Circle the correct answer:

1. ALS may not turn over care of a patient to BLS if:

1. the mechanism of injury warrants ALS care
2. the chief complaint warrants ALS care
3. ALS intervention may be required
4. All the above

2. A 24 year old female shows SVT on the monitor. She complains of feeling like her heart is racing, and she is slightly dizzy. The most appropriate treatment for her is:

1. Adenosine 6 mg rapid IV push
2. Sedation and cardioversion
3. Carotid message and Adenosine 6 mg
4. Adenosine 12 mg repeated once

3. A patient in Pulseless Electrical Activity should receive a fluid bolus of:

1. 250 cc NS
2. 300 cc LR
3. 500 cc NS
4. 500 cc LR

4. Which of the following is not considered an accurate indicator of poor perfusion in an infant?

1. Blood Pressure
2. Capillary refill > 2 seconds
3. Altered Mental status
4. Cyanotic distal extremities

5. A patient suspected of having an Acute Myocardial Infarction should receive the following:

1. Nitroglycerine, immediate transport to the nearest facility, Lidocaine 1mg/kg IV
2. Aspirin only, immediate transport to nearest angioplasty center
3. Up to 3 Nitroglycerine, Morphine 5mg IV, Aspirin 324mg PO
4. Up to 3 Nitroglycerine, Aspirin 324mg PO, transport to the nearest angioplasty Center

6. A stable adult patient in V-Tach can be given a bolus of lidocaine prior to contacting Medical Control.

1. True
2. False

7. The Southern Tier Regional EMS Pediatric Protocols apply to patients under the age of:

1. 8
2. 17
3. 18
4. 21

8. The only time a controlled substance such as diazepam may be given without a medical control order is for an actively seizing patient.

1. True
2. False

9. A patient with respiratory distress and a history of COPD may receive Albuterol 2.5 mg AND Ipratropium 0.5 mg combined in an SVN.

1. True
2. False

10. A patient with 1mm or more of ST elevation in any lead except aVR should be treated according to the Suspected Acute Myocardial Infarction Protocol.

1. True
2. False

11. A 50 year old male patient has a heart rate of 36, chest pain, dyspnea, and pulmonary edema. The most appropriate treatment for this patient is:

1. IV access, Atropine 1mg IV
2. IV access, sedation, transcutaneous pacing
3. Immediate transcutaneous pacing
4. IV access, Atropine 0.5 mg

12. A good physical assessment is important on a tachypneic patient because hyperventilators may believe they are having an allergic reaction or and asthma attack.

1. True
2. False

13. The modified GCS for pediatrics includes assessing the following:

1. Eye opening, facial droop, verbal response
2. Verbal response, eye opening, motor response
3. Crying, AVPU, eye opening
4. Motor response, facial droop, verbal response

14. Approved secondary confirmation devices for confirming proper placement of an ET tube include:

1. Bulb style Esophageal Detector Device; Colorimetric end tidal CO2 detector
2. Auscultating lung sounds with stethoscope; condensation visible in ET tube
3. Esophageal Detector Device; Non–Colorimetric end tidal CO2 detector
4. Syringe style Esophageal Detector Device only

15. An elderly female is found on the floor with a GCS of 7. After routine medical care, a blood glucose check shows a reading of 47. Treatment may consist of:

1. 50 mg Thiamine, 2 mg Narcan
2. 100 mg Thiamine, D50, 2 mg Narcan
3. 2 mg Narcan only
4. D50 only

16. The correct initial dosage of epinephrine for a 4 year old patient in anaphylaxis is:

1. 0.01 mg/kg 1:10,000
2. 0.1 mg/kg 1:1,000
3. 0.01 mg/kg 1:1,000
4. 0.1 mg/kg 1:10,000

17. When treating a pediatric patient, the following apply:

1. Avoid separating the patient from caregivers
2. Airway management and Oxygen therapy are of primary importance
3. Transport should occur early and treatment done en route
4. All the above

18. An asthma patient has received an albuterol / ipratropium treatment with little relief. The next Course of action should be:

