Michigan EMS Protocols

According to the General Pre-Hospital Care Protocol, unless otherwise stated, pediatric protocols will apply to patients up to what weight?

According to the General Pre-Hospital Care Protocol, the first thing you should do on every scene is:

According to the General Pre-Hospital Care Protocol, for most medical conditions, Patient care should be initiated:

You are called to the scene of a person showing obvious signs and symptoms of difficulty in breathing. According to the General Pre-Hospital Care Protocol, your vital signs should include if available:

According to the General Pre-Hospital Care Protocol, you should perform a secondary survey:

General Pre-Hospital Care Protocol, when possible, if a list of the patient’s medications cannot be provided or if writing down the medications would delay transport, you should:

Patients experiencing abdominal pain should not be allowed to:

If the patient’s abdominal pain is non-traumatic, they should be transported in what position?

What type of exam should be conducted on a patient experiencing abdominal pain?

If your abdominal pain patient is also complaining of nausea and vomiting, you should:

Your physical exam of a patient complaining of abdominal pain should include which of the following?

According to the Nausea and Vomiting Protocol, for signs of dehydration what is the pediatric fluid dosage?

According to the Nausea and Vomiting Protocol, a 35 year-old patient is hypotensive after vomiting for two days, what is the NS Fluid Bolus maximum dose?

You are treating a patient that has suffered a syncopal episode. She is 24 and is in the third trimester of her pregnant. Per the Syncope Protocol you should:

You are treating a patient that has suffered a syncopal episode. He is 62 years old. Per the Syncope Protocol you should:

You are treating a patient that has suffered a syncopal episode. He is 57 years old. He still has an altered mental status. Per the Syncope Protocol you should:

You arrive and find a 66 year old female that had a syncopal episode. The patient is conscious and alert, however she is lying at the bottom of a stairwell. She stated she was at the top of the stairwell when the syncopal episode occurred. She does not know how she ended up at the bottom of the stairwell. She has a large laceration to her head. According to the Syncope Protocol you should:

You arrive and find an 88 year old male patient that had a syncopal episode. He is conscious upon your arrival. Your vital signs indicate that he is hypotensive. You should:

You arrive and find an 8 year old male patient that had a syncopal episode. He is conscious upon your arrival. Your vital signs indicate that he is hypotensive. You should

You are treating a patient that has been involved in a motor vehicle accident. She is 24 and is in the third trimester of her pregnancy. Her vital signs indicate she may be in hypovolemic shock. You should:

Your patient is a 19 year old male that appears to be suffering from shock symptoms. Per the shock protocol your assessment should:

You are assessing a patient that you believe is suffering from shock. During the assessment you discover the patient is wearing a transdermal patch. You should:

An 89 year old patient that presents with shock symptoms that you suspect are caused by a cardiac etiology. According to the Shock Protocol you should:

You arrive to find a 91 year old female that appears to be suffering from shock. When you assess her lungs, you note pulmonary edema. You should:

You are treating a 29 year old female patient suffering from shock symptoms. You have provided the patient with a fluid bolus. Her blood pressure increased from 50/30 to 98/60. You should:

You find an adult male patient that is wheezing after being stung by a bee. He is prescribed an EPI auto-injector. You should:

A 27 year old male patient ate a peanut butter cookie and had an allergic reaction. You have given Epinephrine to him. After 5 minutes you re-evaluate him and find that the blood pressure has improved, however he is still having difficulty breathing. Per the Anaphylaxis/Allergic protocol you should:

A 4 month old male which weighs 8 kg is wheezing with low blood pressure after being exposed to a dog. You should:

A 4 year old male which weighs 20 kg is wheezing after being stung by a bee. You should:

An 36 year old weighs 100 kg is wheezing after eating peanuts. You should:

A 21 year old female, was stung by a bee and you have given a fluid bolus and Epinephrine twice, her blood pressure remains low. You should:

You have given Epinephrine 1mg/mL and a fluid bolus to a 43 year old male patient suffering anaphylaxis and hypotension. After your treatments, his blood pressure is increased to 92/68 and the breathing difficulty has subsided. You should:

