SNHD Paramedic Protocol Exam | LATEST UPDATE 2026/2027 | Southern Nevada Health District Paramedic Certification | Questions and Answers with Verified Rationales | Get HighScore | Instant Download

GET HIGHSCORE on the SNHD Paramedic Protocol Exam with this comprehensive test bank covering the official Southern Nevada Health District paramedic protocols—featuring multiple-choice and open-ended questions with verified answers and detailed rationales. The purpose of the Clark County EMS protocol manual is to provide guidance for all prehospital care providers and emergency department physicians within the Clark County EMS System. The GOAL of the manual is to STANDARDIZE prehospital patient care in Clark County. Nothing contained in these protocols shall be construed to expand the scope of practice of any licensed Attendant beyond that which is identified in the Clark County Emergency Medical Services Regulations. Nothing contained within these protocols is meant to delay rapid patient transport to a receiving facility—patient care should be rendered while EN ROUTE to a definitive treatment facility . Master General Assessment & Patient Definition: A patient is defined as any individual that, upon contact with an EMS system, has a complaint or mechanism suggestive of potential illness or injury, obvious evidence of illness or injury, or is identified by an informed 2nd or 3rd party caller as requiring evaluation . Pediatric treatment protocols apply to children who have not experienced puberty. For suspected traumatic brain injury (TBI), elevate the head of bed to 30 degrees and maintain ETCO2 at 35 mmHg . Radio contact to receiving facility is required for all trauma patients, emergency (code 3) returns, need for telemetry physician, and per protocol . Master Waiting Room Criteria: A patient may be placed in the waiting room ONLY if ALL criteria are met: Heart Rate 60-100, Respiratory Rate 10-20, Systolic BP 100-180, Diastolic BP 60-110, Room air pulse ox 94%, A&O x4, did NOT receive any parenteral medications during transport EXCEPT single dose analgesia and/or antiemetic, does NOT require continuous cardiac monitoring, can maintain sitting position, and left with verbal report to hospital personnel . Master Trauma & Burn Management: Parkland Burn Formula: 4mL x (body weight in kg) x (% BSA burned) = total fluids for 24 hours; give 1/2 in first 8 hours, remainder over next 16 hours . For children, a fall greater than 10 feet or two times the height of the child requires transport to Level 1 or 2 trauma center. For adults, a fall greater than 20 feet requires transport to Level 1, 2, or 3 trauma center . Ejection from a motor vehicle requires transport to Level 1, 2, OR 3 trauma center (NOT only Level 1 and 2) . For traumatic cardiac arrest, interventions prior to terminating resuscitation: provide effective ventilation with 100% oxygenation for two (2) minutes, open airway with BLS measures, perform bilateral needle thoracentesis if tension pneumothorax suspected . BVM is acceptable if pulse oximetry can be maintained at or above 90% . Master Respiratory & Cardiac Protocols: For pulmonary edema/CHF with hypertensive and diastolic BP 100 mmHg, Nitroglycerin dose is 1.6 mg SL. For normotensive, Nitroglycerin dose is 0.4 mg SL . EKG findings consistent with hyperkalemia: bradycardia with widening QRS complexes . For a patient in shock (non-trauma, non-cardiogenic), administer Normal Saline 500-2000 mL bolus . Master Pharmacology & Medication Dosing: Naloxone (Narcan) for suspected overdose: 2.0 mg IN/IM/IV, may be repeated to max dose 10mg . For pediatric unresponsive with respiratory depression: 0.1 mg/kg . Epinephrine 1:1000 dose 0.5 mg IM (max 1.5 mg, may repeat q15 min) . For anaphylaxis with airway involvement, administer Epinephrine 1:1000 0.5 mg IM, may repeat