2017 NYS Collaborative Protocols Update - Mountain Lakes CCT Exam

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* 1. First and Last Name

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* 2. NYS EMT Number

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* 3. Mountain Lakes Region ALS Technician Number

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* 4. Primary Agency in Mountain Lakes Region

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* 5. Your patient has been successfully resuscitated from a VF cardiac arrest. Pulse is 100 BPM and BP is 64/38. Which intervention is NOT indicated in management of this patient?

12 Lead ECG

Metoprolol 5mg IV over 5 minutes

2 liters IV maximum of Normal saline

Norepinephrine 2-20mcg/min IV infusion

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* 6. When treating a patient for severe vertigo / nausea, a CCT may utilize Diphenhydramine 25mg IV or IM on standing orders.

True

False

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* 7. You are dispatched to a 70-year-old male patient complaining of difficulty breathing. During your assessment you auscultate rales lung sounds and note that his BP is elevated. Your differential diagnosis is Pulmonary Edema. What is the appropriate dose of Nitroglycerin for this patient?

Two doses every 5 minutes if the patients systolic BP is 160-200 mmHg

One dose every 5 minutes if the patients systolic BP is 160-200 mmHg

Three doses every 5 minutes if the patients systolic BP is 160-200 mmHg

Two doses every 5 minutes if the patients systolic BP is 120-160 mmHg

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* 8. What is the appropriate criteria for determining that you should 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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* 9. Which medication used in cardiac arrest should be diluted in a minimum 20 cc of Normal Saline to minimize post ROSC hypotension and phlebitis?

Lidocaine

Atropine

Amiodarone

Sodium bicarbonate

Epinephrine

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* 10. 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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* 11. All of the following requirements must be met for termination of resuscitation in the field without an online 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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* 12. Solumedrol has been replaced by Dexamethasone in all indications for use of a steroid.

False

True

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* 13. Under the Agitated Patient protocol, CCT's have a standing order for

Midazolam (Versed) up to 5 mg IV or up to `10 mg IM; may repeat up to 20 mg

Midazolam (Versed) up to 2.5 mg IV or up to 5 mg IM; may repeat up to 15 mg

Midazolam (Versed) up to 2.5 mg IV or up to 5 mg IM; may repeat up to 10 mg

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

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

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* 15. What is the standing order dose of Magnesium in a pregnant seizure patient?

4 grams IV over 20 minutes

4 grams IV over 30 minutes

2 grams IV over 10 minutes

4 grams IV over 15 minutes

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* 16. Under the Acute Asthma protocol, the standing order for Dexamethasone (Decadron) is

20 mg PO, IM, or IV

5 mg PO, IM, or IV

15 mg PO, IM, or IV

10 mg PO, IM, or IV

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* 17. The Pulmonary Edema - Acute Cardiogenic protocol calls for "aggressive Nitroglycerin 0.4 mg SL or equivalent, as needed". List the 3 bullet points / doses with MAP criteria for this.

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* 18. In the Hyperkalemia protocol, after obtaining vascular access, AEMT's and CCT's can administer

Lactated Ringers 500 mL bolus

NS 250 mL IV bolus

NS 500 mL IV bolus

NS 1000 mL IV bolus

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* 19. What is the pediatric dose for Hydroxocobalamin (Cyanokit) in a symptomatic smoke inhalation patient?

This medication is contraindicated in pediatric patients

50mg/kg max of 5g IV/IO over 15 minutes

70mg/kg or max of 5g IV/IO over 15 minutes

70mg/kg or max of 5g IV/IO over 30 minutes