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Sudden Cardiac Death / Geriatric Assessment 1. Patient survival outcomes are most affected by prehospital _______________ a. Endotracheal intubation b. Medication administration c. ECG rhythm recognition d. Chest compressions 2. Paramedics have been performing this cycle of CPR for one minute when the defibrillator arrives, they a. Administer 300mg of Amiodarone b. Continue CPR until the two minute cycle is complete c. Place an impedance threshold device instead of the pads d. Continue chest compressions until the pads are placed 3. The defibrillator pads have been placed on this patient in a shockable rhythm. While the device is charging, the paramedics should ____________. a. Obtain IO access b. Continue chest compressions c. Increase the rate of rescue ventilations d. Begin medication administration 4. What is the rationale for performing quality CPR with minimal interruptions? a. Blood flow to the gut is improved b. Blood will be warmed with circulation via CPR, improving the outcomes for patients with return c. Quality, uninterrupted CPR works like a sump pump to build pressure within the cardiovascular system, improving blood flow to the vital organs d. Quality, uninterrupted CPR directly causes brain neurons to fire 5. According to the revised 2012 Region VIII SOPs, with blunt traumatic arrests, the Provider may: a. Never consider withholding resuscitative efforts b. Consider withholding resuscitative efforts with medical control direction c. Withdraw resuscitative efforts at any time d. Withdraw resuscitative efforts after 15 minutes 6. There has been a substantial increase in the frequency of ______________encountered during cardiac a. Pulseless electrical activity b. Ventricular fibrillation c. Asystole d. Ventricular tachycardia 7. Sudden cardiac death is most likely the result of occlusion of the ___________________. a. Carotid arteries b. Pulmonary veins c. Aorta d. Coronary arteries 8. The correct dosage of epinephrine for the 2 month old patient in cardiac arrest is: a. Epinephrine (1:1,000) 0.01mg/kg IV/IO b. Epinephrine (1:1,000) 0.02 mg/kg IV/IO c. Epinephrine (1;10,000) 0.01mg/kg IV/IO d. Epinephrine (1:10,000) 0.02 mg/kg IV/IO 9. The correct dosage of epinephrine for the 2 month old patient in cardiac arrest, weighing 5 kg is: a. Epinephrine (1:1,000) 0.05mg IV/IO b. Epinephrine (1:1,000) 1mg IV/IO c. Epinephrine (1:10,000) 0.05mg IV/IO d. Epinephrine (1:10,000) 0.1mg IV/IO 10. The paramedics monitor reveals the patient is in the following rhythm: Based on the above rhythm, which of the following interventions is their immediate priority? a. Lidocaine 1mg/kg IV/IO or Amiodarone 300mg IV/IO b. Precordial thump c. Defibrillation at recommended initial energy d. Epinephrine 1mg IV/IO 11. According to Region VIII SOP’s, how many minutes of CPR should the paramedics perform before checking for a pulse or a cardiac rhythm on the monitor after defibrillation? a. Check immediately, there is no delay in determining ROSC b. 1 minute c. 2 minutes d. 5 minutes 12. The medical condition that is defined as the loss of cognitive over time is; a. Delirium b. Dementia c. Dehydration d. Dyspnea 13. According to the CE material, Two (2) factors that may result in reduced complaints from the elderly which can affect how EMS personnel assess and treat the elderly patient are: a. Nutritional and hydration issues b. Decreased pain receptors and ability to relay actual complaints c. Physiological changes and use of medications d. Social and economic related fears 14. When treated a patient under the Region 8 Adult Pulmonary Edema SOP, a provider must inquire about the use of Viagra, Levitra, Cialis, and Revatio with in the last ___ hours prior to the administration of nitroglycerin. 15. The rule of 5’s for assessing an elderly dementia patient is; a. Use words with 5 syllables or less over 5 seconds to see how quickly the patient responds. b. Ask the same questions 5 times every 5 minutes to assess if there is a variance in the patients c. Use sentences with 5 or less words that have 5 or less letter so the patient understands what is d. Inquire on 5 events that the patient experienced over the last 5 hours to access short term 16. The “M” in the D-E-M-E-N-T-I-A acronym for reversible causes of dementia stands for; a. Mental disease process b. Medication interactions c. Metabolic or endocrine disorders d. Malnutrition 17. Elder abuse or neglect is defined as: a. Mistreatment or absence of care that results in harm or loss to an older person. b. Mistreatment or absence of care that results in harm or loss to an older person that only occurs at c. Abuse that includes physical, sexual, psychological abuse, or financial exploitation, d. Answers A and C 18. According to the Region 8 Emergency Medical Services Standard Operating, Lasix (furosemide) is indicated in which of the following situations: a. New onset Adult pulmonary edema or congestive heart failure patient with a systolic blood b. New onset Adult pulmonary edema or congestive heart failure patient with a systolic blood c. History of pulmonary edema or congestive heart failure with a systolic blood pressure d. History of pulmonary edema or congestive heart failure with a systolic blood pressure 19. A patient in atrial flutter has a normal atrial rate between; a. 80 and 100 b. 100 and 150 c. 250 and 350 d. 40 and 60 20. In cases of suspected elder abuse, EMS providers are mandated to notify; a. Illinois Department of Children and Family Services b. Illinois Department of Public Health c. Illinois Department of Aging Abuse Hotline d. Local law enforcement and resource hospital 21. Which of the following statement is false when it comes to caring with for a patient with Osteoporosis: a. Additional padding may be required for proper immobilization b. In spite of the disease process, c-spine immobilization is rarely difficult c. Adult size cervical collars may not properly fit these patients. d. Providers should consider padding longboards to prevent tissue breakdown. 22. According to the “Adult Right of Refusal/Involuntary Treatment or Transport” policy, a patient is considered a potential danger to themselves when they: a. Are homicidal b. Are unable to care themselves c. Refuse EMS services d. Refuse ALS interventions 23. True or False: According to the “Adult Right of Refusal/Involuntary Treatment or Transport” policy, providers are required to contact medical control for a diabetic “wake up” call where a patient received D50 IV push. 24. According to the “Do Not Resuscitate” Guidelines policy, a _______________ is required to ensure a a. A living will attached b. A durable power of attorney present c. A witness signature d. Approval of medical control physician 25. True or False: According to the “Do Not Resuscitate” Guidelines policy, verbal DNR orders may be honored by field personnel without contacting medical control to approve.

Source: https://www.edward.org/workfiles/ems/01-2013-Test.pdf