McHENRY WESTERN LAKE COUNTY EMS SYSTEM
ALS PROTOCOL EXAM 2016 (ECRN Version)
Please Submit Your Answers on the Answer Sheet Provided
1. When EMS is bringing a patient to the ED, what is an EMS “time-out”?
a.
b.
c.
d.
When the ambulance will be out of service while writing the report
The time allowed for an uninterrupted handover report
The amount of time allowed for the EMS provider to write their report
When a member of the crew has misbehaved and has to stand in the corner
2. You receive a report for a patient having a severe allergic reaction. Assessment
reveals severe swelling of the face and mouth, absent lung sounds; the patient is
gasping for air. BP 70/palp. The crew is administering oxygen via BVM and
attempting vascular access, What is the most urgent intervention indicated at this
time?
a.
b.
c.
d.
Epinephrine (1 mg/1mL) 0.5 mg IM
Diphenhydramine 50 mg IM
Albuterol 2.5 mg via HHN
Magnesium sulfate 2 g IVPB
3. Is the treatment indicated in Question # 2 within the scope of practice for the
EMTB?
a. Yes
b. Yes, but only if a paramedic is present
c. No this a paramedic skill only
4. You receive report on an adult patient, with a history of asthma. He is experiencing
severe shortness of breath, audible wheezing and speaking in one word sentences.
The crew reports that they have already administered Epinephrine (1mg/1mL) 0.3
mg IM. They are enroute with a 8 minute ETA. What should the next action should
be to:
a.
b.
c.
d.
Administer a second dose of Epi (1mg/1ml) 0.5 mg IV/IO
Administer Mag Sulfate- 2gm IVPB over 5-10 minutes
Start a nebulizer of Albuterol 2.5 mg and Ipratropium 0.5 mg
Place King tube immediately
5. EMS is on the scene with a 55 y/o male that is complaining of dizziness, and
headache. Vitals: B/P 240/140, P 128, Resp. 28, PaO2 96%, EtCO2 31 mm/Hg, L/S
Rales bilaterally. The BEFAST assessment found no changes in status. They have
determined the patient should receive Nitroglycerin, and are consulting with OLMC
for the correct dosing. What is the Nitroglycerin dose?
a.
b.
c.
d.
Nitroglycerin is contraindicated
Nitroglycerin 0.4 mg [BLS] X 1
Nitroglycerin 0.4 mg [BLS] X 3
Nitroglycerin 0.4 mg [BLS] unlimited
6. Your receive report from EMS for an LVAD patient who appears to have an issue
with the LVAD device. What can be done in the field?
a. With their contact to OLMC, you will contact the BIOMED to respond to the ED
STAT
b. Instruct the crew to change the battery pack
c. Instruct the crew to call LVAD Coordinator listed on patient information sheet for
instructions
d. Arrange for FFL to the scene for Aeromedical transport; as they are trained to
deal with an LVAD
7. EMS provides a report for a 52-year old patient demonstrating a sinus bradycardia,
rate of 40, BP 60/38. Patient is complaining of light headedness and weakness;
mentation is now is altered. You administer Atropine 0.5 mg – HR is now 72,
however BP is unchanged, IV fluid bolus given. Your next treatment should be:
a.
b.
c.
d.
Initiate transcutaneous external cardiac pacing
Administer Atropine 1 mg IVP
Initiate a Dopamine drip at 5mcg/kg/min
Cardiovert the patient at 100J
8. Which of the following components is NOT part of the pre-hospital stroke
assessment?
a.
b.
c.
d.
Cranial nerves
Limbs
Medications
Mental status
9. An ETCO2 value of less than ______ in 2 consecutive readings and qSOFA criteria
are met; can be an indicator of septic shock.
a.
b.
c.
d.
10
15
20
25
10. QuickSOFA criteria includes all of the following EXCEPT:
a.
b.
c.
d.
Respiratory rate of 22 or greater
Altered mentation
SBP of 100 mm/Hg or less
Pedal edema
11. What are the three levels of patient acuity as defined for Region IX EMS ?
a.
b.
c.
d.