1. A second albuterol / ipratropium treatment
2. Contact Medical Control
3. A second albuterol only treatment
4. A second ipratropium only treatment

19. A patient with a Suspected Acute MI should be transported to:

1. angioplasty center of patient's choice
2. nearest facility after contacting Medical Control
3. angioplasty center after calling Medical Control at the angioplasty center
4. angioplasty center after contacting usual Medical Control

20. Treatment for low blood glucose in a pediatric patient occurs when BG levels fall below:

1. 90
2. 80
3. 70
4. 60

21. When transferring care of a patient from ALS to BLS:

1. An ALS assessment must be completed, and the findings documented on the ALS PCR.
2. ALS must contact Medical Control in all cases before releasing patient to BLS
3. ALS may allow the patient to be transported by a CFR in Medical Control in contacted.
4. All the Above

22. Which of the following are drugs that may be used to treat an adult patient in V-tach with a pulse?

1. Lidocaine, Procainimide, Bretylium
2. Lidocaine, Mag Sulfate, Procainimide
3. Bretylium, Lidocaine, Amiodarone
4. Epinephrine, Lidocaine, Procainimide

23. Neonatal resuscitation may includes the following except:

1. ETT suctioning to clear meconium up to 3 times, and maintaining ETT in place if infant remains limp
2. Chest compressions if heart rate is 60-80 and not rapidly increasing
3. Immediate medication therapy if infant is not active
4. Dry, warm, position, and stimulate patient to breathe

24. The first treatment a pediatric asystole patient should receive is immediate transcutaneous pacing.

1. True
2. False

25. A length-based tape should be used to determine appropriate equipment and drug dosages for pediatric patients.

1. True
2. False

26. Endotracheal meconium aspiration can be performed on a neonate up to ____ times.

1. 1
2. 2
3. 3
4. 4

27. Which of the following would NOT cause a patient to meet Major Trauma Criteria?

1. Glasgow Coma Scale of less than 14
2. Motorcycle crash
3. Fall of 15 feet
4. Bilateral humerus fractures

28. Appropriate treatment for a 3 year old child in V-Fib may include:

1. Epinephrine 0.01mg/kg 1:10,000
2. Epinephrine 0.1 mg/kg 1:1000
3. Defibrillation at 4j/kg after each medication
4. All the Above

29. Treatment of a 4 year old with respiratory distress and a history of asthma may include:

1. Albuterol SVN
2. Ipratropium SVN
3. Epinephrine 1:1000 0.01 mg/kg SQ
4. All the Above

30. A Combitube can be used in place of endotracheal intubation anytime the provider thinks it's necessary.

1. True
2. False

31. Adult paddles can be used on children weighing:

1. <10 kg
2. >10 kg
3. Any Weight
4. Never on Children

32. A blood glucose check should be done on EVERY seizure patient with a GCS under 15.

1. True
2. False

33. When treating a patient with a suspected stroke:

1. Transport rapidly to nearest appropriate facility
2. Perform Cincinnati Stroke Scale and Fibrinolytic Therapy Risk Assessment
3. Do all treatment in route if possible
4. All the above

34. A patient with signs and symptoms of pulmonary edema has a systolic BP of 280. Treatment prior to calling medical control may consist of:

1. Nitroglycerine every 3 minutes, furosemide 40 mg IV
2. Nitroglycerine every 3 minutes, furosemide 40 mg IV, Morphine 5 mg IV
3. Furosemide 40 mg IV, Dopamine 1-5 mcg/kg/min
4. Nitroglycerine if patient is having chest pain, furosemide 40mg IV

35. According to the Obstructed Airway protocol, after all other attempts to clear an obstruction have failed, you may use an ET tube to push the obstruction into the right mainstem bronchus.

1. True
2. False

36. A pediatric fluid bolus should be:

1. 250 cc, given slowly
2. 100 cc, rapidly and repeated once
3. 20cc/kg, given over 1 hour
4. 20cc/kg rapidly

37. An unstable adult patient with a wide complex tachycardia should be cardioverted at:

1. 50
2. 100
3. 200
4. 300

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