Medic Proto Test

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FlyingSheep
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267077
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Medic Proto Test
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2014-03-19 08:45:48
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Medic Proto Test
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Medic Proto Test
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  1. List the 5 main items list in the "Protocols for All Patients" ( these were the items which are bold and underlined)
    Scene safe, BSI, assessment, treatment, and transport.
  2. List 5 things which are done under patient assessment in the “Protocols for All Patients”
    Initial assessment, identify priority patients, report triage, transport
  3. In the Written Communications portion of “Protocols for All Patients” what does the paramedic have an obligation to assure?
    All the information of the scene and pt is received; if the pt can only refuse transport if mentally competent; report all abuse.
  4. In “Protocols for All Patients” what is the difference between “Base” and “Non-Base” hospitals?
    Base hospitals contain medical control and are for emergencies, non-base for transports.
  5. List the key priorities in the “Protocols for ACS Patients”.
    Efficient scene times, transport, identification of ACS, 12 lead and contact with medical control
  6. List the medications which may be given to patients of suspected ACS and the dosages.
    • Aspirin 324mg chewed;
    • 0.4mg Sublingually every 5 minutes for a max of 3 doses; nitro drip at 10mcg/min
  7. For a patient with suspected ACS, list in order the steps for caring for this patient according to the “Protocols for ACS”
    Identify concerns, aspirin, 0xygen therapy, IV NS TKO, Nitro, morphine.
  8. What are the two variations of patients in “Protocols for Allergic Reactions”?
    Systemic/mild reaction and hypotensive/severe reaction
  9. List the medications given in the “Protocols for Allergic Reactions” and their dosages. What are the actions expected from each one. Are there any actions which require medical control before administration?
    • Albuterol 2.5mg/3cc NS via nebulizer;
    • diphenhydramine 50mg IV;
    • 0.3mg SQ epi 1:1,000 or 0.3mg slow IVP at 1:10,000; fluids;
    • SoluMedrol by direct order
  10. What are the specific considerations listed under “Allergic Reactions” to take note of?
    Bug bites/stings remove stinger if possible and wash wound; for snake bites don't elevate wound, no ice or constriction, and wash well the wound.
  11. For “Protocols for Behavioral Emergencies” what will the history of these patient to include?
    Obtain history (history of suicidal ideation, drugs, crisis events); assess for suicidal behaviors; treat any medical problems; use law enforcement if needed.
  12. In “Protocols for Behavioral Emergencies” how will a patient with suicidal behavior be managed?
    Never leave patient alone/unattended, remove any potential weapon from patient and/or surroundings, obtain history specifically concerning hallucinations/delusions, determine if the patient may be a harm to self and others.
  13. In “Protocols for Abnormal Blood Glucose”, list 6 reasons a patient may refuse transport.
    • No disease aside from hypoglycemia. 
    • No other complaint/symptom
    • Glucose corrected to above 80
    • Responsible adult is present to monitor
    • No medication error/dosing contributed to hypoglycemia
    • Patient is eating
    • Patient's insulin dose has not changed in the previous 10 days
  14. List the medications, their dosages and routes of administration given in “Abnormal Blood Glucose” protocols.
    • Glucose 30g PO,
    • thiamine 100mg IM/IV,
    • D50 at 50g IV,
    • glucagon 1mg IM
  15. List the management for a person with a blood glucose over 200 mg/dL
    Fluids (20cc/kg NS) for hypotension; oxygen if needed; cardiac monitoring
  16. List the circumstances when resuscitation would be withheld in the “Cardiac Arrest” protocols.
    Prolonged arrest as evidenced by lividity, rigor mortis, tissue decomposition, generalized body cooling.
  17. List the circumstances for termination of a trauma code in “Cardiac Arrest” Protocols.
    Contact with medical control.
