2020 ALS Protocol Quiz

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0 points

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With signs of herniation and traumatic brain injury (hypertension, bradycardia, dilated pupil, posturing, etc), what is the proper way to manage the patient's airway? *

1 point

Ventilate 20-30 breaths per minute, ETCO2 at 35-40 mmHg

Ventilate 10-12 breaths per minute, ETCO2 at 30 mmHg

Ventilate 12-20 breaths per minute, ETCO2 at 30 mmHg

Ventilate 20-30 breaths per minute, ETCO2 at 50 mmHg

What age is considered an adult in WVOEMS protocols? *

1 point

>15

> 18

> 12

> 16

Which of the following medications do you have to receive orders for, prior to administration? SELECT ALL THAT APPLY *

1 point

Labetalol

Diltiazem (Cardizem)

Dopamine

Amiodarone/Lidocaine infusion

Required

At what pressure setting do you begin with CPAP? *

1 point

3-5 cmH2O

10 cmH2O

15 cmH2O

50 cmH20

CPAP may be applied to a patient who is NOT awake and oriented *

1 point

If qualitative and quantitative ETCO2 is continually monitored

If PT is altered due to hypercapnia

CPAP may never be applied to a PT who is not awake and oriented

All of the above

Other:

Under what conditions may Nitroglycerin be administered along with CPAP?

1 point

systolic BP > 110

systolic BP > 180

5 min after CPAP has been applied, AND systolic BP > 110

5 min after CPAP has been applied, AND systolic BP > 180

Clear selection

What is the dose of Fentanyl for pain management in patients > 55 years old? *

1 point

1 mcg/kg: MAX 100mcg. Repeated order per Medical Command

1 mcg/kg: MAX 100mcg. Repeated dose is standing order

0.5 mcg/kg: MAX 100mcg. Repeated order per Medical Command

0.5 mcg/kg: MAX 100mcg. Repeated dose is standing order

What is the dose of Morphine for pain management in patients > 55 years old? *

1 point

1 mg slow IV; repeat Q 5 min: MAX 10 mg

2 mg slow IV; repeat Q 5 min: MAX 10 mg

1 mg slow IV; repeat Q 5 min: MAX 5 mg

2 mg slow IV; repeat Q 5 min: MAX 4 mg

What is the pediatric dose for Acetaminophen? And what is the dose? *

1 point

5 g/kg

15 g/kg

15 mg/kg

5 mg/kg

What is the pediatric dose of Dextrose for children > 2 years old? *

1 point

D25 2 ml/kg: MAX 12.5g

D50 1 ml/kg: MAX 25g

D10 5 ml/kg: MAX 5g

WHOLE BOX!

What is the pediatric dose of Dextrose for children 1 month - 2 years old? *

1 point

D25 2 ml/kg: MAX 12.5g

D50 1 ml/kg: MAX 25g

D10 5 ml/kg: MAX 5g

HALF THE BOX!

What is the pediatric dose of Dextrose for children <1 month old? *

1 point

D25 2 ml/kg: MAX 12.5g

D50 1 ml/kg: MAX 25g

D10 5 ml/kg: MAX 5g

QUARTER OF THE BOX!

What is the fluid bolus dose for a patient in hypovolemic shock? *

1 point

20 ml/kg: MAX 2L. Repeat as needed

10 ml/kg: MAX 2L. Repeat as needed

20 ml/kg: MAX 2L. Repeat per Medical Command order

10 ml/kg: MAX 2L. Repeat per Medical Command order

What is the fluid bolus dose for a patient in cardiogenic shock? *

1 point

20 ml/kg: MAX 2L. Repeat as needed

250 ml MAX: Repeat as needed

20 ml/kg: MAX 2L. Repeat per Medical Command order

250 ml MAX: Repeat per Medical Command order

To restrain a patient experiencing a behavioral emergency you must obtain orders from medical command prior to using soft restraints *

1 point

True

False

If a patient is experiencing nausea/vomiting, you must obtain orders from medical command prior to administering Zofran 4mg ODT *

