Protocol - EMS

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Questions and Answers

Which of the following documents is NOT acceptable as a DNR order?

Oral DNR Order from EMS System Medical Consultation

Out-of-state EMS/DNR Form

EMS/DNR Bracelet

Advanced directives without a MOLST or DNR Order (correct)

How can an EMS/DNR Order be revoked?

By notifying a government agency

By obtaining consent from an authorized decision-maker

By rewriting the original order

By physical cancellation or destruction of order devices (correct)

What must EMS clinicians do upon receiving a verbal revocation of a DNR Order from the patient?

Immediately resuscitate the patient

Inform a Base Station

Document the revocation thoroughly (correct)

Ignore the revocation if no device is destroyed

What is the primary criterion for not initiating resuscitative measures?

Presence of a MOLST form or acceptable EMS/DNR Order Signup and view all the answers

Who has the authority to revoke an EMS/DNR Order verbally?

The patient only Signup and view all the answers

Which of the following statements about the EMS clinician's role in DNR Orders is true?

They must consult a Base Station for any confusion regarding DNR Orders. Signup and view all the answers

Which criterion allows EMS clinicians to pronounce death in the field?

Decapitation Signup and view all the answers

What action should be taken if a patient is unresponsive and there is no visible DNR order?

Assume the patient wants resuscitation Signup and view all the answers

What is required for an EMS clinician to honor a DNR request from an authorized decision-maker?

Void or refuse all DNR devices Signup and view all the answers

What should be done before formally pronouncing death of a pulseless, apneic patient in a multi-casualty incident?

Confirmation of asystole by ALS Signup and view all the answers

What is the first action that BLS must take to confirm death?

Confirm the patient is unresponsive, pulseless, and apneic Signup and view all the answers

What must be documented after the pronouncement of death?

Exact time and location of the pronouncement Signup and view all the answers

Which of the following is NOT a valid criterion for pronouncement of death in the field?

Chest movement Signup and view all the answers

In the case of an obviously pregnant female patient, what should be done prior to any pronouncement of death?

Initiate resuscitation and transport to a facility Signup and view all the answers

Which situation allows for EMS clinicians to terminate resuscitation efforts?

An injury is incompatible with life Signup and view all the answers

What is an important responsibility of EMS following a pronouncement of death?

Notify law enforcement and follow local policies Signup and view all the answers

What is the correct administration method for epinephrine in infants under 5 years of age with mild symptoms?

0.15 mg IM in the lateral thigh Signup and view all the answers

Which of the following symptoms indicate a severe allergic reaction?

Pharyngeal swelling and stridor Signup and view all the answers

What is the maximum number of times albuterol can be administered for wheezing within a 30-minute period?

Twice Signup and view all the answers

In which situation is intravenous administration of epinephrine acceptable?

For an epinephrine infusion during cardiac arrest Signup and view all the answers

What is the appropriate dose of epinephrine for a 6-year-old child experiencing moderate symptoms?

0.3 mg IM in the lateral thigh Signup and view all the answers

What concentration of epinephrine is appropriate for the intramuscular route in adults?

1 mg/mL Signup and view all the answers

What can be administered as a rescue inhaler for moderate allergic symptoms in children?

Albuterol nebulizer Signup and view all the answers

Which of the following symptoms is associated with the diagnosis of anaphylaxis?

Stridor Signup and view all the answers

For pediatric patients younger than 5 years, what is the appropriate dose of epinephrine administered intramuscularly?

0.15 mg Signup and view all the answers

What is incorrect regarding the administration of epinephrine for less than 5 years old?

IV administration is appropriate for all ages Signup and view all the answers

Which of the following is a sign of mild allergic symptoms?

Localized swelling Signup and view all the answers

What should be done if blood pressure goals are not met at an epinephrine infusion rate of 2 mL/min?

Obtain medical consultation Signup and view all the answers

How long can albuterol be repeated after the initial dose for moderate symptoms?

Within 30 minutes Signup and view all the answers

Which route should epinephrine never be administered via, except in specific emergencies?

Intravenous Signup and view all the answers

What is the correct initial action for managing a patient experiencing nausea?

Place the patient in a position of comfort. Signup and view all the answers

What is the appropriate dose of epinephrine for patients aged 5 years or older if using an auto-injector?

0.3 mg Signup and view all the answers

Which of these options is a possible symptom of gastrointestinal compromise in anaphylaxis?

Persistent nausea Signup and view all the answers

Which of the following is NOT an indication for nausea/vomiting management?

Skin irritation Signup and view all the answers

What rating scale is used to measure a patient's pain level?

0 to 10 scale Signup and view all the answers

Which position should a patient be placed in if experiencing nausea?

Left lateral position Signup and view all the answers

For mild to moderate pain, what is the pain rating range according to the scale?

1-5 Signup and view all the answers

What is a common method to help manage nausea besides medication?

Allowing inhalation of isopropyl alcohol vapors. Signup and view all the answers

Which patient group is explicitly mentioned as needing analgesics?

DNR/MOLST patients Signup and view all the answers

In which scenario would you NOT administer analgesics?

When a patient is completely asymptomatic Signup and view all the answers

Study Notes

Pronouncement of Death in the Field

EMS clinicians can pronounce death when criteria such as decapitation, rigor mortis, decomposition, or dependent lividity are observed.
Pulseless and apneic patients in multi-casualty incidents can be pronounced dead to allocate resources.
Asystole must be confirmed by ALS before formal death pronouncement; exceptions include obviously pregnant females who require resuscitation.
Document the time and location of the pronouncement, and notify law enforcement per local policies.
Acceptable DNR (Do Not Resuscitate) orders must be verified before withholding resuscitation.

EMS DNR/MOLST

In cases with acceptable DNR orders present, no resuscitation measures shall be initiated if the patient is in cardiac or respiratory arrest.
Advanced directives without a MOLST or formal DNR order are not honored without EMS Medical Consultation.
Revocation of a DNR order can occur through physical destruction of DNR devices or a verbal request from the patient, documented by EMS professionals.

Allergic Reaction – Pediatric

Symptoms range from mild localized swelling to severe respiratory distress and loss of peripheral pulses.
BLS guidelines for mild symptoms in patients under 5 years include administering a pediatric epinephrine auto-injector (0.15 mg IM).
For patients aged 5 and older, the dose is increased to 0.3 mg IM.
Moderate symptoms require the same initial treatment, with potential use of albuterol for wheezing.

Anaphylaxis – Pediatric

Acute severe allergic reactions can manifest as urticaria, respiratory compromise, hypotension, and GI symptoms.
Administer epinephrine based on age; under 5 years receive 0.15 mg IM; 5 years and older receive 0.3 mg IM.
Albuterol may be used for wheezing or bronchospasm.

Nausea/Vomiting – Pediatric

Indications for treatment include nausea, vomiting, and medication side effects.
Position patient comfortably and consider spinal motion restriction if necessary.
Inhale vapors from isopropyl alcohol wipes can help manage symptoms.

Pain Management – Adult

Analgesic treatment is appropriate for patients with moderate to severe pain.
Pain severity is rated on a scale from 1 to 10, where 1 is mild discomfort and 10 is extreme pain.
Communication of pain levels can also be done using the FACES scale for patients who find it difficult to articulate their condition.

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Description

This quiz explores the protocols and policies related to pronouncing death in the field by EMS clinicians. It covers criteria for declaring death, the handling of DNR orders, and the responsibilities of the EMS team in such situations. Test your knowledge on these crucial guidelines and ensure you are well-informed.