q15 min up to 1.5 mg . Ondansetron (Zofran) for abdominal pain/flank pain/nausea/vomiting: 4.0 mg ODT/IM/IV/IO. Pediatric dose: 0.15 mg/kg up to max 4.0 mg . Diphenhydramine (Benadryl) for allergic reaction with NO airway involvement: 50 mg IM/IV/IO/PO . For moderate allergic reaction (skin disorders and wheezing with adequate tidal volume): Epinephrine 0.5 mg IM, Albuterol 2.5 mg SVN, IV access, Benadryl 50 mg IM/IV . Albuterol dose: 2.5 mg in 3cc SVN . For severe allergic reaction in shock: Epi 1:1000 0.5 mg IM, Albuterol 2.5 mg SVN, IV 500-2000 mL NS, Benadryl 50 mg IM/IV, push dose epi 5-10 mcg IV, consider Dopamine 5-20 mcg/kg/min . For hypoglycemia with BGL 60 mg/dL and patent airway: D10 25g (250mL of 10% solution). Pediatric D10 max single dose: 25g . For hypoglycemia without IV access: Glucagon 1 mg IM . Master Cardiac Arrest & Resuscitation: For cardiac arrest with suspected hypoxia as cause: early ventilation is recommended . For a patient in cardiac arrest or in whom ability to adequately ventilate cannot be established: transport to closest facility . Pulse checks performed every 2 minutes during cardiac arrest . Chest compressions rate: 30:2 until advanced airway placed, then 100-120 BPM . Master Special Populations & Destination Protocols: Sexual assault victims: 13 years old transported to Sunrise Hospital; 13-18 years old to Sunrise Hospital or UMC; 18 years and older to UMC; outside 50-mile radius to nearest appropriate facility . Internal disaster protocol: only patients in whom an airway cannot be established or patients in cardiac arrest can be taken to a hospital on internal disaster . For pregnant patient with limb delivery: place in left lateral recumbent position . Master Status Epilepticus & Seizure Management: Status epilepticus defined as: two or more seizures successively without an intervening lucid period OR a seizure lasting over five minutes . Midazolam (Versed) for seizure: 0.1 mg/kg IM/IN/IV up to maximum 5.0 mg . Diazepam (Valium) for pregnant patient refractory to Magnesium Sulfate: additional doses every 5 minutes . Master Drowning & Cold-Related Illnesses: For drowning: administer O2 15L NRB/ETCO2, Albuterol 2.5 mg SVN, consider CPAP, consider 12-lead EKG . A Submersion Incident Report Form must be submitted to SNHD after a drowning incident . Hypothermia categories: Severe 82°F (28°C), Moderate 82-90°F (28-32°C), Mild 90-95°F (33-35°C) . Do NOT rub skin to warm localized cold injury . Master Hyperkalemia & Electrolyte Disorders: Hyperkalemia defined as potassium level 5.5 mmol/L. Potassium 5.5-6.5 mmol/L causes tall tented T waves. Potassium 6.5-7.5 mmol/L causes loss of P waves. Treatment: Albuterol 2.5 mg continuous SVN, Calcium Chloride 1.0g slow IVP, Bicarb 1.0 mEq/kg slow IVP. Calcium Chloride is contraindicated if patient is taking Digoxin . Master Hypothermia & Active Cooling: For heat stroke (temperature 104°F, hot dry skin, hypotension, AMS): active cooling with cold packs, ice, fanning, AC. Do NOT place cold packs directly on skin . For heat exhaustion (elevated temp, cool moist skin, weakness): active cooling, IV 500-2000 mL NS to effect SBP 100 . Master Behavioral Emergencies & Restraints: The S.A.F.E.R. model: Stabilize situation by containing and lowering stimuli, Assess and acknowledge the crisis, Facilitate identification and activation of resources (chaplain, family, friends, police), Encourage patient to use resources and take action, Recovery or referral (leave with responsible person or transport) . Inappropriate restraint positions: arms behind back, hogtied, prone . Dystonic reaction (involuntary muscle movements/spasms of face, neck, upper extremities): treatment with Diphenhydramine 50 mg IV/IM . Master Approved Hypothermia Centers: Approved hypothermia (post-resuscitation) centers include: Centennial