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SYSTEM ENTRY REGION XL EMS QUESTIONS
AND ANSWERS 100% CORRECT
"List 3 examples that should be called in as OLMC rather than a pre-notification call? -
CORRECT ANSWER 1. Regionalized Systems of Care transports including patients with:
a. Acute coronary syndrome and STEMI criteria b. Suspected acute stroke c. Trauma Field Triage Criteria (Steps 1-4) d. Ventricular Assist Device (VAD) e. Obstetric related complaint
- Cardiac Arrest a. For patients in whom resuscitation is initiated, OLMC should be consulted before moving the patient. OLMC is required in making the decision to continue on-scene resuscitation, transport, or terminate resuscitation. b. Patients that meet criteria for withholding resuscitation (see Initiation or Withholding of Resuscitative Measures Policy B.5) do not require OLMC consultation (i.e. DOA).
- Complex patient care situations and/or questions regarding the appropriate destination. For example: a. Any patient potentially requiring a Level 1 Trauma Center, but not clearly meeting Trauma Field Triage Criteria b. Patients with possible acute coronary syndrome or stroke symptoms that may not meet defined criteria for specialty center transport c. Patients potentially requiring diversion for critical airway stabilization" "What should you do in the event you cannot reach your assigned base station for an OLMC call?
CORRECT ANSWER If
the contact is unsuccessful:
- Attempt to contact the next closest Resource/Associate Hospital.
- All attempts at contact must be documented in the patient care report.
- Notification of a communication problem must be made to the Resource/Associate Hospital and the ambulance service provider's supervisor on duty after arriving at the receiving hospital."
"List the equipment that is required to be brought in with EMS personnel for all calls: -
CORRECT ANSWER Equipment
When responding to all requests for out-of-hospital care, the EMS personnel (First Responder, EMT-B, Paramedic) must take the following to the initial contact with the patient:
- Quick response bag
- Conveyance device
- AED,AED 1000 (3 Lead), or monitor/defibrillator
- O2" "List the additional eqiupment that is required to be brought in for a patient witgh a possible
cardiac or respiratory complaint: - CORRECT ANSWER EMS personnel must bring in the
monitor/defibrillator for any known cardiac or respiratory calls."
"Define T + 5 - CORRECT ANSWER To override the bypass on the closest stroke center if the
next one is over 5 minutes away" "A daily inspection of all EMS vehicles is required. List the items that must be inspected at the
beginning of each shift. - CORRECT ANSWER The daily inventory inspections must include
the following components: A. Medications will be inspected on a daily basis and Inspection Form completed. B. All Airway equipment, cardiac equipment, Adult Quick Response Bag (QRB), Pediatric QRB will be inspected on a daily basis and Inspection Form completed. C. If medications, supplies or equipment are maintained with "plastic/aluminum ties/locks"- it is an EXPECTATION the medications, supplies and equipment will be inventoried and inspected on a DAILY BASIS and the ties/locks replaced on the equipment. D. Medications and equipment due to expire will be exchanged WITHIN 7 BUSINESS DAYS according to Region XI EMS Policy. V. Controlled Substances A. As part of the daily inventory, controlled substances should be carefully inspected and an inventory form should be signed and dated by each ALS company. B. Any missing doses, expired doses, or suspected tampering should be immediately brought to the attention of the Resource Hospital EMS Coordinator and the ambulance service provider (e.g., the supervisor of the private ambulance service provider or the duty chief on call for the Chicago Fire Department)."
"List the 3 elements that must be found in SEction B of a POLST form - CORRECT ANSWER
Section "B" of the POLST Form refers to medical interventions for patients who are NOT in respiratory or cardiac arrest. There are three options of treatment levels: i. Full Treatment: Primary goal of sustaining life by medically indicated means. In addition to treatment described in Selective Treatment and ComfortFocused Treatment (see #2 & #3 below), use intubation, mechanical ventilation and cardioversion as indicated. Transfer to hospital and/or intensive care unit if
b. Contact OLMC as needed. c. Reasonable force may be used to restrain the patient if the patient is a risk to self or others (see Restraints Policy B.17). d. The requirement to initiate assessment and patient care may be waived in favor of assuring that the patient is transported to the closest appropriate emergency department. Document clearly and thoroughly the reasons for deviation in care. Advise patient of his/her medical condition/why transport is necessary, including the consequences of refusing/delaying care."
