OPS 046 Stroke Alert Protocol

Question 1

OPS-046 supplements which protocols?

A. State EMS protocols only
B. TEMS Regional Medical Protocol and Stroke Plan
C. AHA guidelines only
D. Hospital stroke pathways

Answer 1

B.
TEMS Regional Medical Protocol and Stroke Plan

Question 2

Which of the following is NOT listed as a stroke symptom in OPS-046?

A. Weakness
B. Vision problems
C. Chest pain
D. Dizziness

Answer 2

C.
Chest pain

Question 3

Which stroke assessment tool is used as the initial screening?

A. NIHSS
B. RACE
C. GCS
D. BEFAST

Answer 3

D.
BEFAST

Question 4

A patient is considered BEFAST positive when:

A. All categories are abnormal
B. At least three categories are abnormal
C. Any BEFAST element is positive
D. RACE score is ≥ 5

Answer 4

C.
Any BEFAST element is positive

Question 5

The “E” in BEFAST stands for:

A. Extremities
B. Eyes
C. Effort
D. Evaluation

Answer 5

B.
Eyes

Question 6

Which BEFAST component addresses coordination?

A. Balance
B. Arms
C. Speech
D. Time

Answer 6

B.
Arms

Question 7

BEFAST stands for:

Answer 7

Balance
Eyes
Face
Arms
Speech
Time

Question 8

Which BEFAST element focuses on symptom onset?

A. Face
B. Speech
C. Time
D. Eyes

Answer 8

C.
Time

Question 9

The RACE score ranges from:

A. 0–5
B. 0–6
C. 0–9
D. 1–10

Answer 9

C.
0-9

Question 10

All BEFAST-positive patients must receive which additional assessment?

A. APGAR
B. NIH Stroke Scale
C. RACE
D. Glasgow Coma Scale

Answer 10

C.
Race

Question 11

A RACE score ≥ ___ indicates a Large Vessel Occlusion stroke.

A. 3
B. 4
C. 5
D. 6

Answer 11

C.
5

Question 12

When performing RACE, personnel should NOT score:

A. Facial droop
B. Arm lift
C. Old deficits
D. Gaze deviation

Answer 12

C.
Old deficits

Question 13

Facial droop scoring on RACE includes:

A. Normal, mild, severe
B. Absent, mild, severe
C. Present or absent only
D. Partial or complete

Answer 13

B.
Absent, mild, severe

Question 14

How long must a patient hold their arm to score a “0” on RACE?

A. >5 seconds
B. >8 seconds
C. >10 seconds
D. >15 seconds

Answer 14

C.
>10 seconds

Question 15

Leg lift scoring requires the patient to hold the leg for:

A. >3 seconds
B. >4 seconds
C. >5 seconds
D. >10 seconds

Answer 15

C.
>5 seconds

Question 16

Head or gaze deviation is scored as:

A. 0–2
B. 0–3
C. 0–1
D. 1–2

Answer 16

C.
0-1

Question 17

Which cortical questions are used for right-sided weakness?

A. Can you move your right arm / Whose arm is this
B. Say a sentence / Repeat a phrase
C. Close your eyes / Make a fist
D. Name an object / Count backward

Answer 17

C
Close your eyes / Make a fist

Question 18

Which cortical questions are used for left-sided weakness?

A. Close your eyes / Make a fist
B. Can you move your left arm / Whose arm is this
C. What day is it / Where are you
D. Smile / Raise your eyebrows

Answer 18

B.
Can you move your left arm / Whose arm is this

Question 19

A patient answers one of two cortical questions correctly. The score is:

A. 0
B. 1
C. 2
D. 3

Answer 19

B.
1

Question 20

Medical control must be notified when:

A. RACE ≥ 5 only
B. BEFAST is positive
C. Blood glucose is abnormal
D. Patient is hypertensive

Answer 20

B.
BEFAST is positive

Question 21

Which phrase MUST be used during radio notification?

A. Neurological emergency
B. Possible CVA
C. Stroke Alert
D. Code Neuro

Answer 21

C.
Stroke Alert

Question 22

When RACE ≥ 5, personnel should state:

A. Severe stroke
B. LVO suspected
C. Large Vessel Occlusion Stroke
D. Priority neurological patient

Answer 22

C.
Large Vessel Occlusion Stroke

Question 23

Which vital sign is mandatory to report for stroke?