Level 1, Level 2, Level 3
Low, Medium, High
Emergent, Critical, Lower Acuity
Red, Yellow, Green
12. Which of the following protective athletic equipment should be removed by EMS
providers, prior to transport to the hospital with the appropriate support crew ?
a.
b.
c.
d.
Football helmets and shoulder pads
Hockey helmets and shoulder pads
Lacrosse helmets and shoulder pads
All of the above
13. Full-face motorcycle helmets should be removed because:
a.
b.
c.
d.
Helmets can increase neck flexion when patient is on a backboard
The front of the helmet puts pressure on the patient’s chest
Airway cannot be observed with full face in place
a and c are correct
14. A patient with a fractured femur is experiencing severe pain (10/10). After
administering fentanyl, pain unchanged (10/10). Upon assessment, EMS reports
the patient is experiencing muscle spasms to the leg. BP 130/80. Your orders for
the patient should include:
a.
b.
c.
d.
Versed 2 mg increments slow IVP q. 2 min
Repeat Fentanyl once in 5 min: 0.5 mcg/kg (max 50 mcg) to a total of 1.5 mcg/kg
Nitroglycerin 0.04 mg SL
Aspirin 324 mg SL
15. According to Peds Initial Medical Care Protocol, non-pharmacologic pain
management may include:
a.
b.
c.
d.
Distraction
Parental presence
Cold packs
All of the above
16. The treatment of choice for a 2 y/o pediatric patient who demonstrates severe
respiratory distress with stridor and seal bark cough, suspected croup would be:
a.
b.
c.
d.
Albuterol 2.5mg via HHN
Ipatropium 0.5 mg via HHN
Epinephrine 3.0 mg via HHN
Duo Neb (Albuterol / Ipatropium) continuous throughout the transport
17. A peri-viable birth is from what week(s) of gestation?
a.
b.
c.
d.
38-40 weeks
30-32 weeks
20-26 weeks
<18 weeks
18. Acrocyanosis is the blue discoloration of the distal extremities, in a newborn, and is
a common finding.
a. True
b. False
19. You receive an abbreviated report from EMS for a full arrest being transported from
a dialysis center. The initial call was dispatched for a patient with symptomatic low
blood pressure. Upon arrival they found CPR being performed by the staff. What is
a special consideration to support the resuscitation of this patient in addition to
standard cardiac arrest ACLS protocols?
a.
b.
c.
d.
Sodium Bicarbonate 0.03 mg IVSP with caution (1mg/10ml) = 0.3ml dose
Magnesium 2 Gm in16 mL NS (slow IVP) IVPB over 5-10 min. Max 1 Gm/minute
Sodium Bicarbonate 50 mEq slow IVP over 5 min followed by 20 mL NS IV flush
Narcan 4mg IN/IVP
20. Your report on the patient described in Question #19 notes the inability to establish IV
Or IO access due to bilateral amputations below the knee. What alternative
treatment would be indicated?
a.
b.
c.
d.
21.
In-line Albuterol 5 mg continuous neb up 20 mg (throughout transport)
Albuterol 2.5 mg/ Ipratropium 0.5mg in HHN
HHN Albuterol 5 mg continuous neb up to 20 mg (throughout transport)
Narcan 4mg IN/IVP
You receive report from the scene of a house fire. EMS describes a patient that
sustained severe burns throughout their body. The patient’s clothes are stuck to
their skin. What direction would provide to the crew in this situation
a. Pull the clothes that are stuck off
b. Irrigate the skin for 10 min to cool the burning process then apply a dry sterile
dressing
c. Wrap the burned tissue with clear plastic wrap
d. Apply ice to the burned areas
22.
What treatment is indicated for an adult patient who demonstrates altered sensorium
and a blood glucose reading of 62 mg/dl?
a.
b.
c.
d.
Dextrose 10% (25 g/250 mL) 12.5 grams/125 mL
Dextrose 10% (25 g/250 mL) 25 grams/250 mL
Dextrose 10% (25 g/250 mL) 6.25 grams/75 mL
Dextrose 50% (25 g/50 mL) amp
23. EMS is on the scene of an industrial accident. The patient has a severe wound to the
lower extremity that is bleeding profusely. Attempts to apply direct pressure and
elevate the extremity are unsuccessful. The EMTP reports the have made the
decision to apply a tourniquet. However as they re-assess the patient, the bleeding is
still not controlled. What is the next step treatment?
a.
b.
c.
d.
