 9 For a suspected traumatic brain injury, how far should the head be elevated? - ANSWER- 30 degrees Which of the following should be performed for a patient with hyperthermia? - ANSWER- *Passive cooling measures *remove from environment *remove tight clothing *temperature measurement

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Chemical burns meets criteria to be transported to a burn center. - ANSWER- True A fall greater than how many feet places the pediatric patient into Step 3 of the Trauma Field Triage Criteria - ANSWER- 10 When rescucitation has been terminated in the field, what should happen to all medical devices? - ANSWER- left in place Define severe hypothermia. - ANSWER- < 82F For a patient to be transported to an approved alcohol and drug abuse facility, the pulse rate must be between what range - ANSWER- 60 - 120 A patient that is less than 10 years old or over 50 years old with second and/or third degree burns in over 10% of the body surface area meets criteria to be transported to a burn center - ANSWER- True Describe a full thickness (3rd degree) burn - ANSWER- *Charred skin *Leathery skin *Painless A patient on a legal psychiatric hold may be placed in the ER waiting room. - ANSWER- False Cervical stabilization is the placement of an approved, properly-sized cervical collar and securing the patient to a long spinal board - ANSWER- False EMS providers are mandatory reporters in regards to suspected abuse of any vulnerable person - ANSWER- True When should defibrillation be attempted during an unwitnessed cardiac arrest? - ANSWER- After 2 minutes of CPR A patient may be placed in the ER waiting room if their respiratory rate is in what range - ANSWER- 10 - 20 A body can be moved without the coroners permission - ANSWER- False What should burns be covered with? - ANSWER- Dry sterile dressings What is often associated with submersion incidents? - ANSWER- Hypothermia

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Electrical burns, including lightning injuries meets criteria to be transported to a burn center - ANSWER- True Telephone contact may only be used if the call is recorded via a phone patch through the FAO at 702- 382 - 9000 - ANSWER- False What is the goal of the protocol manual? - ANSWER- Standardize prehospital care in Clark County. What should SPO2 be maintained at for patients on home oxygen or with chronic conditions? - ANSWER- > 90% Patients must have suspected OR electrocardiographic findings consistent with hyperkalemia (bradycardia with widening QRS complexes) BEFORE initiating treatment. - ANSWER- True Patients who have been exposed to carbon monoxide should be transported to what type of facility? - ANSWER- Hyperbaric Chamber Deep suctioning is recommended during neonatal rescuitation. - ANSWER- False A body can be moved without the coroners permission - ANSWER- False STEMIs, strokes, or a patient with acute coronary syndrome may be transported to a remote outpatient emergency department. - ANSWER- False What are possible causes of Obstructive Shock - ANSWER- *Pericardial Tamponade *Pulmonary Embolus *Tension Pneumothorax Which of the following hospitals are approved pediatric centers - ANSWER- *St. Rose Siena, Summerlin Hospital *Sunrise Hospital *University Medical Center Carefully monitor patients as you treat them; stable tachycardia may convert to unstable rhythms/conditions quickly - ANSWER- True Telemetry contact shall be established in which of the following situations - ANSWER- *All Code 3 (emergency) transports *Any medical emergency in which the EMS provider's judgement suggests consultation with a telemetry physician is necessary *For all trauma patients going to a trauma center *When telemetry is required per protocol

