General Protocols
An ALS provider is performing an action that you believe to be dangerous for your patient. What should you do?
Speak up.
What is the formula for calculating shock index?
Heart Rate (HR)/Systolic Blood Pressure (SBP)
What is I70 exit for the Foothills Rainbow Station?
Exit 252 WB.
Can you use Ketamine for sedation at Highland Rescue?
No.
What are the indications for C-collar in the latest protocol release?
Age over 65 OR parasthesias in extremities OR objective neurological deficit OR uncooperative/cannot follow directions. (What about provider judgement?)
A patient is intoxicated, A&Ox4, but clearly altered. They are refusing transport to the hospital. They are stumbling into the road where there is busy traffic. Should you transport this patient?
Yes, they are altered and a threat to themselves.
In the presence of hemorrhagic shock, what are the medications we give along with whole blood, and what are the doses?
Calcium chloride 1gm. TXA 1-2 gm's. O2 titrated.
How long after a call do you need to have your chart completed?
Within 48 hours.
Should you give TXA through the same IV that administers blood?
No.
What are the indications for chest needle decompression?
Severe respiratory distress. Hypotension (why?). Unilateral or decreased breath sounds.
You have an 84 y/o M with a positive BEFAST assessment, with onset of 30 minutes. He is hypertensive and tachycardic. Is this an ALS or BLS transport?
ALS.
For Medical Shock, what is the fluid administration dose?
20 mL/kg, up to 1 L (protocol 4000)
You get dispatched to the address: 60 S. Pine Road. Do you take a left or right, leaving the station's parking lot?
Left
What is the current adult dose of epi for someone in suspected anaphylactic shock?
0.5 mg IM.
What are the indications for SMR in pediatric pts?
You have a high index of suspicion of domestic violence for your 34 y/o F pt who called after "falling down the stairs." She does not have any intellectual, developmental, or physical disabilities. Should you call Adult Protective Services?
No, she does not fall under the category of an "At Risk" adult. Consider law enforcement.
When caring for a patient in shock, the line for permissive hypotension is a systolic pressure of around 90 mmHg, except in which case?
Suspected head injury. >100 mmHg
What is the nose art on 287?
Blucifer.
What are 3 of the 5 contraindications listed in 9045 for the antipsychotics we carry?
- Suspected MI
- Systolic BP under 100
- Signs of Respiratory Depression
- Known QT prolongation
- Pregnancy
Where should a TQ be placed on a limb?
Apply tourniquet proximal to the wound and not across any joints.
You have a 75 y/o pt who is presenting with AMS, fever, hypotension, and a heart rate of 80. This patient has been sick for 2 days and is progressively getting worse. They are on Atorvastatin, Levothyroxine, Metoprolol, and Sertraline. Would you consider Sepsis for this patient?
Yes.
You have a patient who was hit in the ribs with a baseball bat. Upon arrival you find the pt complaining of left flank pain, left absent lung sounds, and presenting with a positive shock index. What type of shock is likely?
Obstructive Shock.
What is the code to get into gym if it's locked?
80401
You can use Diphenhydramine for two listed indications, per our protocols. One is an allergic reaction. What is the other?
Dystonic medication reactions or akathisia (agitation or restlessness), possibly caused by droperidol administration.
According to protocol 8070, where should a pelvic binder be placed?
Pelvic binders should be placed around greater trochanters, not "hip bones".