Apply 4x4’s
Tighten the tourniquet
Apply a second tourniquet proximal to the first
Administer 1-2 L of 0.9 NS
24. It is acceptable for EMS to give the patients name and date of birth over the phone
when giving report for a suspected Stroke Alert.
a. True
b. False
25. Plastic wrap is applied to a thermal burn for which of the following reasons:
a.
b.
c.
d.
Decrease air movement over the burn
Decrease pain
Prevent contamination and hypothermia
All of the above
26. What information should you request when receiving report for a possible stroke alert?
a.
b.
c.
d.
27
Last meal eaten
qSOFA assessment
Last known well time
All of the above
You receive report from EMS on the management of a patient with a head injury.
They report the patient to demonstrate an irregular breathing pattern and that they
are providing assisted ventilations at > 20 times a minute. You would instruct them to
adjust the ventilations by monitoring:
a.
b.
b.
d.
SPO2 greater than 88%.
SPO2 greater than 94%.
ETCO2 35-40 mmHg
ETCO2 30-35 mmHg
28. EMS gives report from the scene on a full arrest. The patient remains in asystole with
a capnography reading of <10. They are not able to identify any causes of the arrest.
The EMTP would like to withdraw resuscitative efforts. According to the SOP how long
would they have to have worked the resuscitation to meet the guidelines for
withdrawal of resuscitative efforts?
a.
b.
c.
d.
20 min
10 min
45 min
30 min
29. Does the scenario described in Questions # 28 meet the criteria for withdrawal of
resuscitative efforts?
a. Yes
b. No
30. In directing the treatment of a pediatric patient with moderate to severe respiratory
distress, with S/S of RSV/bronchiolitis, which medication listed below is the treatment of
choice?
a.
b.
c.
d.
Epinephrine (1mg/10 ml) 0.5 mg with 6 L of O2 HHN
Epinephrine (1mg/ 1ml) 0.5 mg with 6L of O2 HHN
Atropine 0.5 mg IVP
Oxygen 15L NRB
31. What is the goal for patient outcome when we consider the administration of Narcan?
a.
b.
c.
d.
Wake them up
Improve the patients respiratory rate and effort
Teach them a lesson by reversing their high
Confirm they have taken opiates
32. EMS is called to the scene for a known diabetic patient with complaints of feeling dizzy,
headache and confusion, GCS 13. They report a blood glucose reading of 45 mg/dl.
What dextrose dosage and concentration should be administered?
a.
b.
c.
d.
Dextrose 50% 1 amp
Dextrose 10% (25 g/250 ml), ½ bag (125 ml)
Dextrose 10% (25g/250 ml), whole bag (250 ml)
Oral glucose
33. The patient in Question # 32 has received dextrose and a repeat blood glucose reveals a
reading of 140 mg/dl. The patient is refusing transport and wants to sign off. His GCS is
now 15. What needs to occur before EMS can leave the scene?
a.
b.
c.
d.
The patient needs to be advised to eat
The EMS needs to contact OLMC
The patient must be decisional
All of the above
34. Which of the following is not required for a POLST to be valid?
a.
b.
c.
d.
3 signatures (including PA or Physician Signature)
Date
2 signatures (including Spouse and Patient)
Patient’s name
35. In the treatment of patient with a head injury as the result for a motorcycle accident.
What is the goal in treatment after ABC’s?
a.
b.
c.
d.
Maintain SPB 110-120 or higher to maintain cerebral perfusion pressure (CPP)
Maintain MAP between 65-75
Administer IVF boluses in 1000 ml increments
All of the above
36. EMS is called by home healthcare for a 70 y/o/f that has been sick for the past week.
The patient is bed ridden due to weakness. Pt has a history of a UTI for past 2 weeks
and is not taking her antibiotics because they make her nauseous. GCS is 13 and the
patient is confused beyond her normal mentation. Vitals: B/P 80/40, P 122, R 28,
SpO2 92%,; EtCO2 30 mm/Hg. The patient’s skin is warm and dry (Temp 102OF).
