Emergency Medical Protocols

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Questions and Answers

What is the primary function of the Rescue Task Force (RTF)?

Conducting investigations of the incident

Providing force protection and managing victim movement (correct)

Establishing communication systems at the incident scene

Providing medical training to emergency personnel

In what zone can RTFs operate according to the established protocols?

Cold zone only

Warm zone only (correct)

Any zone depending on the number of victims

Hot zone only

Which of the following is NOT a task traditionally assigned to a Rescue Task Force?

Post-incident psychological assessment (correct)

Rapid extrication of victims

Triage of victims

Threat suppression

What does the 'H' in the THREAT acronym stand for?

Hemorrhage Control Signup and view all the answers

What type of equipment do RTF members utilize for their protection?

Ballistic Protective Equipment (BPE) Signup and view all the answers

What is the purpose of establishing Unified Command during an incident?

To develop a comprehensive action plan involving all organizations Signup and view all the answers

Under what condition might the warm zone become a hot zone during an operation?

When there is a sudden emergence of a new threat Signup and view all the answers

Who comprises the Unified Command in an ASHER incident?

Fire, EMS, and law enforcement representatives Signup and view all the answers

What is a potential benefit of educational programs for caregivers of first responders?

Develop strategies to prevent relapse in mental health Signup and view all the answers

Why might retirees from fire departments be at a higher risk for mental health issues?

Loss of sense of purpose post-retirement Signup and view all the answers

What should effective insurance coverage for first responders include?

Access to first responder specific resources Signup and view all the answers

Which aspect is crucial for Employee Assistance Programs to be effective for first responders?

Managers knowledgeable in first responder mental health Signup and view all the answers

What role can retirees play in supporting mental wellness within fire departments?

Offering peer support and promoting resiliency Signup and view all the answers

What may be a contributing factor to retirees experiencing suicidal ideation?

Perceived low levels of connectivity with the community Signup and view all the answers

What is essential for culturally aware providers working with first responders?

Knowledge of first responder culture and needs Signup and view all the answers

Which factor should be limited to support effective mental health programs for first responders?

Potential impedances to accessing specific resources Signup and view all the answers

What must be done to the patient identification device to protect it from hazardous conditions?

Hole-punch and laminate it Signup and view all the answers

Who is NOT required to sign the DNRO form for it to be valid?

A witness to the signing Signup and view all the answers

What happens if the device is not laminated but is properly completed?

The DNRO order remains valid Signup and view all the answers

Which of the following statements about revoking a DNRO is true?

A DNRO can be revoked at any time by the patient or surrogate Signup and view all the answers

What information must be documented in the EMS Run Report regarding a witness used for patient identification?

The full name, address, and relationship of the witness Signup and view all the answers

What type of care should an EMS provider provide to a patient with a DNRO during transport?

Comforting and pain-relieving care, but not resuscitation Signup and view all the answers

What is required for the DNRO form to be considered valid?

It must be signed by the patient and physician Signup and view all the answers

Which of the following is NOT a method for verifying the identity of a patient subject to a DNRO?

Opinion of the EMS provider Signup and view all the answers

What is the primary action taken when announcing a Mass Casualty Incident (MCI)?

Specify the general category of the incident. Signup and view all the answers

In what scenario would a second alarm and MCI Level 3 response be assigned separately?

In a fire with multiple victims. Signup and view all the answers

What should be done when a trauma center is overwhelmed during an MCI?

Inform MedCom to find alternative trauma centers. Signup and view all the answers

What is one of the considerations for patient transport in an MCI?

Request air transport for special needs patients. Signup and view all the answers

What role does Medical Control (Medcom/MRCC) play upon notification of an MCI?

To gather and relay information about hospital capacities. Signup and view all the answers

Which of the following units are included in the first response assignment during an MCI?

All units already on scene and those en route. Signup and view all the answers

What is a key consideration regarding the use of mobile command during an MCI?

To streamline communication and supply logistics. Signup and view all the answers

What should be done if there are 'walking wounded' patients during an MCI?

Utilize mass-transit resources for their transport. Signup and view all the answers

Who should receive a nasopharyngeal airway (NPA) insertion?

Semi-conscious patients with an intact gag reflex Signup and view all the answers

What is the ventilation rate determined by for a patient?

