EMS Provider Responsibilities Quiz

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Questions and Answers

What is the maximum number of attempts allowed for intraosseous access?

Three attempts

One attempt

Four attempts

Two attempts (correct)

What must be assessed for patients prior to and after every move?

Nutritional requirements

Sleep patterns

Exercise routines

Comfort levels (correct)

What should be obtained if IV lines are not possible during a critical intervention?

Surgical intervention

Central venous access

Nasogastric tube

Intraosseous access (correct)

What must be verified for patients under 10 years of age?

Patient weight using Broslow Tape (A) Signup and view all the answers

What is the responsibility of the Critical Care Transport (CCT) team regarding patient information?

To maintain and respect patient privacy (B) Signup and view all the answers

What should be included in the Patient Care Report (PCR) after every transport?

Copies of all strips printed during care (A) Signup and view all the answers

Who must be contacted when transporting patients under the age of 16?

Medical Control (C) Signup and view all the answers

In addition to patient comfort, what should be assessed after every intervention?

Changes and trends in patient condition (D) Signup and view all the answers

What is the maximum number of doses for Ipratropium when given via nebulizer?

4 doses (C) Signup and view all the answers

Which of the following medications can be used in the management of severe asthma exacerbation?

Magnesium Sulfate (A) Signup and view all the answers

How often can Racemic Epinephrine be administered?

Every 20 minutes (C) Signup and view all the answers

What is the standard dose of Epinephrine for IM administration?

0.3 mg (C) Signup and view all the answers

What is the purpose of capnography monitoring during transport?

To verify airway placement (D) Signup and view all the answers

What is the recommended IV dose of Dexamethasone?

10 mg (D) Signup and view all the answers

Prior to connecting capnography equipment, what should be established?

A baseline wave form pattern (B) Signup and view all the answers

Which medication requires medical control for patients over 50 years of age?

Racemic Epinephrine (C) Signup and view all the answers

What is the duration of the probationary period after System certification is granted?

90 days (B) Signup and view all the answers

What happens if a provider completes fewer than ten transports during their probationary period?

Their probationary period is extended to 180 days. (A) Signup and view all the answers

What certification is required for Critical Care EMT-Paramedic?

CCEMTP (D) Signup and view all the answers

Which of the following is NOT listed as a required credential for Registered Nurses?

O2 Administration (A) Signup and view all the answers

Who reserves the right to deny System provider status?

The EMS Medical Director (B) Signup and view all the answers

Which of the following certifications is recognized for a Prehospital RN?

ENPC (C) Signup and view all the answers

What must all System providers successfully complete annually?

System protocol testing and skills evaluation (C) Signup and view all the answers

Which of the following is NOT a certification required for maintaining System Certification?

FCP (C) Signup and view all the answers

What is a common requirement for both Critical Care EMT-Paramedics and Registered Nurses?

Active membership in Memorial EMS System agency (D) Signup and view all the answers

Which training courses are required for EMT-Paramedics?

PHTLS and ACLS (B) Signup and view all the answers

What is a primary focus in the treatment of emphysema?

Ensuring full expiration after each inspiration (B) Signup and view all the answers

Which of the following conditions primarily affects the bronchi?

Chronic bronchitis (A) Signup and view all the answers

What is a significant assessment step for respiratory distress patients?

Assess the events leading up to their current status (A) Signup and view all the answers

What should the patient's position be during treatment if they can tolerate it?

Semi-Fowlers position or higher (A) Signup and view all the answers

Which device is recommended for administering oxygen when possible?

100% Oxygen via Non-Rebreather Mask (NRB) (B) Signup and view all the answers

What should be monitored to determine if an advanced airway is needed?

Changes in patient condition (A) Signup and view all the answers

Which of the following conditions are contraindications for i-Gel use?

Tracheostomy (B) Signup and view all the answers

What medication can be administered via nebulizer for respiratory patients?

Albuterol 2.5 mg in 3 mL (B) Signup and view all the answers

What is the first step in the i-Gel airway insertion procedure?

Don appropriate PPE (A) Signup and view all the answers

When should CPAP or BiPAP be initiated according to the guidelines?

