Mid Term Written Practice Set
What is the correct dose for Glucose ?
1 Tube Adult : 10-20 grams , vary on what is purchased 1 time dose Pediatric : <2 y/o MD order
What is the minimum time frame for hydrostatic testing of oxygen cylinders?
3-10 years depending on cylinder type, after initial 5 years
What does ASA do ?
helps mimic platelet clotting
What is the Action Circle?
immediate area around the involved vehicles where PPE is required and which will remain clear of non-essential personnel
After the AED delivers a shock, the rescuer should
immediately restart CPR, beginning with the chest compressions
When using the AED, after delivery of the shock; what is the next step?
immediately resume high quality CPR for 5 cycles/2 minutes
When listening to breath sounds, it is important to listen for at least
ne full breath ____________ at each examination site.
CPAP is most appropriate for;
only those in sever respiratory distress
What is the location to Auscultate Bronchovesicular Sounds?
posterior chest between the scapulae and in the center part of the anterior chest
After sliding the piercing spike of the administration set into the IV bag port, you should:
prime the line and flush the air out of the tubing.
Prior to applying a nonrebreathing mask on a patient, you must ensure that the:
reservoir bag is 3/4 inflated
During two person CPR after an advanced airway has been placed:
resume uninterrupted compressions / 1 breath every 6-8 seconds
You are ventilating a patient with a stoma; however, air is escaping from the mouth and nose. To prevent this you should:
seal the mouth and nose
Sz is the medical abbreviation for?
seizure
The mask on the BVM is transparent?
so that vomitus or other fluids are easily detected and corrective action can be taken
Compression: Ventilation ratio for a pediatric (1 rescuer) is.
30 compressions 2 breaths
Compression: Ventilation ratio for an adult (1 or 2 rescuer) is.
30 compressions 2 breaths
A 26 y/o male that was trapped in a residential house fire. Firefighters bring the patient to you. PE reveals 2o burns to his anterior left and right legs, abdomen and posterior right arm. What is the TBSA%?
31.5 % Left Leg 9% Right Leg 9% Abdomen: 9% Posterior Right Arm: 4 1/2 %
Stable patients should be reassessed at _____ minute intervals?
5
What is the location to Auscultate Bronchial Sounds ?
9 anterior Chest near the 2nd and 3rd intercostal spaces
Which of the following victims needs CPR?
A victim who is unresponsive with no normal breathing and no pulse
What type of flow meter since it is affected by gravity is attached to the wall in the box of a Rescue vehicle or the wall of the hospital?
Back Pressure Compensated flow meter
What device is utilized to move overweight/obese patients?
Bariatric Stretcher Lifting Tarp Fat Blanket
What is a contraindication for ASA?
Being Allergic to it
If an unresponsive infant is not breathing and has a heart rate of 50 beats per minute and signs of poor perfusion despite oxygenation and ventilation with a bag and mask, which of the following should you perform?
Both chest compressions and breaths
What breath sound is heard on the right supraclavicular area? . Is the above sound ________ than the sound of vesicular sounds
Bronchovesicular louder
What is the correct route for glucose?
Buccal ( between check and gum)
Patient on CPAP becomes unresponsive and apenic. Which of the following steps should be taken?
Discontinue CPAP and ventilate the patient with BVM
As an EMT what is your primary concern when treating a patient?
Do no Harm
Glasgow Coma Scale Eye opening Best Verbal Response Best Motor Response E 4 V 5 M6
E 4 - Spontaneous 3- To sound 2- To pressure 1- None V 5- Orientated 4- Confused 3- Words 2- Sounds 1- None M 6- Obeys commands 5- Localizing to pain 4- withdraws from pain 3- flexes to pain ( decorticate) 2- extends to pain 1- No motor response
Other than the Laryngoscope Blade/handle, Name a(n) placement verification device used with endotracheal intubation.
ETCO2 Detector Stethescope Turkey Baster Capnometer
A supraglottic adjunct protects the airway by closing off which orifice?
Esophagus
Before applying the CPAP to a patient it is vital to;
Explain to the patient what you are doing and what to expect
When performing the physical exam portion of the secondary assessment, the EMT should first ___________ , then __________and finally __________ the area or region
Expose, visualize, palpate
When using a stair chair, the EMT at the foot, normally should face which direction?
Facing the patient
If the DNRO is presented to an emergency medical technician in a setting other than a health care facility, it CAN NOT be honored. True or False
False
True or False: Pulse oximetry (SpaO2) is an approved substitute for the pulse assessment when taking vital signs.
False
True or False: You would be surprised to hear wheezing and rhonchi at the same time.
False
True or False : Blood glucose monitoring is a vital sign that an EMT is able to preform.
False , this is a diagnostic sign not a vital sign
Which physical exam is done for a responsive medical patient or non-significant MOI patient?
Focused Physical Exam 1. System involved for Medical Patient. 2. Region involved for Non-Sig trauma patient
The first element or step of the Primary Assessment component of the Patient Assessment is?
Form a general impression
You find a 27 year old female lying on the floor in the corner of the bedroom curled in ball. She is mumbling and you can't understand what she is saying. Her eyes are open and her pupils are constricted. When you tell her to hold out her arm so you can take her BP she complies. What is her GCS , document it correctly.
