Copy of 2017 NYS Collaborative Protocols Update - Mountain Lakes Paramedic 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. When treating a patient for severe vertigo / nausea, a paramedic may utilize Diphenhydramine 25mg IV or IM on standing orders.

True

False

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* 6. 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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* 7. 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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* 8. 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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* 9. All of the following requirements must be met for termination of resuscitation in the field without an online medical control 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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* 10. Solumedrol has been replaced by Dexamethasone in all indications for use of a steroid.

False

True

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* 11. 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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* 12. Under the Cardiac Arrest: Ventricular Fibrillation or Pulseless Ventricular Tachycardia protocol, the dose of Amiodarone 300 mg IV should be diluted in ____ mL of normal saline to prevent hypotension after ROSC.

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* 13. The standing order dose of Magnesium in a pregnant seizure patient is

4 grams IV over 20 minutes

2 grams IV over 20 minutes

4 grams IV over 10 minutes

8 grams IV over 30 minutes

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* 14. Under the Hyperkalemia protocol, one of the medical control considerations / options is Albuterol 2.5 mg in 3 mL (unit dose), via nebulizer (without ipratropium) repeated every 10 minutes.

False

True

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* 15. In the case of excited delirium, which of the following can be given on standing order by a paramedic?

Etomidate 14 mg IM

Midazolam 20 mg IM

Ketamine 250 mg IM

There are no standing orders for excited delirium

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* 16. The Post Intubation Management Protocol:

May only be utilized by RSI credentialed paramedics

Allows CCT and paramedic providers to administer fentanyl 100 mcg IV once, and then 50 mcg IV every 5 minutes, as needed on standing order

Requires the use of vecuronium 10 mg every 30 minutes to assure that the tube does not become dislodged

Recommends Trendelenburg position when possible to prevent aspiration

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* 17. According to the Pediatric: Stridor protocol, in order for the patient to receive Dexamethasone (Decadron), he/she must be at least 2 years old.

True

False

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* 18. 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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* 19. True or false? The Eclampsia protocol has been deleted and merged into the Seizure protocol.

True

False

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* 20. What is the criteria for paramedics to administer Sodium Bicarbonate and Calcium Chloride without a medical control order in patients with known or suspected hyperkalemia?

In cases of cardiac arrest or rhythm changes during RSI

Patients who are in renal failure and not yet receiving dialysis

Patients with known elevated laboratory values

Patients with a crush injury