SNHD AEMT protocol study set examination test for 2024 candidates with correct marking sch, Exams of Medicine

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SNHD AEMT protocol study set examination test for 2024 candidates with correct marking schemes  Acetylsalicylic Acid - Correct answer Aspirin  Acetylsalicylic Acid (Aspirin) class - Correct answer Non- steroidal anti-inflammatory (NSAID)  Acetylsalicylic Acid (Aspirin) action - Correct answer Platelet inhibition  Acetylsalicylic Acid (Aspirin) dose - Correct answer Adult:  324mg PO (81mg tablets x 4)  Pediatric:  not recommended for use  Acetylsalicylic Acid (Aspirin) route - Correct answer PO - Chew and swallow  Acetylsalicylic Acid (Aspirin) contraindications - Correct answer Allergy to aspirin  Acetylsalicylic Acid (Aspirin) adverse reactions - Correct answer None  Activated charcoal  Class - Correct answer Adsorbent  Activated charcoal  Action - Correct answer Inhibits gastrointestinal absorption of toxic substances  Activated charcoal  Dose - Correct answer Adult:  50gm PO  Pediatric:  1gm/kg PO;  minimum dose 10gm  Maximum dose 50gm  Activated charcoal  Route - Correct answer PO  Activated charcoal  Contraindications - Correct answer Altered mental status; ingestion of acid, alkalis, or petroleum distillate;  an inability to swallow; previous administration of an emetic  Activated charcoal  Adverse reactions - Correct answer Nausea  Vomiting  Albuterol - Correct answer Proventil  Albuterol (Proventil)  Class - Correct answer Sympathomimetic  Albuterol (Proventil)  Action - Correct answer Bronchodilator  Albuterol (Proventil)  Dose - Correct answer Both adults and pediatrics:  2.5 mg and 3 mL SVN, repeat until improved  Albuterol (Proventil)  pediatric: o mg/kg IM; max single dose 0.3 mg; may repeat q 15 min. Up to max 0.9 mg  Epinephrine  Route - Correct answer IM  IV  ETT  SVN  Epinephrine  Contraindications - Correct answer Underlining cardiovascular disease/angina;  hypertension;  pregnancy;  patient over 40 years of age; hyperthyroidism  Epinephrine  Adverse reactions - Correct answer Palpations due to tachycardia or ectopic beats may produce arrhythmia if cardiac disease present;  elevation of blood pressure; headache;  anxiousness  Epinephrine Auto-injector  Class - Correct answer Sympathomimetic  Epinephrine Auto-injector  Action - Correct answer Bronchodilation  positive chronotrope  positive initrope  Epinephrine Auto-injector  Dose - Correct answer Both adult and pediatrics:  Assist patient with his or her own epinephrine auto-injector  Epinephrine Auto-injector  Route - Correct answer IM  Epinephrine Auto-injector  Contraindications - Correct answer Underlining cardiovascular disease/angina;  hypertension;  pregnancy;  patient over 40 years of age; hyperthyroidism  Epinephrine Auto-injector  Adverse reactions - Correct answer Palpations due to tachycardia or ectopic beats may produce arrhythmia if cardiac disease present;  elevation of blood pressure; headache;  anxiousness  Glucagon  Class - Correct answer Insulin antagonist  Glucagon  Action - Correct answer Reverses the effects of hypoglycemia  Glucagon  Dose - Correct answer Adult:  mg IM for no IV access  Pediatric:  .5 mg IM for no IV access  Glucagon  Route - Correct answer IV  IM  Glucagon  Contraindications - Correct answer None  Glucagon  Adverse reactions - Correct answer Nausea  vomiting  Glucose  Class - Correct answer Carbohydrate  Glucose  Action - Correct answer Quick infusion of sugar into blood for metabolism  Glucose  Oral dose - Correct answer Adult:  25 gm glucose between the gum and cheek, if gag reflex is present  Pediatric:  Up to 25 gm glucose between the gum and Cheek if gag reflex is presence and as tolerated  Glucose  D50 dose - Correct answer Adult:  25 gm slow IVP  Pediatric:  See specific protocol for dosing based on weight, age, and concentration  Glucose  D10 (10% dextrose in 250 ml NS) dose - Correct answer Both Adult and Pediatrics:  1ml/kg max dose 250ml  Glucose  D10 (10% dextrose in 250 ml NS) route - Correct answer Slow IVP  IV drip  PO  Glucose  Contraindications - Correct answer None  Glucose  S.A.F.E.R - Correct answer S: stabilize the situation. (contain and lower stimuli)  A: assess and acknowledge the crisis.  F: facilitate identification and activation of resources.  E: encourage patients to use resources.  R: recovery/referral, leave patients in care of responsible person/profession or transport to appropriate facility.  Pediatrics, age for a destination - Correct answer Less than 18 years old  Pediatrics, age for protocols - Correct answer 12 years old or less  Profound altered mental status - Correct answer Defined as:  A deficit that includes disorientation, bewilderment, and difficulty following commands.  