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SNHD EMT PROTOCOLS EXAM PREP 2025-2026 EMERGENCY
MEDICINE STUDY GUIDE
1. WHAT IS THE
DE- FINITION
OF A PATIENT?
2. WHAT DOES ASA
STAND FOR?
3. WHAT DOES THE
S IN DCAP-BTLS
STAND FOR?
4. WHAT DOES THE
P STAND FOR IN
OPQRST?
5. WHAT REQUIRES
A TELEMETRY?
6. WHAT PERCENT-
AGE SHOULD AN
SPO2 MAINTAIN?
7. DROWNING
PROTOCOL
1.A person who has a complaint or mechanism suggestive of potential illness or injury
2,A person who has obvious evidence of illness or injury
3.A person identified by an informed 2nd or 3rd party caller as requiring evalua- tion for potential illness or injury
Acetylsalicylic Acid (ASPIRIN)
Swelling
Provocation
- For all time sensitive or life threatening conditions
- EMS provider discretion
- For all trauma patients going to a trauma center
- When telemetry contact is required per protocol
94% EQUAL OR ABOVE
If the patient is breathing on their own place them on 15L/min NRB
SNHD EMT PROTOCOLS EXAM PREP 2025-2026 EMERGENCY
MEDICINE STUDY GUIDE
8. WAITING ROOM
CRITERIA
9. WHEN SHOULD
PROCEDURES BE
DONE
10. HOW MANY
TIMES CAN YOU
ASSIST WITH NI-
TROGLYCERIN?
11. ACUTE CORO-
NARY SYN-
DROME
12. NITROGLYCERIN
CONTRAINDICA-
TIONS
If the patient is is cardiac arrest, emphasis should be on oxygenation and venti- lation
If transfer of care has not occurred, the patient may be placed in the hospital waiting room or appropriate waiting area. This does not include psychiatric patients Heart Rate: 60- Respiratory Rate: 10- Systolic BP: 100- Diastolic BP: 60- Room air pulse oximetry: >94% A+Ox
Ideally, procedures should be done enroute to the hospital.
May assist the patient with their own medication x
Keep oxygen above 94% Aspirin: 324mg PO Nitroglycerin: may assist the patient with their own x
Hypotension Bradycardia Tachycardia (HR above 100) in the absence of heart failure Evidence of right ventricular infarction ED medication within last 48 hours
SNHD EMT PROTOCOLS EXAM PREP 2025-2026 EMERGENCY
MEDICINE STUDY GUIDE
ALTERED MEN-
TAL STATUS
PEARLS
21. TREAT BEFORE
ADVANCE AIR-
WAY PROCE-
DURES
Recommended Exam: Mental status, HEENT, skin, heart, lungs. Back, extremities, neuro Pay careful attention to the head exam for signs of injury Be aware of AMS as presenting signs of an environmental toxin or Haz-Mat exposure. Protect personal safety and other responders Do not let alcohol confuse the clinical picture; alcohol is not commonly a cause of total unresponsiveness to pain If narcotic overdose or hypoglycemia is suspected, administer narcan
Hypoglycemia and opiate overdose
- SAFER term S: Stabilize the situation by containing and lowering the stimuli
A: Assess and acknowledge the crisis
F: Facilitate the identification and activation of resources
E: Encourage patient to use resources and take action in their best interest
R: Recovery or Referral- leave the patient in care of responsible person or profes- sional, or transport to the appropriate facility
- BEHAVIORAL EMERGENCY
Consider medical causes for the patient's behavior
Hypoxia, intoxication/overdose, hypoglycemia, electrolytes, head injury, postictal state