When SBP is greater than 90 mmHg (A) Signup and view all the answers

How should the i-Gel's cuff be prepared before insertion?

Left dry (B) Signup and view all the answers

After inserting the i-Gel, how should one confirm its placement?

Using an ETCO2 detector or waveform capnography (C) Signup and view all the answers

What is the purpose of pre-oxygenating the patient with 100% oxygen?

To optimize oxygen saturation before intubation (A) Signup and view all the answers

What materials are needed to lubricate the i-Gel during its insertion?

Water-soluble jelly (C) Signup and view all the answers

During i-Gel insertion, the device should be directed towards which anatomical landmark?

The hard palate (C) Signup and view all the answers

Which monitoring device must continuously monitor the patient during i-Gel use?

Pulse oximetry (C) Signup and view all the answers

Study Notes

Provider Responsibilities

Successful completion of a 90-day probationary period is mandatory after System certification; if fewer than 10 transports are completed, the period extends to 180 days.
The EMS Medical Director can deny certification or impose further evaluation requirements on candidates.

Certification Requirements

Critical Care EMT-Paramedic (EMT-P)/Prehospital RN (PHRN)

Must have a current CPR card from AHA or ARC.
Complete courses in PHTLS, ITLS, TNCC, TNS, or BTLS.
ACLS certification required.
Additional coursework like CCEMTP, FP-C, CCP-C is necessary.
Active membership in the Memorial EMS System agency is needed.
Annual protocol testing and skills evaluation must be successfully completed.

Registered Nurse (RN)

Current CPR card from AHA or ARC is mandatory.
Training in PHTLS, ITLS, TNCC, TNS, or BTLS is required.
ACLS certification needed alongside PEPP, PALS, or ENPC.
Additional qualifications can include CCEMTP, CEN, CCRN, CFRN, or CTRN.
Active membership in Memorial EMS System agency is required.
Must complete annual protocol testing and skills evaluation.

Patient Care Guidelines

Patients at risk for hemodynamic instability should ideally have two large bore IV lines.
In the absence of IV access, intraosseous access should be established with a maximum of two attempts permitted.
Continuous monitoring of invasive lines for accuracy is essential.
Pain assessment and management must occur before and after each patient repositioning.
Assessment should include vital signs and comfort evaluations.

Specific Considerations for Children

Contact Medical Control for patients under 16 years.
Verify weight using Broslow Tape for patients under 10 years.
Assessment of temperature and blood glucose is critical.

CCT Team Responsibilities

Ensure family has an opportunity to see the patient before transport.
Provide destination information to the family.
Maintain patient privacy and respect confidentiality.
Complete and transfer all necessary documentation and reports during the transport process.

Respiratory Assessment

Focus on the event timeline leading to the patient’s current condition.
Compare with previous respiratory events and document associated symptoms.
Assess any compensation methods employed by the patient and their effectiveness.

Treatment Protocols

Position the patient in semi-Fowler’s or higher as tolerated.
Administer 100% oxygen via NRB; if intolerable, switch to cannula.
Secure advanced airway based on protocol and monitor closely for respiratory changes.
Administer Albuterol and Ipratropium as nebulized treatments with specified dosages.
Consider steroids like prednisone, methylprednisolone, or dexamethasone as needed.
Use racemic epinephrine for respiratory distress with specified dosage and repeat guidelines.

Capnography Monitoring

Essential for verifying advanced airway placement and assessing respiratory status.
Monitor according to quantitative (waveform) capnography standards during transport.
Establish baseline capnography data from the transferring facility if available.

i-Gel Airway Insertion Procedure

Employ appropriate PPE and pre-oxygenate the patient with 100% oxygen.
Select correct i-Gel size and check for damage before use.
Lubricate only designated parts of the i-Gel, avoiding the cuff's interior.
Insert the i-Gel carefully, ensuring correct placement verified through capnography and breath sound auscultation.
Continuous monitoring of vital signs and airway security is necessary.

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Description

This quiz covers the essential responsibilities of EMS providers as outlined in the Critical Care Manual by the Memorial EMS System. Participants will learn about the certification requirements and the importance of successful evaluations to meet the standards set by the Medical Director. Test your knowledge on the responsibilities and probationary periods necessary in the EMS field.