The first thing that should be done on a behavioral health emergency is:

Based on statements your patient made, you believe your patient will harm himself. You should:

You are caring for a patient suffering from a psychological disorder. You should:

Your patient is very agitated. He has a history of a psychological disorder. He is raising his voice and pacing. You should:

Based on statements your patient made, you believe your patient will harm himself. You may:

The definition “temporary custody of an individual by a law enforcement officer with or without the individual’s consent for the purpose of protecting that individual’s health and safety, or the health and safety of the public and for the purpose of transporting the individual if the individual appears, in the judgment of the law enforcement officer, to be a person requiring treatment,” falls under which of the following in the Psychological Emergencies Protocol?

If a psychiatric patient requests transport to a specific OCMCA hospital, and that request requires bypassing a closer OCMCA hospital, the transporting crew must:

Per the Return of Spontaneous Circulation (ROSC) protocol, EMS providers must do which of the following actions when the cause of the arrest (medical or trauma) is unknown?

You are providing post cardiac arrest care to a patient with Return of Spontaneous Circulation (ROSC), while reassessing the patient you are unable to palpate a pulse. What is the next procedure?

While monitoring vital signs for a 30-year-old patient with Return of Spontaneous Circulation (ROSC), you determine the systolic blood pressure to be 80 mm/Hg. What is the next treatment?

The proper ventilation rate for a patient with ROSC (Return of Spontaneous Circulation) and in need of ventilation assistance is?

While managing the ventilations of a trauma patient, what should be avoided? Pick the best answer.

You are called to the scene of a patient who was hit in the chest multiple times by a baseball bat. Your patient is complaining of chest pain. You should administer oxygen to maintain a pulse oximetry level of:

The protocol that should be followed for severely injured patients meeting trauma triage guidelines and methodology:

According to the General Trauma Protocol, while alerting the receiving hospital that you are in route to their facility with a patient involved in a traumatic injury, it is important to include:

You are treating a patient involved in a traumatic injury. Vascular access…

You are transporting a traumatic patient that had an FDA and MCA approved occlusive seal dressing applied to an open or sucking chest wound and you notice the patient’s shortness of breath is worsening. The first thing you should do is:

You’re treating a patient with intestinal eviscerations. You should:

You are treating a burn patient with a possible burned airway. You should

A patient is rescued by a fire department from a burning building. The patient was trapped in a bedroom. His heart rate is 120, blood pressure 150/90 and the pulse oximetry is 98%. The patient should be given:

Per the Burns Protocol, to determine the extent of a burn you should use:

A patient is removed from a house fire with burns to his left arm. The outside temperature is 46 degrees Fahrenheit. What should be done next with the patient.

Your adult patient is suffering from thermal burns covering 18% of his body. What is the proper treatment?

You arrive at a chemical plant and are encountered by a patient covered in a brown powder complaining of burning pain all over. After you don the appropriate PPE, you should:

You have responded to an adult male patient. He is unconscious after doing some electrical work. Upon arrival you find him still in contact with the wires. You should:

Your adult male patient has a thermal burn over 45% of his body. What is an appropriate fluid bolus for him per the protocol?

Your pediatric female patient has a thermal burn over 45% of her body. What is the appropriate fluid bolus for her per the protocol?

You have a teenage male patient suffering from thermal burns. He fell into a campfire and his clothes caught fire. You have determined the fire is out. You should:

You are treating a patient that has been involved in a motor vehicle accident. She is 24 years old and has a small laceration on her left wrist. To control the bleeding, you should first:

A 24 year old male cut his upper right leg with a chain saw. The laceration is deep and is located on the outside of his right leg too high for a tourniquet. You should consider:

You are treating a patient that has a severely angulated fracture to his left upper arm. You cannot find pulses and have no capillary refill distal to the injury. You determine the patient has decreased perfusion. You should:

A 10 year old female fell off her bike in a park and injured her right elbow. She cannot move her arm. Prior to applying the splint to the extremity, you should:

A 14 year old male patient was in wood shop and amputated his left index finger. You have dressed the wound on his hand. Your partner has found the amputated finger. You should:

A 24 year old female was found with a knife impaled in her right thigh. You should:

A 32 year old female patient was involved in a motorcycle accident. She has a midshaft femur fracture. You should consider using a __________ to splint the fracture.