Consider behavioral restraints No prone position
SNHD EMT PROTOCOLS EXAM PREP 2025-2026 EMERGENCY
MEDICINE STUDY GUIDE
EXCITED DELIRI-
UM
25. DYSTONIC REAC-
TION
26. WITNESSED VS.
UNWITNESSED
CARDIAC ARREST
27. ALBUTEROL
DOSE
Medical emergency-combination of delirium, psychomotor agitation, anxiety, hallucinations, speech disturbance, disorientation, violent behavior, insensitivity to pain, hyperthermia, increased strength
Potentially life threatening, associated with the use of physical control measures include physical restrains, TASER, or similar device
Most common in male subjects with a history of serious mental illness and/or acute or chronic drug abuse, particularly stimulants
Condition causing involuntary muscle movements or spasms-typically face, neck, and upper extremities
Typically an adverse reaction to drugs such haloperidol
When recognized administer Diphenhydramine 50mg IM/IV/IO
Witnessed: CCC greater than 2 inches 100-120 bpm
Unwitnessed: 2 minutes of CCC
ADULT: 2.5mg in 3ml SVN PEDS: 2.5 mg in 3ml SVN
- BURN CRITERIA Patients that meet the criteria shall be transported to the nearest burn center
Second degree burns >10% BSA Any third degree burns Burns that involve the face, hands, feet, genitalia, perineum, or major joints Electrical burns including lightning injury Chemical burns Circumferential burns Inhalation burns Burn injury with concomitant trauma
35. WHAT FORM
MUST BE SUB-
MITTED FOR A
DROWNING?
36. SIGNS AND
SYMPTOMS OF
HYPERKALEMIA
37. WHAT IS ACTIVE
COOLING?
38. FOR WHEEZING
ADMINISTER:
39. SIGNS AND
SYMPTOMS OF
SMOKE INHALA-
TION
40. APPROVED
SNHD submersion incident report form
Cardiac conduction disturbances Irritability Abdominal distention Nausea Diarrhea Oliguria Weakness
Cold packs Ice (do not place on patient's skin) Fanning Air conditioning
Albuterol: 2.5mg in 3mL SVN
Facial burns Signed nasal or facial hair SOBfacial edema Stridor Grunting respirations
Centennial Hills STROKE CENTERS Henderson Mountain View Southern Hills Spring Valley
41. APPROVED NIR
HOSPITALS
42. SIGNS AND
SYMPTOMS OF A
STROKE
- What is the score for absent facial palsy?
St. Rose Sienna St. Rose San Martin Sunrise UMC Valley Summerlin
Centennial Hills Henderson Hospital Southern Hills Spring Valley St. Rose Sienna Sunrise UMC Valley
AMS Weakness, paralysis Blindness or other sensory loss Aphasia, dysarthria Syncope Vertigo, dizziness Vomiting Headache Seizure Respiratory pattern change Hypertension, hypotension
0
What is the score for severe leg motor function?
- What is the 0 score for absent head/gaze devia- tion?
- What is the 1 score for present head/gaze devia- tion?
- What is the score 0 for performing both tasks in aphasia?
- What is the score 1 for performing 1 task in aphasia?
- What is the score 2 for performing neither task in aphasia?
- What is the score 0 for a patient rec- ognizing impair- ment in agnosia?
- What is the score for being unable to recognize arm or leg impair- ment in agnosia?
- What is the score for being unable to recognize both arm and leg im- pairment in ag- nosia?
- STROKE SCENE TIME
- VENTILATION MANAGEMENT
- ANY VICTIM/PA- TIENT OUTSIDE OF MILES?
- PEDIATRIC AL- LERGIC REAC- TION PEARLS
64. CARDIAC ARREST
FOR PEDIATRICS
less than 10 min
Titrate to >94% with an OPA or an NPA
50 miles, they travel to nearest facility
Recommended Exam: Mental Status, skin, heart, lungs Anaphylaxis is acute and potentially lethal multi system allergic reaction
Epinephrine is the first-line drug that should be administered in acute anaphylaxis IM epi 1:1,000 should be administer before IV/IO access Contact medical control for refractory anaphylaxis
Consider extraglottic airway AED
weighing more than 30 kg?
- NEONATAL RESU- Hypovolemia and Hypoglycemia SICATIONS CON- SIDERATIONS
72. NEONATAL
RESUSCITATION
CPR
CPR 3:1 Ratio
Most will respond to BVM, compressions, and EPI; if not,, consider hypovolemia, pneumothorax, or hypoglycemia
3:
- DNR Verbal instructions from the family is not valid
- IF PRESENTED WITH A DNR:
- DNR IS INVALID IF:
- TRANSFERRING PHYSICIAN MUST PROVIDE:
77. PRESUMPTIVE
SIGNS OF DEATH
Verify the validity
Patient says they want help
Name of receiving facility and physician
Copies of available diagnostics, x-rays, medical records, copy of code status, DNR, POLST, and advance directives
Paperwork is applicable
Any isolation precaution information, and the EMTALA form prior to releasing the patient
Unresponsive Apnea
78. CONCLUSIVE
SIGNS OF DEATH
79. BODY DECOM-
POSITION:
80. PUBLIC INTOXI-
CATION?
