Podcast
Questions and Answers
What is the maximum number of attempts allowed for intraosseous access?
What is the maximum number of attempts allowed for intraosseous access?
What must be assessed for patients prior to and after every move?
What must be assessed for patients prior to and after every move?
What should be obtained if IV lines are not possible during a critical intervention?
What should be obtained if IV lines are not possible during a critical intervention?
What must be verified for patients under 10 years of age?
What must be verified for patients under 10 years of age?
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What is the responsibility of the Critical Care Transport (CCT) team regarding patient information?
What is the responsibility of the Critical Care Transport (CCT) team regarding patient information?
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What should be included in the Patient Care Report (PCR) after every transport?
What should be included in the Patient Care Report (PCR) after every transport?
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Who must be contacted when transporting patients under the age of 16?
Who must be contacted when transporting patients under the age of 16?
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In addition to patient comfort, what should be assessed after every intervention?
In addition to patient comfort, what should be assessed after every intervention?
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What is the maximum number of doses for Ipratropium when given via nebulizer?
What is the maximum number of doses for Ipratropium when given via nebulizer?
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Which of the following medications can be used in the management of severe asthma exacerbation?
Which of the following medications can be used in the management of severe asthma exacerbation?
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How often can Racemic Epinephrine be administered?
How often can Racemic Epinephrine be administered?
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What is the standard dose of Epinephrine for IM administration?
What is the standard dose of Epinephrine for IM administration?
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What is the purpose of capnography monitoring during transport?
What is the purpose of capnography monitoring during transport?
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What is the recommended IV dose of Dexamethasone?
What is the recommended IV dose of Dexamethasone?
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Prior to connecting capnography equipment, what should be established?
Prior to connecting capnography equipment, what should be established?
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Which medication requires medical control for patients over 50 years of age?
Which medication requires medical control for patients over 50 years of age?
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What is the duration of the probationary period after System certification is granted?
What is the duration of the probationary period after System certification is granted?
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What happens if a provider completes fewer than ten transports during their probationary period?
What happens if a provider completes fewer than ten transports during their probationary period?
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What certification is required for Critical Care EMT-Paramedic?
What certification is required for Critical Care EMT-Paramedic?
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Which of the following is NOT listed as a required credential for Registered Nurses?
Which of the following is NOT listed as a required credential for Registered Nurses?
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Who reserves the right to deny System provider status?
Who reserves the right to deny System provider status?
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Which of the following certifications is recognized for a Prehospital RN?
Which of the following certifications is recognized for a Prehospital RN?
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What must all System providers successfully complete annually?
What must all System providers successfully complete annually?
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Which of the following is NOT a certification required for maintaining System Certification?
Which of the following is NOT a certification required for maintaining System Certification?
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What is a common requirement for both Critical Care EMT-Paramedics and Registered Nurses?
What is a common requirement for both Critical Care EMT-Paramedics and Registered Nurses?
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Which training courses are required for EMT-Paramedics?
Which training courses are required for EMT-Paramedics?
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What is a primary focus in the treatment of emphysema?
What is a primary focus in the treatment of emphysema?
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Which of the following conditions primarily affects the bronchi?
Which of the following conditions primarily affects the bronchi?
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What is a significant assessment step for respiratory distress patients?
What is a significant assessment step for respiratory distress patients?
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What should the patient's position be during treatment if they can tolerate it?
What should the patient's position be during treatment if they can tolerate it?
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Which device is recommended for administering oxygen when possible?
Which device is recommended for administering oxygen when possible?
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What should be monitored to determine if an advanced airway is needed?
What should be monitored to determine if an advanced airway is needed?
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Which of the following conditions are contraindications for i-Gel use?
Which of the following conditions are contraindications for i-Gel use?
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What medication can be administered via nebulizer for respiratory patients?
What medication can be administered via nebulizer for respiratory patients?
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What is the first step in the i-Gel airway insertion procedure?
What is the first step in the i-Gel airway insertion procedure?
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When should CPAP or BiPAP be initiated according to the guidelines?
When should CPAP or BiPAP be initiated according to the guidelines?
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How should the i-Gel's cuff be prepared before insertion?
How should the i-Gel's cuff be prepared before insertion?
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After inserting the i-Gel, how should one confirm its placement?
After inserting the i-Gel, how should one confirm its placement?
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What is the purpose of pre-oxygenating the patient with 100% oxygen?
What is the purpose of pre-oxygenating the patient with 100% oxygen?
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What materials are needed to lubricate the i-Gel during its insertion?
What materials are needed to lubricate the i-Gel during its insertion?
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During i-Gel insertion, the device should be directed towards which anatomical landmark?
During i-Gel insertion, the device should be directed towards which anatomical landmark?
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Which monitoring device must continuously monitor the patient during i-Gel use?
Which monitoring device must continuously monitor the patient during i-Gel use?
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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.