EMR vs EMT Quiz: Compare and Learn Protocols

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Questions and Answers

When administering Ativan, in what way should the IV administration be diluted?

Ringer's Lactate

Sterile Water

Normal Saline (correct)

Dextrose

Which medication can be used for patient agitation in elderly and all adults?

Haldol

Zyprexa (correct)

Ativan

Versed

What is the maximum dose of Ketamine that can be administered IM?

400mg (correct)

65mg

700mg

5mg

Which medication listed is known for potentially causing prolongation of QT?

Haldol Signup and view all the answers

What is the maximum amount of Versed that can be administered?

4mg Signup and view all the answers

Which medication should not be used for transporting a patient in police custody?

Zyprexa Signup and view all the answers

When should aeromedical transport be requested to respond to the scene?

When BLS personnel request it, and ALS is delayed or unavailable Signup and view all the answers

What is the recommended course of action if the most highly trained EMS provider on the scene decides that aeromedical transport is unnecessary?

Cancel the aeromedical transport as soon as possible Signup and view all the answers

Under what circumstances should patients in cardiac arrest following blunt force trauma be transported via aeromedical services?

They should never be transported via aeromedical transport Signup and view all the answers

What is the role of good clinical judgment in the decision-making process for aeromedical transport?

It ensures appropriate decision-making in complex situations Signup and view all the answers

When can ALS personnel request aeromedical transport to the scene?

Only when BLS personnel are unable to do so Signup and view all the answers

Under what conditions should field termination be considered?

If the presenting rhythm shows no response to interventions Signup and view all the answers

In which situation can resuscitation efforts be stopped without a DNR or POST?

When health care facility staff identifies DNR forms as correct Signup and view all the answers

What should be done if the appropriateness of resuscitation is questionable during ALS care?

Consult Medical Control for assistance Signup and view all the answers

What should an EMR do when faced with a patient showing PEA or Asystole?

Recognize CPR and AED Signup and view all the answers

In what circumstance should the family be given a '2 minute' warning?

To prepare for field termination Signup and view all the answers

When should resuscitative efforts be stopped according to Elkhart County EMS Guidelines?

When resuscitation appears to be non-effective Signup and view all the answers

What should be considered before delivering medication through the nasal passage?

Suctioning the nasal passage Signup and view all the answers

How much dead space is present in the MAD?

0.1 mL Signup and view all the answers

What is the maximum volume of medication that should be administered per nostril?

1 mL Signup and view all the answers

How long should you wait before administering the remaining medication if the dose is greater than 1 mL?

2 – 3 minutes Signup and view all the answers

What is the purpose of holding the crown of the head stable during medication administration?

To prevent the patient from moving during administration Signup and view all the answers

What is the most commonly used route of parenteral medication administration?

Intramuscular (IM) Signup and view all the answers

In the case of bradycardia, which medication should be given before Epinephrine if the bradycardia is due to an increase in vagal tone or primary AV block?

Atropine Signup and view all the answers

According to the guidelines, what is the maximum dose of Magnesium Sulfate that can be administered in the case of Status Asthmaticus?

2 g Signup and view all the answers

What is the recommended initial dose of Epinephrine in the case of tachycardia with a wide QRS complex?

0.01 mg/kg IV/IO Signup and view all the answers

What is the minimum heart rate that indicates bradycardia in a child over 1 year of age?

Less than 60 bpm Signup and view all the answers

Which medication is recommended for a newborn or infant with sinus tachycardia?

Adenosine Signup and view all the answers

What is the recommended initial dose of Adenosine in the case of stable, narrow QRS tachycardia in a child over 1 year of age?

0.1 mg/kg IV Signup and view all the answers

What is the recommended initial dose of Albuterol in the case of acute asthma?

2.5 mg via nebulizer Signup and view all the answers

What is the recommended initial dose of Methylprednisolone in the case of acute asthma?

1 – 2 mg/kg IM Signup and view all the answers

Study Notes

Aeromedical Transport

Patients in cardiac arrest at the scene following blunt force trauma should not be transported via aeromedical transport
Aeromedical transport can be requested to respond to the scene when ALS personnel request it, or when BLS personnel request it and ALS is delayed or unavailable
If the most highly trained EMS provider on the scene determines that aeromedical transport is not needed, it should be cancelled ASAP

Medication Administration via MAD Nasal Device

Always deliver half of the medication dose up each nostril
Do not use more than 1 mL of medication per nostril
If a higher volume is required, apply it in two separate doses, allowing a few minutes for the initial amount to be absorbed
Make allowances for the 0.1 mL dead space in the MAD when calculating the volume to be administered

Intramuscular (IM) Medication Administration

IM injection is the most commonly used route of parenteral medication administration
The drug is injected into the muscle tissue, from which it is absorbed into the bloodstream
Do not give medication within 6 hours of prior administration

Patient Agitation

Call for law enforcement ASAP
Apply appropriate oxygen therapy
Take vital signs
Use vascular access with blood draw if possible and safe for the provider
Administer one of the following medications:
- Versed (Midazolam) 2-5mg IV/IM/IN/IO
- Ativan (Lorazepam) 1-2mg IV/IM/IN/IO
- Valium (Diazepam) 5mg IV/IM/IN/IO
- Ketamine 5mg/kg IM once, max dose 400mg
- Zyprexa 10mg IM (can be used in elderly and all adults)

Cardiac Arrest

PEA/Asystole:
- Recognize CPR and AED
- Check for DNR
- Perform 2-minute cycles of high-quality CPR
Bradycardia:
- ABC
- Apply appropriate oxygen therapy with pulse oximetry
- Vital signs
- If heart rate is less than 60 bpm and the patient's mental status and respiratory rate are decreased, ventilate with a BVM
- Start CPR if no movement with ventilations

Tachycardia

ABC
Apply appropriate oxygen therapy with pulse oximetry
Vital signs
UNSTABLE:
- Synchronized cardioversion at 0.5 – 1.0 J/kg; may repeat at 2 J/kg if unsuccessful
STABLE Wide QRS:
- Adenosine 0.1mg/kg IV; may repeat in 1 – 2 minutes at 0.2 mg/kg IV
STABLE Narrow QRS:
- Adenosine (Adenocard) 0.1 mg/kg IV; may repeat in 1 – 2 minutes at 0.2 mg/kg IV

Acute Asthma

ABC
Apply appropriate oxygen therapy with pulse oximetry
Vital signs
Determine if the patient has been given their own asthma medications
Assist with patient-prescribed metered dose inhaler
DuoNeb (Albuterol 2.5 mg + Atrovent 0.5 mg) via nebulizer once, may repeat Albuterol 2.5 mg once
Consult Medical Control Physician for Epinephrine 1:1000 dose 0.01 mg/kg SQ (0.5 mg max) if in severe distress

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Description

Test your knowledge on field termination protocols for EMR, EMT, and Advance Stop Paramedics. Learn about the criteria for considering termination, such as presenting rhythm, patient age, and family communication.

EMR / EMT / Advance Stop Paramedic Protocols Quiz