GCS of 12 E4V2 M6
You find a 20 year old female experiencing severe abdominal pain. She is lying on her living room sofa, her eyes are open and she answers all questions appropriately. When you ask her to sit up she comlies with effort due to pain associate with any movement. What is her GCS , document it properly.
GCS of 15
You find a 40 year old male with a history of insulin dependent diabetes. He is unconscious, doest respond to verbal stimuli and his eyes are closed. When you apply a sternal rub he attempts to raise his right hand and push your hand away. What is his GCS, document it correctly.
GCS of 7 E1V1 M5
Using proper documentation, what is the GCS of the following patient: opens eyes when pinched; clear speech, makes no sense; pulls hand away when pinched.
GCS10 E2V3MR5
A 25 year old female is pulled from a backyard swimming pool after being submerged for an unknown period of time. On exam you find her breathless , pulse less , cyanotic and unresponsive to stimuli. What is her GCS , document it correctly.
GSC of 3
A 30 year old male is involved in a head on MVC. He is suffering from obvious head trauma. You noted heady front- end collision damage and a spree webbed windshield. His eyes are closed but he opens when spoken to. he does not move after painful stimulation. He is confused and unsure of his name. What is his GSC, document it correctly .
GSC of 8 E3 V4 M1
A contraindication for using the OPA is?
Gag Reflex Conscious
What can significantly reduce lung volume due to elevation of the diaphragm.
Gastric Distention
During bag-mask ventilation, which of the following is recommended to minimize the risk of gastric inflation?
Give a breath just until you see the chest rise
When administering breaths by using a bag-mask device for a child who is not breathing but does have a pulse, the rescuer should
Give breaths at the rate of 1 breath every 3 to 5 seconds
When a child has a heart rate greater than 60 per minute and a pulse but is not breathing effectively, the rescuer should
Gives breaths without Chest compressions
What does the the diaphragm of the stethoscope detect ?
High pitched sounds
What is the difference between High quality CPR and poorly done CPR
High quality CPR is done to maintain adequate blood pressure to ensure perfusion of vital organs, while poorly done CPR will circulate blood and oxygen but is inadequate to perfuse vital organs
HTN is the medical abbreviation for?
Hypertension
What is the correct route for an EPI-PEN?
IM lateral Mid-Thigh between the knee and waist
What is an INT and what is it used for?
IV Saline Lock or Intermittent Needle Therapy b. This provides an alternative to conventional IV therapy c. The Saline Lock is a plastic male adapter with a rubber hub at the end and a plastic tip that is inserted directly into an IV catheter. d. Indicated for precautionary venous access.
List one of the adjuncts used by an EMT to protect an airway.
King Tube iGel Comitube LMA
What is the location to Auscultate
L and R mid clavicular (2nd or 3rd ICS) L and R anterior axillary 4th or 5th ICS
What does the bell of the stethoscope detect?
Low pitched sounds
An EMT in the State of Florida can initiated a non-medicated IV under the following condition(s):
Medical Director approval after completion of approved IV course and presence of a Paramedic.
What is the minimal level of BSI protection?
Medical Gloves, Eye protection . Mask as well now due to covid
Assessing the chief complaint or history of present illness use the mnemonic OPQRST, which stands for
Onset Provocation/Palliation Quality Radiation Severity Time
Name a contraindication to a Transport Ventilator.
Over pressurization Syndrome Water Ascent Injury Tension Pneumothorax Blast injury Bends Pneumothorax
What is the location to Auscultate Tracheal Breath sounds ?
Over the Trachea
Rewrite the bolded underlined sections using the proper abbreviation or definition. Past medical history: coronary artery bypass graft.
PMHx: CABG
What is the correct rout for ASA ?
PO, pill you swallow
In the eyes of the law, a poorly written patient care form indicates that:
Patient care was inadequate or haphazard
Height; having a Tracheostomy/Laryngectomy; or responsive with a gag reflex are contraindications for a supraglottic adjunct. List one of the remaining three.
Patient who has ingested a caustic substance Esophageal disease FBAO Foreign body airway obstruction
Documentation of patient disposition refers to:
Patients placement in the ED
To ventilate a patient with a stoma and no tube in place, which size mask is used with the BVM?
Pediatric
If a victim of foreign body airway obstruction becomes unresponsive, the rescuer should immediately
Perform Chest compressions
When assessing the mental status of a patient, the term A&Ox4 indicates the patient is alert and oriented to
Person Place Time Events Leading up to
Something that, given a particular illness/injury, would be expected to bepresent but is not; is called a.
Pertinent Negative
As a safety measure to prevent improper gas to fill a cylinder, portable oxygen cylinders use the ______ system and the stationary ( cascade ) oxygen cylinders use the ______ system
Pin indexing , American Standard
Once the AED is on the scene, what is the first step the rescuer should perform to operate the AED?
Place the AED pads on the chest
Name four possible conditions that may contribute to absent or diminished breath sounds.