Patients over what age with a mechanism of injury with the potential for causing injury will have a rigid extrication collar applied even if the spinal injury clinical assessment is negative?

Under what conditions would the patient have a positive spine injury assessment?

According to the Spinal Assessment Protocol if there is NOT a mechanism potential for spinal injury, you should:

Which of the following are clinical criteria to be assessed if there is a mechanism of injury with the potential for causing spine injury? Pick the best answer

Which of the following patient’s does not need a spinal injury clinical assessment?

A dive rescue team finds a drowning victim. The water temperature is 36 degrees Fahrenheit. The patient has been in the water for 75 minutes. He is in cardiac arrest. You should:

A dive rescue team finds a drowning victim. The water temperature is 65 degrees Fahrenheit. The patient has been in the water for 65 minutes. He is in cardiac arrest. You should:

A dive rescue team finds a drowning victim in the early spring. You and the dive rescue team cannot determine the water temperature. The patient has been in the water for 70 minutes. He is in cardiac arrest. You should:

A dive rescue member using a SCUBA tank had an underwater emergency and had to ascend rapidly. This patient should be transported:

A dive rescue member, using SCUBA equipment, experienced an underwater emergency and had to ascend rapidly. Due to the patient’s signs and symptoms, you determine that she requires treatment with a hyperbaric chamber. The medical control may consider:

You are treating a patient found floating in a pool. According to the Drowning Protocol, while assessing this patient you should consider:

You are treating a drowning victim that is now conscious. You are keeping the patient warm and dry. You should consider:

You have assessed your 24 year old male patient and determined he is suffering from heat cramps. You should:

You assessed your 19 year old female patient. You have determined she is suffering from heat exhaustion. After moving her to a cool environment you should:

You assessed your 39 year old male patient. You have determined he is suffering from heat stroke. After moving him to a cool environment and began cooling the patient you should:

You assessed your 39 year old male patient. You have determined he is suffering from an altered mental status and heat stroke. After moving him to a cool environment and beginning cooling you should:

You assessed your 30 year old female patient. You have determined she is suffering from exertional heat stroke. The patient was doing yard work. The patient has a child swimming pool full of cold water. You should:

A 65 year old male was found in an alley behind a restaurant. The staff stated he paid for his meal and left 30 minutes ago. It is January and the temperature is 12 degrees Fahrenheit. He is pulseless and apneic. You should:

A 24 year old female was stranded in a snow bank in January during a large snow storm. She has been there for 2 hours without the car running. Your assessment reveals the patient has a temperature of 90 degrees Fahrenheit. She is conscious and alert. You should:

A 32 year old male is found outside in February. He was found leaning up against a dumpster. He is unconscious. His temperature is 82 degrees Fahrenheit. You should:

A homeless person flags you down as you were driving by. It is January and there is slushy snow on the sidewalk where he is standing. Upon investigation you discover his shoes are soaking wet and you believe he may be suffering from frostbite. You should:

If you are treating a patient with frostbite you should:

You find an unconscious female in a snow bank. The patient is pulseless and apneic. You begin CPR. Her body temperature is less than 86 degrees Fahrenheit. You should:

You are performing CPR on an adult hypothermic patient. You should:

When performing CPR an adult hypothermic patient, you should:

You find an unconscious male in a snow bank. The patient is pulseless and apneic. You begin CPR. His body temperature is less than 86 degrees Fahrenheit. You should:

If glucose is less than _____ mg/dL and demonstrating signs of hypoglycemia, 25 gm of Dextrose should be given IV:

If respiratory depression is present due to a suspected opioid overdose, administer:

Blood glucose levels should be rechecked how long after glucose administration?

A patient with an acute change in mentation that is associated with hypoglycemia, opioid overdose or unknown etiology, best describes which protocol?

