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2013 Integrity Ambulance Standing Orders Paramedic Pretest Note: The pretest is not inclusive of the questions and content of the post test. You as the provider are responsible for all material contained within the appropriate Standing Orders Training Manual. Name: Date: 1. Describe the use of lidocaine 10% and lidocaine jelly during intubation: 2. You’re transporting a 20 year old patient from a Chinese Restaurant in severe respiratory distress from anaphylaxis from a peanut allergy. He has altered mental status and is hypotensive after appropriate fluid administration. In your drug bag you have Benadryl 50mg, Epinephrine (1:10,000) and Epinephrine (1:1000). What drug, route and dosage is the primary administration for this case? 3. You’re transporting a 3 y.o. patient with asthma in severe respiratory distress. The Broselow tape shows him to approximate at 28 lbs. You access the drug bag for epinephrine (1:1000) 30ml/30mg. How much epi will you administer? 4. List the H’s and T’s of Trauma/Cardiac Arrest and the possible ways to manage in the prehospital environment. 5. When you arrive on scene for a cardiac arrest, this is a “load and go” operation. You should immediately move the patient to the truck and initiate transport. True _____ False _____ 6. Under 48 hours after incident, ALL trauma patients shall have ______________ placed as a minimum. 7. While performing _____________ neck rotation/movement, if the patient experiences pain in the cervical region, the patient shall have a _________ placed. If pain is below _____________, the patient shall be ____________________. 8. Regardless of timing, a patient ______ years old shall be fully immobilized if they remain _________ or were placed into bed immediately after the fall and not moved further. 9. The definition of a distracting injury is one that: 10. Describe recommendations for the use of tourniquets in hemorrhage control: 11. For non-life threatening situations who require IVs, only ____ attempts should be made in the field, additional attempts shall be performed while en route. 12. When orders are received from a hospital ED/ER, you must get orders from the ___________ and document his/her name in the ____________ box on the EMS report. 13. Patients with difficulty breathing, irregular pulse, chest pain or ____________ shall be placed on a monitor and a copy of the _____ must be attached to the EMS report. (Not applicable if patient has an active DNR-CC) 14. For trauma patients, scene time should be limited to _______ minutes or less. 15. Which treatments are permitted for a patient with a DNR-CC? a. Oxygen, Morphine, Monitor, Fracture Stabilization b. C-PAP, Morphine, Nasal Trumpet c. Bag-assisted breathing, Bleeding Control, Deep Suctioning d. High-flow O2, NTG, Lasix, Morphine 16. Which device can Paramedics NOT access? a. PICC Line b. Central Line c. Fistula d. Graft e. Sub-Q Port 17. Paramedics can only access these sites when a patient is _______________. They may also access when the patient is _____________________. 18. During access of these sites, a __________ technique should be used. This is accomplished by cleaning the site with Betadine _____ times. 19. Atropine for bradycardia should be administered in ______mg doses, up to a max of _____mg. 20. You MUST finish all NTG doses for chest pain patients prior to administering morphine. True _____ False _____ 21. By administering Furosemide to a patient with pneumonia, you can likely push the patient into _____________ shock due to their borderline dehydration. 22. When considering the intubation of an allergic reaction/anaphylaxis patient, the paramedic should use an ETT that is ___________ than normal. 23. You can administer oral glucose to an unresponsive patient. True _____ False _____ But, you have to: 24. You should transport all infants _________ with a history or temperature of >100.4 F. 25. Describe the unassisted neck movements to evaluate c-spine injury after clearing patients with the Selective Spinal Immobilization checksheet: 26. The decision to implement or not to implement spinal immobilization is the sole responsibility of ________________. 27. You are called to the ECF for a 62 year old female that was found on the floor by nursing staff after lunch today. She was placed into her wheelchair and placed next to the nurse’s station for observation. She has not had any mental changes, but would like to be seen at the hospital to “check out her new hip implant to make sure it’s okay.” (After all, she did pay a lot of money for it.) You must: a. b. c. d. 28. Complete SSI form, fully immobilize and transport Complete SSI form, apply c-collar and transport Complete SSI form, evaluate c-spine pain by moving patient’s head, transport Complete SSI form, evaluate c-spine with unassisted movements, transport You are called back to the ECF for this same patient four days later. She now complains that her neck hurts just a little. When she was at the ER, they released her without any definitive findings. The nurse states that she was “bruised so bad the x-rays were inconclusive.” You complete the SSI form without exclusions, control c-spine, palpate spinal column without pain and ask the patient to perform unassisted neck movements. During movement she states she has pain “between her shoulder blades.” You must: a. b. c. d. Complete SSI form, fully immobilize and transport Complete SSI form, apply c-collar and transport Complete SSI form, evaluate c-spine pain by moving patient’s head, transport Complete SSI form, evaluate c-spine with unassisted movements, transport 29. In the abbreviation of “PERRLA” related to eye exams, Accommodation means: 30. The phone number for “Life Connection of Ohio” is _______________________. 31. The _____ is the primary airway device for pediatrics, except in extreme cases. 32. A patient with pulmonary arterial hypertension (PAH) may have been on the drug ________ or is now on Flolan. This patient would require extreme caution for the administration of NTG. 33. You should not administer narcotic analgesia if there is any suspicion of ____________. 34. Having a patient rise from lying to standing and assessing their vitals is called_______ _________ _________. If there is a ____ - _____mmHg of decrease in BP or a pulse increase of ____ - _____ beats per minute, the patient is considered to be volume depleted. 35. List the five disorders than can mimick a stroke: a. b. c. d. e. 36. List one of the exceptions to transportation guidelines of trauma victims: 37. For inhalation burns, the paramedic may consider 3ml of saline ____________. 38. Paramedics should elevate the head of the patient to at least _____o when major eye trauma has occurred. 39. Define “buccolingual crisis.” 40. Define the following: O– P– Q– R– S– T– 41. Combative patients may be restrained chemically with the following medications. Denote the dose for each route. Versed - ___ mg IV Versed - ___ mg IM Versed - ___ mg IN Valium - ___ mg IV 42. Selective Spinal Immobilization is not to be used for patients under ____ years old. 43. List the 6 Rights of Drug Administration: 44. Connect the following medication trade names and generic names: 45. Midazolam Proventil Adenocard Valium Albuterol Benadryl Diazepam Lasix Ipratropium Adenosine Diphenhydramine Versed Furosemide Atrovent For the renal dialysis patient in asystole or PEA arrest, administration of ______mg of Calcium Chloride 10% and _____mEq of Sodium Bicarb.