Pneumonectomy Mucus Plugs Aspiration Pleural
The primary pulmonary abnormality in patients with an asthma or COPD attack is;
Poor Ventilation
Pin Indexing System is usually for what
Portable Cylinders
A rapid body scan is completed during what phase of the patient assessment?
Primary Assessment
Define Auscultation
Process of listening to the lung and chest sounds
In addition to BSI, what is essential to minimize the risk of cross contamination?
Proper Hand washing
As part of HIPAA, _____ _____ _____ is often denoted by a specific set ofpersonal identifiers that any healthcare operations has on a patient.
Protected Health Information (PHI)
Proximal Refers to ____ and distal refers to ___
Proximal refers to how close something is in relation to a point of attatchment , while distal refers to how far it is to that point. Such as the wrist is distal to the elbow , but the elbow is proximal to the wrist Proximal means the body part is closer to the torso . Distal means is further from the torso.
The vital signs that should be documented on all patients are
Pulse Respiration Blood Pressure Skin condition Mental Status Pupils
List one of the diagnostic signs utilized by an EMT.
Pulse Oximetry Blood Glucose monitor Breath sounds End Tidal CO2 Limb Leads Cardiac Monitor Capnometry
PERRL stands for?
Pupils equal, round and reactive to light
EKG Color and Location : RA LA LL RL
RA: White LA: Black LL: Red RL: Green
Abnormal breath sounds caused by the passage of air through the medium sized and smaller bronchi and alveoli that contain fluid is called.
Rales
Caused by the passage of air through the medium sized and smaller bronchi and alveoli that contain fluid.
Rales
What breath sound is also known as "crackles"?
Rales
When assessing respirations, the EMT should document what three (3) things?
Rate Quality Depth
What 3 parameters should be documented regarding Pulse?
Rate , Strength, Rhythm
What 3 parameters should be documented regarding Respirations?
Rate, Depth, Quality
When assessing the pulse, the EMT should document what three (3) things?
Rate, Strength , Regularity
What does RTQ2 mean?
Read the question twice and make sure you know what it is asking
The __________ reduces cyclender pressure to a working level , while the _______- controls the rate , together they are know as a __________
Reducing Valve Flow meter Regulator
Define Chief Complaint.
Reflects the medical complaint or trauma injury that promoted the 911 call for assistances. It shouldn't reflect the writers opinion of the patients problem.
Abnormal breath sounds caused by the passage of air through the larger bronchi that contain thick secretions is called.
Rhonchi
The purpose of High Quality CPR is
To maintain adequate blood pressure to ensure perfusion of vital organs
What position will EMS stretchers NOT go into?
Trendelenburg Position
What should be done prior to attaching the oxygen regulator to the cylinder?
Turn the valve center clockwise to slowly crack the cylinder (50 psi ) and confirm gasket in place
When inserting the stylet inside an ET tube, you should:
avoid inserting the stylet past Murphy's eye.
In an un-witness cardiac arrest, the AED should be turned on to analyze when?
based on local protocols
c/c is the medical abbreviation for?
chief complaint
List the three (3) components of a good patient care report (PCR).
completeness of information Accuracy Legibility
During the transport phase of an EMS call, it is MOST important to:
converse with the patient and provide reassurance.
The analytical process that assists the EMT in reaching a field diagnosis is referred to as:
critical thinking
Scene Assessment represents the beginning of patient assessment. In addition to Scene Safety and BSI, List one of the four remaining elements that comprise the Scene Assessment.
# of patients C Spine MOI/NOI Additional Resources
How long will a D cylinder last at 1800psi with a NC delivering 36% oxygen? (Show work) Is humidification required?
( 1800-200)x0.16/4 LPM=64 minutes Yes Humidification is required because time exceeds 60 minutes
What is the formula to determine the duration of an oxygen cylinder?
( Gauge Pressure-Safe Residual Pressure) x Cylinder Factor / Rate (LPM) = duration in minutes
D Cylinder @ 1575 psi gauge pressure will last how long @ 10 LPM ?
(1575-200)x0.16/10 LPM = 22 minutes
Transport time is 20 minutes. You are administering high concentration O2 to a patient from a D cylinder with 1700 psi gauge pressure. How long will cylinder last at starting flow rate for device? Do you have enough O2 to complete the transport?
(1700-200)x0.16/15 LPM= 16 minutes I do not have enough O2 to complete this transport
You are working a Cardiac Arrest on an adult patient with an advanced airway in place. How long will an E cylinder last @ 1700 psi gauge pressure at the starting flow rate for device?
(1700-200)x0.28/15 LPM= 28 minutes
You are transporting a patient on a 36% O2 via NC from a D cylinder with 2000 psi gauge pressure. How long will cylinder last? Do you need humidified oxygen ( based on time cylinder will last?
(2000-200)x0.16/4 LPM= 72 minutes yes we need to humidify this oxygen because it exceeds 60 minutes.
E cylinder @ 2000 psi gauge pressure will last how long @ 6 LPM?
(2000-200)x0.28/6 LPM= 84 minutes
List the three (3) components of the Secondary Assessment.
