REMAC OLMC Examination
Please submit a completed (1) Exam Answer Sheet, and (2) Physician Information Sheet, within 5 days of the course date to the NYC REMAC via:
MAIL:
Regional EMS Council of NYC 475 Riverside Drive, Suite 1929 New York, NY 10115
Attn: On-Line Medical Control
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1. A physician is present at a scene where patient care is being provided by REMAC credentialed paramedics. His/her requests regarding the care and movement of this patient can only be followed if they are:
1 point
2. All of the following are true EXCEPT: ‘Discretionary Decisions’ may include, but are not limited to:
1 point
3. Of the following, the CORRECT answer is: In the absence of intravenous access, the following medications are approved for intranasal administration when an appropriate atomizer device is available:
1 point
4. According to the General Operating Procedures (GOP), which of the following is NOT included in the definition of an unstable dysrhythmia
1 point
5. EMT-Basics are permitted to transport a patient:
1 point
6. Which of the following is NOT a standing order for a patient experiencing severe respiratory distress due to chronic obstructive pulmonary disease?
1 point
7. An emancipated minor is someone under the age of 18 years, and ALL of the following EXCEPT:
1 point
8. Paramedics are on-scene with a 94-year-old female who has a past history of CHF and insulin- dependent diabetes mellitus. The patient presents: cool, pale and diaphoretic, bilateral diffuse rales, pink frothy sputum, B/P 190/120, HR 124, RR 32 and labored. The patient weighs 84 pounds, IV access has been established, the patient will not tolerate CPAP. The paramedics are requesting 2mg of Lorazepam and 80 mg of Furosemide. What is the correct dose of Furosemide to be administered to this patient?
1 point
9. An ALS unit is enroute to the hospital with a 400-pound patient in cardiac arrest. CPR is in progress, the patient is intubated, however IV access cannot be established due to excessive adipose tissue. The unit is requesting Discretionary Orders to administer the cardiac arrest drug regimen via the Endotracheal Tube. The crew should be instructed to:
1 point
10. An ALS unit is on scene with a 36-year-old male who is unconscious after suffering severe oral/dental trauma via a baseball bat to the face. Upon palpation, the patient’s jaw appears to be unhinged and in several pieces. The patient has no other visible or palpable deformities, C-Spine precautions have been initiated, IV access has been established and spinal restriction rendered. The crew has contacted Medical Control for Discretionary Orders in order to perform nasal intubation. The paramedic states he has performed this technique successfully at least a dozen times in the cadaver lab where he works part time. As the Medical Control Physician, you should tell the paramedic:
1 point
11. You have a patient presenting with historical/physical findings of an acute stroke. Which one of the following conditions would prevent you from transporting the patient to the nearest NYS DOH designated Stroke Center?
1 point
12. Who makes the ultimate decision on who accompanies the patient in the patient compartment of the ambulance?
1 point
13. A paramedic unit calls with a dialysis patient who is in stable SVT that has not responded to Adenosine. They call medical control and request orders for Diltiazem. What dose should be ordered?
1 point
14. A Paramedic is treating an adult burn patient with severe 3rd degree burns of the lower extremities. There is no airway compromise and vital signs are as follows: B/P 100/60, HR 110 regular, RR 30 and deep, SPo2 is 96% with the patient receiving oxygen at 15 LPM via a Non- Rebreather mask. What would be the appropriate medication to use for this patient?
1 point
15. According to Article 30 of the New York State Public Health Law, which entity is charged with coordinating emergency medical services in New York City?
1 point
16. When may an EMT or Paramedic (EMT-P) exceed their level of training?
1 point
17. If a scene is determined to be unsafe for EMS personnel while on assignment, what is the correct action to be taken?
1 point
18. How is ondansetron administered under Severe Nausea/Vomiting Protocol?
1 point
19. A paramedic is treating a victim that was trapped in a burning building. The victim was rescued by firefighters, but not before sustaining smoke inhalation injury. The patient is unconscious and an ET Tube has been properly placed, but only one IV infusion line is available. As per the Smoke Inhalation Protocol, which of the following is correct?
1 point
20. A paramedic is treating a patient in cardiac arrest secondary to ventricular fibrillation. As per the REMAC Protocols [and no medication shortages], which of the following represents the correct sequence of medications that would be administered under standing orders?
1 point
21. A paramedic is treating a 45-year-old male who presents with palpitations, shortness of breath and is very anxious. He has been placed on a monitor, which shows a Supraventricular Tachycardia at a rate of 180. His vital signs are stable and the paramedic decides to administer Adenosine. What is the total amount of Adenosine that can be given to this patient under standing orders?
1 point
22. A paramedic is treating a patient who has second degree burns to the neck, shoulders, and upper chest. The patient denies any respiratory distress but is in extreme pain from the burns. The patient’s vitals are blood pressure of 132/84, pulse of 110, respiratory rate of 20 and regular. Which of the following is a true statement regarding treatment of this patient's pain?