1 point

True

False

A right sided 12 lead must be obtained to confirm right sided/inferior MI prior to skipping nitrates? *

1 point

True

False

You must first obtain Medical Command order prior to performing a percutaneous cricothyrotomy? *

1 point

True

False

Which is the correct order for preferred sites of IO placement of an adult? *

1 point

distal tibia, proximal humerus, proximal tibia

proximal tibia, proximal humerus, distal tibia

proximal humerus, proximal tibia, distal tibia

proximal tibia, distal tibia, proximal humerus

Which is the correct order for preferred sites of IO placement of a pediatric? *

1 point

distal tibia, proximal humerus, proximal tibia

proximal tibia, proximal humerus, distal tibia

proximal humerus, proximal tibia, distal tibia

proximal tibia, distal tibia, proximal humerus

The ONLY site permitted for chest decompression is the 2nd intercostal space? *

1 point

True

False

What is the first line medication used for chemical restraint during a psych/behavioral issue? *

1 point

Versed 5mg IV/IM/IN (>55 y/o: 2mg IV/IM, 5mg IN)

Haloperidol (Haldol) 5mg IM

Versed 2mg IV/IM/IN (>55 y/o: 1mg IV/IM, 2mg IN)

NONE

For the patient in EXCITED DELIRIUM, what is the dose of Ketamine? *

1 point

5 mg IM, 2 mg IV/IO

2 mg IM/IV/IN

5 mg/kg IM, 2 mg/kg IV/IO

NONE

What is the MAX does of Ketamine? *

1 point

320 mg IM, 200 mg IV

2 mg IM/IV/IN

5 mg/kg IM, 2 mg/kg IV/IO

5 mg IM, 2 mg IV/IO

What is the dose of Versed during status epilepticus? *

1 point

Versed 2 mg IV/IM, 5 mg IN (>55 y/o: 1mg IV/IM, 5mg IN)

Haloperidol (Haldol) 5mg IM

Versed 2mg IV/IM/IN (>55 y/o: 1mg IV/IM, 2mg IN)

NONE

All of the following should be performed after ROSC of your patient who becomes responsive, EXCEPT *

1 point

12 lead

induced hypothermia

Maintain ETCO2 35-45

Maintain SBP > 90

Backboards used ONLY to transport the patient to the ambulance gurney should be gently removed after placing the patient on the cot *

1 point

True

False

Apply full immobilization if the patient is assessed and exhibits with any of the following (SELECT ALL THAT APPLY): *

1 point

Abnormal sensory/motor exam – abnormal findings such as paresthesia, loss of sensation in extremities, weakness or paralysis in extremities, or loss of urethral or sphincter control.

Distracting injuries that produce pain that may distract the patient from the pain of a spine injury.

Complaints of pain or tenderness on examination of the spine including palpation of the entire spine and range of motion (if appropriate).

Patient reliability is questioned such as the following examples: intoxicated, elderly, young, altered mental status, chemically altered, or those patients that you cannot adequately perceive or communicate with.

Required

Ambulatory patients with spinal pain should be immobilized utilizing a "standing take down" *

1 point

True

False

The TXA Protocol is OPTIONAL *

1 point

True

False

The following are indications for administration of TXA (SELECT ALL THAT APPLY): *

1 point

Known or suspected hemorrhage

≥ 12 years of age

Sustained systolic blood pressure < 90mmHg and Heart rate >110

Time of injury < 3 hours

Required

The following are contraindications for administration of TXA (SELECT ALL THAT APPLY): *

1 point

Pregnancy

< 18 years of age

Allergy to TXA

Time of injury > 3 hours

Required

TXA is to be mixed by adding _______ into a 100mL or 250mL bag of NS *

1 point

100 mg

1 g

100 mcg

5 mg

TXA requires MCP order *

1 point

True

False

Administration of Epi for Anaphylaxis/Allergic Reaction to patients > 12 years old requires MCP order *

1 point

True

False

For non-cardiac pain management, secondary to Fentanyl or Morphine, what is the dose of Ketamine *

1 point

10 mg

0.2 mg/kg (MAX 20 mg)