1 . Patient History 2. Vital Signs 3. Physical Exam
Each _____ LPM increase in flow rate increasing O2 concentration approximately _____ % with the Nasal Cannula
1 LPM 4%
A 44 y/o auto mechanic had a hot radiator exploded while he was working on a vehicle. PE reveals 2o burns to his left facial cheek. What is the TBSA%?
1% if its the size of his palm
The oxygen flow range for the nasal cannula is ____ to _____ liters per minute, which delivers an O2 concentration rage of _____ to ____ percent
1-6 LPM 24-44 %
What information should be documented in the General Impression?
1. Age 2. Gender 3. Ethnicity 4, Position PT was found 5. Level of Distress 6. Overall Appearance ( any unusual circumstances )
List the contraindication(s) for the OPA
1. Alert and Oriented 2. Gag Reflex 3. Improper Size 4. Hypothermia Caustic Substance Ingestion 5. Oral Damage
List the six (6) components of a Scene Assessment.
1. BSI 2. Scene Safety 3. # Of patients 4. MOI/NOI 5. Consider Spinal Precautions 6. Obtain Additional Resources
List the six (6) Vital Signs taken on all patients.
1. Blood Pressure 2. Pulse 3.Respierations 4.Skin conditions 5. Pupillary Response 6. Mental Status
14. List the indication(s)/function(s) for the NPA.
1. Can be used on a Pt with a gag reflex 2. Keeps nasal airways open for o2 flow
List the two (2) types of oxygen regulators found pre-hospital.
1. Constant Flow Selector Valve 2. Back Pressure Compensated Flow meter
List the mnemonic and what each letter represents for signs of injury during a physical exam.
1. DCAP-BTLS- TIC Deformities Contusions Abrasions Punctures/ Penatrations Burns Tenderness Lacerations Swelling Tenderness Instability Crepitus
What are the three (3) steps to perform a physical exam?
1. Expose 2. Visualize 3. Palpate
As part of the secondary assessment match the appropriate physical exam with the MOI/NOI. 1. Significant MOI 2.Non-Significant MOI 3.Responsive Medical 4.Unresponsive medical
1. Full head to toe 2.Focused on region involved 3.Focused on system involved 4.Full head to toe
List the five (5) components of the Primary Assessment (In order).
1. General Impression 2. Determine Responsivness (AVPU) 3.ABC's 4.Rapid Body Scan 5.Prioritize Transport
List the five (5) components of the Primary Assessment, IN ORDER.
1. General Impression 2. Level of Responsiveness ( AVPU) 3. ABC's 4.Rapid Body Scan 5.Determine priority of patient care and transport
13. List the contraindication(s) for an NPA.
1. Improper size 2. Positive signs of basilar skull fracture 3. Suspected mid face fracture
What is the major benefit of CPAP?
1. It provides the lung ventilatory support while you are administering the specific therapy for the condition 2. Basically buys you time while you treat the specific conditions
List two (2) adjuncts an EMT has to protect the airway.
1. King Tube 2. Esophageal Tracheal Comi Tube
What are the two types of laryngoscope blades ?
1. Macintosh ( Curved) 2. Miller ( straight)
14. List the indication(s)/function(s) for the OPA
1. Maintains a patent airway by holding the tongue in place 2. Keeps teeth apart when ventilating with a BVM 3. Serves as a bite block in certain cases
What is the exception to not immediately resuming high-quality CPR?
1. Obvious Signs of Life 2. ROSC
What information should the radio report contain when transporting a patient to the hospital? (NOT verbal report given at hand-off).
1. PT Age and Sex 2. Chief Complaint 3. Current Vital Signs 4. ETA
List the two (2) safety systems used for oxygen cylinders.
1. Pin indexing system 2. American Standard System
List the three (3) methods to establish/maintain a patent airway.
1. Positioning ( head-tilt chin lift/ Jaw Thrust Maneuver) 2. OPA 3. NPA
List the two methods of obtaining a blood pressure.
1. Pulse 2. Auscultation
List five (5) diagnostic signs that an EMT can assess.
1. Pulse Oximetry 2. Blood Glucose Monitoring 3.Capnometry 4. Cardiac Monitor 5. Breath Sounds
List the five (5) components of the Reassessment.
1. Repeat Primary Assessment 2. Assess serial vital signs 3. PQRST 4. Check interventions 5. Patient Transport decision
List the six (6) vital signs that an EMT can assess.
1. Respirations 2.Pulse 3.Pupils 4.Blood Pressure 5. Mental Status 6. Skin Condition
List the six (6) Rights for Medications
1. Right Drug 2. Right Patient 3. Right Dose 4.Right Route 5. Right Documentation 6. Right Time
List the two (2) types of suction catheters.
1. Rigid ( Tonsil Tip/ Yankuer) 2. Soft (French)
List the six (6) components of the Scene Assessment.
1. Scene Safety 2. Appropriate BSI 3. MOI/NOI 4.# of Patients 5.Additional Resources 6. C-Spine Consideration
List the five (5) components of the Reassessment.
1. Serial Vital Signs 2. Primary Assesments 3. Transport Decisions 4. Interventions 5. PQRST
What should be documented regarding the physical exam?
