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Questions and Answers

Your patient responds to your voice with incomprehensible murmurers. Using the AVPU scale, he is classified as responsive to?

verbal stimuli

Vitals signs have to be taken on-scene in every situation.

False

What does SAMPLE stand for?

Signs and symptoms, allergies, medications, past medical history, last meal, events leading to current state.

What forms of abuse are EMS providers mandated to report?

Child, Spouse, and Elder Abuse must be reported. Signup and view all the answers

A PCR/E-PCR has to be completed when no patient contact is made.

True Signup and view all the answers

What does HIPAA stand for?

Health Insurance Portability and Accountability Act of 1996. Signup and view all the answers

When reporting responsiveness, EMS providers should use _______________ to avoid less clear descriptors.

AVPU Signup and view all the answers

For a hypoglycemic patient, when is it appropriate to give oral glucose, juice, or non-diet soda?

If the patient is alert enough to sit unsupported and drink without assistance. Signup and view all the answers

When is aspirin contraindicated for an MI patient?

Recent GI bleed and known allergy. Signup and view all the answers

According to NYS BLS protocol, the administration of nitroglycerin for chest pain is indicated if the adult patient's BP is than _____mmHg.

120 Signup and view all the answers

According to NYS BLS protocol, a maximum of ____ total doses of nitroglycerin can be given without medical direction to adult chest pain patients.

3 Signup and view all the answers

When is it appropriate to actively rewarm frostbite in the field?

If the patient does not need to walk further and there will be a transport greater than 30 minutes. Signup and view all the answers

For a generalized hypothermia patient, pulse checks should last at least _____ before CPR is started.

30-45 seconds Signup and view all the answers

If severe hypothermia is present, defibrillation can be performed.

True Signup and view all the answers

You should suspect your patient has Epiglottitis if they have a high-grade fever, muffled voice, stridor, and drooling.

Epiglottitis (bacterial) Signup and view all the answers

You suspect your patient has croup (viral) if they have cold-like symptoms, a barky cough, and a low-grade fever.

Croup (viral) Signup and view all the answers

Ideally, a BVM used for emergency situations should:

Be self-inflating, have no pop-off valve, and have an anatomically shaped, clear mask. Signup and view all the answers

List signs of respiratory failure in children.

Increased respiratory effort with retractions, breathing less than 10 per minute, head bobbing, grunting, accessory muscle use, absent or shallow chest wall movement, limp muscle tone, altered mental status, slow or absent heart rate, poor skin perfusion. Signup and view all the answers

Signs of impending cardiac arrest in a pediatric patient are:

Altered mental status, bradycardia, and cyanosis. Signup and view all the answers

For a heat exhaustion patient, when is it appropriate to give fluids orally?

Conscious and not nauseated, able to drink without assistance. Signup and view all the answers

What position should a nauseated patient be transported in?

Left lateral recumbent. Signup and view all the answers

If your choking patient becomes unconscious, you should:

Begin CPR. Signup and view all the answers

Your pediatric patient choked on a small toy piece. What should be done?

Monitor closely and transport in the position of comfort with blow-by oxygen administration. Signup and view all the answers

For a patient who has ingested a poison, whom should you contact?

Medical Direction. Signup and view all the answers

Before an advanced airway is placed, during CPR the adult patient should be ventilated every - seconds to a rate of - breaths per minute.

5-6 seconds (10-12 bpm) Signup and view all the answers

After an advanced airway is placed, the adult patient should be ventilated every - seconds to a rate of _ - _ breaths per minute.

6-8 seconds (8-10 bpm) Signup and view all the answers

During rescue breathing, each breath should be given over:

1 second. Signup and view all the answers

The primary advantage of a nasopharyngeal airway is:

That it can be used in a patient who has an intact gag reflex. Signup and view all the answers

BVM's must have a volume of at least _____mL for newborns and infants.

500 (Child BVM) Signup and view all the answers

For infants and children, ventilations should be delivered every - seconds once an advanced airway is in place.

2-3 (20-30 breaths per minute) Signup and view all the answers

When an advanced airway is in place you should not pause compressions for ventilations.

True Signup and view all the answers

Which should occur first: turn on the AED or attach the AED patches?

Turn on the AED. Signup and view all the answers

For EMT's, a maximum of ___ defibrillations should occur before beginning transport.

3 Signup and view all the answers

If you are off duty at a local elementary school when a child collapses, what should you do with the available AED?

Ensure quality CPR and use the adult patches to assess for a shockable rhythm. Signup and view all the answers

The time goal for recognition of stroke symptoms until time of arrival at a stroke center is ____ hours.

3.5 Signup and view all the answers

Skin exposed to chemicals should be flushed for at least ____ minutes.

20 Signup and view all the answers

Burn patients with burns less than _____ % can be treated with moistened dressings for comfort.