"List the consequences of failing to do a mandatory module. - CORRECT ANSWER F.
Completion of mandatory regional CE modules.
- There WILL NOT be make-up dates upon completion of a module. a. If EMS personnel fail to attend the mandatory scheduled module without prior notice and/or valid excuse approved by the EMSMD or EMS Coordinator, they must make arrangements with the EMS Coordinator to complete the mandatory CE. b. This will be scheduled at the Coordinator's discretion at his/her convenience and availability. c. There will be a charge of $100.00/hour of CE credit for unexcused absence for mandatory CE make ups. This fee must be submitted to the EMS Coordinator or designee at the beginning of the educational session; NO PERSONAL CHECKS ACCEPTED.
- If the mandatory CE is not completed by EMS personnel by the assigned date, the Resource Hospital will initiate action toward suspension of medical privileges. a. The suspended individual will be reinstated upon completion of the mandatory CE. b. The charge will be $150.00/hour of CE credit for completion of a module after the suspension date.
- Failure to comply with these stipulations will result in an individual's inability to function within Region XI's EMS system."
"List what you must complete in order to re-license - CORRECT ANSWER IDPH normally
mails a "Renewal Form" to all EMS personnel at their respective home address. In this mailing IDPH will provide a PIN number and address of the IDPH EMS website. On the IDPH EMS website personnel will find an ONLINE LICENSING AND RENEWAL LINK. The required amount of Con ED hours, current CPR certification and the completed IDPH web relicensing requirement."
"List 5 Reasons an EMT/paramedic could have their license suspended - CORRECT ANSWER
Any suspension must be based on one or more of the following: A. Failure to meet the education and training requirements prescribed by the state or EMSMD; B. Violation of the EMS Act or any rule or regulation promulgated under the Act; C. Failure to maintain proficiency in the provision of basic or advanced life support services; D. Failure to comply with the provisions of the system's Standing Medical Orders (SMOs) and/or policies and procedures; E. During the provision of emergency care, engaging in dishonorable, unethical, or unprofessional conduct of a character likely to deceive, defraud or harm the public;"
"Define RFC - CORRECT ANSWER I. A Request for Clarification (RFC) is to be used for the
purpose of improving communication and understanding between the participants of the Region XI EMS System."
"List the full components of a full set of vital signs - CORRECT ANSWER An initial full set of
vital signs is required on every patient including: pulse, blood pressure, respiratory rate, pulse oximetry and neurologic status assessment"
"How often should vital signs be reassessed? - CORRECT ANSWER A repeat set of vital signs
is required at least every 15 minutes on stable patients and at least every 5 minutes on unstable patients"
"When should blood glucose levels be obtained? - CORRECT ANSWER Blood sugar should be
checked on any patients with altered mental status or with known or suspected diabetes"
"Define OPQRST - CORRECT ANSWER Obtain OPQRST History:
- Onset of Symptoms
- Provocation-location, any factors that worsen or relieve symptoms
- Quality of symptoms or pain
- Radiation of pain
- Severity of symptoms-pain scale
- Time of onset and circumstances surrounding onset"
"Define SAMPLE - CORRECT ANSWER. Obtain SAMPLE History:
- Symptoms
- Allergies
- Medications
- Past Medical/Surgical History
OR
Assist patient with prescribed EpiPen. If wheezing, Albuterol 2.5 mg Repeat Albuterol as needed. Closely monitor, if no improvement administer a second dose of Epinephrine after consultation with Medical Control."