The patient's SpO2 and EtCO2 levels Signup and view all the answers

What intervention is advised if excessive ventilation rates are used?

Monitor cardiac output for decline Signup and view all the answers

Which patients should not receive aggressive normalization of EtCO2 readings?

Cardiac arrest pre/post return of spontaneous circulation Signup and view all the answers

In which scenario should oxygen be withheld?

Oxygen should never be withheld from patients who are dyspneic or hypoxic Signup and view all the answers

What should be the primary intervention for a patient with a foreign body airway obstruction who is conscious?

Deliver abdominal thrusts Signup and view all the answers

What is the appropriate action if a patient experiences failure to maintain airway patency after a foreign body removal?

Perform cricothyrotomy immediately Signup and view all the answers

What should be done if air exchange is adequate with a partial airway obstruction?

Encourage the patient to cough Signup and view all the answers

What is the maximum SpO2 level that should be maintained for all patients?

94% Signup and view all the answers

What procedure is indicated for children under 12 years of age who cannot be ventilated after foreign body airway obstruction?

Needle cricothyrotomy Signup and view all the answers

Study Notes

BHAP & CISM Activation Process

Effective insurance for first responders should include specific providers and high-level services, limiting access impediments.
Employee Assistance Programs (EAPs) should be accessible to both first responders and their families with a knowledgeable program manager.
EAPs should provide first responder-specific mental health professionals and treatment options.

Do Not Resuscitate Order

A Do Not Resuscitate Order (DNRO) form and patient identification device are required for EMS personnel to recognize and respect a patient’s wishes.
The DNRO form must be signed by the patient's physician and the patient, or their designated surrogate if they are unable to provide consent.
The patient's identity must be verified during transport using identification or a reliable witness, and the information must be recorded.
A DNRO can be revoked at any time by the patient, their healthcare surrogate, or designated attorney.

Mass Casualty Incident

The Rescue Task Force (RTF) is a combined team of fire, EMS, and law enforcement personnel who provide force protection, triage, and victim extraction during a mass casualty incident.
The Unified Command (UC) establishes a shared leadership structure during a mass casualty incident, typically including representatives from law enforcement, fire, and EMS.
Trauma transport criteria should be followed, and hospitals overwhelmed with patients may notify MedCom to direct transport to alternate facilities.
Air and mass-transit resources should be considered for patients with special needs and walking wounded, respectively.
Mobile command, medical supply, and communication trailers should be considered as needed.
Medical Control (Medcom/MRCC) will evaluate each hospital's capacity and communicate this information to the Transport Officer.
A Hospital Coordinator may be assigned to each hospital for communication during large-scale incidents.

Ventilatory Assistance

Oxygen administration is a critical component of patient care, and it should not be withheld if the patient is experiencing dyspnea or hypoxia.
A target SpO2 of 94% should be maintained for most patients, while those with COPD and asthma should maintain an SpO2 of 90%.
Third-trimester pregnant trauma patients, head injury patients, decompression sickness, and carbon monoxide/cyanide exposure patients should receive 15 LPM of oxygen via a non-rebreather mask.
Excessive ventilation rates should be avoided in patients experiencing cardiac arrest, bronchospasm, and high EtCO2, as they can be detrimental.

Foreign Body Airway Obstruction

Abdominal thrusts and chest compressions should be utilized for conscious and unconscious patients respectively.
INFANTS should receive chest compressions and back blows.
A laryngoscope should be used to visualize the foreign body and attempt extraction with Magill forceps.
Surgical cricothyroidotomy (age > 13 y/o) or needle cricothyroidotomy (age < 12 y/o) should be performed if the foreign body cannot be extracted or the airway cannot be adequately ventilated.
DO NOT attempt to remove a partial airway obstruction unless ventilation is compromised. Encourage the patient to cough.
A Delayed Sequence Intubation Protocol should be consulted if spontaneous breathing ceases, ventilation fails, or airway patency is lost after removal of the foreign body.

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Description

This quiz covers essential protocols for emergency medical services, focusing on BHAP & CISM activation processes and the Do Not Resuscitate Order. Topics include effective insurance for first responders, employee assistance programs, and the requirements for recognizing and respecting a patient's DNRO wishes.