Questions and Answers
What size gauge/needle should be used for needle cricothyrotomy?
What is an absolute contraindication for needle cricothyrotomy?
Transection of the distal trachea.
What happens if patient transfer of care and patient offloading from the ambulance gurney exceeds 25 minutes?
It is documented and tracked as APOD (ambulance patient offload delay).
What criteria must be met for APOD unusual event procedures for immediate offloading?
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When is vascular access clinically indicated?
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What are the guidelines on what not to do in 8010 IFT?
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Who receives (0.1 mg/ml), 0.005 mg/kg IV/IO every 10 minutes for persistent hypotension?
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What are the requirements for a physician on scene to take over the call?
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What is required information for reporting child abuse/neglect?
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What must be checked for determining death in EMS?
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What is required for trauma age and co-morbid factors?
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What characterizes major burn classifications in adults?
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What does the rule of nines entail for adults?
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What is a key component of critical trauma patient transport decision?
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Study Notes
Needle Cricothyrotomy
- Needle gauge for cricothyrotomy: 10-16.
- Procedure contraindications include transection of the distal trachea.
- Essential monitoring includes EtCO2, waveform capnography, and pulse oximetry.
Patient Transfer and Offloading
- If patient offloading exceeds 25 minutes, it is labeled as APOD (ambulance patient offload delay).
- Immediate offloading criteria for APOD: stable vital signs, alert and oriented status, no ALS interventions, and not under WIC 5150 hold.
Vascular Access Criteria
- Clinically indicated for IV medication or fluid resuscitation.
- If patient condition risks worsening, vascular access is required.
- ECG monitoring must be discontinued if not clinically indicated before removing the patient.
Interfacility Transport (IFT) Guidelines
- EMT-Ps cannot transport patients with non-EMT-P scope IV drips or blood products.
- Allowed to monitor peripheral lines of fluids and administer specific medications (e.g., Lidocaine, Dopamine).
Newborn Care Protocols
- Newborns receive specific dosages for persistent hypotension (0.1 mg/ml) every 10 minutes.
- Epinephrine (0.1 mg/ml) for newborns with heart rates less than 60 after initial assessment.
Physician on Scene Protocol
- Physician must notify base hospital and provide identification.
- Must agree to take full responsibility and accompany the patient to the receiving facility.
EMT-P Responsibilities
- Notify base hospital regarding physician takeover of patient care.
- Maintain control of drugs and equipment; document on EPCR.
Child Abuse/Neglect Reporting
- Required information includes the reporting person’s name, child’s name, present location, nature of abuse, and incident location.
Organ Donation Protocol
- Unconscious adult patients may have their belongings checked for donor status indicators.
- No searches allowed after patient death.
Care of Minors
- EMS must contact base hospital for minors under nine whose guardians refuse care and for those not requiring transport.
Assess and Refer Criteria
- Requires presence of a parent/guardian if under 18, GCS of 15, and absence of clinical distress or substance impairment.
Determination of Death
- Criteria include pulseless/apneic state combined with conditions like decomposition, rigor mortis, significant trauma, or evisceration.
Major Burn Classification (Adults)
- Serious burns defined as >20% TBSA, >5% full thickness, high voltage burns, and significant burns to sensitive areas.
Rule of Nines for Burns
- Adult: Head 9%, each arm 9%, torso front/back 18%, genitalia 1%, each leg 18%.
- Pediatric: Head 18%, each arm 9%, torso front/back 18%, each leg 14%.
Trauma Transport Decisions
- Transport to Level I or II trauma centers based on injury mechanisms (e.g., high-speed accidents, ejection from vehicles) and patient stability.
Trauma Age and Co-Morbid Factors
- Risks increase for patients over 65 and those on anticoagulants.
- Special considerations for children regarding trauma center transport.
Penetrating Trauma Arrest
- Criteria for death determination in penetrating trauma: Asystole in two leads with no pulse.
Trauma Treatment Protocols
- Airway management and IV fluid resuscitation tailored to patient stability and injury type.
- Specifics for blunt versus penetrating trauma treatment approaches.
Hypothermia Management
- Key interventions include warmth, IV fluids, and monitoring. Heat packs used for effective warming strategies.
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Description
Test your knowledge on the ICEMA Protocol with these flashcards. This quiz covers essential procedures like needle cricothyrotomy, including the proper gauge and contraindications. Perfect for healthcare professionals looking to refresh their skills!
