2016_Q4_CE_Basic Aurora Health Care 2016 4th Quarter CE Quiz Revised Protocol Review This quiz MUST be completed by December 31, 2016. ALL EMS Services are required to begin using these protocols by January 1, 2017. The accompanying document can be downloaded here : Protocol Document Once this quiz is completed it will automatically be submitted to email@example.com. This quiz is intended to be completed by all EMS providers, regardless of level of licensure. It is understood that some questions may ask about skills that you are not able to perform. We encourage all providers to be aware of skills allowed at other levels of licensure. Questions 1-25 MUST be answered by all providers. Questions 26-35 MUST be answered by all AEMT's, Paramedics and RN's functioning at an ALS level. EMR's and EMT's may also answer them. You will receive a link for the advanced portion after you complete this section. Name* First Last Department*Email* Current Level of Licensure*EMREMT-BAEMT/Intermediate/IV TechParamedicPassword*Enter the password supplied by your department to continue with the quiz.1. The medication and dose recommended for wheezing in our protocols due to an Allergic or Anaphylactic reaction is:*a. Atrovent 0.5mg in 2.5mlb. Benadryl 25mgc. Albuterol 2.5mg in 3mld. Epinephrine 2.5mg You are caring for an adult patient who has experienced unwitnessed cardiac arrest. CPR is being performed and an AED is arriving at the same time you are. Please answer the following five questions regarding the above cardiac arrest patient. 2. Patients experiencing cardiac arrest have the greatest chance of survival if basic level skills are administered as soon as possible. The AED should be applied:*a. immediately, the patient’s rhythm analyzed and defibrillation administered if appropriate.b. after 2 minutes of high-quality chest compression.c. after 6 minutes of high-quality chest compressions.d. after ALS has arrived and begun providing ALS level care.3. A non-visualized advanced airway should be inserted:*a. as soon as possible to adequately ventilate the patient.b. after applying the AED and a shock is indicated.c. after six (6) minutes of CPR have been performed.d. never in this patient.4. ALS may insert an Endotracheal tube (ETT):*a. as soon as possible.b. when a non-visualized airway has NOT been successfully inserted and CPR is still continuing.c. at any point while CPR is in progress and time allows.d. when Return of Spontaneous Circulation (ROSC) has been obtained and maintained/sustained.5. The patient should/may be transported to the hospital:*a. as soon as possible and while CPR is still in progress.b. only after contacting medical control if CPR is still in progress.c. when ROSC has been obtained and maintained/sustained.d. b and c.e. all of the above.6. EMS may terminate resuscitation without contacting medical control if:*a. at least twenty (20) minutes of CPR have been performed.b. the cardiac arrest was unwitnessed by EMS.c. no shock was ever indicated or administered during resuscitation.d. there has been no return of pulse an anytime during resuscitation.e. ONLY if all of the above are true.7. You are caring for a patient who is refusing to be transported to the hospital. In your opinion, the patient is in need of services only available at the hospital. You choose to contact the Emergency Department and have the physician speak with the patient. Using the ED physician to speak with a patient has been shown to:*a. have no effect on the patient’s decision.b. reduce refusal of care/transport by 50%.c. reduce refusal of care/transport by about 1/3.d. reduce refusal of care/transport by about 1/2.8. EMS must obtain 12-leads from a patient suspected of suffering from Acute Coronary Syndrome (ACS). A 12-lead should be obtained:*a. within five (5) minutes of EMS arrival at patient.b. again prior to transport if patient remains symptomatic.c. again upon arrival to hospital if patient remains symptomatic.d. any time there is an observed rhythm change OR chest pain worsens.e. All of the above. Serial/multiple 12-leads are always appropriate when suspecting Acute Coronary Syndrome.9. Your EMS crew is caring for a patient who has pulmonary edema you suspect is due to Congestive Heart Failure (CHF). The patient is in severe respiratory distress and you are considering CPAP. You are not sure if CPAP is appropriate for this patient so you need to review your protocol. While you are doing that, your partner is preparing to administer Nitroglycerine (NTG) to the patient. You have reviewed your CPAP protocol and realize that CPAP is appropriate for this patient as long as certain criteria are met.*a. True.b. False.10. EMS is allowed to remove barbs in a patient from an Conducted Electrical Weapon (TASER). EMS is NOT allowed to remove barbs if they are located in/near:*a. eyes, ears, mouth, or face.b. genitals.c. spine, hands, feet or a joint.d. all of the above.11. Your patient is experiencing an issue (e.g. STEMI) that indicates the patient should to go a hospital capable of providing a specific time-sensitive procedure (e.g. cath lab). The closest hospital does not provide that level of care. The patient insists on going to the closest hospital, contrary to your opinion. What do you do?*a. Transport the patient to the hospital capable of providing the procedure against the patient's wishes knowing it is the patient’s best interest.b. Transport the patient to the closest hospital without having any discussion with the patient.c. Attempt to educate the patient on the need to go to a hospital capable of providing the procedure but comply with the patient's wishes.d. Refuse to transport the patient and turn them over to another EMS service.12. Intraosseous (IO) insertion is appropriate standard of care for certain patients. IO placement in the following locations is acceptable for an adult patient.