"List the 4 steps in Region Xl trauma criteria - CORRECT ANSWER Region XI EMS uses a four
step trauma field triage decision scheme (reference attachment 1) to identify injured persons requiring transportation directly to a trauma center. The four steps are: Step 1: Physiologic Criteria Step 2: Anatomic Criteria Step 3: Mechanism of Injury Criteria Step 4: Special Consideration Criteria"
"In Region Xl, at what age are you an adult trauma patient? Pediatric? - CORRECT ANSWER
Pediatric: Newborn-15 years Adult: over 16"
"Pediatric Level 1 Trauma Centers - CORRECT ANSWER John H. Stroger Hospital of Cook
County Lurie Children's Hospital of Chicago (Ann & Robert H.) University of Chicago Medical Center (Comer Children's Hospital)"
"Describe the documentation on the patient care report after tourniquet application -
CORRECT ANSWER MANDATORY DOCUMENTATION
Location of injury and mechanism involved. Methods attempted to control bleeding and the time direct pressure was applied. Location of application of tourniquet Time of application of tourniquet Reassessment of tourniquet and its effectiveness Person at receiving hospital to whom use and location of the tourniquet is reported to"
"Appropiate treatment for a burn patient - CORRECT ANSWER Remove clothing
Clothing should be cut, not pulled off
Smoldering clothing should be extinguished with water Remove all accessories and jewelry Do not attempt to cool patient Estimate BSA Cover with dry dressings or sheet"
"Treatment for a sucking chest wound - CORRECT ANSWER Occlusive dressing
(tape on 3 sides)" "All patients greater than weeks gestation should be transported to an appropiate perinatal
facility - CORRECT ANSWER 20"
"4 examples of obstetrical emergencies - CORRECT ANSWER Bleeding in pregnancy
nuchal cord breech birth prolapsed cord"
"List the hospitals in Region Xl that are not approved for OB transports - CORRECT ANSWER
Community first medical Jackson Park Loretto Lurie Children's Weiss South Shore Thorek"
"APGAR score components - CORRECT ANSWER appearance, pulse, grimace, activity,
respiration"
"A pregnant trauma patient should be transported in what position and why - CORRECT
ANSWER Place mother on left lateral recumbent position to take pressure of the vena cava,
which will prevent supine hypotensive syndrome"
"Treatment for cardiac arrest chest pain - CORRECT ANSWER Assist patient with prescribed
0.4 mg NTG tab or spray Repeat VS SBP ≥ 100? YES, ≥ 100 Repeat NTG q 5 min for continued CP if SBP remains ≥ 100
know 5 rights right patient, the right drug, the right dose, the right route, and the right time/date."
"Resource Hospitals - CORRECT ANSWER Advocate Illinois Masonic, Cook County Health,
Northwestern, University of Chicago"
"Associate Hospitals - CORRECT ANSWER North- Resurrection
Central-Rush South-Mt. Sinai, Holy Cross, U of C"
"Capnography (ETCO2) - CORRECT ANSWER 35-45 mm Hg (mercury)
ventilation Amount of CO2 in air"
"Fee amount for Target Solutuons - CORRECT ANSWER $80"
"AAOx3 - CORRECT ANSWER does not equal decision making capacity"
"Most important predictor for survival - CORRECT ANSWER High quality chest
compressions know job well watch ETCO2"
"ROSC achieved? - CORRECT ANSWER transport to STEMI"
"Life saving interventions - CORRECT ANSWER Control Bleeding
Manage Airway"
"Age of consent - CORRECT ANSWER 12 ??"
"CGS - CORRECT ANSWER Eyes
Verbal Motor"
"King Airway - CORRECT ANSWER Red for short, purple (largest 6ft and over), yellow
(shortest)"
"King Airway Contraindications - CORRECT ANSWER Intact gag reflex
less than 4ft, esophagial diseases, ingested acostic substances (adrenal)"
“Explain the difference between an online medical control (OLMC) and a pre-notification call? -
CORRECT ANSWER Online Medical Control (OLMC): Base Station contact is required for: 1)
Medical direction in Regionalized Systems of Care patients or complex patient care situations or
- Situations not clearly defined by the Region XI Policies & Procedures as needed by the EMS provider. A. Goal: To provide immediate medical direction to the EMS provider for situations where patient care or destination may be impacted. Communication method: OLMC calls will be made through the MED Channels or cellular lines and all contact will be recorded. Pre-Notification: EMS should contact the receiving hospital directly for ALS transports in situations where the Region XI Standing Medical Orders/Protocols have been followed. A. Goal: To provide direct communication between EMS providers and the receiving hospital for straightforward BLS or ALS patient transports. No medical direction will be given by non-Region XI Base Station hospitals receiving pre-notification reports. Communication method: Pre-notification reports should be given through a hospital's dedicated telemetry line if the hospital is a Resource/Associate Hospital within Region XI (or another Region). Contact may also be through a dedicated EMS telephone line or MERCI radio if the participating hospital does not have a telemetry line."