1. State the type of assessment used and any pertinent findings. Medical: unresponsive: Full body assessment Responsive: Focused system involved assessment Trauma: Significant MOI: Full body assessment, head to toe Non significant MOI: focused injury site assessment
Define Quality Improvement/Continuous Quality Improvement.
1. This is a system of internal and external reviews and audits of all aspects of an emergency medical system. This allows us to see how effective the system is and see how we can improve it. 2. This is used to ensure that the public receives the highest quality of prehospital care. By identifying the aspects of the system that can be improved and implementing plans and programs to carry that along.
In an unwitnessed arrest, when is the AED utilized?
1. Usually after 1-2 minutes of high quality CPR or Immediately 2. Based on Local protocols since no definitive evidence based research exist
An AED will recognize what two (2) rhythms?
1. V Fib 2. Pulsless V Tach
As an EMT, where could you expect to find the DNRO?
1. You could expect to find it in a noticeable place such as the foot or head of a bed, or the refrigerator. 2. It should be readily available so that the patients wishes can be honored.
List the 3 methods for establishing/maintaning a patent airway
1. head tilt chin lift ( Positioning) 2. Jaw thrust maneuver 3. OPA and NPA
. As an EMT, how do you know that a DNRO is properly completed?
1. the form will be signed by the competent patient or the patients representative and by a Florida licensed physician. It will be on either original canary yellow form or copied onto similar yellow colored paper. 2. Dated with 1 year
. List the minimum requirements to establish a LZ.
1.Area should be hard or grassy level surface that measures 100'x100' (Recommended) 2.Clear area of loose debris and survey for overhead or tall hazards 3. Mark Landing site with weighted cones or headlights
What should be documented under patient disposition?
1.Disposition of the patient at the ED such as ( transferred to bed 6 without incident) 2.Documentation of who you gave the patient care report to. 3.Documentation of who personal possessions, valuables and medications were given to. 4.Consequences of refusal stated
How should multiple medications be documented?
1.Document only those prescriptions/OTC medications that relate to the current problem 2.If too numerous , document list brought to the ED or medications brought to ED
What should be documented regarding the General impression?
1.Document the circumstances/environment the patient was found to give background and allow the medical facility to develop a baseline against further medical care can be based. 2. Include Demographics : Age , Gender, Ethnicity , Position found and level of distress.
What should be documented regarding the Medical History portion of SAMPLE?
1.Document those aspects of the PMHx that relate to the current problem. 2.The Medical history should be pertinent to the chief complaint or have some should be documented regarding the Medical History portion of SAMPLE? cause or effect on the C/C
What is the Move over Act?
1.Motorist approaching a stopped emergency vehicle with its lights flashing must L get out of the closest lane as soon as it is safe on multilane highways. 2.Slow to 20 mph below the posted speed limit on two lane roads 3.Slow to 5 mph if the posted limit is 20mp or less
After you identify an unresponsive victim with no breathing (or no normal breathing) and no pulse, chest compression should be initiated within
10 seconds
The oxygen flow range for the Nonrebreather Face Mask is _______ to ____ liters per minute , which delivers an O2 concentration range of _____ to _____ percent
10-25 LPM 90-100 %
According to the 2020 AHA Guidelines the proper rate of compressions per minute for the Adult, Child and Infant is?
100-120 Compressions Per Minute
The standard starting flow rate for the Adult BVM is?
15 LPM
What is the industry standard for connections for airway adjuncts?
15 mm or 22 mm
The compression to ventilation ratio for 2-rescuer child CPR is
15:2
The compression to ventilation ratio for 2-rescuer infant CPR is
15:2
The depth of chest compressions for an adult victim should be at least
2 Inch ( 5cm)
What is the Safe Residual Pressure?
200 PSiI ( considered to be empty )
Oxygen cylinders are considered full between _____-_______ pis and the Safe Residual pressure is ______ psi
2000-2200 , 200
What is there no such thing as?
A dumb question
Which physical exam is done for an unresponsive medical or significant MOI patient?
A full body Assessment ( systematic Head to Toe)
Which of the following statements regarding a patient refusal is MOST correct? 1. Advice given to a patient who refuses EMS treatment should not be documented 2. A mentally competent adult has the legal right to refuse EMS care and transport 3.Documentation of proposed care is unnecessary if the patient refuses treatment 4. A patient who consumed a few beers will likely be able to refuse EMS treatment
A mentally competent adult has the legal right to refuse EMS care and Transport
List the conditions that an EMT employed by a licensed ALS provider can start a non- medicated IV.
A non-medicated IV is initiated only in accordance with the department approved protocols of the licenses ALS providers medical director. Protocols include a requirement that the IV be initiated in the presence of a paramedic who directs the EMT to initiate the IV. b. If the licensed ALS provider elects to utilize EMTS in this capacity, the provider should ensure that the medical director provides training at least equivalent to that required by the 1999 US DOT EMT intermediate national standard curriculum relating to IV therapy.
After placement of any supraglottic adjunct it is critical to verify correct placement. The first region assessed is the?
Abdomen
What is high concentration oxygen
Above 90% via NRBFM
What should not be administered if Syrup of Ipecac has been given?
Activated Charcoal
Which of the following is the MOST reliable indicator of adequately performed positive-pressure ventilations with a BVM device?
