SNHD Protocols Exam With 100% Correct Answers 2024, 181 Questions and Correct Answers, With Complete Solution.

SNHD Protocols Exam With 100% Correct Answers 2024, 181 Questions and Correct Answers, With Complete Solution. SNHD Manual The goal of the manual is to standardize prehospital care in Clark County If a physician giving on-line medical consultation directs you to provide care not explicitly stated in the protocol manual you must...? You and the telemetry physician must immediately notify OEMSTS. In addition, after finishing the call, you as the provider must make all prehospital care documentation/records of your deviation and telemetry physician's name available to OEMSTS. This will then be used for Quality Improvement Review. If a physicians orders are against protocol, could possibly endanger patient, or there is a lack of resources. What must you do...? You must notify telemetry physician why you are not able to carry out the order. Then, indicate the following on prehospital records: the order given, time it was given, and reason the order could not be carried out. Then all documentation/records must be available immediately after the call to OEMSTS and then will be used for Quality Improvement Review. What is a PATIENT 1) A person who has a complaint or mechanism suggestive of potential illness or injury; 2) A person who has obvious evidence of illness or injury; or 3) A person identified by an informed 2nd or 3rd party caller as requiring evaluation for potential illness or injury. Pediatric Patient Destination Age 18 ASA Acetylsalicylic Acid CCC CPR Continuous Chest Compression CPR: Compressions - Push hard (≥2 Inches) Push fast (≥100/min) BVM - at 8 BPM DCAP-BTLS Deformities; Contusions; Abrasions; Punctures/Penetrations; Burns; Tenderness; Lacerations; Swelling M.A.D. Mucosal Atomizer Device Drugs that can be administered through a M.A.D. Nalaxone START triage RED (Immediate/Life Threatening): Dyspnea, severe bleeding, severe medical problem, signs of shock, severe burns, open chest or abdominal injuries Yellow (Delayed/Seriously injured but no life threats): Burns (with no airway obstruction), multiple bone/joint injuries, back injuries with/without spinal cord injuries. Green (Walking Wounded): Minor fractures/soft tissue injuries Black (Dead/Fatally injured): Obviously dead, Fatally injures such as open brain trauma, respiratory arrest (if resources limited), cardiac arrest. Trauma Patients shall be transported... According to Trauma Field Triage Protocol Burn patients shall be transported.... According to Burn Protocol Pediatric patients shall be transported... (18 y/o) According to the Pediatric Destination Protocol Patients with evidence of a stroke shall be transported... According to Stroke (CVA) protocol Sexual assault victims 13 y/o shall be transported to Sunrise Hospital Sexual assault victims ≥18 y/o shall be transported to UMC Sexual assault victims between ages 13 and 18 y/o shall be transported to Either UMC or Sunrise Hospital Sexual assault victims outside the 50 mile radius of appropriate facility shall be transported to Nearest appropriate facility Where should stable patients be transported to Their hospital of choice or nearest facility For patients outside of the 50 mile radius of protocol designated transport destination shall be transported to Nearest appropriate facility Waiting Room Placement requisites Patient cannot be on a legal psychiatric hold and must meet the following requirements: + HR: 60-100 + RR: 10-20 + Systolic: 100-180 + Diastolic: 60-100 + Room air SPO2: 94% + A/O x 4 + No medication was given except for a single dose of Morphine/Ondansetron + Paramedic opinion states pt. does not need ECG monitoring + No IV fluids are necessary If a hospital declares an internal disaster that hospital shall be bypassed with the exceptions of Cardiac arrest patients or whom adequate ventilation has not been established In a General Adult Trauma Assessment how do you manage breathing Maintain SPO2 94%: + If patients GCS 8 BVM + If patients GCS ≥8 titrate O2 For an adult trauma patient with no palpable pulse what is the fluid bolus 1L of Normal Saline In the General Adult Trauma Trauma Triage, what is the following step if patient does (YES) has a palpable pulse Obtain vascular access Trauma: Sucking Chest Wound Apply an occlusive dressing and tape down three sides Trauma: How do you control an active hemorrhage Hemorrhage control tourniquet Trauma: Suspected Traumatic Brain Injury Raise head 30 degrees Trauma: Abdominal Evisceration Wet trauma dressing What should you do with a patient showing signs hypovolemia complaining of abdominal/flank pain, nausea & vomiting Obtain vascular access and bolus 500 mL (may repeat up to 2000 mL) Suspected Acute Coronary Syndrome treatment + Obtain vascular access + Maintain SPO2 94% + Administer 324 mg of ASA + Assist pt with own NTG as prescribed; may repeat x 3 (if not contraindicated) + Telemetry is required