81. HANDLE ISSUES
WITH OTHERS AT
THE LOWEST LEV-
EL
82. WHEN RESUSCI-
TATION IS TER-
MINATED YOU
LEAVE...
Pulseless Fixed dilated pupils Asystole on 2 leads
Rigor and lividity
No resuscitation attempt
When in doubt, take to the ER
ABC, BGS, ILS, ALS
Leave everything in place
- TFTC ALL AGES RR <10 or > 29 breaths/min GCS MOTOR < Room-air pulse oximetry < 90% Respiratory distress or need for respiratory support
- PELVIC FRAC- TURES MUST GO TO:
- MVC TRAVEL- ING 40MPH OR MOTORCY-
Level 1 or 2 trauma
Level 1, 2, or 3 trauma center
92. DOSE OF AS-
PIRIN?
324mg PO (81x4)
- (^) ALBUTEROL Sympathomimetic and bronchodilator CLASS/ACTION?
- (^) ALBUTEROL AD- Tachycardia VERSE REAC- Palpitations TIONS? Anxious Headache
- (^) GLUCAGON Insulin antagonist/reverse hypoglycemia CLASS/ACTION?
- PATIENT EN- Requesting=contact representative or agency COUNTER RE- VIEWED
- (^) ADULT HEAD 9% (4.5% front and back) RULE OF 9S
- ADULT ARM 9% (split in half front and back) RULE OF 9S
- (^) ADULT LEGS 18% (split front and back) RULE OF 9S
- ADULT ANTERI- 18% (split chest and abdomen) OR TRUNK RULE OF 9S
- (^) ADULT POSTERI- 18 (split top and bottom) OR TRUNK RULE OF 9S
102. ADULT GROIN
RULE OF 9S
103. PEDIATRIC HEAD 18%
RULE OF 9S
104. PEDIATRIC ARMS 9%
RULE OF 9S
105. PEDIATRIC LEGS 14%
RULE OF 9S
106. PEDIATRIC AN- 18%
TERIOR TRUNK
RULE OF 9S
107. PEDIATRIC POS- 18%
TERIOR TRUNK
RULE OF 9S
108. PEDIATRIC 1%
GROIN RULE OF
9S
- (^) POST Physician Orders for Life-Sustaining Treatment
- (^) WHAT IS THE 30: CORRECT COM- PRESSION TO VENTILATION RA- TIO FOR AN ADULT IN CAR- DIAC ARREST
115. HOW MANY
TIMES CAN NI-
TROGLYCERIN BE
REPEATED
TWICE, EVERY 5 MINUTES
116. IF BLEED- SECOND TOURNIQUET
ING CANNOT
BE CONTROLED
WITH A TOURNI-
QUET, WHAT
SHOULD BE CON-
SIDERED NEXT
117. WHAT IS NOT A TACHYPNEA
SIGN OF HEAT
CRAMPS
118. WHEN CAN OVER 10KG
ADULT PADDLES
BE USED ON
CHILDREN
119. WHAT IS THE 2.0 - 4.0 MG IN
EMT DOSE OF
NALOXONE FOR
A PATIENT WITH
A SUSPECTED
OVERDOSE?
120. WHAT IS COLD WATER IMMERSION THERAPY
THE PREFERRED
METHOD OF AC-
TIVE COOLING
121. DURING ACTIVE FALSE
WARMING PRO-
CEDURES, HEAT
PACKS MAY BE
PLACED DIRECT-
LY ON A PA-
TIENTS SKIN
122. WHAT SHOULD REFER TO THE TERMINATION OF RESUSCITATION OR DNR/POLST PROTOCOL
BE DONE IF THE
PATIENT MEETS
THE CRITERIA
FOR
PREHOSPITAL
DEATH
DETERMINA-
TION OR IF
THERE IS A
DNR/POLST
PRESENT
123. WHAT IS NOT A CARDIAC ARREST
SIGN AND SYMP-
TOM OF A SE-
VERE ALLERGIC
REACTION
124. WHAT IS ASSOCI- ONLY AFFECTS ONE PART OF THE BODY
ATED WITH FO-
CAL SEIUZRES
125. OXYGEN ADMINISTRATION