1 point
23. A NYC 911 participating EMS Agency ambulance arrives on the scene of a medical emergency. A non-NYC 911 Agency ambulance is already on the scene and caring for the patient. Both the NYC 911 ambulance, as well as, the other ambulance are Paramedic ambulances. As per the General Operating Procedure, the NYC 911 ambulance should:
1 point
24. The proper dosage for Amiodarone for an 87-year-old male who weighs 85lbs is:
1 point
25. Paramedic calls and requests permission for chemical restraint for an extremely agitated patient with a history of severe schizophrenia who is non-compliant with medication. The patient weights about 175 lbs. The paramedic should be advised to administer
1 point
26. What medication and dose are available as sedation for cardioversion?
1 point
27. Which of the following is NOT an approved site for prehospital intraosseous access in the NYC region?
1 point
28. What medication and dose are available for Transcutaneous Pacing?
1 point
29. With respect to the Medical Orders of Life-Sustaining Treatment (MOSLT) form, which of the following is a true statement?
1 point
30. You are operating as Telemetry (On-Line Medical Control) Physician when the FDNY Office of Medical Affairs and NYC REMAC issue an Influenza-Like-Illness (ILI) Notification. While in this activated state, which of the following are TRUE:
1 point
31. All of the following medications are approved by NYC REMAC for intranasal (IN) administration when an appropriate atomizer is available EXCEPT:
1 point
32. A patient becomes critical or unstable, and a transport decision is requested from On-Line Medical Control. The On-Line Medical Control physician MUST direct the patient to be transported to the:
1 point
33. If a patient cannot tolerate a non-rebreather mask, the EMT/Paramedic should use a nasal cannula set at ___liters per minute:
1 point
34. A 78-year-old male presents with: BP 80/50, HR 40, RR 26 with signs/symptoms of decompensated shock. Standing orders have been completed, including transcutaneous pacing and the patient exhibits insufficient improvement in cardiac status. Under Medical Control Options, the appropriate dose of Dopamine for this patient would be:
1 point
35. A paramedic calls for a 68-year-old female presenting with shortness of breath and difficulty breathing. Patient has brought up pinkish sputum twice since the crew arrived. Patient is not febrile and has a history of CHF, MI four years ago, and CAD. Vitals are: HR: 70R, RR 26, BP 190/110. SPO2 is 90 on non-rebreather mask. CPAP therapy is available under Standing Orders. What would prevent application of CPAP?
1 point
36. What is the maximum dose of etomidate for sedation-facilitated intubation?
1 point
37. You are working at FDNY On Line Medical Control and receive a call for a STEMI. Paramedics are caring for an 86-year-old male with acute exacerbation of chronic chest pain and dyspnea. He is unsure of any prior cardiac workup results. There has been no relief with the patient’s nitroglycerin at home. Paramedics have administered 162 mg aspirin and have the following vital signs: BP 170/90, HR 96, RR 14, SpO2 96% on 2 liters via nasal cannula. They have sent the EKG to you for review as it is a wide-complex rhythm with ST elevations in the lateral leads. What is the next step to take?
1 point
38. Severe sepsis criteria include all of the following except:
1 point
39. Which of the following is not an acceptable destination facility for a patient to be redirected to by 911 Online Medical Control?
1 point
40. Which of the following would preclude a patient from having CPAP being instituted?
1 point
41. Which of the following is available under standing orders for out-of-hospital treatment of a witnessed partial seizure?
1 point
42. A nurse in a Trauma Center calls OLMC to inquire, why two (2) tourniquets were used on a 13- year-old boy with an amputation above the wrist? Bleeding was controlled and a distal pulse was absent on the affected extremity. The most appropriate response would be?
1 point
43. Which of the following does not require a class order by an FDNY Office of Medical Affairs Medical Director to administer?
1 point
44. In which cardiac protocol is sodium bicarbonate available as a Medical Control Option?
1 point
45. Which of the following is FALSE regarding prehospital tourniquet application?
1 point
46. A REMAC-credentialed paramedic is attempting endotracheal intubation on a patient in respiratory distress with AMS. What is an acceptable therapy in this region to prevent deoxygenation during laryngoscopy?
1 point
47. What is the initial dose of anesthetic for infusion after intraosseous access has been obtained?
1 point
48. A paramedic unit is on the scene of a 60-year-old diabetic male being treated for osteomyelitis. The patient has a peripherally inserted central catheter (PICC) in the brachial vein of his left arm. The patient’s wife states she thinks it’s clogged because she cannot administer his antibiotic infusion through the catheter. She states this has happened in the past, rectified at the hospital by “pushing some fluid through the line”. The patient and wife state transport is unnecessary and only want the line fixed. The paramedic calls Online Medical Control for a discretionary decision to flush the catheter with saline because it states in the REMAC General Operating Procedures “Any line that cannot be easily flushed with 10 mL of normal saline should be considered NOT functional”. Which of the following choices is the best response to this scenario?
1 point
49. Which of the following is NOT a contraindication to CPAP use in the NYC region?
1 point
50. A patient is being treated for myocardial ischemia. Under which condition should nitroglycerin ALWAYS be withheld by the paramedic crew?
1 point
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