10% (NYS protocol) Signup and view all the answers

An open fracture is:

Any open wound near a suspected bone injury. Signup and view all the answers

When can a limb be manually realigned?

Severe long bone fracture with deformity. Signup and view all the answers

When is extremity traction contraindicated?

Injury close to the knee, hip, or pelvis. Signup and view all the answers

Trauma Field Triage decisions are based on how many criteria?

3 criteria: injuries found, vitals, mechanism of injury. Signup and view all the answers

Adult trauma patients with respiratory rates less than or greater than should be transported to the trauma center.

10 or 29 Signup and view all the answers

Chemical burns to the eyes must be irrigated for a minimum of _____ minutes.

20 Signup and view all the answers

For eye injuries, you should bandage:

Both eyes to reduce sympathetic eye movement. Signup and view all the answers

If your patient is on a NRB at 12 lpm and the reservoir fully collapses with each breath, you should:

Increase the flow to 15 lpm. Signup and view all the answers

You can assume the patient is hypoperfusing with a BP less than 90mmHG if what clinical signs are present?

Loss of peripheral pulses and altered mental status. Signup and view all the answers

Ventilations should be provided if an infant's heart rate is less than ______bpm.

100 Signup and view all the answers

CPR should be started if an infant's heart rate is less than _____bpm.

60 Signup and view all the answers

If a newborn infant's respiratory rate is depressed and central cyanosis is present, you should:

Position and stimulate the baby, suction the mouth and nose as needed, and begin ventilations if there is no clinical improvement. Signup and view all the answers

When is it appropriate to insert a sterile gloved hand/fingers into the vagina during childbirth?

Breech birth that is not progressing and prolapsed umbilical cord. Signup and view all the answers

Nebulized albuterol is administered with an O2 flow rate of:

4-6 LPM. Signup and view all the answers

Your patient has a GCS of 14. What should be done when he refuses to go to the hospital despite serious injury?

Request police and contact medical direction. Signup and view all the answers

What should be done if your patient with hemophilia fell from a ladder and his wife is preparing to administer a clotting factor?

Allow her to proceed, and contact medical control if transport may be delayed. Signup and view all the answers

Hyperventilation causes a _ in CO2 levels which in turn causes the blood vessels of the brain to ___________.

Decrease, constrict. Signup and view all the answers

Excessive hyperventilation can lead to cerebral _________________.

Cerebral hypoxemia due to excessive cerebral vasoconstriction. Signup and view all the answers

A single episode of or __ significantly increases mortality due to head trauma.

Hypoxia, hypotension. Signup and view all the answers

Cushing's triad indicates:

Increased intracranial pressure. Signup and view all the answers

Cushing's triad consists of:

Increased systolic BP, decreased heart rate, and abnormal respirations. Signup and view all the answers

Colorimetric CO2 detectors turn ________ when CO2 is exhaled, confirming the ET tube is in the trachea.

Yellow. Signup and view all the answers

During CPR, your patient has an ETCO2 of 8. What should be done?

Assure high-quality CPR is being performed. Signup and view all the answers

During CPR, your patient's ETCO2 rapidly changes from 12 to 20mmHg. What should be assessed next?

Assess for return of spontaneous circulation (ROSC). Signup and view all the answers

Pediatric AED patches are designed for use on children ________ years of age.

1-8. Signup and view all the answers

For patients with potential tuberculosis, the most appropriate BSI includes:

Gloves and a #M sub-micron molded surgical mask. Signup and view all the answers

Potential infectious disease exposures must be reported to your agency's:

Infection Control Officer. Signup and view all the answers

Who can consent to or refuse medical care for themselves according to NYS policy?

Any person who is 18 years of age, or is pregnant or the parent of a child, or who is married. Signup and view all the answers

What is the Abandoned Infant Protection Act?

It grants immunity to anyone abandoning an infant (5 days old or less) at a safe place. Signup and view all the answers

How long does an EMS provider have to submit written documentation of suspected child abuse or neglect?

48 hours. Signup and view all the answers

Airborne disease protection requires the use of:

#M sub-micron molded surgical mask (Ex N95), and placing a surgical mask on the patient unless the patient is on O2 via mask. Signup and view all the answers

Droplet protection requires:

Disposable gown, gloves, goggles, and mask when within 6.5 feet of the patient. Signup and view all the answers

Common droplet spread infectious diseases include:

Measles, mumps, chickenpox, meningitis, tuberculosis, pneumonia, common cold, influenza. Signup and view all the answers

The antidote for nerve agents is:

Atropine first, then pralidoxime (2-PAM), this is the Mark I Kit. Signup and view all the answers

What PPE is required for nerve agents?

SCBA, goggles, gloves made of viton, nitrile, or neoprene, and protective coveralls or aprons. Signup and view all the answers

What does SLUDGEM stand for?

