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SNHD PARAMEDIC PROTOCOL EXAM STUDY GUIDE
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Identify the Parkland Burn Formula for Fluid Replacement. - correct answer - 4ml x (body weight in kg) x (% BSA burned) = total fluids for 24 hours, Give 1/2 in the first 8 hours; give remainder over next 16 hours Pg. 28 For children, a fall greater than ______ requires transport to a Level 1 or 2 trauma center. - correct answer - 10 feet or two times the height of the child Pg. 127 What is the dose of Naloxone (Narcan) in the setting of a suspected overdose? - correct answer - 2.0 mg IN/IM/IV; may be repeated to a max dose of 10mg Pg. 45 For a traumatic cardiac arrest, what interventions must be performed prior to considering terminating resuscitation efforts? - correct answer - Provide effective ventilation with 100% oxygenation for two (2) minutes Your text here 1Your text here 2
Open airway with basic life support measures Perform bilateral needle thoracentesis if tension pneumothorax suspected Pg. 125 For a patient in Pulmonary Edema/CHF, who is hypertensive with a diastolic blood pressure greater than 100 mmHg, what is the dose of Nitroglycerin? - correct answer - 1.6 mg SL Pg. 49 Which patient(s) can be taken to a hospital that has been placed on internal disaster? - correct answer - A patient in which an airway cannot be established A patient in cardiac arrest Pg. 12 A patient who was ejected from a motor vehicle requires transport to a Level 1 and 2 trauma center only. - correct answer - False (Level 1, 2 or 3) Pg. 127 When should radio contact be established to a receiving facility? - correct answer - All trauma patients
Pg. 6 Additional doses of Hydropmorphone (Dilaudid) are by physician order only. - correct answer - True. Pg. 47 What is the dose of Benadryl for a pediatric patient experiencing a dystonic reaction? - correct answer - 1.0 mg/kg Pg. 96 What is the western border for Sunrise Hospital and Trauma Center's trauma catchment area? - correct answer - Paradise Pg. 128 Pulse oximetry in a pediatric patient should be maintained at: - correct answer - > 94% Pg. 70 For patients on home oxygen or with chronic conditions, supplemental oxygen should be used to maintain an oxygen saturation of: - correct answer - > 90% Pg. 67
When termination of resuscitation occurs in the field, what should happen to all medical interventions? - correct answer - All medical interventions should be left in place Pg. 125 For adults, a fall greater than ______ requires transport to a Level 1,2, or 3 trauma center. - correct answer - 20 feet Pg. 127 Arterial lines can be used during an interfacility transport. - correct answer - False Pg. 121 What is the pediatric dose of Amiodarone for a wide complex tachycardia? - correct answer - 5 mg/kg in 50cc NS over 20 minutes Pg. 108 If defibrillation is needed on a patient with a permanent implanted pacemaker, the defibrillator paddles or self adhesive electrodes should be placed how far away from the pulse generator of the pacemaker? - correct answer - 1 inch Pg. 134
Pulse above 100 Patient grimaces Appearance is normal except for extremities Patient is crying - correct answer - 7 Pg. 34 What is the definition of status epilepticus? - correct answer - Two or more seizures successively without an intervening lucid period A seizure lasting over five minutes Pg. 54 For a patient in Pulmonary Edema/CHF, who is normotensive, what is the dose of Nitroglylcerin? - correct answer - 0.4 mg SL Pg. 49 What is the dose of Magnesium Sulfate for a patient in respiratory distress and who is wheezing or is suffering from bronchospasm?
- correct answer - 2.0g in 50 ml Normal Saline over 10 minutes Pg. 51 What is the dose of Fentanyl for pain management? - correct answer - 1.0 mcg/kg IN/IM/IV
Pg. 47 Describe EKG findings consistent with hyperkalemia. - correct answer - Bradycardia with widening QRS complexes. Pg. 38 For a patient in shock, how much Dopamine should be administered? - correct answer - 5 - 20 mcg/kg/min Pg. 55 Which of the following are approved hypothermia (post-resus.) centers? - correct answer - Centennial Hills, Desert Springs, Mountain View Hospital, St. Rose De Lima, St. Rose Siena, Southern Hills, Spring Valley, Summerlin, Sunrise, UMC, Valley Pg. 65 A patient complaining of abdominal pain, flank pain, or nausea/vomiting shall receive how much Ondansetron (Zofran)? - correct answer - 4.0mg Pg. 15 An auto vs pedestrian/bicyclist thrown, run over, or with significant (greater than 15 mph) impact requires transport to a Level 1, 2, or 3 trauma center. - correct answer - False (greater than 20mph)
Which of the following may indicate pre-eclampsia? - correct answer - Severe headache Vision changes RUQ pain Pg. 44 What is the dose of DuoNeb in a pediatric patient with a history of wheezing? - correct answer - 3.0 ml SVN once Pg. 100 What is the dose of D10 for a patient experiencing hypoglycemia?