  18. List the medications, routes and dosages, and indications for these medications in the “Cardiac Arrest” Protocols.
    • 1mg of 1:10,000 Epi via IVP every 3-5 minutes, vasopressor
    • Vasopressin single dose 40 units IVP, vasopressor
    • Amiodarone 300mg IVP first dose with 150mg repeated doses every 3-5 minutes,antiarrythmics
    • Lidocaine 1.5 mg/kg IVP use in place of amio every 3-5 minutes, antiarrythmics
    • Mag Sulfate 2g IV, muscle relaxer
    • Sodium bicarbonate 1mEq/kg IV, treat acidosis
    • Amiodarone 150mg infusion in 100cc D5W over 10 minutes, antiarrythmics
    • Atropine 1mg IV for a max of 3mg, positive chronotrope
    • Dopamine 5-20mcg/kg/min, positive chronotrope/inotrope
    • Calcium Chloride 1mg IV slow, calcium supplement
  19. List the three primary elements of stroke assessment as given in the protocols for “CVA/TIA”
    Smile - Facial droop, Speech - slurred speech, Extended arms - motor coordination
  20. List specifics managementsfor patients with suspected stroke or TI
    • Place in aposition of comfort,
    • no elevated head past 30 degree
    • 18g IV NS TKO with blood specimen, second saline lock AC for CT
    • Manage glucose via medical control
    • Oxygen
  21. In the “Protocols for Dysrythmias”, list the medications, routes and dosages, and the indications for these medications.
    • Midazolam 2-5mg IV, sedation
    • Morphine 2-10 mg IV with 2mg increments, pain control
    • Fentanyl 1-2 mcg/kg first, 0.25 mcg/kg for repeated doses up to 3.0 mcg/kg max, pain control
    • Atropine 0.5-1mg IVP, positive chronotrope
    • Dopamine 5-20 mcg/kg/min IV titration, positive chronotrope
    • Adenosine 6mg RIVP repeated at 12mg twice
    • Amiodarone 150mg infusion in 100cc D5W
    • Diltiazem 20mg IV over 2 min
  22. List the management specific for hypothermic cardiac arrest as given in the “Protocols for Heat/Cold Emergencies”
    Make one defibrillation attempt.
  23. List the medications, routes and dosages and indications used in the “Protocols for Hypertensive Emergencies” When should these drugs be given by the paramedic?
    • Nitro 0.4 mg SL and/or infusion, vasodilator
    • Labetol 20 mg IV over 1-2 minutes, repeat or increase via medical control
    • Furosemide via medical control
  24. List the management specific to “Drowning/Near Drowning Emergencies” protocol.
    • Assess patient
    • Gather history
    • Establish line
    • Provide oxygen
    • External rewarming as indicated
    • Treat dysrhythmias
    • Transport,
    • Alert team
  25. List the medications, routes and dosages, and indications given or the obstetrical patient in the “Obstetrics” Protocol.
    • Magnesium Sulfate 1-4g IV slowly over 20 minutes, muscle relaxer
    • Oxytocin 10 units IM, 20 units/10000cc NS
    • Morphine 2mg increments maxed 10mg IV, promotes uterine contraction
    • Toradol 15-30mg IV or 30-60mg IM,
    • Fentanyl 1-mcg/kg initial 0.25mcg/kg per 5-10min max 3mcg/kg IV, pain control
  26. Give the monitoring and assessment for a patient who is being given pain medications.
    • Frequently assess level of pain
    • Monitor vitals
    • Treat nausea
  27. List the medications, dosages and routes of administration and indications for pain medications in the “Pain Management” protocol.
    • Morphine 2-10 mg IV with 2mg increments, pain control
    • Toradol 15-30mg IV or 30-60mg IM, pain control
    • Fentanyl 1-mcg/kg initial 0.25mcg/kg per 5-10min max 3mcg/kg IV, pain control
  28. In the protocol for “Poisoning” list the medications, dosages and routes of administration and indications.
    • Morphine 2mg increments maxed 10mg IV, pain control
    • Toradol 15-30mg IV or 30-60mg IM,
    • Fentanyl 1-mcg/kg initial 0.25mcg/kg per 5-10min max 3mcg/kg IV, pain control
  29. List the medications which may be used according to the “Respiratory” protocols. Give the routes of administration and dosages. Which drugs require medical control contact before administration?
    • Albuterol 2.5mg in 3cc NS Nebulized
    • DuoNeb 05.mg/3mg in 3cc NS Nebulized
    • Epi 0.3mg SQ with medical control contact
    • SoluMedrol, only with direct medical control order
    • Nitro 0.4mg SL and/or Infusion
    • Flurosemide, only with direct medical control order, diuretic
    • Morphine, only with direct medical control order
  30. Which respiratory conditions will use CPAP? In which conditions is CPAP contraindicated?
    • Indicated: COPD, Pulmonary Edema,
    • Contraindicated: Asthma (without medical control order), tension pneumothorax
  31. List the indications for the use of restraints.
    When necessary to protect patient, responders, and/or bystanders
  32. List the types of restraints which may be utilized.
    Verbal, physical, chemical
  33. List the medications which may be given under the “Restraint” protocol and include the dosage and routes as well as indications.