2 mg/kg (MAX 100 mg)

5 mg

For PICC line access, _____ mL of blood should be aspirated using AT LEAST a _____ mL syringe *

1 point

10, 10

5, 10

5, 5

2, 5

A PICC line <2.0 French has a MAX flow rate of _____ mL/hr, and anything > 2.0 French has a MAX flow rate of _____mL/hr *

1 point

500, 1000

250, 500

125, 250

50, 100

Caution should be used with administration of which medications through a PICC line (SELECT ALL THAT APPLY)? *

1 point

Adenosine

Dextrose

Zofran

Ketamine

Required

Which of the following would be appropriate reasons to cease resuscitation efforts? *

1 point

Aystole > 20 min with no defibrillation or rhythm changes

ETCO2 < 10 mmHg for >10 min with high quality CPR

Proper DNR forms provided

ALL THE ABOVE

Following ROSC, what is the dose for amiodarone infusions? *

1 point

300g bolus

300g/250mL at 100 gtts/min

150mg/100mL at 1mg/min

150g bolus

Following ROSC, what is the dose for lidocaine infusions? *

1 point

1.5 mg/kg

1g/250mL, titrated to 1-4 mg/min

10 mg

150g/250mL at 100 gtts/min

Following ROSC, an infusion requires MCP order *

1 point

True

False

For bronchospasm, what is the initial medication and dose for a 10 year old? *

1 point

5.0 mg Albuterol

2.5 mg Albuterol, 0.5 mg Atrovent

5.0 mg Albuterol, 0.5 mg Atrovent

2.5 mg Albuterol

Atrovent is contraindicated for what age group? *

1 point

< 1 year old

< 18 year old

< 12 year old

It is never contraindicated

For an adult with bronchospasm, after no relief from TWO A&A administrations, what is your next immediate action? *

1 point

Magnesium Sulfate, 2g/100mL over 20 mins, per MCP order

Magnesium Sulfate, 2g/100mL over 20 mins

Dexamethasone, 10 mg IV/IM, per MCP order

Dexamethasone, 10 mg IV/IM

What medication should accompany Dexamethasone for an adult patient in severe respiratory distress? *

1 point

Magnesium Sulfate, 2g/100mL over 20 mins, per MCP order

Magnesium Sulfate, 50 g/kg/100mL over 20 mins

Magnesium Sulfate, 50 mg/kg/100mL over 60 mins, per MCP order

Magnesium Sulfate, 50 mg/kg/100mL over 60 mins

What is the pediatric dose of Magnesium Sulfate? *

1 point

50mg/kg IV/IM in 100mL over 1 hour per MCP

50mg/kg IV/IM in 250mL over 10 min per MCP

10 mg IV/IM, per MCP order per MCP

10 mg IV/IM per MCP

What is the dose of Dexamethasone for a pediatric patient? *

1 point

1 mg/kg (20 mg MAX) IV/IM, per MCP order

1 mg/kg (20 mg MAX) IV/IM

0.6 mg/kg (10 mg MAX) IV/IM, per MCP order

0.6 mg/kg (10 mg MAX) IV/IM

For a patient in severe respiratory distress with signs of impending respiratory arrest, you can administer 0.3 mg (0.15 mg pediatric) Epi 1:1,000 IM on standing orders *

1 point

True

False

EMS Time Out Report – This report constitutes a verbal exchange of information to provide continuity of patient care. WVOEMS recognizes the ______format to meet this need. *

1 point

D-CHART

SOAPIER

MIST

FOAM

The patient hand off report shall be written documentation of a minimal set of data and shall be provided to the receiving facility prior to EMS departure. This may take the place of an EPCR. *

1 point

True

False

If the provider is unable to contact Medical Command, properly authorized EMS personnel may continue to follow the appropriate protocol(s) in the best interest of the patient. However, the provider must then: *

1 point

Provide written documentation within 72 hours to Medical Command

Immediately upon arrival at the receiving facility, contact Medical Command by phone

Notify your EMS agency director of the reason contact was not made

Do nothing. Contact with Medical Command is optional

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