Hills, Desert Springs, Mountain View Hospital, St. Rose De Lima, St. Rose Siena, Southern Hills, Spring Valley, Summerlin, Sunrise, UMC, Valley . Each question includes detailed rationales explaining the "why" behind every protocol decision, reinforcing clinical judgment for paramedic certification and field readiness. Pass your SNHD Paramedic Protocol Exam with confidence on your first attempt. DOCUMENT ACCESS: This study guide is available as an instant digital download (PDF) immediately upon purchase. Fully text-searchable, printable, and accessible anytime through your user account. Trusted by thousands of paramedic candidates for SNHD Paramedic Protocol Exam success and Nevada EMS certification . 4. VERTICAL KEYWORDS / TAGS SNHD Paramedic Protocol Exam 2026/2027 Southern Nevada Health District Paramedic Certification Multiple Choice and Open-Ended Questions with Verified Answers and Detailed Rationales Clark County EMS System Protocols Parkland Burn Formula 4mL x kg x BSA 24 Hours Half First 8 Hours Pediatric Fall Trauma Criteria 10 Feet or Two Times Height Adult Fall Trauma Criteria 20 Feet Naloxone Narcan Dose 2.0 mg IN IM IV Max 10 mg Traumatic Cardiac Arrest Interventions 100% Oxygen 2 Minutes Bilateral Needle Thoracentesis Pulmonary Edema CHF Nitroglycerin 1.6 mg SL Hypertensive 0.4 mg SL Normotensive EKG Hyperkalemia Bradycardia Widening QRS Shock Fluid Resuscitation Normal Saline 500-2000 mL Patient Definition Complaint Mechanism Obvious Evidence 2nd 3rd Party Caller TBI Head Elevated 30 Degrees ETCO2 35 Radio Contact Receiving Facility All Trauma Code 3 Returns Telemetry Physician Waiting Room Criteria Normal Vital Signs No Parenteral Meds Single Dose Analgesia Antiemetic Internal Disaster Protocol Airway Cannot Be Established Cardiac Arrest Motor Vehicle Ejection Trauma Center Level 1 2 or 3 BVM Acceptable SpO2 ≥90% Albuterol Dose 2.5 mg SVN Epinephrine 1:1000 Anaphylaxis 0.5 mg IM Max 1.5 mg Ondansetron Zofran Abdominal Pain Flank Pain Nausea 4.0 mg Pediatric Ondansetron 0.15 mg/kg Max 4.0 mg Diphenhydramine Benadryl Allergic Reaction 50 mg IM IV IO PO Status Epilepticus Two or More Seizures No Lucid Period Lasting Over 5 Minutes Midazolam Versed Seizure 0.1 mg/kg IM IN IV Max 5.0 mg Diazepam Valium Pregnant Patient Refractory Magnesium Sulfate Every 5 Minutes Sexual Assault Transport Sunrise UMC Age-Based Hypoglycemia D10 25g Glucagon 1 mg IM Pediatric D10 Max Single Dose 25g Cardiac Arrest Pulse Checks Every 2 Minutes Traumatic Cardiac Arrest Termination Criteria CPR Compression Rate 30:2 Until Airway Then 100-120 BPM Limb Delivery Left Lateral Recumbent Position Cord Presentation Trendelenburg Moist Cord Insert Gloved Hand Breech Presentation Support Body and Head Active Cooling Measures Cold Packs Ice Fanning AC Heat Stroke Temperature 104°F Hot Dry Skin Hypotension AMS Heat Exhaustion Elevated Temp Cool Moist Skin Weakness Heat Cramps PO Fluids Hypothermia Categories Severe 82°F Moderate 82-90°F Mild 90-95°F Drowning Submersion Incident Report Form Albuterol CPAP Burn Transport Criteria 2nd Degree 10% BSA Under 10 or Over 50 20% BSA Circumferential Burns Face Hands Feet Genitalia Perineum Major Joints Electrical Chemical Inhalation Hyperkalemia Tall Tented T Waves 5.5-6.5 mmol/L Loss P Waves 6.5-7.5 mmol/L Hyperkalemia Treatment Albuterol Calcium Chloride Bicarb Calcium Chloride Contraindication Digoxin Hypothermia Approved Centers Centennial Hills Desert Springs Mountain View St Rose De Lima St Rose Siena Southern Hills Spring Valley Summerlin Sunrise UMC Valley Dystonic Reaction Diphenhydramine 50 mg IV IM SAFER Crisis Model Stabilize Assess Facilitate Encourage Recovery Inappropriate Restraint Positions Arms Behind Back Hogtied Prone Get HighScore SNHD Paramedic Protocol Exam Downloadable PDF Nevada Paramedic Certification Study Guide