    • Midazolam 1.5-5mg IV, sedation
    • Haloperidol 5mg IM,
  34. In the protocols for “Seizures” list the medications, dosages and routes.
    • Diazepam 5mg IV initial
    • Midazolam 5mg IM or 2.5mg IV
  35. List other important assessment and management considerations for patients who are or have experienced a seizure.
    • Ensure patent airway
    • Remove potential objects that may harm patient
  36. What are the types of shock covered under the “Shock” protocols?
    Anaphylactic, cardiogenic, hypovolemic, and neurogenic/septic shock
  37. What is the fluid management for patients experiencing a shock state? Is there an exception to this formula?
    • NS, 20cc/kg Pulmonary edema is an exception.
    • Neurogenic/septic shock as ordered by medical control
  38. List the medications, dosages and routes of administration used for shock states. What are the specific indications for the use of these medications?
    • Anaphylactic Shock
    • Albuterol 2.5mg/3cc NS via nebulizer;
    • diphenhydramine 50mg IV;
    • Epi 0.3mg SQ 1:1,000 or 0.3mg slow IVP at 1:10,000;
    • fluids;
    • SoluMedrol by direct order
    • Cardiogenic shock
    • Fluids 20cc/kg NS (No evidence of pulmonary edema)
    • Dopamine 5-20mcg/kg/min IV, treat hypotension
    • Septic Shock
    • Dopamine 5-20mcg/kg/min IV, treat hypotension
  39. List the indications for spinal precautions as given in the “Trauma” Protocol.
    AMS, intoxication, injury, neurologic deficit, spinal pain/tenderness
  40. List any specific management for the following trauma situations as listed in the “Trauma” protocols. Burn:
    • Stop burning
    • Monitor respiratory
    • Physical assessment
    • Remove constricting items
    • IV fluids
    • Pain management
  41. List any specific management for the following trauma situations as listed in the “Trauma” protocols. Chest Trauma:
    • Stabilize fractures or flail with bulky dressings
    • Seal open chest wounds - watch for tension pneumo
  42. List any specific management for the following trauma situations as listed in the “Trauma” protocols. Abdominal Trauma:
    • Stabilize, stop bleeding
    • Assess fetal movement, vaginal bleeding, contractions in pregnant patients
  43. List any specific management for the following trauma situations as listed in the “Trauma” protocols. Head Trauma:
    • Elevate head 30 degree with maintaining C-spine
    • Contact medical control prior to intubation to consider sedation
    • Hyperventilate if signs of brainstem herniation or increased ICP with AMS
    • Treat seizure
  44. List any specific management for the following trauma situations as listed in the “Trauma” protocols. Soft Tissue/orthopedic:
    • Control hemmorrhage (direct pressure, elevation, pressure dressing, tourniquet)
    • Cold packs
    • Morphine and Toradol for pain management via direct medical control
  45. List the medications, dosages and routes and the indications when caring for a pediatric allergic reaction.
    • 0.01mg/kg epi every 15-20 mins as needed
    • Diluted in 10cc NS and IV infused over 5-10 mins hemodynamically unstable patients
    • Benadryl 2mg/kg IV
    • Solumedrol 2mg/kg IV
  46. List any specific assessment components given for pediatric patients.
    Normal assessment with all patients of all ages, parents/caretakers may be needed exclusively for history, major difference is that medical control is advised for life threatening concerns.
  47. Summarize how a pediatric patient with circulatory collapse is managed according to the pediatric protocols.
    Manage airway, IV NS 20cc/kg, MAST, administer any medication by medical control orders
  48. List the specific management considerations for a pediatric head injury patient.
    Patent airway, Cspine, IV, elevate head of bed (no Cspine), hyperventilate (20-25), treat seizure
  49. List specific management considerations for a pediatric respiratory distress patient.
    Secure patent airway - oxygenate/ventilate as needed, treat respiratory disease/allergies, monitor rhythm

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