You arrive at a home and suspect your patient may be having a stroke. What assessment should you complete per the Stroke or Suspected Protocol?

During your assessment for a stroke how would you assess facial droop according to the Stroke or Suspected Stroke Protocol?

You suspect your patient may be having a stroke. You are assessing the patients arm drift. How long should you have the patient hold their arms straight out?

The Cincinnati Pre-Hospital Stroke Scale assess the patient for:

What is considered to be a positive sign of stroke per the Stroke or Suspected Protocol?

You are treating 72 year old female with a possible stroke. As you move her to the stretcher she begins to have a seizure. You should:

When you evaluate the history of the present illness for a possible stroke patient, what item should be documented per the Stroke or Suspected Stoke Protocol?

When interviewing the patient’s family they state: “My Mom finished eating dinner around 6:30 pm. Everything was normal. She went to her bedroom to get ready for bed. She did not come back to the living room. I found her slurring her speech and unable to move her arm at 7:30 pm and I called you. What should be documented per the Stroke or Suspected Stroke Protocol. Choose the best answer.

You are assessing a conscious 85 year old male patient for a possible stroke. You determine his blood sugar is 45mg/dL. You should:

You have completed your assessment of a 77 year old female possible stroke patient and noted no facial droop, no arm drift but has a speech deficit. Your patient is considered:

You are called to an 80 year old male stating he thinks he is having a stroke. He has a severe headache and high blood pressure. He has no facial droop, no arm drift and no abnormal speech. This patient is:

If you have a patient exhibiting positive signs of a stroke you should notify the hospital:

Epinephrine should be considered for respiratory distress exhibiting signs of impending respiratory failure and inability to do what?

The treatments and medications administered to a patient in respiratory distress should be based on what?

Your patient is complaining of respiratory distress, and states that he has a history of Asthma. If available, which of the patient’s medications should you assist him in using?

CPAP should be considered for patients presenting with which of the following?

You and your partner have arrived on scene of a patient actively seizing. What actions should immediately be performed?

You’ve been dispatched to medical emergency for an adult patient having seizures; after you arrived and during your patient assessment you have obtained the patients’ blood sugar is less than 60 mg/dL. What is the dose of Dextrose to be administered?

You have been dispatched and arrived at a medical emergency for a patient who possibly had a seizure at a local grocery store. During your initial assessment you find an adult patient who is not actively seizing and has an altered level of consciousness. What protocol should be referred to?

The Sepsis Protocol applies to patients ______________ years old and above.

Patients with a suspicion of systematic infection should be evaluated using the sepsis inclusion criteria. How many of the inclusion criteria are needed to utilize the treatments in the Sepsis Protocol?

An 87 year old female has a urinary catheter. The urine looks cloudy and smells foul. You suspect a systemic infection. What symptoms does she need to meet the inclusion criteria for the Sepsis Protocol?

A 45-year-old male had post leg fracture surgery. He has redness and swelling at the incision site. There is a foul odor emanating from the incision site. You suspect a systemic infection. What symptoms does he need to meet the inclusion criteria for the Sepsis Protocol?

You are treating a 75 year old female that you have a clinical suspicion that she may have systemic infection. She meets the inclusion criteria in the Sepsis Protocol. You should place the patient:

You are treating a 14 year old male that you have a clinical suspicion that he may have systemic infection. He meets the inclusion criteria in the Sepsis Protocol. You should:

You have been dispatched to a medical emergency where a patient is being combative and is an imminent physical threat to themselves and to responding personnel. What treatment protocol would responding EMS providers reference?

You are on scene of an excited delirium patient who is hyperthermic after obtaining a temperature. Your treatment will include fluids to the skin and placing ice packs on the patient. Where would appropriate placement of ice packs be?

You are treating a patient with symptoms of excited delirium and you’re going to establish an IV of NS; per protocol, delivering a fluid bolus up to how many liters is permissible?

EMS providers should coordinate with who before any physical contact with a patient they suspect is experiencing symptoms of excited delirium?