for STEMI's Nitroglycerine Contraindications + BP 100 systolic + HR 60-100 HR + RHF + Inferior Wall STEMI + Any ED medications have been taken (Viagra/Levitra within the last 24 hours and Tadalifil/Cialis within the last 48 hours) ADULT Allergic Reaction: What is the treatment if no airway obstruction or breathing difficulties are present + Obtain vascular access + Administer 50 mg IM/IV of Diphenhydramine + Reassess in 5 min. ADULT Allergic Reaction: What is the treatment if airway obstruction or breathing difficulties are present + Administer 0.5 mg of 1:1000 IM Epinephrine (may repeat up to 1.5 mg with 15 min in between) + 2.5 mg in 3 cc SVN Albuterol (repeat as necessary) + IV access + 500 cc NS bolus (may repeat until 2L) + Administer 50 mg IM/IV Diphenhydramine + Notify Receiving Hospital Epinephrine is a first-line drug that should be used... Specifically for ACUTE allergic reactions (signs of airway involvement) Allergic Reaction Severity levels: + MILD: involves skin rashes, itchy sensations, or hives w/o respiratory involvement + MODERATE: involve skin disorders and may include respiratory involvement such as wheezing, however patient is still able to maintain adequate tidal volume + SEVERE: involve skin disorders, respiratory difficulty, and may include hypotension AMS Altered Mental Status What should be checked on all AMS patients Blood Glucose testing If AMS patient has a BG reading of 60, you should + Administer Oral Glucose if patient is protecting airway (EMT-B) (or) + Administer 25 g of D10 IV, may repeat after x1 after 5 min (or) + Administer 1.0 mg of Glucagon IM if IV access is not available If AMS patient has a BG reading of 60, you should Consider a 500 cc bolus of NS (repeatable to 2L) If AMS patient is unresponsive, with respiratory depression, and suspected narcotic overdose, you should Administer NALOXONE 0.4 - 2.0 mg IN/IM/IV; may repeat 2.0 mg IN/IM/IV if patient slow to respond; titrate to effect; max dose 10 mg With an AMS patient consider the following differentials: + Head trauma + CNS (stroke, tumor, seizure, infection) + Cardiac (MI, CHF) + Hypothermia + Infection + Thyroid + Shock (septic, metabolic, traumatic) + Diabetes + Toxicological or ingestion + Acidosis/Alkalosis + Environmental exposure + Hypoxia + Electrolyte abnormality + Psychiatric disorder Behavior Emergencies: Consider the following medical causes 1. Hypoxia 2. Intoxication / Overdose 3. Hypoglycemia / Electrolytes 4. Head Injury 5. Post-ictal State 6. Excited Delirium What does the pneumonic S.A.F.E.R. stand for in S.A.F.E.R. Model + S-STABILIZE the situation by containing and lowering the stimuli. + A-ASSESS and acknowledge the crisis. + F-FACILITATE the identification and activation of resources (chaplain, family, friends or police). + E-ENCOURAGE patient to use resources and take actions in his/her best interest. + R-RECOVERY or referral - leave patient in care of responsible person or professional, or transport to appropriate facility. In a behavior emergency if patient is a harm to self you should Apply 2 point restraints; consider law enforcement; use a 4 point restraint if needed In a behavior emergency if a patient is a harm to others 4-point restraints; hood if indicated; NO PRONE POSITION Excited Delirium Syndrome + Medical emergency-combination of delirium, psychomotor agitation, anxiety, hallucinations, speech disturbances, disorientation, violent behavior, insensitivity to pain, hyperthermia, and increased strength. + Potentially life threatening, and associated with the use of physical control measures including restraints, TASER, or similar device. + Most common in MALE subjects with a history of serious mental illness and/or acute or chronic drug abuse, particularly stimulants. Dystonic Reaction + Condition causing involuntary muscle movements or spasms typically of the face, neck and upper extremities. + Typically an adverse reaction to drugs such as Haloperidol (may occur with administration). + When recognized, administer Diphenhydramine 50 mg IM/IV/IO. In a general adult assessment of bradycardia what can an AEMT do IV access What should you do for a THERMAL burn 1. stop burning process with sterile water or NS 2. Remove smoldering clothing (DO NOT REMOVE STUCK CLOTHING) 3. ONLY apply a dry sterile dressing 4. Administer 500 cc fluid bolus if signs of hypoperfusion or 10 %BSA present 5. Repeat step 4 up to 2L if patient condition improvement is not visible 6. Consider inhalation injury and transport to UMC What should you do for a ELECTRICAL/CHEMICAL burn 1. If eyes are involved flush eyes with NS for 10-15 minutes 2. Remove all and any jewelery, constricting items, and expose the burned area 3. For electrical burns identify entrance/exit wounds and cover with dry sterile dressing 4. Administer 500 cc fluid bolus if signs of hypoperfusion or 10 %BSA present 5. Repeat step 4 up to 2L if patient condition improvement is not visible 6. Transport to UMC Burn differentials