"Write out an example of a pre-notification call? - CORRECT ANSWER Pre-Notification
Report A. Identify agency and number B. State "This is a pre-notification report." C. Age and sex D. Chief complaint E. Vital signs F. "Routine protocols followed" G. Additional details that may be needed for the receiving hospital to prepare for the patient H. Destination and ETA An example includes patients with spinal immobilizatipn or who are unable to sit in a wheelchair or chair. Those who may need an immediate bed upon emergency department arrival."
"Name the 6 call disposition types - CORRECT ANSWER Patient Transported to Appropriate
Emergency Department: Patient Initiated Refusal No Patient Found Patient Deceased on Arrival (DOA
medical orders by a physician or practitioner based on the patient's medical condition and preferences. These orders provide guidance during life threatening emergencies and must be followed by all healthcare providers."
"List the 5 elements that must be found on a DNR/POLST to be considered valid - CORRECT
ANSWER A valid DNR/POLST Order will contain at least the following information:
- Name of the patient;
- Name and signature of attending practitioner;
- Effective date;
- The words, "Do Not Resuscitate" or "DNR";
- Evidence of consent - either: i. Signature of patient or ii. Signature of legal guardian or iii. Signature of durable power of attorney for health care agent or iv. Signature of surrogate decision maker If the required evidence of consent does not appear on the DNR/POLST Order, the order is not valid for prehospital use." "Describe the appropiate personal protective equipment EMS providers should use when
handling a patient with a cough or fever: - CORRECT ANSWER Wear an N95 mask, gloves,
and eye protection when examining and caring for patients with signs and symptoms of a respiratory infection, fever, or flu-like symptoms (temperature range 100°F or greater, runny nose, cough, sneezing, and bodily aches)."
"What information must be documented when dealing with a crime scene situation: -
CORRECT ANSWER Document observations at the crime scene as soon as possible on the
patient care report. Include name and star number/badge number of law enforcement personnel interacted with at the scene."
"Describe Region Xl's process for tracking continuing education hours - CORRECT ANSWER
Tracking of CE for First Responders will be the responsibility of the individual First Responder and the ambulance service provider (employer). Each ems provider must maintain an active account with the Region Xl online educational system. Each EMS provider within the Region XI System must maintain an active account with the Region XI online educational platform. This allows the Resource Hospital to track Continuing Education hours."
"How many hours of CE must you have for re-licensure? - CORRECT ANSWER 120 Region Xl
100 IDPH
uploaded to Target Solutions CE must have EMS component"
"What is the maximum amount of CE you can have in any one category for relicensure> -
CORRECT ANSWER No more than 20% of didactic hours may be in
a single topic area."
"What should you do if you have a name or address change? - CORRECT ANSWER Must let
resource hospital know. Must contact EMS system coordinator. If independent, must contact the IDPH, division of EMS. Informing the IDPH, Resource Hospital and employer, in writing, of a change of address and/or employer within 72 hours. Providers must also immediately update their Region XI online educational platform profile."
"List 4 examples of when a RFC can be submitted: - CORRECT ANSWER Examples of use
include but are not limited to: A. Questions regarding usage and/or deviations in policies and procedures and/or standing medical orders B. Questionable orders communicated from Resource/Associate Hospital to EMS personnel C. Anticipation of misunderstanding relative to patient care, e.g., personality conflicts, etc. D. Patient care and/or services above and beyond the call of duty provided by EMS personnel."