You are treating a pediatric patient with difficulty breathing. Mom hands you a summary of her child’s visit to the pediatrician the day before. It shows the patient’s weight. Mom verifies that the child was weighed yesterday. This makes the weight on the paper a “known weight.” According to the MI- MEDIC Protocol what should you use to determine the weight for this patient?

When dosing pediatric medications with the MI-MEDIC cards, you should be cautious not to confuse:

You are treating a 24 year old female that is having contractions. This is her third pregnancy. She is having strong regular contractions every minute and 45 seconds. Her water has broken, and she feels a need to push. You should:

You are on scene with a 32 year old female and a newborn male baby. The newborn is breathing normally. You are preparing to cut the cord. You should:

You are assessing a newborn infant. The APGAR score is 5. You should:

You are caring for a 34 year old female that is giving birth. When you check for crowning you notice the umbilical cord presenting at the vaginal opening. You should:

You are caring for a 19 year old female that is giving birth. When you check for crowning you notice one of the baby’s arms presenting at the vaginal opening. You should:

You are caring for a 23 year old female patient that is pregnant. Her blood pressure is 190/112, she has marked peripheral edema and a diminished level of consciousness. You patient is showing signs of:

You have just assisted a new Mom in the delivery of her newborn baby boy. After cutting the cord. You should:

You are caring for a newborn baby girl. She has weak cry and showing signs of respiratory distress. You should:

You are caring for a newborn baby boy. The airway is clear and his heart rate is 120. He is showing signs of significant respiratory distress. You should:

You are caring for a newborn baby boy. The airway is clear and his heart rate is 50. You have ventilated with supplemental oxygen for 30 seconds without improvement. You should:

You have initiated CPR on a newborn baby. The compression to ventilation ratio is:

You have initiated CPR on a newborn baby. The preferred technique is:

A newborn crying vigorously to reflex of stimulus would warrant what score on APGAR:

Your patient is 5 months old and is displaying an altered mental status. BGL evaluation reveals a reading of 50 mg/dl. According to your protocol, this reading indicates that:

You are treating an 8 y/o patient with a BGL reading of 40 mg/dl. In preparing Dextrose for administration, you should:

In order to give Dextrose 25% to a 4 year old patient who is hypoglycemic, you will need to:

If you are unable to ventilate a pediatric patient after airway repositioning, you should assume what?

Treatment of pediatric respiratory distress should include titrating oxygen saturation what percentage?

A pediatric patient’s airway should be managed with which of the following?

When should vascular access be attempted on a pediatric patient in respiratory distress?

What age group is Croup most common in?

At what rate should an infant in respiratory arrest be ventilated?

For a pediatric febrile seizure, passive cooling is obtained by?

A Pediatric fever is defined as a core temperature of what?

You’ve responded to a home residence for an 8-month-old patient who had a seizure. Upon arrival your patient is no longer seizing and is unresponsive and after your assessment you suspect the patients’ blood glucose is low. When do you administer Dextrose for patients less than 1 year old?

You’ve arrived on scene at a home daycare for a 4 y/o patient that had a seizure. Upon arrival your patient is no longer seizing. Staff advises you the patient is a diabetic; and your assessment confirms a blood glucose level of 37 mg/dL. What is the correct concentration of Dextrose to be administered to your patient?

What is the first step you should take when arriving at a patient possibly in cardiac arrest?

Excellent CPR is a priority when treating a cardiac arrest patient. You should:

According to the General Cardiac Arrest Protocol, how long should you check for a pulse and breathing?

For a pregnant patient in cardiac arrest, select the appropriate action:

Which of the following is/are goals to maintaining high quality CPR?

While providing care to a patient with Acute Coronary Syndrome, oxygen should be administered when a pulse oximetry reading is at what point?

Providers who are assisting a patient in taking their own Nitroglycerin sublingual tablets must assess to determine that the patients systolic blood pressure is above?

Prior to administering (or assisting with the administration of) Nitroglycerin, providers should question all patients to determine if they have taken which of the following medications?

If providers do not have pulse oximetry available while providing care for a patient with acute coronary syndrome, what is the proper rate for oxygen administration?

