Dieseases and Recognition
A patient has altered mental status, sweating, and a blood glucose of 48 mg/dL. What condition should you suspect?
Hypoglycemia. See Adult Diabetic Emergencies, Protocol 2.10A.
What is the listed adult oral glucose dose for an awake, alert patient with a blood glucose of 60 mg/dL or lower?
15 grams of oral glucose.
What should EMS prioritize when treating a patient with a life-threatening condition?
: Treat life-threatening conditions in the order they are identified, following applicable protocols.
What does STEMI stand for?
ST-elevation myocardial infarction.
A patient has a temperature of 102°F. What condition does this meet the recognition criteria for?
Adult fever — Protocol 2.15A, because the temperature is at least 100.4°F.
A patient has wheezing, difficulty breathing, and a history of asthma. Which protocol applies?
Adult Respiratory Distress (Asthma/COPD/RAD), Protocol 2.08A.
In the adult diabetic emergency protocol, when should blood glucose be rechecked after oral glucose?
After 15 minutes. The protocol allows a repeat dose if the blood glucose remains 60 mg/dL or lower.
In an adult with hypoglycemia who is awake and alert, what is the listed first-line treatment in the diabetic emergency protocol?
Oral glucose solution, 15 grams, followed by a blood glucose recheck in 15 minutes.
Which Rhode Island protocol covers acute coronary syndrome and STEMI?
Protocol 3.02.
A patient with kidney failure receives regular dialysis and develops weakness. Which protocol should you consider?
Dialysis Emergencies and Renal Failure — Protocol 2.11.
A patient with a suspected infection has altered mental status and signs of poor perfusion. Which serious condition must EMS consider?
Sepsis. See the age-appropriate Sepsis Protocol, 2.22A or 2.22P.
What is the listed adult IM epinephrine dose for the applicable moderate allergic reaction/anaphylaxis pathway?
0.3 mg IM in the lateral thigh, using the applicable protocol criteria.
In pediatric reactive airway disease/asthma, what medication is included with the initial albuterol nebulizer dose in the protocol?
Ipratropium 500 mcg.
What does ROSC stand for?
Return of spontaneous circulation.
A patient has severe abdominal pain. Why should EMS be cautious about giving oral medication?
Some patients may require surgical intervention, and oral medications may be inappropriate under the applicable protocol.
A patient has facial droop, arm weakness, and difficulty speaking that began suddenly. Which protocol applies?
Ischemic Stroke, Protocol 2.12.
What is the listed initial albuterol dose range for adult asthma/COPD-related respiratory distress?
2.5–5 mg by nebulizer, according to Protocol 2.08A.
Why is the patient's blood glucose rechecked after treatment for hypoglycemia?
To determine whether the glucose level has improved and whether further protocol-directed treatment is indicated.
What does VF stand for in cardiac arrest care?
Ventricular fibrillation.
A patient has a sudden severe headache, declining mental status, and signs suggesting increased intracranial pressure. Which protocol applies?
Acute Neurologic Event with Evidence of Increased Intracranial Pressure — Protocol 2.01.
A patient develops hives, airway swelling, and difficulty breathing after a bee sting. What emergency should you suspect?
Anaphylaxis. See Protocol 2.04A for adults or 2.04P for pediatric patients.
What IV dextrose option is listed for an adult patient with hypoglycemia who is not alert to verbal stimuli or is nauseated/vomiting, under the advanced-care pathway?
D10W 250 mL (25 g) IV over 5 minutes, or Dextrose 50% 25 g/50 mL IV. The protocol includes additional conditions and repeat-dose criteria.
What should EMS do if a patient's presentation does not clearly meet the recognition criteria of a specific protocol?
Consult Medical Control for guidance.
After ROSC, what oxygen saturation range does the routine patient care protocol specify?
94–99%, by titrating oxygen to the lowest concentration needed to maintain that range.
A patient has a history of adrenal insufficiency and develops weakness and signs of shock. Which condition-specific protocol should EMS consult?
Adrenal Insufficiency — Protocol 2.03.