SD EMS PROTOCOLS 2026 QUESTIONS
AND ANSWERS WITH COMPLETE
SOLUTIONS 100% CORRECT!!!
Question: What is the clinical purpose and utility of the BEFAST assessment tool?
Answer: ✔✔ It serves as a validated Prehospital Stroke Screening Scale utilized
by emergency providers during the initial physical exam to identify individuals
experiencing an acute stroke or Transient Ischemic Attack (TIA).
Question: What distinct clinical assessments are performed for each letter of the
"BEFAST" mnemonic?
Answer: ✔✔ The diagnostic screening tool evaluates the following parameters:
B - Balance: Assess for sudden gait instability, lack of coordination, or
ataxia (loss of full control of bodily movements).
E - Eyes: Screen for acute visual disturbances, including double vision
(diplopia), blurred vision, or a sudden loss of sight.
F - Face: Observe for an asymmetrical facial droop when the patient smiles.
A - Arms/Legs: Test for unilateral motor weakness or hemiparesis, typically
demonstrated via a pronator drift or extremity drop.
S - Speech: Listen for slurred pronunciation (dysarthria), an inability to find
the correct words (aphasia), or a complete absence of verbal output.
T - Time: Document an exact and reliable time mark for when the patient
was Last Known Well (LKW).
Question: What is the operational purpose of the FASTED tool in prehospital
stroke management?
Answer: ✔✔ It is a Prehospital Stroke Severity Scale specifically designed to
evaluate patients who have already screened positive on the initial BEFAST exam,
helping providers identify potential Large Vessel Occlusions (LVO) that require
specialized stroke center intervention.
Question: What specific criteria and points are measured within the "FASTED"
scoring framework?
,Answer: ✔✔ The severity tool breaks down into the following quantified
observations:
F = Facial Palsy: Scored as a $0$ (normal or minor) or $1$ (significant,
clear asymmetry).
A = Arm Weakness: Evaluated as $0$ (no drift), $1$ (drift present but
some effort against gravity), or $2$ (no movement against gravity or
immediate drop).
S = Speech Changes: Graded as $0$ (unimpaired), $1$ (mildly slurred or
mild aphasia), or $2$ (severe aphasia, global aphasia, or completely
unintelligible).
T = Time: Explicit focus on determining the symptom onset window.
E = Eye Deviation: Tracked as $0$ (normal gaze) or $1$ to $2$ based on
the presence of a forced or fixed conjugate gaze deviation to one side.
D = Denial / Neglect: Evaluated from $0$ to $2$ based on whether the
patient ignores one side of their body, fails to recognize their own affected
limb, or demonstrates agnosia.
What does BRUE stand for and what are the four signs? -ANSWER ✔✔Brief,
Resolved, Unexplained Event; an observer reports a sudden, brief, yet resolved
episode of one or more of the following:
1. Absent, decreased, or irregular breathing
2. Color change (cyanosis or pallor)
3. Marked change in muscle tone (hypertonia or hypotonia)
4. Altered level of responsiveness
BRUE is an episode involving an infant younger than...? -ANSWER ✔✔12
months
,What is LEADSD and what does it stand for? -ANSWER ✔✔Acronym for the
steps to be performed in the assessment and documentation of endotracheal
intubation attempts;
1. Lung Sounds
2. End-Tidal CO2 Detection Device
3. Absence of Abdominal Sounds
4. Depth
5. Size
6. Documentation
What are two things you see in a symptomatic opioid overdose? -ANSWER
✔✔Decreased LOC and/or respiratory depression (e.g., respiratory rate of <12 or
EtCO2 ≥40 mmHg)
What is a pediatric patient? -ANSWER ✔✔Children known or appearing to be 14
years or younger
What is the age range for a neonate? -ANSWER ✔✔From birth to 30 days
What is the age range for an infant? -ANSWER ✔✔One month to one year
Is a pediatric trauma patient determined by age or weight? -ANSWER ✔✔A
pediatric trauma patient is determined by age, regardless of weight
What are the two Perilaryngeal Airway Adjunct (PAA) options? -ANSWER ✔✔1.
Supraglottic airway
2. Retroglottic airway
, What is the only supraglottic airway approved for prehospital use in San Diego
County? -ANSWER ✔✔The "i-gel"
What is the only retroglottic airway approved for prehospital use in San Diego
County? -ANSWER ✔✔The "King Airway"
What is an unstable patient (15 years or older)? -ANSWER ✔✔SBP ˂90 mmHg
and exhibiting any of the following signs/symptoms of inadequate perfusion, e.g.,
• Diaphoresis
• Severe dyspnea
• Significant chest pain of suspected cardiac origin
• Altered mental status (decreased LOC, confusion, agitation)
• Pallor
What is an unstable patient (14 years or younger)? -ANSWER ✔✔Exhibiting any
of the following signs/symptoms of inadequate perfusion, e.g.,
• Diaphoresis
• Delayed capillary refill
• Difference in peripheral vs. central pulses
• Altered mental status (decreased LOC, confusion, agitation)
• Pallor, mottling, or cyanosis
• Hypotension by age
AND ANSWERS WITH COMPLETE
SOLUTIONS 100% CORRECT!!!
