General Patient Care/Monitoring & Vascular Access

Question 1

What is patient history?

Answer 1

OPQRST/SAMPLE

Question 2

What do you bring to patient’s side?

Answer 2

Equipment, medication, and resources

Question 3

What is skill level 1?

Answer 3

Treat all patients with respect; ensure scene/crew safety, BSI/PPE precautions, request ALS/additional resources as needed, consult OLMD as needed, bring equipment, medication, resources to patient’s side, establish LOC, manage Immediate Life Threats IAW appropriate protocols, complete initial assessment/patient hx/physical exam as indicated by patient presentation, treat illness/injury IAW applicable protocol or OLMD instruction, airway management, oxygen, patient monitoring, and medication administration.

Question 4

What is respiratory distress/SOB?

Answer 4

Titrate SpO2 ≥94%

Question 5

What is hypoxemia or cyanosis?

Answer 5

SpO2<90%

Question 6

What vitals should you be monitoring?

Answer 6

HR, RR, BP, SpO2, and pain

Question 7

What other places can you get an SpO2?

Answer 7

Ear, toe, and scalp

Question 8

How to take temperature?

Answer 8

Oral tympanic, temperature as patient condition/protocol requires

Question 9

BGL?

Answer 9

obtain as patient condition or protocol requires

Question 10

Why do you monitor carbon monoxide?

Answer 10

If there is suspected CO exposure, fires/smoke inhalation

Question 11

What is skill 2?

Answer 11

Transport to appropriate facility based on chief complaint AMA, EtCO2, cardiac monitoring, and a 12-lead EKG

Question 12

When does EtCO2 (capnometry) used?

Answer 12

For all AMS/lethargy, hypotension, SOB, *trauma, or cardiac arre3st Tier 2 & 3 will document RR and EtCO2 only

Question 13

When do we use a cardiac monitor?

Answer 13

For all AMS/lethargy, hypotension, CP/SOB, *trauma, or cardiac arrest Skill Level 2 & 3 will document rate ONLY, not complete interpretation

Question 14

What is skill level 3?

Answer 14

Vascular access and temperature

Question 15

What are the three types of vascular access?

Answer 15

IV access via single lumen (standard IV) when required (saline Lock or NS/LR TKO), IV access via double lumen (Twin-Cath IV) when required (limited access, multiple infusions), and IO access if the IV access is unobtainable and/or lie-threatening condition exists.

Question 16

How do you give IO for alert/verbal patients?

Answer 16

2% Cardiac Lidocaine Bristojet, Inj - 40mg IO x 1 for analgesia before fluid administration

Question 17

When do we use blood/fluid warmers?

Answer 17

For all *Trauma/Hypovolemia & Hypothermic patients

Question 18

When may you utilize rectal monitoring?

Answer 18

Truma and hypo/hyperthermia

Question 19

What is skill 4?

Answer 19

External jugular, medication infusions, tunneled catheters, PICC line, dialysis graft/shunt, temperature, EtCO2, and SpHb (Hemoglobin)

Question 20

What do you use for external jugular?

Answer 20

Via single or double umen IV or saline lock

Question 21

What are the two forms of medication infusions?

Answer 21

Vasopressors and infusion pumps

Question 22

How should vasopressors be given?

Answer 22

Via IV placed in the AC, if able

Question 23

What is the formula for infusion pumps?

Answer 23

mL/hr = gtts/min (using 60 gtt tubing)

Question 24

What are the requirements for tunneled catheters, PICC line, dialysis graft/shunt?

Answer 24

IV/IO access must be unobtainable and must have OLMD approval prior o accessing and must be approved/trained by local EMS medical director with documentation in training record.

Question 25

When do BLS calls not resume after evaluating for life threats?

Answer 25

Patient requires or there is a high clinical suspicion that the patient will require ALS interventions, an intervention was performed on the pt requires continuous monitoring that is beyond the EMT scope, patient has received or will require the administration of a medication that is beyond the scope of the EMT, or any patient requiring a hospital alert

Question 26

What is a PCR?

Answer 26

Patient Care Report

Question 27

When does a PCR need to be completed?

Answer 27

As soon as possible after the completion of the call, but no later than the end of the primary provider’s shift.

Question 28

What should be uploaded with the PCR to the receiving facility?

Answer 28

Copies of rhythm strips, EKGs and waveform capnography

Question 29

What temperature is hypothermia?

Answer 29

< 35°C or 95°F

Question 30

What temperature is hyperthermia?

Answer 30

> 38° or 100.4°F

Question 31

How often do you record vital signs?

Answer 31

q 5 min for critical pts and q 15 min for non-critical pts

Question 32

When do you use Blood Tubing?

Answer 32

For massive blood loss or expected blood transfusion

Question 33

What do you do if IV extravasation occurs?

Answer 33

Stop infusion, connect syringe to IV catheter and attempt to withdraw fluids, remove IV catheter, immobilize extremity, and elevate above the level of the heart, and apply heat packs to the area

Question 34

What do you do if IV infiltration occurs?

Answer 34

Stop the infusion and remove the catheter

Question 35

What do you do if IO extravasation/infiltration occurs?

Answer 35

Stop infusion, secure in place, and do not attempt to remove