2017 NYS Collaborative Protocols Update - Mountain Lakes AEMT Exam

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* 1. First and Last Name

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* 2. NYS EMT Number

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* 3. Regional ALS Technician Number

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* 4. Primary Mountain Lakes Agency

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* 5. All of the following requirements must be met for termination of resuscitation in the field without a medical order EXCEPT

18 years old or older

Unwitnessed arrest

No bystander CPR or AED use

At least 30 minutes of resuscitation.

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* 6. Your response team consists of 6 providers and you are the only ALS level practitioner on scene. At 15:35 the family of a 34 year-old female called 911 and they estimate the downtime of the unwitnessed arrest to be less than five minutes. The first arriving BLS providers report that at 15:42 their AED reported “no shock advised.” They explain that they initiated the first compressions and the family planned to speak with the family physician about the MOLST program at the end of this week. It is now 15:59 and continuous CPR has not yielded a ROSC. Is it appropriate to consider Termination of Resuscitation in this scenario?

Yes, resuscitation effort should cease immediately and the patient should not be transported to a hospital. Assistance for the family should be summoned to the scene.

Yes, the Termination of Resuscitation efforts may be appropriate in this situation. Placing the person back in bed with the AED pads left in place would be appropriate.

No, the patient does not meet the minimum age criteria. Contact with medical control must be established before terminating resuscitation

No, medical control must be contacted before terminating resuscitative efforts. Not enough time has passed since CPR began.

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* 7. Which of the following advanced directives can be followed by EMS providers without contacting Medical Control?

Health-Care Proxy.

MOLST or eMOLST

Living Will.

All of the above.

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* 8. You arrive on scene for the reported 5 y/o male patient recently ill with severe nausea and vomiting who was found unresponsive in bed several hours after having been put down for a nap. Following assessment of ABC’s the patient is found to be apneic and pulseless. CPR is started with adequate BVM ventilations, and an AED indicates “No Shock Advised”. As an AEMT your next step is to:

Attach a cardiac monitor

Intubate the patient

Obtain vascular access

Administer Epinephrine 1:1000 IM at a dose of 0.01 mg/kg

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* 9. A patient who was acting agitated at a restaurant when approached by police continues to be highly upset after you started to assess a blood sugar. While he initially consented to testing and transport, he is now yelling that you are letting his spirit drain onto the ambulance floor and he needs to get up to retrieve it. Verbal de-escalation has not reduced the patient’s upset. He weighs approximately 100 kg (220 lbs). What are appropriate assessments and treatments for the AEMT to provide?

Vital Signs and Blood Glucose Monitoring

Midazolam 2.5mg IM and Blood Glucose Monitoring

Vital Signs and Ketamine 250mg IM if ordered by Medical Control

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* 10. When caring for an amputation of the distal forearm, it is best practice to elevate and wrap the stump with moist sterile dressings and cover with dry bandage.

True

False

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* 11. Which of the following is compatible with reimplantation of an avulsed tooth in the field?

The tooth is a deciduous (baby) tooth

The tooth is cracked only at the level of the crown

The patient is awake and alert

The patient must be transported in a supine position

The need to splint a fractured root

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* 12. The clinical triad of Excited Delirium Syndrome includes all of the following EXCEPT:

hypoxemia

psychomotor agitation

physiologic excitation

erratic behavior

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* 13. If your patient shows signs of dehydration and his glucose level is above _____ mg/dL, administer normal saline 500 mL IV bolus, if there is no concern for pulmonary edema.

400

450

500

600

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* 14. Which of the following is true regarding the patella dislocation protocol?

The protocol requires a medical control order to implement.

The procedure can only be done by paramedics.

The protocol can be used for any lateral, medial, or superior dislocation of the patella.

The procedure can be performed by any level of provider, EMT or higher, if the criteria are met.

The procedure should be used on standing order for immediate reduction of a lateral patellar dislocation during the secondary assessment of a seriously injured multi-trauma patient.

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* 15. EMS providers can assist family or caregivers of patients who are actively seizing with the administration of

Fentanyl

Diastat

Benadryl

none of the above

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* 16. What is the appropriate criteria for determining that you will follow the adult Septic Shock- Suspected protocol?

