SNHD AEMT P rotocol Exam Questions with Complete Solutions Latest Updated A patient is defined as - Correct Answer A person who has a complaint or mechanism suggestive of potential illness or injury; A person who has obvious evidence of illness or injury; or A person identified by an informed 2nd or 3rd party caller as requiring evaluation for potential illness or injury Pediatric patient considerations - Correct Answer For patients < 18 yo, use the Pediatric Patient Destination protocol; Pediatric treatment protocols are to be used on children who have not yet experienced puberty.Signs of puberty include - Correct Answer chest or underarm hair on males, and any breast development in females.General Adult Assessment - Correct Answer 1. Scene safety / scene size up; NOI/MOI; PPE/BSI; Bring all equipment to patients side
- Level of consciousness -> unresponsive -> check pulse-> none -> Cardiac arrest
- History - HPI & AMPLE
- Radio contact for all trauma center patients, Code 3 returns, need for telemetry physician & as per
Airway -> sigs of compromised or non protecting -> Ventilation management Breathing -> inadequate or resp. distress -> Resp. Distress Circulation -> bleeding -> General trauma Disability -> Altered or confused -> altered mental status/syncope
Vital signs and physical exam blood glucose testing if indicated Special treatment protocol as indicated Cervical Stabilization as indicated Comfort measures (splint, position of comfort) Vascular access as indicated Oxygen therapy to keep SPO2 > 94%
protocol Transport per Disposition Criteria if applicable 1 / 4
*Transport to closest facility for Airway emergencies (inability to adequately ventilate) Disposition for patients sustaining traumatic injuries - Correct Answer transported in accordance with the Trauma Field Triage Criteria Protocol Disposition for patients sustaining burn injuries - Correct Answer Transported in accordance with the Burns Protocol Disposition for pediatric patients (<18 y/o) - Correct Answer Transported in accordance with the Pediatric Destination protocol Disposition for patients with evidence of stroke - Correct Answer Transported in accordance with the Stroke (CVA) protocol Disposition for sexual assault victims < 13 y/o - Correct Answer Transported to Sunrise Hospital Disposition for sexual assault victims 13-18 y/o - Correct Answer Transported to Sunrise Hospital or UMC Disposition for sexual assault victims 18 y/o and older - Correct Answer transported to UMC Disposition for sexual assault victims outside a 50-mile radius from the above facilities - Correct Answer Transported to the nearest appropriate facility Disposition for stable patients - Correct Answer Transported to the hospital of their choice, if the patient has no preference the patient should be transported to the nearest appropriate facility Disposition for patients outside a 50 mile radius from the protocol designated transport destinations - Correct Answer The licensee providing emergency medical care shall transport the patient to the nearest appropriate facility 2 / 4
Waiting room criteria - Correct Answer Upon arrival in the ED, if transfer of care has not occurred in accordance with NRS 450B.790, any patient, excluding patients on a legal psychiatric hold, meeting ALL criteria may be placed in a waiting room
- Normal vital signs
- Did not receive any parenteral medications during EMS transport except a single dose of analgesia
- In the judgment of the Paramedic, does not require continuous cardiac monitoring
- Can maintain a sitting position without adverse impact on their medical condition
- Is left with a verbal report to hospital personnel
- GCS
- Palpable radial pulse>
Heart rate 60-100 Respiratory rate 10-20 Systolic BP 100-180 Diastolic BP 60-110 Room air pulse ox > 94% A&Ox4
and/or an anti-emetic
Internal disaster - Correct Answer If a hospital declares internal disaster, that facility is to be bypassed for all patients except patients in cardiac arrest or in whom the ability to adequately ventilate has not been established Operational exceptions may be initiated in regard to transport to hospitals on internal disaster.General Adult Trauma Assessment - Correct Answer 1. General Adult assessment; cervical stabilization
<8 Ventilation management BVM if O2 sat < 94% >8 Oxygen Keep SPO2 > 94%
No -> vascular access, 1 L NS or LR bolus Yes -> Vascular access
4. Secondary survey:
Suspected tension pneumothorax -> Paramedic 3 / 4
Sucking chest wound -> apply 3-sided occlusive dressing Control active hemorrhage -> Hemorrhage control Obvious fractures -> Immobilize fractures; assess distal pulse Suspected traumatic brain injury -> Raise head of bed 30 degrees Open wounds -> cover with gauze; wet trauma dressing for abdominal evisceration
- Transport and radio contact to appropriate trauma center based on TFTC
- / 4
General Adult Trauma History - Correct Answer Time and mechanism of injury damage to structure or vehicle location in structure or vehicle other injured or dead speed and details of MVC restraints/protective equipment past medical history medications General adult trauma signs and symptoms - Correct Answer Pain, swelling Deformity, lesions, bleeding AMS or unconscious Hypotension or shock Arrest General Adult Trauma Differential (life threatening) - Correct Answer Tension pneumothorax Flail chest Pericardial tamponade Open chest wound Hemothorax Intra-abdominal bleeding Pelvis/femur fracture