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Telemetry contact should be established by radio. - ANSWER- True When are backboards indicated? - ANSWER- Extrication/patient movement The associated monitor file must be uploaded and attached to the ePCR if the monitor was used for which of the following purposes? - ANSWER- *Assessing and/or monitoring the cardiac rhtyhm *Obtaining a 12 lead EKG *Providing electrical therapy including cardioversion, defibrillation, and/or pacing *Monitoring End Tidal CO2 levels and/or waveform of an intubated patient Nothing contained within these protocols is meant to delay rapid patient transport to a receiving facility - ANSWER- True Step 4 of the Trauma Field Triage Criteria assess or measures what? - ANSWER- Special considerations Patients with traumatic injuries shall be transported in accordance with what protocol? - ANSWER- Trauma Field Triage Criteria For a patient to be transported to an approved alcohol and drug abuse facility, the Glasgow coma score must be above what level? - ANSWER- 14 For a patient to be transported to an approved alcohol and drug abuse facility, the systolic blood pressure must be between what range - ANSWER- 90 - 180 Which of the following is considered supportive care? - ANSWER- *Suction the airway *Administer oxygen *Position of comfort *Splint *Control bleeding, *Pain medication (ALS only) *Emotional support *Contact hospice, home health, attending physician, or hospital as appropriate *Be attentive of any actions the patient may take to revoke his authorization to withhold life-resuscitating treatment Licensed EMS personnel are not obligated to continue rescucitation efforts that have been started by other persons at the scene if the patient meets the criteria in the Prehospital Death Determination protocol - ANSWER- True When can telephone contact to a receiving facility be used - ANSWER- When it is routed via a recorded phone patch through the Fire Alarm Office

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How many sides should be secured on an occlusive dressing? - ANSWER- 3 If cardiac arrest is witnessed by EMS or CPR in progress and patient is unresponsive with no pulse, begin CPR at 30 compressions and two ventilations - ANSWER- False What type of patients should ambulance attendants transfer? - ANSWER- Only those whose therapy required during transfer lies within the ambulance attendant's capabilities A patient may be placed in the ER waiting room if their respiratory rate is between what range? - ANSWER- 10 - 20 A patient with a diastolic blood pressure between what range may be placed in an ER waiting room? - ANSWER- 60 - 100 What is considered a hypertensive patient in the setting of Pulmonary Edema/CHF? - ANSWER- Diastolic BP > 100 mmHg A patient may be placed in the ER waiting room if their diastolic blood pressure is between what range? - ANSWER- 60 - 100 A patient care report will be completed for each incident/patient encounter. - ANSWER- True During normal childbirth, what should happen if the amniotic sac is not already broken - ANSWER- Puncture the amniotic sac What should happen to orogastric or nasogastric tubes during transfer? - ANSWER- *Left in place *Closed off *Set to suction Choose all that apply to describe the S.A.F.E.R. model. - ANSWER- *Stabilize the situation by containing and lowering the stimuli. *Assess and acknowledge the crisis. *Facilitate the identification and activation of resources (chaplain, family, friends, or police) *Encourage patient to use resources and take actions in his/her best interest. *Recovery or referral - leave patient in care of responsible person or professional, or transport to appropriate facility. Identify the correct T's in the pneumonic "H's and T's - ANSWER- *Tension Pneumothorax *Tamponade, Cardiac *Toxins

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*Thrombosis, pulmonary *Thrombosis, coronary During a pediatric cardiac arrest, how often should compressors be switched - ANSWER- Every 2 minutes What kind of dressing should be applied to an abdominal evisceration - ANSWER- Wet trauma dressing What are possible causes of Hypovolemic Shock? - ANSWER- *Hemorrhage *Trauma *GI Bleeding *Ruptured Aortic Aneurysm *Pregnancy Related Bleeding For a drowning victim in cardiac arrest, what should emphasis be placed on? - ANSWER- Oxygenation/Ventilation During child birth, if the child is a breach delivery, how should the child be handled - ANSWER- Support body of baby during delivery of head Where should a pediatric burn patient be transported to? - ANSWER- UMC Pediatric ED During epistaxis, how many sprays of oxymetazoline are sprayed in each nostril - ANSWER- 2 How many times can a patient be assisted with their own Nitroglycerin - ANSWER- 3 Define pregnancy hypertension - ANSWER- * > 140 systolic *> 90 diastolic *Relative increase of 30 systolic from patient's normal pre-pregnancy BP *Relative increase of 20 diastolic from patient's normal pre-pregnancy BP When should patient care be rendered - ANSWER- En route to a definitive treatment facility EMS personnel can access arterial lines during transfer - ANSWER- False What is the compression to ventilation ratio in neonatal resuscitation - ANSWER- 3: During a pediatric cardiac arrest, when should adult paddles/pads be used - ANSWER-

