MICN LA COUNTY FINAL (2026) COMPREHENSIVE QUESTIONS AND VERIFIED
ANSWERS ( DETAILED & ELABORATED) ACTUAL EXAM 2026 TEST!!
Question 1
An ALS unit requests to divert from a local hospital due to "Internal Disaster." According to LA
County policy, what is the maximum duration for an ALS diversion?
A) 60 minutes
B) 90 minutes
C) 120 minutes
D) 180 minutes
E) Indefinite until the hospital clears
Correct Answer: C) 120 minutes
Rationale: Per LA County EMS policy, ALS diversion (Advanced Life Support) typically
lasts for a maximum of 120 minutes (2 hours). After this time, the hospital must re-evaluate
its status.
Question 2
An EMS unit is transporting a patient to a STEMI Receiving Center (SRC). If the SRC is on
diversion, how long does that diversion typically last?
A) 60 minutes
B) 120 minutes
C) 180 minutes
D) 240 minutes
E) 30 minutes
Correct Answer: C) 180 minutes
Rationale: Specialty diversions, such as those for STEMI Receiving Centers (SRC), are
granted in 180-minute (3-hour) increments.
Question 3
The APOT (Ambulance Patient Offload Time) standard in LA County requires that patients are
offloaded from EMS to the hospital staff within:
A) 15 minutes 90% of the time
B) 20 minutes 80% of the time
C) 30 minutes 90% of the time
D) 45 minutes 75% of the time
E) 60 minutes 100% of the time
Correct Answer: C) 30 minutes 90% of the time
Rationale: The state and county standard for APOT is to have the patient transferred to a
hospital bed and EMS released within 30 minutes for at least 90% of all arrivals.
Question 4
A patient is found in "extremis" with an unmanageable airway and active CPR in progress. What
is the appropriate transport destination?
A) The closest SRC
, 2
B) The closest Trauma Center
C) The MAR (Most Accessible Receiving)
D) The PMC (Pediatric Medical Center)
E) The SART Center
Correct Answer: C) MAR
Rationale: Patients in "extremis"—meaning they have an unmanageable airway or are in a
state where immediate life-saving intervention is required beyond what can be provided in
the field—must be taken to the Most Accessible Receiving (MAR) facility.
Question 5
Which of the following is a criterion for "911 Re-triage" regarding a trauma patient?
A) GCS of 15
B) Isolated extremity fracture with intact pulses
C) GCS deteriorating by 2 or more
D) Transport time to trauma center is 10 minutes
E) Patient request for a specific hospital
Correct Answer: C) GCS deteriorating by 2 or more
Rationale: Criteria for re-triage to a more specialized center (like a Trauma Center) include
signs of severe physiological distress such as a deteriorating GCS, poor perfusion, need for
intubation, or penetrating injuries to the "trauma box."
Question 6
What is the maximum allowable transport time to an "alternate MAR" if the primary MAR is
unavailable?
A) 5 minutes
B) 10 minutes
C) 15 minutes
D) 20 minutes
E) 30 minutes
Correct Answer: C) 15 minutes
Rationale: If the closest MAR is not an option, an alternate MAR may be chosen provided
the transport time does not exceed 15 minutes.
Question 7
What is the maximum allowable transport time for a patient to be taken to a STEMI Receiving
Center (SRC) rather than the MAR?
A) 15 minutes
B) 20 minutes
C) 30 minutes
D) 45 minutes
E) 60 minutes
, 3
Correct Answer: C) 30 minutes
Rationale: A patient identified with a STEMI should be transported to an SRC if the
transport time is 30 minutes or less. If it exceeds 30 minutes, they go to the MAR.
Question 8
A 10-month-old infant is reported to have had a Brief Resolved Unexplained Event (BRUE)
characterized by a sudden change in muscle tone and color. What is the appropriate destination
for this patient?
A) The closest MAR
B) The closest SART Center
C) The PMC (Pediatric Medical Center)
D) The Perinatal Center
E) Any hospital with an open NICU
Correct Answer: C) PMC
Rationale: Pediatric patients (age 14 or younger) who meet BRUE criteria, or other high-
risk pediatric criteria like status epilepticus or ROSC, must be transported to a Pediatric
Medical Center (PMC).
Question 9
How is a BRUE (Brief Resolved Unexplained Event) defined in the pediatric population?
A) Any child <5 years with a fever
B) An infant <12 months with irregular breathing, color change, or change in muscle tone
C) A teenager with a syncopal episode
D) A child <14 years with a focal neurological deficit
E) An infant with a known history of asthma and wheezing
Correct Answer: B) <12 months WITH irregular breathing, color change, change in muscle
tone, or ALOC
Rationale: A BRUE is specifically identified in infants under 1 year of age where an
observer reports a sudden, brief, and now resolved episode of cyanosis/pallor,
absent/decreased breathing, or marked change in tone.