Salivation, lacrimation, urination, defecation, GI upset, emesis, miosis/muscle twitching/spasm. Signup and view all the answers

If severe signs and symptoms of nerve agent exposure are present, how many Mark I Kits should be administered?

3 in rapid succession. Signup and view all the answers

As children grow older their heart rate becomes _ and their BP .

Slower, increases. Signup and view all the answers

The blood pressure cuff should cover about ___________ of the patient's upper arm when properly sized.

Two thirds (2/3rds). Signup and view all the answers

When possible, suction should be limited to _________________ seconds.

<ol start="10"> <li></li> </ol> Signup and view all the answers

The microscopic sacs in the lungs where gas exchanges with the cells are called:

Alveoli. Signup and view all the answers

Study Notes

Patient Assessment and Response

AVPU scale classifies responsiveness as Alert, Verbal, Painful, or Unresponsive; incomprehensible murmurs indicate response to verbal stimuli.
Vital signs should be taken en route when immediate transport for high-priority patients is needed.

Assessment Acronyms and Protocols

SAMPLE acronym: Signs and Symptoms, Allergies, Medications, Past Medical History, Last Meal, Events leading to current state.
NYS EMS providers must report child, spouse, and elder abuse on the PCR/E-PCR and verbally during care transfer.

Documentation and Regulations

A PCR/E-PCR is required even if no patient contact is made, including stand-bys and cancellations.
HIPAA ensures protection of patient privacy regarding health information.

Medical Conditions and Interventions

Oral glucose can be given to hypoglycemic patients if they are alert and able to safely consume it.
Aspirin is contraindicated in MI patients with a recent GI bleed or known allergy.

Nitroglycerin Use

Administer nitroglycerin for chest pain if adult BP is above 120 mmHg; maximum of three doses allowed without medical direction.

Hypothermia and Frostbite Management

Active rewarming of frostbite is appropriate if transport exceeds 30 minutes and the patient is not advancing further.
Pulse checks in generalized hypothermia should last 30-45 seconds before CPR initiation.

Pediatric Considerations

Signs of respiratory failure in children include increased effort, altered mental status, and poor skin perfusion.
Find signs of impending cardiac arrest in pediatric patients: altered mental status and bradycardia.

Emergency Procedures

Nauseated patients should be transported laterally to prevent aspiration.
If a choking patient becomes unconscious, CPR must be initiated immediately.

Advanced Airway Management

During CPR, ventilations for adults should be given every 5-6 seconds (10-12 breaths per minute) before advanced airway placement.
A nasopharyngeal airway is advantageous for patients with an intact gag reflex.

Cardiac Arrest and Resuscitation

Pediatric AED patches are designed for children aged 1-8; adult patches may be used if pediatric ones are unavailable.
Turn on the AED before applying patches.

Infectious Disease Precautions

Report potential infectious disease exposures to the Infection Control Officer per agency protocols.
Airborne disease protection includes a sub-micron molded surgical mask (e.g., N95).

Chemical and Trauma Management

Chemical burns require at least 20 minutes of irrigation; eye injuries necessitate bandaging both eyes to reduce sympathetic movements.
Trauma field triage is based on injury findings, vital signs, and the mechanism of injury.

Neurological Emergencies

Recognizing stroke symptoms should occur within 3.5 hours of onset for treatment efficacy.
Cushing's triad indicates increased intracranial pressure, characterized by increased systolic BP, decreased heart rate, and abnormal respiration.

Nerve Agent Exposure

Nerve agents require Atropine and Pralidoxime (2-PAM) as an antidote, administered promptly if severe symptoms appear.
SLUDGEM mnemonic details the symptoms of nerve agent exposure: Salivation, Lacrimation, Urination, Defecation, GI upset, Emesis, Miosis/muscle twitching.

Pediatric Development and Vital Signs

As children grow, heart rates decrease while blood pressure increases.
Blood pressure cuffs should cover about two-thirds of the upper arm for accurate readings. Suctioning should be limited to 10 seconds to avoid complications.

General Knowledge

Alveoli are the microscopic sacs in the lungs responsible for gas exchange, essential for respiratory function.

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Questions and Answers

Your patient responds to your voice with incomprehensible murmurers. Using the AVPU scale, he is classified as responsive to?

Vitals signs have to be taken on-scene in every situation.

What does SAMPLE stand for?

What forms of abuse are EMS providers mandated to report?

A PCR/E-PCR has to be completed when no patient contact is made.

What does HIPAA stand for?

When reporting responsiveness, EMS providers should use _______________ to avoid less clear descriptors.

For a hypoglycemic patient, when is it appropriate to give oral glucose, juice, or non-diet soda?

When is aspirin contraindicated for an MI patient?

According to NYS BLS protocol, the administration of nitroglycerin for chest pain is indicated if the adult patient's BP is than _____mmHg.