15kg

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Which of the following are approved stroke centers - ANSWER- *Centennial Hills Hospital *Desert Springs *Mountain View *Southern Hills *Spring Valley *St. Rose Martin *St. Rose Siena *Summerlin *Valley *Sunrise *UMC Choose the 6 rights - ANSWER- Patient Dose Time Drug Documentation Route For a patient in shock, what should the oxygen saturation be kept above - ANSWER- 94% Heparin locks cannot be left in place during transfer - ANSWER- False How deep are compressions in the child victim? - ANSWER- 2 inches What is the treatment plan for heat cramps - ANSWER- *PO fluids as tolerated (by mouth) *Monitor and reassess *Continue general patient care Postpartum Eclampsia/Pre-Eclampsia commonly presents how long after childbirth - ANSWER- Up to 48 hours A patient with a pulse oximetry reading above what percentage may be placed in the ER waiting room - ANSWER- 94 Pediatric patients should be evaluated with a high index of suspicion; occult injuries may be present and pediatric patients can decompensate quickly. - ANSWER- True What is the dose for Aspirin - ANSWER- 324mg

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Rescucitation for a medical arrest may be terminated when which of the following conditions are met - ANSWER- *20 minutes of CPR *Administration of appropriate ACLS meds *Capnography < 10mmHg *Effective ventilation with O *Physician approves termination *Persistent asystole or agonal rhythm A patient in non-traumatic cardiac arrest should be ventilated at what rate - ANSWER- 8 breaths per minute Which of the following hospitals are NIR capable - ANSWER- *Centennial Hills *Spring Valley *St. Rose Siena *Sunrise *UMC *Valley A patient with a systolic blood pressure between what ranges may be placed in an ER waiting room - ANSWER- 100 - 180 How much does one leg represent in an adult patient in the Rule of 9s - ANSWER- 18% All drowning patients should be transported for evaluation because of the potential for worsening over the next several hours - ANSWER- True What is considered a hypertensive patient in the setting of Pulmonary Edema/CHF? - ANSWER- Diastolic BP > 100 mmHg How long should eyes be flushed if they are exposed to chemicals - ANSWER- 10 - 15 minutes If cardiac arrest is unwitnessed by EMS or no CPR is in progress, Continuous Cardiac Compressions should be performed for 2 minutes prior to defibrillation - ANSWER- True Rescucitation that is started in the field by licensed EMS personnel can be discontinued without a physician order - ANSWER- False How much does the head represent in an adult patient in the Rule of 9s - ANSWER- 9% Patients are not to be transported on backboards (unless movement off the backboard would delay immediate transport of patients with life-threatening injuries or acute spinal injuries) - ANSWER- True

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A pediatric patient may be transported to a non-pediatric designated facility if which of the following conditions exist - ANSWER- *At the request of the parents and the child is stable *Incident is greater than 50 miles from a pediatric facility *Receiving facility and physician are contacted and agree to accept the patient Choose all that apply if there is an umbilical cord presentation during child birth. - ANSWER- *Position patient in Trendelenburg and slightly on left side *Wrap cord and keep it moist *Insert gloved hand to lift the baby off the cord *Obtain and document cord pulse According to the Altered Mental Status/Syncope protocol, Glucose shall be administered to a patient with a blood sugar less than _____ - ANSWER- 60mg/dl What medications can be adminstered or monitored during an inter facility transfer - ANSWER- All medications listed on the official drug inventory as appropriate for level of licensure and per protocol Which of the following describes heat stroke - ANSWER- *Hot, dry skin *High body temperature > 104°F *Hypotension *AMS/Coma What are possible causes of a patient's behavior experiencing a behavioral emergency - ANSWER- *Hypoxia *Intoxication/Overdose *Hypoglycemia/Electrolytes *Head injury *Post-ictal state *Excited delirium For patients who meet Trauma Field Triage Criteria, telemetry reports shall include - ANSWER- *Patient age *Gender *Mechanism of Injury *Ambulatory at scene *Suspected injuries *Vital signs *Airway status *Neurological status *ETA *Incident identifier if multiple patients are involved