- correct answer - 25g Pg. 21 Identify which of the following patients should be transported to a burn center. - correct answer - Second and/or third degree burns
10% body surface area (BSA) in patients under 10 years old or over 50 years old, Second and/or third degree burns >20% body surface area (BSA), Inhalational injury, Circumferential burns, Burns that involve the face, hands, feet, genitalia, perineum or major joints, Electrical burns, including lightning injury, Chemical burns Pg. 85
Alcohol is commonly a cause of total unresponsiveness to pain. - correct answer - False Pg. 22 What is the pediatric dose of Ondansetron (Zofran)? - correct answer - 0.15 mg/kg ODT/IM/IV up to max dose of 4.0mg Pg. 74 Resuscitation that is started in the field by licensed EMS personnel can be discontinued without a physician order. - correct answer - False Pg. 125 What is the dose of Midazolam (Versed) for a patient in seizure? - correct answer - 0.1 mg/kg IM/IN/IV up to a maximum of 5.0 mg Pg. 53 A patient complaining of abdominal pain, flank pain, or nausea/vomiting shall have a 12 lead EKG placed on them if their age is over - correct answer - 35 Pg. 15 What is the dose of Calcium Chloride in the setting of a Calcium Channel Blocker overdose? - correct answer - 1gm (10%) slow IVP
What should occur first for an unwitnessed cardiac arrest? - correct answer - 2 minutes of CPR Pg. 134 When would Glucagon be indicated for a patient suffering from Bradycardia? - correct answer - Beta Blocker OD Pg. 25 How should an EMS provider attempt to verify the validity of the DNR/POLST? - correct answer - Patient's name, Patient's age, Patient's condition Pg. 118 St. Rose Dominican - Siena Campus is what level trauma center?
- correct answer - 3 Pg. 128 Which of the following are associated with grand mal seizures? - correct answer - Incontinence, oral trauma, loss of consciousness Pg. 54 What is the pediatric dose of Calcium Chloride in the setting of a Calcium Channel Blocker overdose? - correct answer - 20mg/kg
Pg. 96 Midazolam (Versed) can be administered to a pediatric patient in seizure which of the following ways? - correct answer - IV, IM, IN Pg. 102 What is the dose of Midazolam (Versed) for an intubated patient in which sedation needs to be maintained? - correct answer - 0. mg/kg IV/IN/IM Pg. 67 What is the maximum dose of Epinephrine 1:1,000 for a pediatric patient having an allergic reaction? - correct answer - 0.9mg Pg. 76 Deep suctioning is recommended during neonatal resuscitation. - correct answer - False Pg. 88 A patient experiencing a behavioral emergency may be placed in the prone position. - correct answer - False Pg. 23
According to the Stroke/CVA protocol, which of the following need to be documented on a patient with a suspected stroke or CVA? - correct answer - Last known normal (onset), Witness with phone number, Cincinnati Stroke Scale (CSS) Pg. 59 What are continuous chest compressions? - correct answer - Compressions at a rate of at least 100 compressions per minute and a depth of about 2 inches without pauses for breaths Pg. 29 What is the dose of Benadryl in the setting of a suspected dystonic reaction? - correct answer - 50mg IV/IM Pg. 45 What is the dose of Albuterol for a child who drowned? - correct answer - 2.5 mg in 3.0 ml SVN Pg. 83 Prior to a transfer, what must the transferring the transferring physician notify the receiving physician of? - correct answer - Estimated time of arrival, patient condition, reason for transfer Pg. 121
What is the initial dose of Amiodarone? - correct answer - 300mg Pg. 29 For a patient in Pulmonary Edema/CHF and showing signs of cardiogenic shock with a blood pressure less than 100 mmHg, what is the dose for Dopamine? - correct answer - 5 - 20 mcg/kg/min Pg. 49 What is the APGAR score? Active moving Pulse above 100 Sneezes, coughs, pulls away Appearance is normal over entire body Respirations are good and crying - correct answer - 10 Pg. 34 Nitroglycerine is contraindicated for any patient having taken Viagra or similar medication in the past 24 hours, or 48 hours for Tadalifil, or similar. - correct answer - True Pg. 32 CPAP may be performed on which of the following patients? - correct answer - Respiratory distress with bronchospasm, Pneumonia, CHF
signs of hypo perfusion or has more than 10% of their total BSA burned? - correct answer - 60 ml/kg Pg. 84 Which patients DO NOT need spinal immobilization? - correct answer - Penetrating trauma to the head and/or neck and no evidence of spinal injury, Injuries where placement of the collar might compromise patient assessment, airway management, ventilation and/or hemorrhage control, Patients in cardiac arrest Pg. 132 What is the dose of Sodium Bicarbonate in the setting of a suspected TCA/ASA overdose? - correct answer - 1.0 mEq/kg of 8.4% Pg. 45 What should be used as adjunctive therapy for a patient less than 12 years of age who requires endotracheal intubation? - correct answer - Midazolam (Versed) 0.1mg/kg Pg. 137 What is the APGAR score? Arms/legs are flexed Pulse above 100 Patient grimaces Appearance is normal except for extremities
Patient is crying - correct answer - 7 Pg. 34 What is the pediatric dose of Magnesium Sulfate in a pediatric patient with Torsades De Pointes? - correct answer - 25 mg/kg in 50cc Normal Saline over 10 minutes Pg. 108 A patient who has received which medication(s) can be placed in the ER waiting room? - correct answer - Morphine, Ondansetron (Zofran) Pg. 130 A mild allergic reaction involves skin rashes, itchy sensation, or hives with no respiratory involvement - correct answer - True Pg. 20 Hypoxemia is a common cause of bradycardia. - correct answer - True Pg. 26 What can be used to maintain sedation for endotracheal intubation? - correct answer - Diazepam (Valium), Midazolam (Versed)