What is the most appropriate EMS treatment for this patient?
a.
b.
c.
d.
Contact OLMC, call a Stroke Alert, transport as a critical patient
Contact OLMC, call a Sepsis Alert, give IV Bolus (200 ml) until SBP > 90
Contact OLMC, call a Stroke Alert, give IV wide open
Contact OLMC, call a Sepsis Alert, give IV Bolus (500 ml) until SBP > 80
37.
EMS calls report from the scene of 3 y/o pediatric patient with complaints of SOB.
He demonstrates a dry cough and wheezing. They report bilateral wheezing and a
rash starting around the patient’s mouth. Mom states the patient just ate some
cookies that a friend brought over. Per mom this has never happened before and
the child has no known allergies. Vitals: B/P 80/40, P 122, R 28, PaO2 92%, EtCO2 30
What treatment should be initiated?
a.
b.
c.
d.
Epinephrine (1mg/1 ml) 0.01 mg/kg IM
Epinephrine (1mg/10 ml) 0.02 mg/kg IV/IO
Epinephrine (1mg/10 ml) 0.01 mg/kg IV/IO
Diphenhydramine 1 mg/kg (max 50 mg) IVP/IO
38. The patient in Question #37 has received a dose of Epinephrine and is starting to
improve. Wheezes and cough are still present. Benadryl has also been administered.
What is the next most appropriate medication to administer?
a.
b.
c.
d.
39.
More Epinephrine until all wheezing is gone
Albuterol 2.5 mg and Ipratropium 0.5 mg via HHN
Albuterol 2.5 mg via HHN
Saline via HHN
A physician is authorized to take temporary protective custody of a child if the
circumstances of the child are such that, the child’s return to the custody of the
parent, guardian, or custodian presents an environment is dangerous to the child’s
life or health.
a. True
b. False
40. What is the fluid resuscitation rate to be initiated by EMS in the management of a
35 y/o male who has 2nd degree burns (thermal injury) covering 25% of his body?.
a. 125 ml/hr
b. 250 ml/hr
c. 500 ml/hr
d. TKO
41.
Using the START method of triage, an adult patient whose respiratory rate is 36
would be tagged:
a. Green
b. Yellow
c. Red
42. You receive a radio report from EMS who has responded to 911 call for a pediatric patient
not breathing. Upon arrival to the scene they find the patient is alert and crying. The
parents state the patient did not look like they were breathing when they called 911. The
patient is alert and oriented and vitals are in normal ranges. The parents are
embarrassed and turn to the crew for direction. However, in obtaining a history, the
parents state the patient had a similar episode a few weeks ago. EMS is calling for
direction, as the parents are refusing transport. What should be done next?
a. Advise EMS the parents will need to call their pediatrician in the morning
b. Authorize for the parents sign a refusal of transport
c. Advise EMS to explain to the parents that the patient needs to be transported
and evaluated, possibly placing the Physician on the phone with the parents
d. Request EMS to repeat vitals and contact OLMC before having parents sign AMA
43.
During a multiple patient incident where the number of patients and/or nature of injuries
make normal level of EMS stabilization and care unachievable, which is required?
a.
b.
c.
d.
44.
Place triage tags on all patients
Transport only one patient is each MICU
Create an individual run report on each patient
Give a detailed radio report to the hospital on all inbound patients
During a snow storm, you receive a call from EMS responding to a multicar MVA that
includes a van filled with 8 people. Upon arrival, you have a total of 10 patients and
multiple fatalities. Command determines this is a large scale incident. What criteria
should be followed for the transport of patients?
a. All critical patients will be transported to the closest hospital
b. The closest hospital will provide medical direction to EMS for hospital transports.
c. The Resource hospital will coordinate the hospital distribution for patients based
on the bed availability of the surrounding hospital ED’s and the needs of the
patients based on field triage.
45.
What special considerations are indicated when EMS reports they are transporting a
patient that has made suicidal statements to you while en-route to the hospital.
a.
b.
c.
d.