Question 10
In the field treatment of a BRUE with poor perfusion, what is the appropriate fluid bolus for the
pediatric patient?
A) 10ml/kg NS
B) 20ml/kg NS
C) 50ml/kg NS
D) 250ml NS fixed dose
E) 500ml NS fixed dose
Correct Answer: B) 20ml/kg NS
, 4
Rationale: Pediatric fluid resuscitation for poor perfusion in the context of a BRUE or shock
is 20ml/kg of Normal Saline.
Question 11
A 13-year-old was choking on an apple, but the obstruction was cleared by a parent prior to EMS
arrival. The child is currently asymptomatic. Where should they be transported?
A) PMC
B) Trauma Center
C) EDAP (Emergency Department Approved for Pediatrics)
D) SRC
E) Home (No transport needed)
Correct Answer: C) EDAP
Rationale: Because the respiratory distress resolved and the patient is not currently cyanotic
or in distress, they do not meet PMC criteria. However, all pediatric patients require
transport to an EDAP (the pediatric equivalent of a MAR).
Question 12
Which patient meets criteria for transport to a Perinatal Center?
A) 12 weeks pregnant with abdominal pain
B) 20 weeks pregnant or more in active labor
C) 15 weeks pregnant with high blood pressure
D) 40 weeks pregnant with a sprained ankle and no other complaints
E) 2 weeks postpartum with a sore throat
Correct Answer: B) 20 weeks pregnant or more AND active labor
Rationale: Perinatal center criteria include being 20 weeks or more gestation with active
labor, pregnancy-related complications, or a BP >140/90.
Question 13
A patient is 4 weeks postpartum and presents with a blood pressure of 160/100. Where should
this patient be transported?
A) MAR
B) PMC
C) Perinatal Center
D) SART Center
E) Nearest Urgent Care
Correct Answer: C) Perinatal Center
Rationale: The criteria for Perinatal Center transport extend up to 6 weeks postpartum if
the patient presents with hypertension (>140/90).
Question 14
A paramedic identifies a STEMI on a 12-lead ECG. What is the ECG requirement for STEMI
ANSWERS ( DETAILED & ELABORATED) ACTUAL EXAM 2026 TEST!!
Question 1
An ALS unit requests to divert from a local hospital due to "Internal Disaster." According to LA
County policy, what is the maximum duration for an ALS diversion?
A) 60 minutes
B) 90 minutes
C) 120 minutes
D) 180 minutes
E) Indefinite until the hospital clears
Correct Answer: C) 120 minutes
Rationale: Per LA County EMS policy, ALS diversion (Advanced Life Support) typically
lasts for a maximum of 120 minutes (2 hours). After this time, the hospital must re-evaluate
its status.
Question 2
An EMS unit is transporting a patient to a STEMI Receiving Center (SRC). If the SRC is on
diversion, how long does that diversion typically last?
A) 60 minutes
B) 120 minutes
C) 180 minutes
D) 240 minutes
E) 30 minutes
Correct Answer: C) 180 minutes
Rationale: Specialty diversions, such as those for STEMI Receiving Centers (SRC), are
granted in 180-minute (3-hour) increments.
Question 3
The APOT (Ambulance Patient Offload Time) standard in LA County requires that patients are
offloaded from EMS to the hospital staff within:
A) 15 minutes 90% of the time
B) 20 minutes 80% of the time
C) 30 minutes 90% of the time
D) 45 minutes 75% of the time
E) 60 minutes 100% of the time
Correct Answer: C) 30 minutes 90% of the time
Rationale: The state and county standard for APOT is to have the patient transferred to a
hospital bed and EMS released within 30 minutes for at least 90% of all arrivals.
Question 4
A patient is found in "extremis" with an unmanageable airway and active CPR in progress. What
is the appropriate transport destination?
A) The closest SRC
, 2
B) The closest Trauma Center
C) The MAR (Most Accessible Receiving)
D) The PMC (Pediatric Medical Center)
E) The SART Center
Correct Answer: C) MAR
Rationale: Patients in "extremis"—meaning they have an unmanageable airway or are in a
state where immediate life-saving intervention is required beyond what can be provided in
the field—must be taken to the Most Accessible Receiving (MAR) facility.
Question 5
Which of the following is a criterion for "911 Re-triage" regarding a trauma patient?