Adequate rise of the chest when squeezing the bag
What is the MOST appropriate management for a trauma patient with respirations of 18 breaths/min, shallow and labored, CTA= with no cyanosis?
Administer oxygen via NRFM
A 51-year-old female presents with a sudden onset of chest pain. She is conscious and alert and able to speak in complete sentences. Her respirations are 24 breaths/min, unlabored & regular. You should:
Administer oxygen via nasal cannula at 4 LPM titrated
According to AHA BLS, where is the pulse assessed on an adult; child & infant.
Adult /Pediatric : Carotid Infant : Brachial Femoral acceptable for all 3
List the appropriate age ranges for Basic Life Support (CPR): Adult Child Infant
Adult : ( Puberty to Older) Child: (1 year of age to puberty) Infant: ( Birth to 1 year)
What is the correct dose for Nitroglycerin
Adult : 0.4mg ( 1 tablet or spray) Max 3 times We dont give this to ped population
Indicate the correct Rescue breathing rate for an adult and pediatric patient.
Adult : 10 breaths/min ( 1 breath every 6 seconds) Pediatric: 20-30 breaths/min (. 1 breath every 2-3 seconds)
12. List the starting LPM flow and volume ranges for the following BVMs: Adult Pediatric Infant
Adult BVM: 15 LPM , VOL @ 1000-1600 CC Pediatric BVM: 12LPM (15 on CFR), VOL @ 500cc-700cc Infant BVM: 10 LPM, VOL @ 150cc-240cc
List the maximum suctioning times for the following patients: Adult Pediatric Infant
Adult: 15 Seconds Pediatric: 5-10 Seconds Infant: 5 Seconds
What is the correct dose for ASA ( Aspirin )
Adult: 2-4 chewable aspirin PO ( 162-324 mg) This is a 1 time dose We do not administer ASA to the pediatric Population
List the appropriate depth of compressions for Basic Life Support (CPR): Adult Child Infant
Adult: At least 2 inches ( doesn't exceed 2.5 Inches ) Child: At least 1/3 depth of the chest ( Approx 2 inches ) Infant : At least 1/3 of the chest ( Approx 1 1/2 inches )
To assess responsiveness an EMT uses the mnemonic AVPU to determine the patient's response to external stimuli. AVPU stands for
Alert , Verbal, Responds to painful stimuli, unresponsive
A&Ox4 indicates the patient is?
Alert and Oriented to person, place , time and event leading up to
Exchange of oxygen and carbon dioxide occurs in the;
Alveoli
Successful positive pressure ventilation with the BVM requires:
An airtight mask seal and patent airway
A patient's refusal for EMS treatment and/or transport must be:
An informed Refusal
CPAP should be discontinued if;
Any of the following : The patient becomes extremely claustrophobic and anxious The patient Vomits The patient becomes unresponsive
Establishing a LZ for arrival of the ATU requires:
Area should be hard or grassy level surface that measures 100' x 100' (recommended).
When assembling an I.V. set-up, what must be maintained?
Aseptic Technique
According to the protocol, a potential CPAP candidate patient must have;
At least two of the following: Oxygen Saturation less than 94 % Retractions or use of accessory muscles Respiratory rate greater than 25/min
List an adjunct that provides positive pressure ventilation to an apenic patient.
BVM Transport Ventilaton
CPAP is most appropriate for patients with a history of.
COPD CHF Asthma Pneumonia Pulmonary Edema Emphysema
The properly completed DNRO form will be signed by the competent patient or the patient's representative and by a Florida licensed physician, and it will be on what colored form.
Canary Yellow
A Do Not Resuscitate Order (DNRO) is a form or patient identification device developed by the Florida Department of Health to identify people who do not wish to be resuscitated in the event of
Cardiac Arrest , Pulmonary Arrest
According to the 2020 AHA Guidelines the rescuer should check circulation by assessing the?
Carotid pulse in the adult, carotid pulse in the child and brachial pulse in the infant
If a stuttering sound is heard when using a Transport Ventilator, the EMT should check for? You Answered
Check for an obstruction or a bent tube
Documenting the patient's own statement, or the family or callers' statement, reflecting the medical complaint or trauma injury that promoted the 911 call for assistance is called the?
Chief Complaint
As an EMT you might be involved in what two types of legal cases?
Civil and Criminal
As an EMT your career in EMS will necessarily involve you in both ___- cases
Civil and Criminal Cases
If a shock is advised, what is critical to do immediately prior to shocking the patient with an AED?
Clear everyone
CTA= is the abbreviation for?
Clear to Auscultation , Equally
What two (2) components make up an oxygen regulator?
Combination of a reducing valve and a flow meter
The three (3) components of a good report are
Completeness of information , Accuracy and Legibility
According to 2020 AHA Guidelines the proper single rescuer chest compressions/ventilation ratio for the Adult, Child and Infant is?
Compression to Ventilation Ratio is 30:2 for all ages , except newborns
All information recorded on the prehospital care report must be:
Considered Confidential
What is the most common used pre-hospital regulator?
Constant Flow Selector Valve
Two (2) of the reasons for completing a PCR are
Continuation of care, Quality improvement Research Legal Improvement Insurance Billing
What is a system of internal and external reviews and audits of all aspects of an emergency medical system?