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Telemetry contact shall be established in which of the following situations? - ANSWER- *When telemetry is required per protocol *All code 3 (emergency) transports *Any medical emergency in which the EMS provider's judgement suggests consultation with a telemetry physician is necessary *For all trauma patients going to a trauma center Resuscitation of a traumatic cardiac arrest may be terminated when which of the following conditions have been met - ANSWER- *Physician approves termination of rescucitation *Airway opened with basic lift support measures *Provide effective ventilation with 100% oxygen for 2 minutes *Perform bilateral needle throacentesis if tension pneumothorax suspected Which of the following are considered presumptive signs of death - ANSWER- *Unresponsiveness *Apnea *Fixed dilated pupils *Pulselessness A pregnant patient involved in a MVC should be seen by a physician for evaluation - ANSWER- True Identify the correct H's in the pneumonic "H's and T's" - ANSWER- *Hypovolemia *Hypoxia *Hydrogen Ion (acidosis) *Hypo/Hyperkalemia *Hypothermia All pediatric Step 1 and Step 2 trauma calls that occur within Clark County are to be transported to University Medical Center/Trauma. - ANSWER- True Adult trauma calls that meet Step 1 or 2 of the Trauma Field Triage Criteria Protocol and occur within the St. Rose Dominican Hospital - Siena Campus Catchment Area, City of Henderson, or the geographical area bordered by Paradise Road to the west continuing along that portion where it becomes Maryland Parkway, Sunset Road to the north, and the county line to the east, are to be transported to Sunrise Hospital & Medical Center and the medical directions for the treatment of the patient must be transported to Sunrise Trauma Center - ANSWER- True Where should the time of the tourniquet be written - ANSWER- Somewhere clearly visible on the patient

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The Sunrise Hospital catchment area is for all adult trauma calls and pediatric Step 3 trauma calls that meet the Trauma Field Triage Criteria Protocol and occur within the geographical area bordered by Paradise Road to the west, Sahara Avenue to the north, Sunset Road to the south, and the county line to the east, are to be transported to Sunrise Hospital & Medical Center and the medical directions for the treatment of the patient must originate at that cente - ANSWER- True Localized cold injuries should be rubbed to warm the skin - ANSWER- False Define mild hypothermia - ANSWER- 90°F-95°F The St. Rose Siena catchment area is for all trauma calls that meet Step 3 or in the provider's judgment meet Step 4 of the Trauma Field Triage Criteria Protocol and occur within the City of Henderson or the geographical area bordered by Interstate 15 to the west and Sunset road to the north, and the county line to the east, are to be transported to St. Rose Dominican Hospital - Siena Campus and the medical directions for the treatment of the patient must originate at that center - ANSWER- True Sexual assault victims over the age of 18 shall be transported to what hospital - ANSWER- UMC Hospital Smoldering clothing should be removed from a patient who was burned. - ANSWER- True Select all that apply for a mild allergic reaction - ANSWER- *Skin rashes *Itchy sensation *Hives *No respiratory involvement Inhalation injuries meets criteria to be transported to a burn center - ANSWER- True STEMIs, strokes, or a patient with acute coronary syndrome may be transported to a remote outpatient emergency department - ANSWER- False A traction splint is indicated on which of the following patients - ANSWER- Isolated midshaft femur fracture In the patient with Pulmonary Edema/CHF, what is the target SpO2 reading - ANSWER-

