Podcast
Questions and Answers
AEMT and Paramedic are authorized to implement standing orders without contacting a Base Hospital
AEMT and Paramedic are authorized to implement standing orders without contacting a Base Hospital
True (A)
The EMT is authorized to administer epinephrine auto-injector assistance when on a transport from one medical facility to another
The EMT is authorized to administer epinephrine auto-injector assistance when on a transport from one medical facility to another
True (A)
Treatments in the protocols are listed according to the frequency of the condition
Treatments in the protocols are listed according to the frequency of the condition
False (B)
All treatments can be performed by the EMT, AEMT, and/or Paramedic via standing orders
All treatments can be performed by the EMT, AEMT, and/or Paramedic via standing orders
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A physician on scene can take over for a paramedic and follow these protocols when providing medical care
A physician on scene can take over for a paramedic and follow these protocols when providing medical care
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The protocols define treatment standards for all counties around San Diego
The protocols define treatment standards for all counties around San Diego
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A paramedic cannot administer a medication if the patient allergies are unknown
A paramedic cannot administer a medication if the patient allergies are unknown
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The date of the protocol is "7/1/2021"
The date of the protocol is "7/1/2021"
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Opioid-Dependent Pain Management Patients are individuals prescribed opioids for chronic pain management, specifically those with opioid infusion devices.
Opioid-Dependent Pain Management Patients are individuals prescribed opioids for chronic pain management, specifically those with opioid infusion devices.
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A Brief, Resolved, Unexplained Event (BRUE) is an episode in an infant under 12 months that involves a sudden, brief, yet resolved episode of color change or altered level of responsiveness.
A Brief, Resolved, Unexplained Event (BRUE) is an episode in an infant under 12 months that involves a sudden, brief, yet resolved episode of color change or altered level of responsiveness.
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The BE FAST acronym is used to assess possible Transient Ischemic Attack (TIA) or stroke patients and includes assessing for unilateral face droop, arm weakness, and speech difficulties.
The BE FAST acronym is used to assess possible Transient Ischemic Attack (TIA) or stroke patients and includes assessing for unilateral face droop, arm weakness, and speech difficulties.
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The Leadsd acronym refers to steps for assessing and documenting endotracheal intubation attempts, including checking for lung sounds, end-tidal CO2 detection, and abdominal sounds.
The Leadsd acronym refers to steps for assessing and documenting endotracheal intubation attempts, including checking for lung sounds, end-tidal CO2 detection, and abdominal sounds.
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Nebulizers are used to deliver oxygen to patients.
Nebulizers are used to deliver oxygen to patients.
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Opioids are drugs that have effects on opioid receptors, such as analgesia and somnolence, but not respiratory depression.
Opioids are drugs that have effects on opioid receptors, such as analgesia and somnolence, but not respiratory depression.
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The presence of an end-tidal CO2 detection device signifies an intubated patient needing definitive therapy.
The presence of an end-tidal CO2 detection device signifies an intubated patient needing definitive therapy.
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The acronym BE FAST does not include checking for abnormal pupils.
The acronym BE FAST does not include checking for abnormal pupils.
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Study Notes
Treatment Protocols
- Protocols define basic life support (BLS) and advanced life support (ALS) treatment and disposition standards for San Diego County.
- Treatments are listed sequentially for each condition.
- Refer to the Skills List (S-104) for skill criteria.
- Treatments by EMTs, AEMTs, and Paramedics are authorized by standing orders (SO), except in specific cases. Base Hospital orders (BHO) or Base Hospital Physician Orders (BHPO) are required in other situations.
- EMT skills, effective July 1, 2017, include finger-stick blood glucose tests, intranasal naloxone administration, and epinephrine auto-injector assistance, only when a provider is on-duty and in prehospital settings, including interfacility transports.
- Public safety personnel are authorized to administer intranasal naloxone, when appropriate.
- Mobile Intensive Care Nurses (MICNs) may relay Base Hospital Physician Orders (BHPOs).
- Abbreviations and definitions are in the Glossary of Terms (S-101) and Abbreviations List (S-102).
- Medications are administered per protocol unless contraindicated (e.g., allergies).
- Personal protective equipment (PPE) is required for all patient contacts per relevant guidelines.
- A different protocol might be applied based on changes in patient condition.
Glossary of Terms (Page 1, Protocol S-101)
- BE FAST: Prehospital Stroke Scale for assessment of possible transient ischemic attacks (TIAs) or stroke patients.
- Brief, Resolved, Unexplained Event (BRUE): Sudden, brief episodes (in infants under 12 months) involving breathing, colour changes, muscle tone, or responsiveness.
- Definitive Therapy: Immediate or anticipated need for fluid boluses or medications.
- End-Tidal CO2 (EtCO2) (quantitative capnography): Continuous monitoring of end-tidal carbon dioxide, mandatory for intubated patients.
Pediatric Patient (Page 2, Protocol S-101)
- Pediatric Patient: Children 14 years or younger.
- Neonate: Birth to 30 days.
- Infant: 1 month to 1 year.
- Perilaryngeal Airway Adjunct (PAA) Options: Esophageal-Tracheal Airway Device (ETAD) or Laryngeal-Tracheal (LT) airway.
Unstable Patient Criteria (Page 3, Protocol S-101)
- Age ≥15 years (known or apparent age) with SBP <90 mmHg and signs of inadequate perfusion.
- Age ≤14 years (known or apparent age) with signs of inadequate perfusion.
Abbreviations List (Page 4, Protocol S-102)
- A large list of commonly used abbreviations in EMS settings.
Inventory/Medication Lists and Charts/Skills List (Page 7, Protocol S-103)
- BLS Requirements: Includes Automated External Defibrillator (AED), ambulance cot, stretcher, straps, linens, personal protective equipment (PPE), airways, and splints.
- ALS Requirements: Includes additional equipment for ALS units, such as quantitative end-tidal CO2 monitors, endotracheal tubes, and laryngoscopes.
Treatment Protocol for Abdominal Discomfort (Page 42, Protocol S-120)
- Ensure a patent airway
- Administer 500 mL of fluid bolus for suspected volume depletion.
- Maintain SBP ≥80 if suspected AAA.
- For nausea/vomiting, administer ondansetron, as needed.
Treatment Protocol for Airway Obstruction (Page 43, Protocol S-121)
- BLS: Reassure, encourage coughing, and use airway maneuvers (AHA).
- ALS: Direct laryngoscopy and Magill forceps, as needed.
Treatment Protocol for Allergic Reaction/Anaphylaxis (Page 44, Protocol S-122)
- BLS: Ensure patient airway, monitor O2, safely remove allergen (if possible). Administer epinephrine 0.3 mg (IM) once, if prescribed by physician or if patient self-administers.
- ALS: Monitor/EKG, IV/IO, capillary refill rate, and SpO2. If respiratory involvement, add albuterol via nebulizer and ipratropium bromide, if available.
- Anaphylaxis with SBP <90 mmHg needs a 500-mL fluid bolus to maintain SBP >90 mmHg.
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Description
Test your knowledge on the medical protocols for EMTs and Paramedics established on July 1, 2021. This quiz covers standing orders, treatment standards, and specific conditions relevant to patient care. Understand the guidelines surrounding medication administration and special cases like opioid-dependent patients and BRUE events.
