Kern County EMS Protocols – Questions & Answers Can paramedics monitor naso-gastric infusions ? Correct Ans - Yes Hyperventilation is no longer advocated for routine head trauma. it is only indicated in the patient who is rapidly deteriorating and manifesting signs of impending herniation such as : Correct Ans - -rapidly deteriorating mental status -contralateral paralysis/ weakness -unilateral dialated pupils -decerebrate or dicorticate posturing What medications can be used with MADD device ? Correct Ans - Narcan, Versed, Fentanyl Describe 4 steps of Trauma Activation Criteria Correct Ans - 1.Physiological
- Anatomical
- Mechanism
4.Comorbidities Who can deactivate a trauma activation ? Correct Ans - Only Hall (ALS or BLS) What is the total max time to turn in a PCR ? Correct Ans - 15 hrs What are the load and go situations for trauma ? Correct Ans - -ALOC -Bilateral femur fracture -pelvic fracture Can medications be administered through a saline lock without a line ?Correct Ans - Yes When is a saline lock( not an IV) contraindicated ? Correct Ans - -when their is a possibility of hypotensive issues (trauma/hypovolemia) -burns 1 / 3
Can versed be administered to facilitate CPAP ? Correct Ans - Yes What is the respiratory (DRY) algorithm ? Correct Ans - 1. Airway
- O2
- Dual-Neb
- Epinephrine
- Magnesium Sulfate
6. CPAP
At what number is a hospital considered to be busy based on their hospital score ? Correct Ans - 5 Primary treatment for head injury with herniation ? Correct Ans - Hyperventilation What is the desired BP for head traumas ? Correct Ans - 80 to 90 systolic Can paramedics monitor IV infusion containing Potassium Chloride ?Correct Ans - Yes with a concentration equal or less than 40mEq per liter of IV solution.What hospital is a Base Station ? Correct Ans - BMH, Heart, KMC, Mercy, MSW, AH-B, DRMC, KVH, TH, RRH What hospital can handle burns ? Correct Ans - Bakersfield Memorial What hospital can handle Step 1 or 2 trauma ? Correct Ans - KMC What hospital can handle step 3 trauma ? Correct Ans - All What hospital can handle orthopedic ? Correct Ans - BMH, KMC, mercy, msw, AH-B Which are cardiac facilities? Correct Ans - BMH, heart, and AH-B Where do you transport a STEMI? Correct Ans - BMH, Heart, and AH-B 2 / 3
Where do you transport sexual assault victims? Correct Ans - AH-B If a conscious patient is adamant and insist of being transported to a hospital of his/her choice contrary to a case specific hospital, what do you do ?Correct Ans - Obtain a signed AMA and transport to the hospital of the Pt's choice.What defines medical extremis criteria ? Correct Ans - Unmanageable airway Uncontrolled hemorrhage w/ signs of hypovolemic shock Cardiopulmonary arrest Unconscious/unresponsive (BLS units only) What defines Trauma Extremis Criteria ? Correct Ans - Traumatic Arrest Unmanageable airway our inability to ventilate What defines emergent medical pediatric criteria ? Correct Ans - Cardiac dysthymia Evidence of poor perfusion Severe respiratory distress Cyanosis Persistent altered mental status Status epilepticus Any apparent life-threatening event in less than one year of age When do you not initiate CPR? Correct Ans - Pulseless for more than 10 minutes Obvious death Blunt trauma (pulseless) with fixes pupils Apneic Pt w/ approved DNR or POLST When can a Paramedic terminate CPR ? Correct Ans - -information becomes available that would have prevented initiation.-after 30 mins of resuscitation w/out ROSC -traumatic arrest with transport time greater than 15 minutes.
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