Implement with all respiratory distress - Correct answer Pulse ox and capnography  Status epilepticus - Correct answer Two or more seizures successfully without a lucid period, or a seizure lasting over five minutes  Grand mall seizures - Correct answer (Generalized) are associated with loss of consciousness, incontinence, and oral trauma  Focal seizures - Correct answer Affect only part of the body and are not usually associated with loss of consciousness  Hypotension defined as - Correct answer BP less than 90 systolic, not always reliable, and should be interpreted in context and patients typical BP  Hypovolemic shock - Correct answer Hemorrhage,  trauma,  G.I. bleeding,  ruptured aortic aneurysm,  or pregnancy related bleeding  Cardiogenic shock - Correct answer Heart failure,  MI,  cardiomyopathy,  myocardial contusion,  toxins  Distributive shock - Correct answer Sepsis,  anaphylaxis,  neurogenic,  toxins  Obstructive shock - Correct answer Pericardial Tampanade,  Pulmonary embolus,  tension pneumothorax  Trauma centers - Correct answer University medical center, level one.  Sunrise Hospital, level two.  Saint Rose sienna, level Three.  Pediatric destinations - Correct answer Saint Rose sienna.  Summerlin medical center. Sunrise hospital.  University medical center.  Burn centers - Correct answer University medical center  Sexual assault centers - Correct answer Sunrise hospital, for patients less than 13 years old.  Sunrise hospital, university medical center for patients 13 years old to 17 years old.  University medical Center for patients 18 years old and up  Stroke destinations - Correct answer All hospitals except:  Boulder City Hospital.  Mesa view hospital.  Mike O'Callaghan federal hospital.  North Vista Hospital.  Hypothermia centers - Correct answer All hospitals except:  Boulder city hospital.  Mesa view hospital.  Mike O'Callaghan federal hospital.  North Vista Hospital.  Saint Rose San Martin.  In any cardiac arrest and postarrest resuscitation what should you never do? - Correct answer Hyperventilate  What is the most important airway device and also the most difficult to use correctly? - Correct answer The bag valve mask  Difficult BVM ventilations acronym - Correct answer Moans  Difficult BVM ventilations - moans - Correct answer M: difficult Mask seal, due to facial hair, anatomy, blood/secretion/trauma.  O: Obese or late pregnancy.  A: Age greater than 55.  You are called to the scene for a man who has suffered and inhalation injury after an explosion at a factory. Which hospital should the patient be transported to? - Correct answer UMC  What is the pediatric dose of Narcan? - Correct answer 0.1 mg per kilogram.  IM/IM/IV.  Max single dose 2 mg.  Max total dose to 10 mg.  In the pediatric drowning protocol, after a general patient assessment has been completed, the highest priority should be protecting the airway and adequate ventilation. True or false? - Correct answer True  You are called to a hotel for a male in seizure. Upon arrival, you find that the patient has stopped Seizure activity, but is still unresponsive. After ensuring adequate airway, you check the patients BGL. The patient should be administered glucose if it is noted to be below what MG/DL - Correct answer 60 MG/DL  On all patients suspected of alcohol as the cause of an altered mental status the EMS provider should rule out what other causes? - Correct answer Infection,  trauma,  insulin - hypo/hyperglycemia.  In the termination of resuscitation protocol, resuscitation started in the field may be discontinued only by a physician order when the following conditions have been met for a medical arrest: the patient remains in persistent a-systole or agonal rhythm and has a capnography less than 10 MMHG after 20 minutes of appropriate paramedic resuscitation, to include: - Correct answer CPR,  effective ventilation with 100% oxygen,  administration of appropriate ACLS medications  You arrive on scene for a two-year-old male who was reported to have fallen. The parents inform you that the patient crawled up onto a ladder that had been left by some workers and fell approximately 8 feet to the ground. The patient is 3 feet tall and weighs 55 pounds. He is alert and oriented and acting appropriately per his parents, but Wences when you touch his lower back. Using this information does the patient meets criteria for transport to a trauma center? True or false? - Correct answer True, children go to a trauma center for falls greater than 10 feet or two times the height of the child  A trauma patient with a GCS of 14 must be transported to a trauma center? True or false? - Correct answer False, a patient with a GCS of 13 or less must be transported to a trauma center.  All pediatric step one and step two trauma calls that occur within the Clark County are to be transported to UMC trauma, and medical directions for the treatment of the patient must originate at that center? True or false? - Correct answer True.  And airway adjunct should be inserted in a cardiac arrest patients, with breaths per minute, being performed at a rate of at least what? - Correct answer At least eight breaths per minute  A pregnant patient who presents with a cord presentation should be placed in which position? - Correct answer Place on elbows and knees with hips elevated  Pediatric drowning victims should have CPR performed compressions/ventilation ratio of 15:2? True or false? - Correct answer True.  for drowning victims, Emphasis should be on oxygenation/ventilation. Use traditional 15:2 CPR, not continuous compressions.  