According to NYS BLS protocol, a maximum of ____ total doses of nitroglycerin can be given without medical direction to adult chest pain patients.

When is it appropriate to actively rewarm frostbite in the field?

For a generalized hypothermia patient, pulse checks should last at least _____ before CPR is started.

If severe hypothermia is present, defibrillation can be performed.

You should suspect your patient has Epiglottitis if they have a high-grade fever, muffled voice, stridor, and drooling.

You suspect your patient has croup (viral) if they have cold-like symptoms, a barky cough, and a low-grade fever.

Ideally, a BVM used for emergency situations should:

List signs of respiratory failure in children.

Signs of impending cardiac arrest in a pediatric patient are:

For a heat exhaustion patient, when is it appropriate to give fluids orally?

What position should a nauseated patient be transported in?

If your choking patient becomes unconscious, you should:

Your pediatric patient choked on a small toy piece. What should be done?

For a patient who has ingested a poison, whom should you contact?

Before an advanced airway is placed, during CPR the adult patient should be ventilated every - seconds to a rate of - breaths per minute.

After an advanced airway is placed, the adult patient should be ventilated every - seconds to a rate of _____ - _____ breaths per minute.

During rescue breathing, each breath should be given over:

The primary advantage of a nasopharyngeal airway is:

BVM's must have a volume of at least _____mL for newborns and infants.

For infants and children, ventilations should be delivered every - seconds once an advanced airway is in place.

When an advanced airway is in place you should not pause compressions for ventilations.

Which should occur first: turn on the AED or attach the AED patches?

For EMT's, a maximum of ___ defibrillations should occur before beginning transport.

If you are off duty at a local elementary school when a child collapses, what should you do with the available AED?

The time goal for recognition of stroke symptoms until time of arrival at a stroke center is ____ hours.

Skin exposed to chemicals should be flushed for at least ____ minutes.

Burn patients with burns less than _____ % can be treated with moistened dressings for comfort.

An open fracture is:

When can a limb be manually realigned?

When is extremity traction contraindicated?

Trauma Field Triage decisions are based on how many criteria?

Adult trauma patients with respiratory rates less than ____ or greater than ____ should be transported to the trauma center.

Chemical burns to the eyes must be irrigated for a minimum of _____ minutes.

For eye injuries, you should bandage:

If your patient is on a NRB at 12 lpm and the reservoir fully collapses with each breath, you should:

You can assume the patient is hypoperfusing with a BP less than 90mmHG if what clinical signs are present?

Ventilations should be provided if an infant's heart rate is less than ______bpm.

CPR should be started if an infant's heart rate is less than _____bpm.

If a newborn infant's respiratory rate is depressed and central cyanosis is present, you should:

When is it appropriate to insert a sterile gloved hand/fingers into the vagina during childbirth?

Nebulized albuterol is administered with an O2 flow rate of:

Your patient has a GCS of 14. What should be done when he refuses to go to the hospital despite serious injury?

What should be done if your patient with hemophilia fell from a ladder and his wife is preparing to administer a clotting factor?

Hyperventilation causes a _____ in CO2 levels which in turn causes the blood vessels of the brain to _______________.

Excessive hyperventilation can lead to cerebral _________________.

A single episode of ______________________ or ________________________ significantly increases mortality due to head trauma.

Cushing's triad indicates:

Cushing's triad consists of:

Colorimetric CO2 detectors turn ________ when CO2 is exhaled, confirming the ET tube is in the trachea.

During CPR, your patient has an ETCO2 of 8. What should be done?

During CPR, your patient's ETCO2 rapidly changes from 12 to 20mmHg. What should be assessed next?

Pediatric AED patches are designed for use on children ________ years of age.

For patients with potential tuberculosis, the most appropriate BSI includes:

Potential infectious disease exposures must be reported to your agency's:

Who can consent to or refuse medical care for themselves according to NYS policy?

What is the Abandoned Infant Protection Act?

How long does an EMS provider have to submit written documentation of suspected child abuse or neglect?

Airborne disease protection requires the use of:

Droplet protection requires:

Common droplet spread infectious diseases include:

The antidote for nerve agents is:

What PPE is required for nerve agents?

What does SLUDGEM stand for?

If severe signs and symptoms of nerve agent exposure are present, how many Mark I Kits should be administered?

As children grow older their heart rate becomes ___________ and their BP __________.

The blood pressure cuff should cover about ___________ of the patient's upper arm when properly sized.

After an advanced airway is placed, the adult patient should be ventilated every - seconds to a rate of _ - _ breaths per minute.

Adult trauma patients with respiratory rates less than or greater than should be transported to the trauma center.

Hyperventilation causes a _ in CO2 levels which in turn causes the blood vessels of the brain to ___________.

A single episode of or __ significantly increases mortality due to head trauma.

As children grow older their heart rate becomes _ and their BP .