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Radio Report Order - (ANSWER)-agency name, unit number/call sign, desired destination (if different
than hospital being contacted), level of care being provided
-patient age, sex, approx. weight
-LOC and orientation (GCS)
-Chief complaint/primary impression, symptoms, MOI/NOI, pertinent scene info, pertinent
negatives/associated complaints
-vital signs: BP, HR, RR, SpO2, temperature, pain score 0-10 (Wong Baker)
-Cincinnati Stroke Scale/NIH Stroke Scale findings
-Last known well
-Blood glucose level
-Pupils, lung sounds, skin parameters, history, medications, allergies
-Interventions, medications given, disposition
-Destination, ETA
General Patient Assessment - (ANSWER)Initial Assessment:
-Scene safety/PPE
-ABCs/C-spine: airway (establish and maintain), breathing (assess, assist or provide ventilations, assess
lung sounds), circulation (check pulse, control hemorrhage)
-AVPU
-expose/examine
-priority transport
Focused history and physical exam
-SAMPLE (Signs/symptoms, systematic head-to-toe, GCS; allergies; medications; pertinent medical
history; last oral intake/menstrual period; events leading to)
-initial vital signs
-pain 0-10 scale
,LOYOLA SYSTEM ENTRY EXAM (REGION VIII) BLS EXAM WITH COMPLETE SOLUTIONS
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Detailed physical exam
Ongoing assessment - reassess ABCDs
Most adult SMOs include - (ANSWER)-AIMC or PIMC
-AITC or PITC
-don't do anything if contraindicated
-Refer to other SMOs as needed
-transport, support ABCs, keep warm
-when in doubt contact MD
Considerations for patients with special healthcare needs - (ANSWER)Be aware of situation and
equipment and utilize resources such as caregivers/family
Streamlined BLS communication - (ANSWER)-Name and vehicle number of provider
-Patient age and gender
-Chief complain/MOI
-SMO being followed
-Any deviation from SMO or unusual circumstance
-ETA
Load-and-go situation - (ANSWER)-When needing hospital care for patient stability
-May need to omit/adapt SMO based on own medical judgment
-Document deviations thoroughly
-not implying speed of transport increases but emphasize rapid patient packaging and limited on-scene
time
Withholding or withdrawing resuscitative efforts - (ANSWER)-uncertainty = begin treating and contact
MD
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-emotional support to significant others
Who can pronounce a patient dead? - (ANSWER)ED physician
-document time in PCR
Power of attorney - (ANSWER)-honor only if written POLST/DNR order signed by patient's attending
practitioner is presented
-other healthcare decisions may be made by POA if document allows
-bring all documents to hospital
Living Will/surrogates - (ANSWER)-may not be honored; treat and contact MD
-no situation where surrogate can give direct instructions to EMS provider; treat, contact MD, explain
POLST/DNR orders/withholding treatment - (ANSWER)-confirm validity of POLST/DNR order, call MD if
item is missing
-Must be a written document that hasn't been revoked
-Must include all needed components
-If valid: resuscitative efforts withheld and follow anything on order
-if valid and patient is not in cardiac or respiratory arrest with a decompensating condition: begin AIMC
-If resuscitative efforts were begun prior to order being present, may withdraw effort once validity
confirmed, contact MD
-Illinois POLST form preferred, but accept those of other states/entities as long as minimum
requirements met
Components validating a POLST/DNR order - (ANSWER)NEEDS:
-name of patient
-resuscitation orders
-2 signatures
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-evidence of consent (signature of patient, legal guardian, durable POA for health care agent, OR
surrogate decision maker under Illinois Health Care Surrogate Act)
-signature of attending pracitioner
-effective date
Obviously dead patients/"triple zero" - (ANSWER)-no resuscitative efforts initiated
-Non-breathing, pulseless, asystolic, and one or more of the following: decapitation, rigor mortis w/o
hypothermia, profound dependent lividity, decomposition, mummification/putrefaction, incineration,
frozen state
-Contact MD if obviously dead but not listed above (indicate you have a "triple zero"
-Document pronouncement time and physician name
Hospice patients not in arrest - (ANSWER)-Initiate BLS care and contact MD for orders
-Check for written treatment orders/valid POLST/DNR orders
Blunt traumatic arrest - (ANSWER)-blunt trauma patient w/o vital signs upon arrival - can consider
withholding resuscitative efforts with MD approval
Emerging infectious disease guidance - (ANSWER)
Adult Glasgow Coma Scale (GCS) - (ANSWER)Eye opening
-Spontaneous 4
-To voice 3
-To pain 2
-None 1
Verbal response
-Oriented 5