Question: What is the clinical purpose and utility of the BEFAST assessment tool?
Answer: ✔✔ It serves as a validated Prehospital Stroke Screening Scale utilized
by emergency providers during the initial physical exam to identify individuals
experiencing an acute stroke or Transient Ischemic Attack (TIA).
Question: What distinct clinical assessments are performed for each letter of the
"BEFAST" mnemonic?
Answer: ✔✔ The diagnostic screening tool evaluates the following parameters:
B - Balance: Assess for sudden gait instability, lack of coordination, or
ataxia (loss of full control of bodily movements).
E - Eyes: Screen for acute visual disturbances, including double vision
(diplopia), blurred vision, or a sudden loss of sight.
F - Face: Observe for an asymmetrical facial droop when the patient smiles.
A - Arms/Legs: Test for unilateral motor weakness or hemiparesis, typically
demonstrated via a pronator drift or extremity drop.
S - Speech: Listen for slurred pronunciation (dysarthria), an inability to find
the correct words (aphasia), or a complete absence of verbal output.
T - Time: Document an exact and reliable time mark for when the patient
was Last Known Well (LKW).
Question: What is the operational purpose of the FASTED tool in prehospital
stroke management?
Answer: ✔✔ It is a Prehospital Stroke Severity Scale specifically designed to
evaluate patients who have already screened positive on the initial BEFAST exam,
helping providers identify potential Large Vessel Occlusions (LVO) that require
specialized stroke center intervention.
Question: What specific criteria and points are measured within the "FASTED"
scoring framework?
,Answer: ✔✔ The severity tool breaks down into the following quantified
observations:
F = Facial Palsy: Scored as a $0$ (normal or minor) or $1$ (significant,
clear asymmetry).
A = Arm Weakness: Evaluated as $0$ (no drift), $1$ (drift present but
some effort against gravity), or $2$ (no movement against gravity or
immediate drop).
S = Speech Changes: Graded as $0$ (unimpaired), $1$ (mildly slurred or
mild aphasia), or $2$ (severe aphasia, global aphasia, or completely
unintelligible).
T = Time: Explicit focus on determining the symptom onset window.
E = Eye Deviation: Tracked as $0$ (normal gaze) or $1$ to $2$ based on
the presence of a forced or fixed conjugate gaze deviation to one side.
D = Denial / Neglect: Evaluated from $0$ to $2$ based on whether the
patient ignores one side of their body, fails to recognize their own affected
limb, or demonstrates agnosia.
What does BRUE stand for and what are the four signs? -ANSWER ✔✔Brief,
Resolved, Unexplained Event; an observer reports a sudden, brief, yet resolved
episode of one or more of the following:
1. Absent, decreased, or irregular breathing
2. Color change (cyanosis or pallor)
3. Marked change in muscle tone (hypertonia or hypotonia)
4. Altered level of responsiveness
BRUE is an episode involving an infant younger than...? -ANSWER ✔✔12
months
,What is LEADSD and what does it stand for? -ANSWER ✔✔Acronym for the
steps to be performed in the assessment and documentation of endotracheal
intubation attempts;
1. Lung Sounds
2. End-Tidal CO2 Detection Device
3. Absence of Abdominal Sounds
4. Depth
5. Size
6. Documentation
What are two things you see in a symptomatic opioid overdose? -ANSWER
✔✔Decreased LOC and/or respiratory depression (e.g., respiratory rate of <12 or
EtCO2 ≥40 mmHg)
What is a pediatric patient? -ANSWER ✔✔Children known or appearing to be 14
years or younger
What is the age range for a neonate? -ANSWER ✔✔From birth to 30 days
What is the age range for an infant? -ANSWER ✔✔One month to one year
Is a pediatric trauma patient determined by age or weight? -ANSWER ✔✔A
pediatric trauma patient is determined by age, regardless of weight
What are the two Perilaryngeal Airway Adjunct (PAA) options? -ANSWER ✔✔1.
Supraglottic airway
2. Retroglottic airway
, What is the only supraglottic airway approved for prehospital use in San Diego
County? -ANSWER ✔✔The "i-gel"
What is the only retroglottic airway approved for prehospital use in San Diego
County? -ANSWER ✔✔The "King Airway"
What is an unstable patient (15 years or older)? -ANSWER ✔✔SBP ˂90 mmHg
and exhibiting any of the following signs/symptoms of inadequate perfusion, e.g.,
• Diaphoresis
• Severe dyspnea
• Significant chest pain of suspected cardiac origin
• Altered mental status (decreased LOC, confusion, agitation)
• Pallor
What is an unstable patient (14 years or younger)? -ANSWER ✔✔Exhibiting any
of the following signs/symptoms of inadequate perfusion, e.g.,
• Diaphoresis
• Delayed capillary refill
• Difference in peripheral vs. central pulses
• Altered mental status (decreased LOC, confusion, agitation)
• Pallor, mottling, or cyanosis
• Hypotension by age
