Scope of Practice

Question 1

What type of calls require a paramedic to ride instead of an AEMT?

Answer 1

Cardiac-related chest pain, respiratory distress, stroke/CVA, AMS

All of these patients require a 12-lead.

Question 2

Should obtaining a 12-lead delay transport?

Answer 2

No

Question 3

How can a paramedic give a copy of an EKG to the receiving hospital?

Answer 3

Via static/printed strip or electronic transmission

Question 4

Do EKGs need to be uploaded to a run report?

Answer 4

Yes

Question 5

How quickly should an EKG be obtained?

Answer 5

As soon as possible - do not delay transport.

Question 6

Which EKGs should be transmitted to the receiving hospital?

Answer 6

Any, but especially, chest pain or cardiac-related complaints.

Question 7

Should an AEMT acquire a 12-lead?

Answer 7

AEMTs may acquire and transmit a 12-lead, but they cannot interpret or make any care decisions based on that 12-lead.

Once a 12-lead has been obtained, a medic should ride the call - the only time this may not happen is on a BLS unit.

Question 8

Are medics required to take all calls if a 12-lead has been aqcuired?

Answer 8

Yes

Question 9

How many IV attempts are allotted per provider?

Answer 9

Attempts should be limited to 3 per provider

Question 10

Should an AEMT attempt IV access via an EJ?

Answer 10

No - this is a medic skill ONLY

Question 11

Should a paramedic attempt IV access via an EJ?

Answer 11

Yes - EJs are within the scope of a paramedic only

Question 12

What type of fluids should be initiated on trauma patients?

Answer 12

Warm fluids

Question 13

How should IV piggyback drugs be mixed?

Answer 13

100mL D5W with 60gtts tubing
WITH THE EXCEPTION of Dopamine and Epi drips

Question 14

What medications cannot be piggybacked with D5W?

Answer 14

Dopamine and Epinephrine

Question 15

What patients should receive an IV?

Answer 15

Only patients in need of medication administration or fluid resuscitation

Question 16

Can an AEMT ride with isolated hypoglycemia calls where D50/D10 has been administered?

Answer 16

Yes - provided the patient is stable

Question 17

Can an AEMT ride with ATBX that have been infusing for over 30mins?

Answer 17

Yes - provided the patient is stable

Question 18

Can an AEMT ride with fluids that have been given via IV pump for over 30 mins?

Answer 18

Yes - provided the patient is stable

Question 19

Can an AEMT ride with fluids at infusing at an ALS level?

Answer 19

No - this is paramedic only

Question 20

If time permits, what shall be placed on all intubated patients?

Answer 20

NG/OG tube

Question 21

All intubated patients MUST have what piece of equipment hooked to monitor for maintenance and assessment?

Answer 21

ETCO2, continuous capnography

Question 22

Should initial intubation attempt be video or direct?

Answer 22

Video - unless there is excess fluid that cannot be cleared with suctioning or there are technical issues with device

Question 23

After how many failed attempts should a crash or alternate airway be considered?

Answer 23

After two failed attempts

Question 24

For all patients on a vent, what medication shall be maintained?

Answer 24

Sedation

Question 25

What are the approved sedation medications for patients on a vent?

Answer 25

Ketamine or Versed per the RSI protocol dosages if indicated for maintenance

Question 26

If a patient is on a vent, can paralytics be administered?

Answer 26

If needed, paralytics may be used per the RSI protocol dosages.

Question 27

What weight is considered to be under pediatric protocols?

Answer 27

Less than 60kg or 132lbs in total body weight

Question 28

What age is considered to be under pediatric protocols?

Answer 28

Less than 13 years of age

Question 29

What safety protocol should be established before administering pediatric dosages of any medication?

Answer 29

6 Rights, or double-check with secondary confirmation method

Question 30

What is a quick reference for age/size considerations in peds?

Answer 30

Pedi tape / length-based tape / Broselow tape

Question 31

Where should pediatric patients with significant traumatic injuries be transported?

Answer 31

Vanderbilt Children's Hospital

Question 32

Where should pediatric patients with critical medical illness be transported?

Answer 32

Vanderbilt Children's Hospital or Centennial Children's Hospital

Question 33

Where should pediatric patients with non-critical illnesses be transported?

Answer 33

Closest appropriate facility

Question 34

Where should pediatric patients with non-illnesses in need of immediate stabilization be transported?

Answer 34

Closest appropriate facility

Question 35

When should blood draws be performed?

Answer 35

When possible, blood draws should be obtained on all STEMI, sepsis, and stroke alerts. Obtained no greater than 10min PTA at hospital. Initials and time written on each tube.