Release of liability
HIPAA waiver
Petition for Involuntary Admission
Chain of custody statement
46. EMS reports they are on the scene with a patient that has made suicidal texts to their
friends. Upon arrival, pt. states that they were drinking, but didn’t really mean the texts.
Patient agrees to be transported to ED because he has been really “sad” lately. EMS is
confirming the use of the PES Transport Matrix. Which option is most appropriate?
a.
b.
c.
d.
47.
EMS is providing care to a 35 y/o known asthmatic in severe respiratory distress. Vitals:
B/P 140/86, P 130, R 40 shallow, SpO2 92%, EtCO2 25 mm/hg. They have administered
Epi (1mg/1 ml) 0.3 mg IM x2 and have also given Albuterol 2.5 mg/Ipratropium 0.5mg
x2. What would be the next most appropriate treatment?
a.
b.
c.
d.
48.
Epi (1mg/ 10ml) 0.5 mg by HHN
Epi (1 mg/1ml) 0.5 mg by HHN
Contact OLMC for third round of Albuterol 2.5 mg/Ipratropium 0.5mg
Magnesium Sulfate 2 Gm via IV/IO
You receive a radio report from EMS on the scene of a known opioid drug abuser.
The patient is apneic and has a very weak carotid pulse. Which Narcan dosage is most
appropriate for this patient?
a.
b.
c.
d.
49.
Transport to the closest ED
OLMC must make the destination decision for EMS
Transport to Woodstock ED – PES
Authorize a refusal of service and advise them to refer the patient to his primary
care physician.
0.4 mg q 30 sec; 4mg max until breathing is restored
4 mg q 30 sec; single dose until breathing is restored
1 mg q 30 sec; 4 mg max until breathing is restored
1 mg q 2 min; 4 mcg max until breathing is restored
EMS is on the scene of a combative patient who is making suicidal statements. Local PD is
also on the scene, and they are placing the patient in restraints. EMS is contacting
OLMC for guidance in the most appropriate ED destination for transport. EMS reports
the patient has made statements threatening harm to others and their plan to take their
own life. What would your course of action be for transport?
a.
b.
c.
d.
Transport to the closest ED
Require PD assistance in transport for clearance to the County Jail
Transport to Woodstock ED - PES
Relinquish custody of the patient to the PD.
50.
Which of the following must be present to rule out the use of spinal immobilization by
EMS the field:
a. Negative or uncertain MOI
b. Patient must be reliable (alert, oriented, calm, sober, cooperative, obeying
commands)
c. No distracting injuries
d. No pain or tenderness to palpation of the spine; sensory and motor intact
e. All of the above
51.
You received a radio report for a patient with a gunshot wound to the chest.
What is the minimum SBP that should be maintained?
a.
b.
c.
d.
52.
EMS is calling with a report for an adult patient who is demonstrating tonic/clonic
seizure activity. Which Versed dose it the most appropriate for this situation?
a.
b.
c.
d.
53.
Versed 2 mg (0.2mg/kg IN) increments every 2min. seconds IVP up to 10 mg
Versed 2 mg (0.2mg/kg IN) increments every 30-60 seconds IVP up to 10 mg
Versed 5 mg every 2 min IVP up to 10 mg
Versed 0.2 mg /kg IVP every 30-60 seconds up to 10 mg.
Which of four drugs can be administered via the IN route?
a.
b.
c.
d.
54.
Greater or equal to 90mm/Hg
Equal to 80mm/Hg
Between 110-120 mm/Hg
Greater or equal to 150 mm/Hg
Glucose, Narcan, Versed, Fentanyl
Dextrose, Versed, Valium, Fentanyl
Epinephrine, Glucagon, Versed, Fentanyl
Glucagon, Versed, Narcan, Fentanyl
A healthy 35 y/o patient presents with a narrow complex tachycardia after working in
the yard on a very hot day. Per EMS the patient is complaining of dizziness and chest
discomfort. Vitals: B/P 114/60, P 200, Resp 20, SpO2 is 92%, EtCO2 35 mm/Hg. A 12lead EKG shows PSVT, no ST segment changes. Adenosine has been administered at 6
mg and 12 mg with no changes. What treatment would you order next?
a.
b.
c.
d.