"Where is the RFC form located? - CORRECT ANSWER The Request for Clarification Form
should be copied and readily used by participants of the system. It should be accessible at the Resource/Associate Hospital EMS offices and participating hospital emergency departments"
"Difference between primary and secondary assessment - CORRECT ANSWER Primary
Survey - Should be Airway-Breathing-Circulation (A-B-C), unless specific circumstances such as cardiac arrest or major hemorrhage where Circulation-Airway-Breathing (C-A-B) is indicated. Basically to rule out life threats in no more than 2 minutes. Secondary survey- A full secondary assessment should be completed and documented on every patient unless a critical airway, breathing or circulation problem requires stabilization. It should not delay transport in critical patients. A secondary survey should include the following components: Basically a head to toe assessment to identify any additional DCAP-BTLS." "You come across a patient with a blood glucose level of 40 who is altered. List all of your
treatment options including all meds, routes, doses, and interval for repeats. - CORRECT
ANSWER BS ≤ 60 mg/dl
Check Blood Sugar Glucopaste
CONTRAINDICATIONS
Nasal trauma EQUIPMENT
- Mucosal Atomizer Device (MAD)
- Syringe"
"When is it acceptable to transport a pediatric trauma patient to an adult trauma center? -
CORRECT ANSWER If the transport time to the closest Pediatric Level I trauma center is
anticipated to be greater than 25 minutes, the patient should be transported to the closest Level I trauma center. Scene time should be kept to a minimum."
"List at least 6 patient conditions types that would warrant transport to a Trauma center -
CORRECT ANSWER All penetrating injuries to head, neck, torso and extremities proximal to
elbow or knee Chest wall instability or deformity (e.g., flail chest) Two or more proximal long-bone fractures Crushed, degloved, mangled, or pulseless extremity Amputation or partial amputation proximal to wrist or ankle Pelvic fractures"
"List the Level 1 Trauma Centers utilized by Region Xl EMS - CORRECT ANSWER Level I
Trauma Centers: Christ Medical Center (Advocate) Illinois Masonic Medical Center (Advocate) John H. Stroger Hospital of Cook County Loyola University Medical Center Lutheran General Hospital (Advocate) Mount Sinai Hospital Northwestern Memorial Hospital St. Francis Hospital - Evanston (Presence) University of Chicago Medical Center"
"Indications for tourniquet application - CORRECT ANSWER INDICATIONS
Life threatening extremity hemorrhage that cannot be controlled by other means."
"Procedure for applying a tourniquet - CORRECT ANSWER 1. Visually inspect injured
extremity and avoid placement of tourniquet over joint, angulated or open fracture, stab or gunshot wound sites.
- Apply the tourniquet directly to skin, proximal to the wound, 2-3 inches above the wound or as high as you can go above the wound.
- Secure tourniquet: Pull the free running end of the self-adhering band tight and securely fasten the band back on
itself (if applying to an arm wound). Do not adhere the band past the windlass rod. If applying to a leg wound, the self adhering band must be routed through the friction adapter buckle and fastened back on itself. This will prevent it from loosening when twisting the windlass rod.
- Twist the windlass rod until bright red bleeding has stopped and the distal pulse is eliminated.
- Place the windlass rod inside the clip locking it in place. Check for bleeding and distal pulse. If bleeding is not controlled consider additional tightening or applying a second tourniquet side by side to the first tourniquet and reassess.
- Secure the rod inside the clip with the strap.
- Record time of tourniquet application.
- Cover wound with appropriate sterile dressing and/or bandage. Do not cover tourniquet - the device must remain visible.
- Reassess and document absence of bleeding distal to tourniquet.
- Remove any improvised tourniquets that might have been previously applied." "What are the 3 diagnostic assessments to be used when assessing for a patient with a suspected
stroke: - CORRECT ANSWER Patients with a negative or unattainable CSS may be
transported to a PSC if acute stroke ≤6 hours in duration is suspected by the Base Station based on any of the following:
- Sudden and persistent alteration of consciousness
- Sudden onset severe headache (especially in association with vomiting +/- systolic BP 200)˃
- Severe and sudden loss of balance"
"Components on the Cincinnati Prehospital Stroke Scale. - CORRECT ANSWER 1) Facial
droop: Have patient show teeth or smile Abnormal: One side does not move as the other
- Arm drift: Have patient close eyes and hold arms out for 10 seconds with palms up Abnormal: One arm does not move or drifts down
- Abnormal speech: Have patient say "You can't teach an old dog new tricks" Abnormal: Patient slurs words, uses wrong words, or is unable to speak"
