Recognizing Signs and symptoms.
Millcreek Policies
Protocols
Pre-hospital Alert Criteria
Medications and contraindications
100

You are dispatched to a Suspected Stroke. Name 3 signs/symptoms your pt could be experiencing if they were having a stroke. 

Facial Droop

Arm drift

Aphasia

Unstable Gait

One sided weakness

One sided; abnormal sensation


Nausea and or vomiting

Dizziness

 Altered mental 

visual disturbance 

Unequal pupils 

100

What is the Millcreek policy for ambulance response for all in-district box alarms.

One BLS Unit is to responded to any and all In-district box alarms. (This included Gas boxes).

A secondary BLS Unit is to responded if units arrive on scene and report conditions. (Smoke, fire)

100

According to the BLS protocols what are the vital signs and assessment criteria for CPAP

Tachypnea- RR greater than 24

tachycardia- HR greater than 100

hypertension- greater than 120mmhg systolic 

hypoxia - pulse ox reading of less than or equal to 90%

labored breathing that results in the pt being unable to speak in full sentences. 

100

What are the different “suspicions for infection” in the Pre-Hospital Sepsis ALERT Criteria. ( Name 4)

Indwelling Catheters and or central lines

Pts with altered mental status from a nursing facility. ( Cadia, Manor Care, Millcroft, Coral Springs (Etc)

Chronic Diseases (diabetes, renal failure/dyalsis)

Immunocompromise ( Cancer WITH chemo treatment, HIV+, Transplant recipient)

100

What is the correct dosing for an adult Duo Nebulizer Rx including oxygen 

Albuterol- 5mg

Atrovent- .5mg

oxygen- 8LPM

200

You are dispatched to a Pt experiencing lethargy, AMS and slurred speech. Your stroke eval is negative and the pts family stated the pt has not consumed drugs or alcohol. What are 3 other possible causes for these symptoms. 

Hypo/Hyperglycemic 

Head injury

Seizure

Hypoxia 

Infection

Psychiatric Emergency


200

What steps should be taken to report a workmans comp injury 

where can you find workman’s comp paperwork

Report your injury immediately to the on duty career Lt or shift lead if LT not available 

obtain paperwork from Pinter room mailbox 

fill out paperwork

scan paperwork using printer email to Ed Weinstein, Collin’s, and Doughten

place hard copy in Collin’s mailbox or hand directly to him.
Advise LT or shift lead paperwork had been completed. 

200

What is the protocol for cord prolapse 

Place the mother in the knee to chest position on the stretcher 

keep cord moist with saline soaked gauze 

attempt to release pressure off the cord by gently lifting the presenting part of the cord 

Ensure pulse still be felt in the cord 

200

What does the V.A.N acronym stand for. 

What criteria does the patient need to meet to be ”V.A.N Positive” 

V- Visual 

A- Aphasia

N- Neglect 

If the pt is not experiencing weakness the V.A.N assessment is over and the pt is deemed V.A.N Negative. 

If the pt is found to be suffering from Visual Disturbance they are “V.A.N Positive”

If the pt is noted to have aphasia, slurred speech note to be counted they are “V.A.N Positive”

If the pt is noted to to have neglect, she is considered to be “V.A.N Positive” 

200

At or above what age does the patient fall under the adult protocol for Albuterol 


6 years of age 

300

You are dispatched to an Alpha Sick Person. upon assessment you find your pt is experiencing chest pains. She is tachycardic, Diaphoretic, short of breath, Hypoglycemic, fatigued, and has no radial pulses. Pt stated she has a cardiac Hx however she can‘t remember the name of the condition. What could your pt be suffering from. 

SVT. (Supra Ventricular Tachycardia)

Diabetic Emergency 

P.E

Postictal (seizure) 

M.I

300

What needs to be brought to the scene of a Fire from the BLS unit. 

Stretcher 

Primary bag

AED

Burn Bag

Pediatric Bag

Pet O2 Masks 

300

Give me 5 situations where you would need to contact medical control to obtain a refusal acknowledgment 

Suspicion of intoxication by drugs and or alcohol 

past medical Hx or suspicion of dementia 

Any intervention preformed by any other health care provided 

A summons of EMS to a health care facility or call initiated by a health care provided 

suspicion of acute mental disease or or SI,HI

Suspicion of significant heady injury 

Respiratory distress

Abnormal vitals signs 

AMS, Who remain altered 

age less than 18yo

Any time ALS is dispatched and recalled by BLS.



300

Provide 5 prehospital trauma Code injury pattern criteria 

Penetrating injuries for the Head, Neck or Torso and Proximal extremities. 

Skull Deformity 

Chest wall Instability

Suspected spinal injury with new onset of motor or sensory loss

suspected pelvic fracture 

Suspected fracture to two or more long bones

Crushes, Degloved, Mangled or pulseless extremity

Amputation proximal to the wrist or ankle

Active bleeding requiring a tourniquet or wound packing with continuous pressure

300

what is the indication for Zofran 

Any pt 15 years of age or older, ongoing nausea/vomiting that is not from a toxin or alcohol ingestion 

400

You are dispatched to a Charlie Interfacility Transport with a C/c of “Altered Mental Status”. You arrived on scene staff tell you the pts was being treated for pneumonia. You note the pt to be cold to the touch. You find the pt to be tachepnic, hypotensive and hyperglycemic. Pt is only alert to verbal stimuli. What could your patient be suffering from?

SEPSIS

Diabetes

400

What is the chain of command per new employee ranking structure as stated in operation handbook 

PPC
Career assistant chief 

career captain 

FF/EMT LT

EMT LT

FF/EMT 

EMT

400

Using the BLS protocol rule of 9’S

if your pt has complete burns to his genitalia, left buttocks, and the entire left thigh, what would be the pts burn percentage. 

12.5%

genitalia-1%

thigh-9%

Buttocks-2.5%

400

What does SIRS stand for in the sepsis protocol

What are the SIRS Criteria 

how many SIRS criteria need to be met to activate a Prehospital Sepsis Alert

SIRS stand for, Systemic Inflammatory Response System.

Temperature grater than 100.4 

HR greater than 90

RR Greater than 20 

hypotension- systolic less than  90

If TWO or more SIRS criteria are met along with suspicion of infection Activate the Pre-hospital sepsis alert. 


400

what is the weight requirement for the Adult Epi dose (0.3)

Epinephrine auto-injector delivers a single dose of 0.3mg to a patient 30kg/66lbs or above. 

500

What are some signs and symptoms of a Pulmonary Embolism 

Shortness of breath 

chest pains

pallor

Diaphoresis 

Cough

Rapid or irregular heartbeat 

Fever



500

What bridge should Ambulances not be driven under 

can BLS units be driven under the CSX Railroad 

Stanton Christiana Bridge 

Yes

500

What does A.P.G.A.R stand for

How many point can one pt have 

when should you initiated compressions on a neonate even if they are not Pulseless and apneic 

Appearance 

pulse

grimace

activity 

respirations 

one pt can have a maximum score of 10

If a newborn has a HR less than 60 initiated CPR

500

What are 2 important things to communicate to the receiving facility about your suspected stroke pts Hx aside from your assessment and findings 

Last know well

use of anticoagulants 

Hx of stroke 

500

What are the two contraindications for Benadryl 

If the pt has a known allergy to Benadryl

CNS depression 

M
e
n
u