Synchronized Cardioversion @ 50 joules
Atropine 1 mg IVP
Verapamil 5 mg IVSP over 2 minutes
Amiodarone 150 mg IVSP over 10 minutes
55. EMS contacts OLMC from the scene of a possible drowning at a local pool. Upon arrival,
they have discovered that lifeguards have removed a 20 year old patient from the pool.
The patient is apneic with a palpable rapid pulse. Ventilations are being supported with a
BVM. Upon placing the monitor, you note a rapid narrow complex rhythm at 200 beats
per minute, no P waves, and a QRS complex of 0.08. Management of this patient should
consist of:
a.
b.
c.
d.
Amiodarone 300 mg IV/IO
Synchronized Cardioversion @ 100 joules
Defibrillation @ 360 joules (or biphasic device specific).
Magnesium 2gm IV/IO
56. EMS is working on a patient that was found unresponsive. The V-Fib SOP is being
initiated. After multiple rounds of medications and defibrillations, your patient remains
in V-fib. An ALS Engine shows up with their monitor and equipment. What is your next
step?
a. Instruct the crew use the second monitor to attempt dual sequential
defibrillation
b. Order transport of the patient with CPR in progress
c. Withdraw resuscitative efforts and contact the coroner
d. Acquire and transmit a 12 lead EKG to validate this is truly VF
57. What is the minimally acceptable MAP (mean arterial pressure) in a suspected septic
patient is:
a.
b.
c.
d.
50 mmHg
60 mmHg
65 mmHg
90 mmHg
58. EMS is on the scene of an unresponsive adult male. They have determined no pulses
present and CPR is initiated. Monitor is attached demonstrating VF. An ECG strip is
transmitted for your review. What is correct order that treatment should be
provided?
a. Provide CPR while charging the defibrillator, Defibrillate, Resume CPR
b. Provide CPR, establish IV, administer epinephrine
c. Provide CPR, establish advanced airway
d. Provide CPR while charging the defibrillator, Defibrillate, re-check rhythm, and
continue CPR if needed
59.
The intervention(s) used in the management of the patient with Pulseless Electrical
Activity (PEA) should include:
a.
b.
c.
d.
Atropine 1mg every 3 – 5 minutes IV/IO
Transcutaneous cardiac pacing
Epinephrine (1 mg/10 ml) every 3 to 5 minutes
b and c
60. What is the best indicator of adequate ventilations when an airway is being managed
With a BVM?
a.
b.
c.
d.
Pulse Oximetry
CPAP
EZ CAP
ETCO2
61. Serotonin Syndrome is a potentially life-threatening condition associated with increased
serotonergic activity in the central nervous system (CNS). What medication can be used
to support the patient during the provision of pre-hospital care?
a.
b.
c.
d.
Atropine 0.5 mg IVP/IO q. 3-5 minutes (max 3 mg)
Naloxone 0.4mg 0.4; repeat q. 30 sec until ventilations increase (max 4 mg)
Epi (1 mg/1 ml) IN/IM
Midazolam 2 mg increments slow IVP q. 2 min (0.2 mg/kg IN) up to 10 mg
62.
EMS has been called to the scene for a patient that has passed out. They report that,
upon arrival, they found a 49 y/o female lying on the floor, moaning but unable to
respond to questions. Vitals: BP 134/78, P 110, R 24/Reg, SpO2 98% room air, sinus
tachycardia noted on the monitor, lungs are clear, skin is diaphoretic. There is no family
on the scene to provide PMH. However, they did notice a med alert bracelet on her right
wrist that states she is a diabetic. What should they suspect?
a.
b.
c.
d.
63.
They report a glucose reading for the patient in # 62is 50mg/dl, but are unable to
establish IV access. What treatment should you consider?
a.
b.
c.
d.
64.
Cheeks, palms and soles of feet
Neck, lateral chest, axillae
Anywhere, it does not make a difference
All of the above
What is the initial EMS fluid resuscitation for a child age 8 with 30% TBSA partial
thickness burns > 15% BSA?
a.
b.
c.
d.
