Paramedic and EMT Protocols Quiz 2021

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.