*a. Proximal humerus, sternum, distal femur, proximal tibiab. Proximal humerus, proximal tibia, distal tibiac. Proximal humerus, distal femur, distal tibiad. Proximal humerus, proximal tibia13. Contraindications to an IO include:*a. known or suspected fracture of the chose bone.b. known or suspected infection at chosen insertion site.c. known or suspected orthopedic procedure of the chosen bone.d. all of the above.14. Trauma patients may have C-spine omitted if certain conditions are met. Those conditions/requirements include:*a. patient is conscious, cooperative and able to communicate.b. patient has no midline back, neck pain or tenderness on palpation.c. patient has no distracting injuries (e.g. fractures, significant pain)d. patient has no evidence of intoxication (alcohol or drugs).e. all of the above.15. Oral glucose would be appropriate for a suspected hypoglycemia patient ONLY if:*a. the patient has a blood glucose less than 60 and is unconscious.b. the patient has a blood glucose less than 100.c. the patient is conscious.d. the patient needs it.16. Induced hypothermia is an appropriate therapy for certain patients who have suffered cardiac arrest and Return of Spontaneous Circulation (ROSC) has been obtained and maintained/sustained. The IV infusion of cold Normal Saline is NO longer part of our protocol. Cold packs applied to a patient’s neck, axillas and groin is the acceptable method of cooling. The following criteria must be met to consider cooling a patient.*a. age > 17, non-traumatic cause of cardiac arrest, unable to follow verbal commands.b. any age, traumatic or non-traumatic cause of cardiac arrest.c. patient verbally communicating with EMS and able to follow commands.d. all of the above.17. The appropriate treatment for a chemical splash burn to an eye is:*a. bandage both eyes with dry sterile dressings.b. apply pain medication drops to each eye and ask the patient to hold their eyes shut.c. irrigate both eyes with large amounts of saline solution (IV solution is acceptable).d. all of the above.18. Syncopal episodes may occur as a result of an underlying cardiac issue such as a rate change or other dysrhythmia. Knowing that, EMS should always acquire a 12-lead on a patient who had a syncopal or near-syncopal episode.*a. True.b. False.19. Pediatric patients often present to EMS in respiratory distress. Children less than 2 years old may benefit from nebulized epinephrine. The following criteria must be met to use nebulized epinephrine.*a. Patient is less than 2 years old.b. Patient has stridor or significant wheezing.c. Patient has no prior diagnosis of asthma or bronchiolitis and is not regularly medicated with a beta-agonist for that diagnosis.d. All of the above.20. The procedure for administering nebulized epinephrine includes:*a. placing 1 ml of 1:1,000 epinephrine into a nebulizer and placing in front of patient's face and allow them to breathe the mist.b. repeating the dose after 5-10 minute if non-effective.c. placing 3 ml of 1:1,000 epinephrine into a nebulizer and placing in front of patient's face and allow them to breathe the mist.d. the treatment may not be repeated.21. EMS frequently encounter patients experiencing and complaining of nausea with or without vomiting. Non-ALS providers have minimal tools to manage these issues. ALS is frequently utilized to administer medications for these patients. One therapy now allowed and incorporated into our protocols involve using alcohol prep pad(s). The procedure is:*a. have the patient hold one or more alcohol prep pads under their nose and inhale during the entire EMS contact.b. have the patient place an alcohol prep pad under their nose within 1 " (2.5 cm) and inhale deeply for up to 60 seconds.c. have the patient place one or two alcohol prep pads into their mouth and chew slowly without swallowing.d. have the patient insert (if tolerated) one alcohol prep pad into each nare and inhale slowly.22. Cardiac arrest caused by traumatic injury is typically considered to be non-resuscitatable. There are exceptions to this but when the following conditions are met with a significant mechanism of injury present, resuscitation should not be initiated.*a. Patient is pulseless, apneic and without other signs of life, or:b. Patient is asystolic, or:c. Patient has injury that is incompatible with life.d. All of the above.e. None of the above. All traumatic arrests should include resuscitation attempts.23. The use of hemostatic agents and external skin clamps for hemorrhage control is allowed at all levels of licensure in Wisconsin as long as the user has been trained and it's used approved for the service.*a. Trueb. False24. Hemorrhagic shock in an adult can be categorized into one of four classes, I, II, III or IV. Class II, II and IV almost always involve internal or external bleeding and require definitive treatment. Signs and symptoms of class II, III or IV include:*a. sustained respiratory rate ≥ 20; sustained pulse ≥100 (unless elderly or on beta blockers or digitalis); cool, moist, pale skin; narrowed pulse pressure, and/or a falling BP.b. sustained respiratory rate 12-20; sustained pulse < 100; warm, dry skin; falling BP.c. increasing respiratory rate; decreasing pulse rate; cool, moist, pale skin; widening pulse pressure; stable BP.d. decreasing respiratory rate; increasing pulse rate; warm, dry skin; normal pulse pressure; falling BP.25. There continues to be an ever increasing number of incidents involving mass casualty incidents involving aggressive acts. Tactical EMS (TEMS) and the concept of the Rescue Task Force (RTF) have demonstrated a specific need. Local EMS may or may not be involved in incidents involving TEMS. TEMS members often function in hostile environments and function in one of three zones. Types of care provided in those zones differ based on the threat level. Those zones are known as:*a. Zone 1, 2 or 3b. Zone A, B or Cc. Hot, warm or coldd. Red, yellow or greenContinue with Advanced portion of Quiz? Yes - Continue Complete Quiz* Complete Quiz Checking this box will allow the submit button to appear. Make sure of your answers prior to checking this box and clicking the submit button.