A) GCS of 15
B) Isolated extremity fracture with intact pulses
C) GCS deteriorating by 2 or more
D) Transport time to trauma center is 10 minutes
E) Patient request for a specific hospital
Correct Answer: C) GCS deteriorating by 2 or more
Rationale: Criteria for re-triage to a more specialized center (like a Trauma Center) include
signs of severe physiological distress such as a deteriorating GCS, poor perfusion, need for
intubation, or penetrating injuries to the "trauma box."
Question 6
What is the maximum allowable transport time to an "alternate MAR" if the primary MAR is
unavailable?
A) 5 minutes
B) 10 minutes
C) 15 minutes
D) 20 minutes
E) 30 minutes
Correct Answer: C) 15 minutes
Rationale: If the closest MAR is not an option, an alternate MAR may be chosen provided
the transport time does not exceed 15 minutes.
Question 7
What is the maximum allowable transport time for a patient to be taken to a STEMI Receiving
Center (SRC) rather than the MAR?
A) 15 minutes
B) 20 minutes
C) 30 minutes
D) 45 minutes
E) 60 minutes
, 3
Correct Answer: C) 30 minutes
Rationale: A patient identified with a STEMI should be transported to an SRC if the
transport time is 30 minutes or less. If it exceeds 30 minutes, they go to the MAR.
Question 8
A 10-month-old infant is reported to have had a Brief Resolved Unexplained Event (BRUE)
characterized by a sudden change in muscle tone and color. What is the appropriate destination
for this patient?
A) The closest MAR
B) The closest SART Center
C) The PMC (Pediatric Medical Center)
D) The Perinatal Center
E) Any hospital with an open NICU
Correct Answer: C) PMC
Rationale: Pediatric patients (age 14 or younger) who meet BRUE criteria, or other high-
risk pediatric criteria like status epilepticus or ROSC, must be transported to a Pediatric
Medical Center (PMC).
Question 9
How is a BRUE (Brief Resolved Unexplained Event) defined in the pediatric population?
A) Any child <5 years with a fever
B) An infant <12 months with irregular breathing, color change, or change in muscle tone
C) A teenager with a syncopal episode
D) A child <14 years with a focal neurological deficit
E) An infant with a known history of asthma and wheezing
Correct Answer: B) <12 months WITH irregular breathing, color change, change in muscle
tone, or ALOC
Rationale: A BRUE is specifically identified in infants under 1 year of age where an
observer reports a sudden, brief, and now resolved episode of cyanosis/pallor,
absent/decreased breathing, or marked change in tone.
Question 10
In the field treatment of a BRUE with poor perfusion, what is the appropriate fluid bolus for the
pediatric patient?
A) 10ml/kg NS
B) 20ml/kg NS
C) 50ml/kg NS
D) 250ml NS fixed dose
E) 500ml NS fixed dose
Correct Answer: B) 20ml/kg NS
, 4
Rationale: Pediatric fluid resuscitation for poor perfusion in the context of a BRUE or shock
is 20ml/kg of Normal Saline.
Question 11
A 13-year-old was choking on an apple, but the obstruction was cleared by a parent prior to EMS
arrival. The child is currently asymptomatic. Where should they be transported?
A) PMC
B) Trauma Center
C) EDAP (Emergency Department Approved for Pediatrics)
D) SRC
E) Home (No transport needed)
Correct Answer: C) EDAP
Rationale: Because the respiratory distress resolved and the patient is not currently cyanotic
or in distress, they do not meet PMC criteria. However, all pediatric patients require
transport to an EDAP (the pediatric equivalent of a MAR).
Question 12
Which patient meets criteria for transport to a Perinatal Center?
A) 12 weeks pregnant with abdominal pain
B) 20 weeks pregnant or more in active labor
C) 15 weeks pregnant with high blood pressure
D) 40 weeks pregnant with a sprained ankle and no other complaints
E) 2 weeks postpartum with a sore throat
Correct Answer: B) 20 weeks pregnant or more AND active labor
Rationale: Perinatal center criteria include being 20 weeks or more gestation with active
labor, pregnancy-related complications, or a BP >140/90.
Question 13
A patient is 4 weeks postpartum and presents with a blood pressure of 160/100. Where should
this patient be transported?
A) MAR
B) PMC
C) Perinatal Center
D) SART Center
E) Nearest Urgent Care
Correct Answer: C) Perinatal Center
Rationale: The criteria for Perinatal Center transport extend up to 6 weeks postpartum if
the patient presents with hypertension (>140/90).
Question 14
A paramedic identifies a STEMI on a 12-lead ECG. What is the ECG requirement for STEMI