Adult drowning victims, use traditional 30:2 CPR  Patients who are suffering from pain should initially be treated with the following treatment? - Correct answer Comfort measures,  I.E.  patient positioning, splinting, ice, etc.  If the ability to adequately ventilate a patient cannot be established, what should you do? - Correct answer The patient must be transported to the nearest emergency department  Where should stable patients be transported to? - Correct answer Stable patients shall be transported to the hospital of their choice, if the patient has no preference the patient should be transported to the closest facility  Waiting room placement - Correct answer May not be on legal psychiatric hold.  Heart rate 60-100. Respiratory rate 10-20. Systolic BP 100- 180.  Diastolic BP 60-100.  Room air Pulse ox greater than 94%.  Alert and oriented times four. Did not receive any parental medication during EMS transport- except a single dose of morphine sulfate and/or ondansetron.  Does not require continuous ECG monitoring.  Does not require IV fluids. Can maintain a sitting position without adverse effects on their medical condition.  A complete PCR is left/transmitted and verbal notification given to hospital personnel.  Law-enforcement assistance should be requested on all calls involving what? - Correct answer Involving potentially violent patients  What ages does the systolic blood pressure calculation apply to? - Correct answer Up to age 10  You supplemental oxygen to maintain an oxygen saturation of what? - Correct answer Of greater than 94%;  or greater than 90% for patients on home oxygen for chronic conditions  Cervical stabilization is indicated in any patient who has... - Correct answer A: midline cervical spinal tenderness.  B: focal neurologic deficit.  C: altered mental status.  D: evidence of drug and/or alcohol intoxication.  E: any painful, distracting injury.  If all of these are negative cervical stabilization is not indicated.  When should cervical stabilization not be performed? - Correct answer A: penetrating trauma to the head and or neck and no evidence of spinal injury.  B: injuries where placement of the color might compromise patient assessment, airway management, ventilation and or hemorrhage control.  C: patients in cardiac arrest.  When are backboards indicated? - Correct answer Backboards are only indicated for extrication and patient movement.  Patients are not to be transported on backboards, unless movement off the backboard would delay immediate transfer of patients with life-threatening injuries or acute spinal injuries.  With cervical stabilization what is not recommended? - Correct answer Tape, had straps, wedges, and had and/or next support devices are not recommended.  What are the indications for an extra glottic airway device? - Correct answer This procedure may be performed on any patient and which attempts at basic airway and ventilation support our unsuccessful and who has at least one of the following:  A: hypoxia.  B: respiratory arrest/failure.  C: obtundation.  D: failed endotracheal intubation.  Extra glottic airway device contraindications - Correct answer A: gag reflex.  B: history of esophegeal trauma, or known esophegeal disease.  C: recent ingestion of a caustic substance.  D: tracheostomy or Laryngectomy.  E: suspected foreign body obstruction.  Tourniquet indications - Correct answer This procedure may be performed on any patient that has bleeding from an extremity that cannot be controlled by direct pressure  What are the six rights for medication administration - Correct answer Right drug.  Right patient.  Right dose.  Right time.  Right route.  Right documentation.  For IM or SQ administration what size needle should you use - Correct answer Needle should be 20 gauge or smaller  IM or SQ administration sites - Correct answer Deltoid muscle.  Vastus lateralis muscle, lateral thigh.  Ventro gluteal or dorso gluteal muscles, buttocks.  What does MAD stand for - Correct answer Mucosal Atomizer device  When is a MAD device indicated - Correct answer This procedure may be performed on any patient that requires administration of a medication  What drug can you give through the MAD device - Correct answer Narcan  How would you administer medication through the MAD device - Correct answer A: using the free hand, hold the crown of the head stable.  B: plays the tip of the MAD snuggly again for nostril, and then slightly up an outward, towards the tip of the year.  C: bristly compress the syringe to deliver half the medication and to the nostril.  D: move the device over to the opposite nostril and administer the remaining medication.  Traction splint indication - Correct answer This procedure may be performed on any patient with an isolated closed midshaft femur fracture  Traction splint contraindications - Correct answer A: pelvic fracture or instability.  B: knee, lower leg, or ankle instability.