EMR / EMT / Advance Stop Paramedic Protocols Quiz
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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?

    <p>Haldol</p> Signup and view all the answers

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

    <p>4mg</p> Signup and view all the answers

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

    <p>Zyprexa</p> Signup and view all the answers

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

    <p>When BLS personnel request it, and ALS is delayed or unavailable</p> 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?

    <p>Cancel the aeromedical transport as soon as possible</p> Signup and view all the answers

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

    <p>They should never be transported via aeromedical transport</p> Signup and view all the answers

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

    <p>It ensures appropriate decision-making in complex situations</p> Signup and view all the answers

    When can ALS personnel request aeromedical transport to the scene?

    <p>Only when BLS personnel are unable to do so</p> Signup and view all the answers

    Under what conditions should field termination be considered?

    <p>If the presenting rhythm shows no response to interventions</p> Signup and view all the answers

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

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

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

    <p>Consult Medical Control for assistance</p> Signup and view all the answers

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

    <p>Recognize CPR and AED</p> Signup and view all the answers

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

    <p>To prepare for field termination</p> Signup and view all the answers

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

    <p>When resuscitation appears to be non-effective</p> Signup and view all the answers

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

    <p>Suctioning the nasal passage</p> Signup and view all the answers

    How much dead space is present in the MAD?

    <p>0.1 mL</p> Signup and view all the answers

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

    <p>1 mL</p> Signup and view all the answers

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

    <p>2 – 3 minutes</p> Signup and view all the answers

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

    <p>To prevent the patient from moving during administration</p> Signup and view all the answers

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

    <p>Intramuscular (IM)</p> 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?

    <p>Atropine</p> 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?

    <p>2 g</p> Signup and view all the answers

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

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

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

    <p>Less than 60 bpm</p> Signup and view all the answers

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

    <p>Adenosine</p> 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?

    <p>0.1 mg/kg IV</p> Signup and view all the answers

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

    <p>2.5 mg via nebulizer</p> Signup and view all the answers

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

    <p>1 – 2 mg/kg IM</p> 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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    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.

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