66.
Oral glucose gel
Glucagon 1 mg IN
Narcan 2 mg IM
NTG 0.4 mg SL
What is the priority placement of cold packs for a patient experiencing a heat emergency?
a.
b.
c.
d.
65.
an asthma attack
drug overdose
hypoglycemia
hyperglycemia
IV fluids at 20ml/kg by bolus
IV fluids at a rate of 125ml/hr
IV fluids at a rate of 250ml/hr
IV fluids at a rate of 500ml/hr
EMS care of a woman in labor with a prolapsed cord includes:
a. Putting the mother on her left side
b. Manipulating the cord as needed to try and replace it
c. Placing a gloved hand into the vagina and placing fingers between the pubic
bone and presenting part, with the cord between fingers
d. Monitor the patient with rapid transport to the closest ED
67.
What is the ventilation rate for assisting a pediatric patient without an advanced airway?
a.
b.
c.
d.
68.
1 breath every 3 – 5 seconds
1 breath every 6 – 8 seconds
1 breath every 8 – 10 seconds
1 breath every 10 – 12 seconds
EMS personnel are expected to transport all pediatric patients in an appropriate child
restraint system, as defined by the Illinois Child Passenger Protection Act.
a. True
b. False
69.
What is the compression/ventilation ratio for performing one person CPR on a child?
a.
b.
c.
d.
70.
What is the dose of Sodium Bicarb that should be given to victims of a crush injury?
a.
b.
c.
d.
71.
5 compressions: 1 ventilation
5 compressions: 2 ventilations
15 compressions: 2 ventilations
30 compressions: 2 ventilations
1 amp added to 2nd liter of NS and run at 500ml/hr.
50mEq IV to all victims of a crush injury
50mEq IV over 5 min, only when suspected hyperkalemia
We no longer give Sodium Bicarb to victims of crush injuries
What is the frequency for EMS acquisition/transmission of a 12 Lead ECG in caring for a
patient with chest pain?
a.
b.
c.
d.
Within 5 minutes of patient contact and repeat in 5 minutes
Within 10 minutes of patient contact and repeat in 10 minutes
Within 5 minutes of patient contact and repeat in 10 minutes
Within 10 minutes of patient contact and then only if the patient’s condition
changes
72.
What is the definition of “Hemodynamic Instability” in trauma assessment?
a. Hypotension with Systolic BP (SBP) less than 90 adults/ less than 70-pediatrics
in a single measurement
b. Sustained hypotension with SBP less than 90 adults/less than 70-pediatrics in 2
consecutive measurements taken 15 minutes apart
c. Sustained hypotension with SBP less than 90-adults/less than 70-pediatrics in 2
consecutive measurements taken 10 minutes apart
d. Sustained hypotension with SBP less than 90-adults/less than 70-pediatrics in 2
consecutive measurements taken 5 minutes apart
73.
What is the targeted SBP for a patient with blunt force trauma to the abdomen, who is
demonstrates signs of hypovolemic shock.
a.
b.
c.
d.
74.
EMS contacts OLMC with report for an alert and oriented 58 y/o male who’s been
feeling ill for several days. He’s has abdominal discomfort, weakness, blurred vision
and complains of being thirsty all the time. Past medical history includes asthma and
diabetes. Vitals: BP 80/62, P 130, R 30 non-labored. Lungs are clear bilaterally, SpO2
99% room air. Sinus tachycardia noted on the monitor, skin is warm and dry. You would
suspect:
a.
b.
c.
d.
75.
Greater or equal to 90mm/Hg
Equal to 80mm/Hg
Between 110-120 mm/Hg
Greater or equal to 150 mm/Hg
Hyperventilation Syndrome
Hyperglycemia
Flu
Hypoglycemia
You check the blood glucose on the patient in question #74 and the monitor reads “HI”.
Following initial medical care, what the most appropriate treatment?
a.
b.
c.
d.
IV NS wide open, up to 1 liter
Aspirin, Lasix, Nitro
Glucose Gel, Glucagon or Dextrose
Transport only