94% For a patient to be transported to an approved alcohol and drug abuse facility, the

diastolic blood pressure must be between what range - ANSWER- 60 - 100

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A Glascow Coma Scale below what level places a patient in Step 1 of the Trauma Field Triage Criteria - ANSWER- 13 Describe a superficial (1 degree) burn - ANSWER- *Red *Painful Focal seizures affect the entire body and are usually associated with a loss of consciouness - ANSWER- False How much does the back represent in a pediatric patient in the rule of 9s - ANSWER- 18 All trauma calls that meet the Trauma Field Triage Criteria and occur within any other area of Clark County are to be transported to University Medical Center/Trauma - ANSWER- True What specifically should be brought on scene of a pediatric patient - ANSWER- Broselow Tape Alcohol is commonly a cause of total unresponsiveness to pain - ANSWER- False What is the compression to ventilation ratio for an adult drowning victim in cardiac arrest

• ANSWER- 30: Select all that apply for a severe allergic reaction - ANSWER- *Skin disorders *Respiratory difficulty *Hypotension Trauma Field Triage Criteria - ANSWER- 1. Vital Signs

2. Anatomy of Injury
3. Mechanism of Injury
4. Assess special patients Step 1: Vital signs - Trauma Field Triage - ANSWER- * GCS < 13

• Systolic < 90; or
• Respiratory rate < 10 or > 29 or needs ventilation (must go to level 1 or 2) Step 2: Assess anatomy of injury - Trauma Field Triage - ANSWER- *Penetrating injuries to head/neck/torso/proximal extremities
• flail chest
• 2 or more proximal long-bone fractures
• crushed/mangled/pulseless extremity *amputation proximal to wrist/ankle

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*Pelvis fracture *open or depressed skull fracture *paralysis (Must go to level 1 or 2) Step 3: Assess mechanism of injury - Trauma Field Triage - ANSWER- *Falls: adults > 20ft; child > 10ft or 2 times height of child

• VC; > 40mph; intrusion 12 inches occupant; 18 inches otherwise ---ejection ---rollover with unrestrained occupant ---death in passenger compartment
• motorcle > 20mph *auto v. pedestrian/bicyclist > 20mph (must go to level 1, 2 or 3) Step 4: Assess special patients - Trauma Field Triage - ANSWER- * older adults: risk of injury/death increases after 55yo *SBP < 110 could be shock after 65yo *ground level falls could be serious *children triaged preferentially to a trauma center *anticoagulants/bleeding disorder high rest for rapid deterioration *burns w/o trauma; follow burn protocol *burns / trauma, follow trauma protocol *pregnancy > 20 wks *EMS provider judgment Level 3 trauma center - ANSWER- St. Rose Dominican Hospital - Siena Campus Level 2 trauma center - ANSWER- Sunrise Hospital & Medical Center Level 1 trauma center - ANSWER- UMC Pediatric Level 2 trauma center - ANSWER- UMC Trauma responded by air ambulance go to which center - ANSWER- UMC Patients needing cervical stabilization - ANSWER- A. Midline cervical spinal tenderness B. focal neurologic deficit C. altered mental status D. Evidence of drug/alcohol intoxication E. Painful, distracting injury if A - E negative, no stabilization required 6 Rights - ANSWER- Right drug

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Right Patient Right dose Right time Right route Right documentation Naloxone Hydrochloride - ANSWER- Narcan Even if a patient indicates they wish to receive life-rescusitating treatment, the DNR/POLST Order or Identificaiton shall be honored - ANSWER- False A pediatric patient with an airway emergency, should be transported to which facility - ANSWER- Closest emergency room Patient care should be rendered while en‐route to a definitive treatment facility - ANSWER- True In case of thermal burn - ANSWER- Stop the burning with water or saline Obstructive Shock - ANSWER- Pericardial tamponade Pulmonary embolus Tension pneumothorax Stroke: Left ventricular opacification (LVO) suspected if RACE score is >= - ANSWER- 5