Primary cardiac arrest in the pediatric patient is rare. Most arrests are secondary to respiratory failure. Because of this you should:

You arrive to find a 2-year-old in cardiac arrest. What should the depth and rate of your compressions be?

When an advanced airway (supraglottic or endotracheal tube) is in place, what is your ventilation ratio?

According to the Pediatric Bradycardia protocol, hypotension associated with cardiopulmonary compromise is defined as the:

Since blood pressure readings are not considered accurate for patients under the age of 3, other signs of cardiac compromise in a small child will include all of the following EXCEPT:

You arrive at the hospital with a 7 year old child that you believe has been abused. You should:

You suspect a caregiver is neglecting an elderly female patient. You should:

When an EMS provider encounters a possible victim of abuse or neglect, in addition to filing a verbal and written report with the Michigan Department of Human Services, as a mandated reporter they must:

______________means harm or threatened harm to a child’s health or welfare by a parent, legal guardian, or any other person responsible for the child’s health or welfare…that occurs through non-accidental physical or mental injury; sexual abuse; sexual exploitation, or maltreatment.

You should consider possible child abuse as a cause of a 3 year old male child’s injuries if:

_______________means an action that involves the misuse of an adult’s funds, property, or personal dignity by another person.

You arrive on scene and find 6 year old female patient with circular burns on the patient’s arms. They appear to be the size of a cigarette. One parent indicated that the child grabbed the cigarette and burned her arms three times. The child indicated they were being carried by a parent and hot embers fell on her. Per the protocol this is possible:

According to the Abuse and Neglect Protocol, how long do you have to report verbally and in writing?

Which of the following is NOT an indication for Airway Management and Ventilation, according to the Emergency Airway Protocol?

When performing bag-valve-mask (BVM) ventilations, which is the most appropriate rate?

Which MCA-approved supraglottic airways may be used to secure the airways in unconscious patients that do not have a gag reflex?

For conscious infants (under 1 year old) with evidence of severe FBAO, you should:

All of the following are Combitube Airway Required Documentation except:

The size of the King Airway, both King LT-D and King LTS-D are based on the patient’s height, which is the correct size King Airway per patient criteria:

Your patient presents as a conscious but disoriented and talking 81-year-old male with a possible UTI. He opens his eyes spontaneously. When the medic on the ambulance attempts an IV, the patient withdraws from the pain. What is the Glasgow Coma Scale for this patient?

A GCS of less than _____ represents a significant risk of mortality.

In the secondary survey of the patient assessment, when observing the abdomen, you are looking for what?

At what age does the Glasgow Coma Scale Criteria change for Motor and Verbal Response?

The “A” in “AEIOU TIPPS CHESS” refers to what?

In which two areas of the body does the Patient Assessment Protocol recommend the responder check for Medical Alert Tags?

If there is a specific mechanism of injury with only a localized injury in an alert patient, which exam should be performed on this patient?

You have decided that a patient needs to be restrained you should:

After applying the restraints to a patient, you should:

You have just restrained a 24 year old female patient. This patient appears to be intoxicated. Your radio report to the hospital should include:

You have just restrained a 45-year-old male. His wife explains he is never like this and the patient presented as irrational, erratic and potentially threatening. You evaluate the patient and according to the Patient Restraint Protocol you determine a possible cause could be:

A restrained patient shall NOT be transported in which of the following positions:

If a patient is restrained by police you should:

According to the Refusal of Care Protocol: EMS personnel have a/an ____________ to provide care to any patient presenting to them after a report of an emergency situation:

You are caring for a 21 year male adult that is conscious and A&Ox2. He drank a considerable amount of alcohol per his friends. He is unable to maintain his balance when he attempts to stand. This patient:

You have a 32 year old female patient that is alert and oriented complaining of severe abdominal pain. After the evaluation she informs you she is concerned about getting a bill. She wants to refuse care. You determine she is competent. You must:

You have been treating a 35 year old male patient with low blood sugar. After providing him with IV glucose he became oriented. He does not wish to be transported to the hospital. You should:

In general, ______________ patients are unable to consent or refuse consent for medical care.

A competent minor may refuse consent for medical care if: