South plains

SOUTH PLAINS
EMERGENCY MEDICAL
SERVICES
PRE-HOSPITAL
TREATMENT
PROTOCOL
EMT-BASIC
OCTOBER 2008
*Minimum Passing Grade is 80%*

2008-2009
EMT-BASIC
1. You respond to a youth football game for an injured player who was unconscious for a brief period of time prior to your arrival. You notice that the helmet fits too loose and needs to be removed. Which of the following statements is correct? A. Remove the facemask first then the helmet B. Remove the helmet first then the shoulder pads C. Remove the helmet and shoulder pads simultaneously D. Remove the shoulder pads first and then the helmet 2. When applying an SAED to a pediatric patient, which of the following is/are correct? A. Use pediatric pads if available B. Use adult pads if pediatric pads are not available C. If adult pads are used, apply according to manufacturer’s recommendation D. All of the above are correct 3. Throughout the Protocols, there is equipment with “(recommended)”. What does this mean? A. That these items are recommended and encouraged for this Protocol version B. That these items will be recommended on the next Protocol version C. That these items will be mandatory on the next Protocol version D. Both A and C 4. The adult dose for Epinephrine Auto-injector or SC for an allergic reaction on a 56 year old male with a history of CAD (Coronary Artery Disease) is: A. 0.3mg B. 0.15mg C. 0.5mg D. Epinephrine is contraindicated on a patient with a history of CAD 5. The correct dosage of albuterol for a 4 year old patient with respiratory distress is: A. 1.25mg in 3cc NS repeated once if no relief B. 2.5mg in 3cc NS repeated once if no relief C. 1.25mg in 3cc NS repeated every 5 minutes as needed D. 2.5mg in 3cc NS repeated every 5minutes as needed 6. You are dispatched to a report of “difficulty breathing” at the Red Lobster. The patient is a 30-year-old female who is in obvious respiratory distress. She is moving some air with shallow respirations at a rate of 32/minute. Her husband says it is their anniversary and that his wife ordered shrimp, even though she has had previous reactions to it. He tells you that the reaction usually has been a red rash and nothing else. Patient has no other medical history. The BP is 140/90. The pulse is 120. Initial oxygen therapy has been administered. Your next step should be to: A. Contact medical control B. Administer 0.3 mg Epinephrine SC or by Auto-injector C. Administer Albuterol by nebulizer D. Administer 0.15mg Epinephrine SC or by Auto-injector 7. Treatment for snake bites include all of the following EXCEPT: A. Immobilize the extremity at heart level 8. If carried, the pediatric dosage and route of Glucagon is: 9. The number of required items and medications in the Equipment List is the minimum amount required. Services can opt to carry more, but cannot carry less. 10. You are transporting an 85-year-old female to UMC with respiratory distress. She has a long-standing history of COPD and cardiac problems. She has a TDSHS Out of Hospital DNR and there is no reason to dispute the DNR. While administering Albuterol via a HHN, the patient suddenly goes unresponsive and her breathing slows to 8 breaths per minute. She is now cyanotic and her pulse ox shows 78%. The patient still has a gag reflex and a carotid pulse is present but weak. You should: A. Administer palliative care only since the patient has a valid DNR B. Perform aggressive CPR C. Assist ventilations with a BVM since the DNR is not effective until the cessation of spontaneous D. Contact medical control for further instructions 11. If an SAED is configured to the 2005 AHA Guidelines, how many shocks will an adult patient, in cardiac 12. A neonate should be given cardiac compressions when the: 13. SPEMS required skills may be checked of by any of the following persons EXCEPT: 14. It is acceptable to run multiple protocols, simultaneously, on the same patient. A. True, only with on-line medical direction B. True, with cognizance of cumulative or contradicting medications C. True, only when patient is complaining of chest pain and shortness of breath D. False 15. The patient is a 45-year-old executive who experienced a sudden onset of crushing chest pain while sitting at his desk. He is awake and alert. His skin is cool, pale, and moist. BP-140/90; P-110, weak, regular, R-20 shallow, regular. Your first action should be to: A. Administer oxygen via non-rebreather mask and aspirin 325 mg B. Administer 0.4 mg nitroglycerin SL C. Transport code 1 D. Request paramedic back-up and transport code 3 16. The ResQPOD device is used for which type of patient? A. Pediatric patients with severe dyspnea 17. You respond to a residence for a 25-year-old male complaining of difficulty breathing. Upon arrival, the patient is in obvious respiratory distress. You immediately apply oxygen at 12 LPM via a non-rebreather. His vital signs are: BP-124/84, P-116 strong and regular, R-28 shallow. His pulse ox shows 93% on oxygen and wheezing is noted in both lungs. He has a long-standing history of asthma and diabetes. He tells you that he took a breathing treatment of Xopenex about 10 minutes ago with very little relief. What should you do next? 18. The patient is a 14-year-old female who is complaining of nausea, vomiting, and diarrhea x 8 hours. She has weak radial pulses with a rate of 116. Her skin is pale and warm. BP in the supine position is 110/70. When you attempt to perform the tilt test, she complains that she feels dizzy and that her vision is blurry. You should: A. Administer oxygen; do a head to toe survey; and contact medical control B. Administer oxygen; begin rapid transport; request paramedic back-up; do a head to toe survey C. Administer oxygen; apply and inflate MAST; begin rapid transport; contact medical control D. Tell the patient to “hang in there” and complete the tilt test since you must have the vital signs to 19. You are traveling with your family to Dallas for vacation. 30 miles east of Wichita Falls, you come upon a one-car rollover. You stop to assist and find an unconscious adult male with gurgling respirations and no gag reflex. You have in your possession a first aid kit that has a King Airway or Combi-tube. No ambulance or other EMS personnel are on scene but are en route, according to a bystander. Under our protocols what should you do? A. Manage the airway with jaw thrust maneuver only due to no medical direction for ALS procedures B. Insert the King Airway or Combi-tube under SPEMS Protocols C. Do not assist due to no medical direction D. Place the patient in the recovery position and wait for EMS arrival 20. In the same scenario as the previous question, except that an ambulance is already on scene when you stop to assist. The ambulance is staffed by 2 ECAs and they request that you pass a King Airway or Combi-tube to secure the airway. What should you do? A. Advise the EMS crew to call for an aero medical helicopter B. Pass the King Airway or Combi-tube under the SPEMS protocols C. Obtain online medical direction for authorization D. Pass the King Airway or Combi-tube since it is a BLS procedure 21. You are called to CMC to transfer a patient to a local nursing home. The patient has terminal cancer and is being sent to the nursing home for pain management and palliative care. The patient does NOT have a TDSHS Out of Hospital DNR form but the transferring physician writes “Do Not Resuscitate” on the transfer orders and signs the document. En route, the patient goes into cardiac arrest. You should: A. Begin full resuscitative efforts since EMS cannot honor such physician DNR’s B. Honor the hand written DNR since the physician is responsible for patient care during transport C. Perform chest compressions only and continue transport to the nursing home D. Contact the nursing home for orders 22. During resuscitation of an adult cardiac arrest victim, CPR should be stopped every ______ cycles to 23. The pediatric dosage of Epinephrine for an allergic reaction is: 24. The 3 components of the Cincinnati Stroke Scale are: A. Facial droop, arm drift, and one-sided weakness B. Facial droop, one-sided weakness, and speech C. One sided weakness, arm drift, and speech D. Facial droop, arm drift, and speech 25. Your patient is complaining of severe chest pain. You have the patient on oxygen. You have administered 325mg of aspirin and 0.4mg of nitroglycerin. Five minutes after receiving his first dose of nitroglycerin 0.4 mg SL, the patient continues to have cardiac chest pain. You have requested Paramedic backup. A Paramedic is on the way but is not yet on scene. The patient’s blood pressure is now 96/56. You should: A. Repeat 0.4 mg nitroglycerin SL B. Give no additional nitro and wait for the paramedic C. Apply an AED and shock at 360J D. Repeat the aspirin 26. Which of the following airway devices are authorized by the current Protocols? 27. You respond to an adult patient who has been ejected from an ATV. The patient is unconscious and unresponsive with a head injury and is breathing about 6 breaths per minute. The Glascow Coma Score is 7. You place the Combi-tube or King Airway and begin to ventilate the patient. At what rate should you ventilate this patient? 28. What must be present before fever medication can be given, PO, to a pediatric patient who has had a febrile B. Temperature of 100.4 degrees or above 29. You respond to a 34-year-old female who is having an asthma attack. Her respirations are 32, labored, with bilateral wheezing noted. You administer 2 breathing treatments of Albuterol without relief. Your next step is to: A. Give one breathing treatment of Xopenex and contact medical control if no relief B. Repeat the Albuterol every 5 minutes until relief is noted C. Give Xopenex breathing treatment every 5 minutes as needed D. Give Xopenex breathing treatment and repeat only once if needed 30. Paramedic backup should be contacted for a patient in respiratory distress if serious respiratory distress, wheezing, and pulse ox (on oxygen) is less than: 31. A 16-year-old male is involved in a one-car rollover. He denies any pain or injuries. His vital signs are normal and the exam shows no obvious injuries. He tells you that he lives at home with his parents. He also tells you that he does NOT want to be transported to the hospital. You are unable to reach his parents or other responsible relative. What should you do with this patient first? A. Contact medical control and law enforcement for assistance B. Allow the patient to sign a refusal form C. Have law enforcement transport the patient to the hospital in a patrol car D. Forcibly restrain the patient on a backboard and transport to the hospital 32. If an SAED is not configured to the 2005 AHA guidelines, what should you do? A. Follow manufacturer’s recommendations B. Give only one shock at the lowest setting C. Give no shocks and call for paramedic backup D. Override the SAED and manually defibrillate at 360J or biphasic equivalent 33. In order for an EMT Basic to give Instant Glucose, the glucometer reading must be below what level? 34. You respond to a residence and find a 45 year old female that has fallen out of bed. She has a laceration and bruise to her right arm. After assessing the patient and bandaging the wound, the patient refuses transport. Which type of report should you fill out? 35. A positive “tilt” test refers to: A. Pulse decrease of 20/minute between lying and standing B. Systolic BP decrease of 20 mm Hg between lying and standing C. Increase in pulse of 20/min between lying and standing D. Either B or C 36. You are administering Epinephrine 1:1,000 subcutaneously to a patient having an allergic reaction. You want to administer 0.3mg of the drug. Epinephrine is supplied as 1mg in 1cc. How many cc’s should you administer? 37. In the event that a non-EMS healthcare provider, such as a nurse, is needed to accompany the EMS crew, what must occur before the non-EMS healthcare provider can render care? A. The patient’s condition must deteriorate B. The non-EMS healthcare provider must obtain prior medical direction from a physician C. The non-EMS provider must be ACLS certified D. The non-EMS provider must have a current CPR card 38. Which of the following statements regarding an EMT applying ECG/12 lead electrodes on a patient is/are A. An EMT can apply ECG/12 lead electrodes to a patient having chest pain after Paramedic backup B. An EMT must have appropriate training and testing prior to the placement of the cardiac C. An EMT cannot use monitor placement for interpretation/treatment D. All the above are correct 39. If you work with a volunteer fire department that is located outside of the SPEMS region you may use the SPEMS protocols as long as the volunteer fire department does NOT operate the local EMS service. 40. What is the appropriate ventilation rate during neonatal resuscitation? B. 10% TBS 3rd degree burns located on the back 42. What is the minimum age of a patient that an SAED can be applied and used on? 43. Which of the following conditions MUST be present before you can administer Epinephrine for an allergic reaction before contacting medical control? 44. If a patient is successfully resuscitated out of cardiac arrest but is still not breathing, the ResQPOD should 45. A newborn is pink with blue extremities, has a pulse of 104, grimaces with suctioning, actively moves, and has slow respirations. The APGAR score is: 46. Contraindications to administering oxygen include: 47. Which of the following minors cannot legally refuse transport and sign the refusal form?
A. A 15 year old female who is pregnant B. A 16 year old who is emancipated from his/her parents C. A 17 year old who is on active duty with the US Army D. A 17 year old whose parents are away on vacation 48. If carried, the adult dosage and route of Glucagon is: 49. Which drug and dose can be given to a pediatric patient with febrile seizures? A. Children’s Aspirin, 80mg B. Children’s Tylenol (Acetaminophen), 7.5mg/kg up to 350mg C. Children’s Tylenol (Acetaminophen), 15mg/kg up to 700mg D. Children’s Motrin (Ibuprofen), 10mg/kg up to 800mg A. All unresponsive patients B. All unresponsive patients with blood glucose level below 70mg/dL C. All patients with blood glucose level below 70mg/dL D. All unresponsive patients with blood glucose level above 70mg/dL **END OF EXAMINATION**

Source: http://www.spems.org/files/BasicExam_2008-2009_.pdf