Suspected infection, Systolic BP < 100 or altered mental status, heart rate 88, respiratory rate >
32

Suspected infection, Systolic BP > 90 or altered mental status, heart rate 80, respiratory rate > 16

Suspected infection, Systolic BP < 90 or altered mental status, heart rate 88, respiratory rate > 32

Suspected infection, Systolic BP < 90 or altered mental status, heart rate 110, respiratory rate > 32

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* 17. In the general stroke protocol, if time from symptom onset to estimated arrival in the ED will be less than ___ hours, transport the patient to a NYS DOH Designated Stroke Center, or consult medical control to discuss an appropriate destination facility.

4.5

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* 18. When should a patient with a Ventricular Assist Device (LVAD) receive CPR?

Never

If there is no palpable pulse

If there is no detectable blood pressure

If there is no evidence of pump function and the patient is unresponsive

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* 19. Under “Resource: Automatic Transport Ventilator,” it is acceptable to use this device in the event of Cardiac or Respiratory arrest if the patient is already on the ventilator.

True

False

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* 20. All of the following are permitted airway management interventions for the AEMT EXCEPT.

OPA/NPA

Using Magill forceps to relieve an upper airway obstructions

Oral ETT placement in an unresponsive adult.

Oxygen therapy to maintain SPO2

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* 21. How many shocks can you deliver to a hypothermic patient in cardiac arrest?

There is no limit.

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* 22. Under the Pediatric: Overdose / Toxic Exposure protocol an AEMT may administer Naloxone (Narcan) 1 mg IN, 0.5 mL per nare if there is a suspected opioid overdose with hypoventilation or respiratory distress.

False

True

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* 23. If a patient's glucose level is below 60 mg/dL and the they cannot swallow on command, an AEMT has which of the following care options available to them.

Dextrose 10%, up to 25 grams (250 mL) IV and Glucagon 2 mg IM

Dextrose 50%, up to 25 grams (250 mL) IV and Glucagon 5 mg IM

Dextrose 10%, up to 25 grams (250 mL) IV and Glucagon 1 mg IM

Dextrose 10%, up to 50 grams (250 mL) IV and Glucagon 1 mg IM

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* 24. Under the Crush Injuries protocol, AEMT's can use all of the following EXCEPT

Normal Saline 1 liter IV bolus

Vascular access, ideally at 2 sites (no more than one IO)

Cardiac monitor, if possible, with 12-lead ECG repeated at 30 minute intervals

Nitrous oxide by self-administered inhalation, if equipped

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* 1. First and Last Name

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* 2. NYS EMT Number

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* 3. Regional ALS Technician Number

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* 4. Primary Mountain Lakes Agency

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* 5. All of the following requirements must be met for termination of resuscitation in the field without a medical order EXCEPT

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* 7. Which of the following advanced directives can be followed by EMS providers without contacting Medical Control?

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* 10. When caring for an amputation of the distal forearm, it is best practice to elevate and wrap the stump with moist sterile dressings and cover with dry bandage.

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* 11. Which of the following is compatible with reimplantation of an avulsed tooth in the field?

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* 12. The clinical triad of Excited Delirium Syndrome includes all of the following EXCEPT:

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* 13. If your patient shows signs of dehydration and his glucose level is above _____ mg/dL, administer normal saline 500 mL IV bolus, if there is no concern for pulmonary edema.

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* 14. Which of the following is true regarding the patella dislocation protocol?

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* 15. EMS providers can assist family or caregivers of patients who are actively seizing with the administration of

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* 16. What is the appropriate criteria for determining that you will follow the adult Septic Shock- Suspected protocol?

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* 17. In the general stroke protocol, if time from symptom onset to estimated arrival in the ED will be less than ___ hours, transport the patient to a NYS DOH Designated Stroke Center, or consult medical control to discuss an appropriate destination facility.

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* 18. When should a patient with a Ventricular Assist Device (LVAD) receive CPR?

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* 19. Under “Resource: Automatic Transport Ventilator,” it is acceptable to use this device in the event of Cardiac or Respiratory arrest if the patient is already on the ventilator.

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* 20. All of the following are permitted airway management interventions for the AEMT EXCEPT.

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* 21. How many shocks can you deliver to a hypothermic patient in cardiac arrest?

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* 22. Under the Pediatric: Overdose / Toxic Exposure protocol an AEMT may administer Naloxone (Narcan) 1 mg IN, 0.5 mL per nare if there is a suspected opioid overdose with hypoventilation or respiratory distress.

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* 23. If a patient's glucose level is below 60 mg/dL and the they cannot swallow on command, an AEMT has which of the following care options available to them.

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* 24. Under the Crush Injuries protocol, AEMT's can use all of the following EXCEPT

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* 25. What is the phone number for the NYS Child Abuse and Maltreatment Register?