Continuous Quality Improvement
In medical terminology, what term refers to a condition, that if present, dictates that a certain procedure or action SHOULD NOT be undertaken by the EMT.
Contraindication
Compression: Ventilation ratio for a pediatric (2 rescuer) is.
Cycles of 15 compressions and 2 breaths
To auscultate for lung sounds, it is recommended that you utilize the ____ of the stethoscope.
Diaphragm
D Cylinder Factor E Cylinder Factor
D is 0.16 E is 0.28
During the physcial exam portion of the Secondary Assessment what mnemonic is utilized?
DCAP-BTLS-TIC
The most important benefit of the use of pre-hospital CPAP in patients with severe respiratory distress is;
Decreased need for intubation
DCAP-BTLS-TIC (What does each letter represent)
Deformities Contusions Abrasions Punctures Burns Tenderness Laverations Swelling Tenderness Instability Crepitus
Assessing the trauma patient use the mnemonic DCAP-BTLS-TIC, which stands for
Deformities Contusions Abrasions Puntures Burns Tenderness Laserations Swelling Tenderness Instability Crepitus
Preparation is the key to good courtroom demeanor. If a witness is prepared, there is no room for error. The witness will testify truthfully and their demeanor will more naturally evolve. The basis of preparation prior to the deposition is
Good report writing
. Which end of the scoop stretcher should be locked first?
Head First
To ensure confidentiality, medical information may only be shared as appropriate with. (In general, no exceptions)
Healthcare workers involved in Tx of Pt.
Information provided on the PCR should give a clear and accurate picture of what occurred in the prehospital environment. The two basic rules to follow are
If it wasn't written down , it wasn't done If it wasn't done, dont write it down
n a witness cardiac arrest, the AED should be turned on to analyze when?
Immediately
What is the purpose of the pin-indexing system?
It prevents the filling of a portable oxygen cylinder with anything other than oxygen.
List one of the methods to establish/maintain a patent airway.
Jaw Thrust Maneuver NPA OPA Positioning Head tilt chin lift oropharyngeal
OPQRST (What does each letter represent)
Onsent Provocation/Palliation Quality Radiation Severity Time
List the flow rates for the Micro and Macro administration sets.
Micro : 60 gtt/ml Macro: 10-15 gtt/ml
List the two types of laryngoscope blades
Miller ( straight) Macintosh (Curved)
The Florida law that requires motorist approaching a stopped emergency vehicle with lights flashing to get out of the closest lane is called.
Move Over Act
List the LPM ranges and oxygen percentages for the Supplemental Airway adjuncts. Nasal Cannula Simple Face Mask Partial Rebreather Face Mask Non-Rebreather Face Mask
Nassal Cannula : 1-6 LPM, O2 @ 24-44 % Simple Face Mask : 6-12 LPM, O2 @ 28-50% Partial NonRebreather Face Mask: 5-15 LPM, O2 @ 40-70% Non-Rebreather Face Mask: 10-25 LPM, O2 @ 90-100%
When should the student wear the safety vest
Needs to be worn by the student any time they are outside of the vehicle on a roadway or other area that vehicular traffic is present.
Is the pulse oximetry a substitute for assessing the patient's pulse?
No
Does an EMT make a definitive diagnosis, a field diagnosis or nether?
No , but they can make field diagnosis for treatment purposes
In the adult patient, suction time should be limited to?
No more than 15 seconds
What airway adjunct should always be used with the BVM, unless contraindicated?
OPA : Oropharyngeal
List the mnemonic and what each letter represents for history of present illness (C/C.
OPQRST Onset Provocation/Palliation Quality Radiation Severity Time
After assembling equipment, measuring and inserting catheter, to apply suction what must be done?
Occlude opening on the catheter as you withdraw the catheter
Where should the hands be placed to perform chest compressions on an adult?
On the lower half of the breastbone
List the mnemonic and what each letter represents for past medical history.
SAMPLE Signs and Symptoms Allergies Medications Past medical history Last oral intake Events leading up to
What is the correct route for Nitroglycerin?
SL ( Sublingual) dissolved Under tongue
List one of the alternate methods used for the narrative portion on PCR charting?
SOAP CHART
When manually off-loading, what prevents the wheeled stretcher from being removed from the vehicle accidentally?
Safety Hook
Assessing the past medical history use the mnemonic SAMPLE, which stands for
Sighs and Symptoms, Allergies, Medications , Past medical history , Last oral intake , Events leading up to
SAMPLE (What does each letter represent)
Signs and Symptoms Allergies Medications Pertinent Past Medical history Last oral intake Events leading up to
Errors in the PCR should be corrected how?
Single Line through the mistake and your inititals next to the mistake. Then write the corrected information.
What is a pertinent negative?
Something that , given a particular illness/injury, would be expected to be present but is not.
CPAP works primarily by;
Splinting the lung by keeping the alveoli expanded
American Standard System is usually for what
Stationary Cylinders
During cross-examination what should be the EMT's response to defense counsel being overly friendly?
Stay alert ; bear in mind that the purpose of the defense is to discredit or diminish the effect of your testimony
What type adjunct (not specific device) can an EMT use to establish a protected airway.
Supraglottic Adjunts
The palpation method of taking the BP only obtains the _____ pressure.
Systolic
A 50 y/o industrial worker was working with volatile chemicals and has spilled the chemical on him. PE reveals 2o and 3o burns to his abdomen, groin and anterior thighs and his anterior lower legs. What is the TBSA%?
TBSA% is 37 % Abdomen: 9% Anterior things: 18% Anterior Legs : 9% Groin: 1 %
Do Not Resuscitate Orders are usually prescribed for someone who is suffering from a(n).
Terminal Condition End Stage Condition Vegetative State
The term protect the airway refers to?
The act of preventing the entry of foreign material into the tracheal opening
The rescuer knows the rescue breath for an infant victim is effective when:
The chest rises visibly
The compression to ventilation ratio for 2-rescuer adult CPR is
The compression to ventilation ratio for 2-rescuer adult CPR is
You should instruct the patient to breathe in what manner
The patient needs to have their mouth slightly open and breath deeper than normal.
What is the indication for CPAP?
The treatments of severe respiratory distress since in COPD, Congestive Heart Failure, and to a lesser degree Asthma
To determine proper insertion depth of the King LTS-D:
Use of connector aligns with teeth or gums
What breath sound is heard over most of the chest? The above sound is ________ and it last the longest on _____________.
Vesicular Soft , inspiration
Name the three normal breath sounds.
Vesicular Bronchovesicular Bronchial/Tracheal
Heard normally over the entire chest wall and are produced by air moving through the small airways and lung tissue.
Vesicular Breath Sounds
What breath sound is heard over most of the chest?
Vesicular Breath Sounds
To minimize exposure, what should be done at the conclusion of all patient contacts?
Wash your hands as soon as possible. Just in case pathogens have penetrated the glove and contacted your skin
A whistling or signing sound that results from the constriction of airways.
Wheezing
List the proper color and extremity for EKG Lead Placement
White (RA) Black (LA) Red (LL) Green(RL)
Students may ONLY perform those skills:
Within the scope of practice for an EMT
What is defined as: "one who gives evidence in a cause before a court and who attests or swears to facts or gives or bears testimony under oath".
Witness
The recommended depth of chest compressions for an infant is
at least 1/3 the depth of the chest ,approx 1.5 inches ( 4cm)
List the five abbreviations for the different areas of the lungs. LLL LUL RLL RML RUL
a.LLL ( Left Lower Lobe) b. LUL(Left Upper Lobe) c. RLL ( Right Lower Lobe) d. RML (Right Middle Lobe) e. RUL ( Right Upper Lobe)
What should always be done prior to placing the EKG electrodes on the patient?
a.Try to attach the lead snap on connector to the head of the electrode patch prior should always be done prior to placing the EKG electrodes on the patient. to placing the patch onto the patient . Since it can be difficult or painful to place them while on the patient. b. Prior to attaching the EKG electrodes wipe the area with a towel so that the patches might adhere to the skins surface. ( If debris , blood or sweet cover the patients chest/abdomen. You might also have to shave the area where the patch is going to be attached if the patient is too hairy.
Why is it important to compress to the appropriate depth during CPR
adequate depth of compression is needed to create blood flow during compressions
Rhonchi
are usually heard in larger bronchi and airways.
After delivering your patient to the hospital, you sit down to complete the patient care report. When documenting the patient's last blood pressure reading, you inadvertently write 120/60 instead of 130/70-the patient's actual blood pressure. To correct this mistake, you should:
draw a single horizontal line through the error, initial it , and write the correct data next to it
The Purpose of high quality CPR is
ensure adequate blood pressure
What should the EMT do if the drip chamber is over filled?
invert the bag and squeeze the chamber to empty the fluid back into the bag
What is the danger in puncturing either the drip chamber or IV tubing?
it can cause an air embolism
Why should an EMT avoid the use of "EMS lingo"?
it is not easily understood by laypersons.
When using a glucometer, if the device doesn't give an actual number, a reading of LO (LOW) indicates a BGL:
less than 40 mg/dl
Proper technique for suctioning the oropharynx of a conscious adult patient includes:
measure, occlude opening and suctioning while withdrawing the catheter from the oropharynx
While en route to the scene of a shooting, the dispatcher advises you that the caller states that the perpetrator has fled the scene. You should:
stage away from the scene and confirm with law enforcement personnel scene is safe
List one of the verification devices to confirm endotracheal tube placement
stethoscope
The MOST important step in assembling intravenous (IV) equipment is to:
strictly adhere to aseptic techniques.
Assessing the skin condition as part of the baseline vital signs relates to?
the color , temperature and the moisture of the skin
After determining the proper size for the NPA it must be ____ prior to inserting.
well lubricated
When using the AED, after initial analyzation indicates NO SHOCK, what is the next step of subsequent NO SHOCK analyzations?
you need to do a pulse check and proceed appropriately to the findings. Since the AED only recognizes pulseless V-Fib and V-Tac to shock, we need to confirm if a pulse has been restored by high quality CPR.