A. Blood pressure
B. Oxygen saturation
C. Heart rate
D. Blood glucose

Answer 23

D.
Blood glucose

Question 24

Medical control notification must include:

A. Patient insurance status
B. Last Known Well time
C. Past medical history
D. Medication list

Answer 24

B.
Last Known Well Time

Question 25

Stroke Alert patients must be transported to: A. Any emergency department B. The closest hospital C. The closest appropriate facility D. A comprehensive stroke center

Answer 25

C. The closest appropriate facility

Question 26

LVO patients may benefit from transport to: A. Urgent care B. Primary stroke center only C. Comprehensive stroke center D. Trauma center

Answer 26

C. Comprehensive stroke center

Question 27

Destination decisions for LVO patients require: A. Battalion Chief approval B. Hospital discretion only C. Medical control consultation D. EMS supervisor approval

Answer 27

C. Medical control consultation

Question 27

Which assessment results must be documented? A. Only BEFAST B. Only RACE C. Both BEFAST and RACE D. Only Stroke Alert declaration

Answer 27

C. Both BEFAST and RACE

Question 28

Stroke patient transport should begin: A. After IV access B. After full assessment C. Immediately with care en route D. After CT notification

Answer 28

C. Immediately with care en route

Question 29

The goal on-scene time for stroke patients is: A. <5 minutes B. <8 minutes C. <10 minutes D. <15 minutes

Answer 29

C. <10 minutes

Question 30

The declaration of a Stroke Alert must include: A. Who declared it B. Time of declaration C. Location of patient D. Transport unit

Answer 30

B. Time of declaration

Question 31

The Last Known Well must be documented as: A. Approximate B. Shift estimate C. Date and time D. Time only

Answer 31

C. Date and Time

Question 31

Blood glucose documentation for stroke is: A. Optional B. Recommended C. Required D. ALS-only

Answer 31

C. Required

Question 32

Patient diversion after calling hospital for stroke must be: A. Avoided B. Verbally reported only C. Documented in PCR D. Approved by the hospital

Answer 32

C. Documented in PCR

Question 33

Newly hired personnel are trained by who for stroke assessments: A. Field Training Instructors B. Company officers C. Hospital educators D. NFR Training Staff

Answer 33

D. NFR Training Staff

Question 34

QA review includes documentation of: A. Oxygen flow rate B. Pain score C. Blood glucose D. IV attempts

Answer 34

C. Blood glucose

Question 34

QA monitoring includes appropriateness of: A. Medication administration B. Stroke Alert activation C. IV size selection D. Transport speed

Answer 34

B. Stroke Alert activation

Question 35

Scene time compliance is monitored for: A. <8 minutes B. <10 minutes C. <12 minutes D. <15 minutes

Answer 35

B. <10 minutes

Question 36

Skill performance issues are addressed by: A. Hospital QA staff B. EMS medical director C. FTIs, officers, and chiefs D. Dispatch supervisors

Answer 36

C. FTIs, officers, and chiefs

Question 36

PCRs are periodically reviewed by: A. Battalion Chiefs B. Medical Control C. NFR Quality Improvement Officer D. Training Division

Answer 36

C. NFR Quality Improvement Officer

Question 37

Which therapy is mentioned in OPS-046 (stroke)? A. Aspirin B. Heparin C. tPA D. Amiodarone

Answer 37

C. tPA

Question 38

Endovascular thrombectomy is associated with: A. Small vessel strokes B. LVO strokes C. Hemorrhagic strokes only D. TIAs

Answer 38

C. Hemorrhagic strokes only

Question 39

BEFAST is best described as: A. Diagnostic tool B. LVO predictor C. General stroke screening D. Hospital assessment

Answer 39

C. General stroke screening

Question 39

Which assessment tool identifies LVO? A. BEFAST B. FAST C. RACE D. GCS

Answer 39

C. RACE

Question 40

RACE is performed: A. On all medical patients B. Only if BEFAST is negative C. On all BEFAST-positive patients D. Only at the hospital

Answer 40

C. On all BEFAST-positive patients

Question 41

Failure to document LKW would violate: A. Training standards B. QA requirements C. Dispatch procedures D. Hospital policy

Answer 41

B. QA requirements

Question 42

Stroke Alert designation is part of: A. Dispatch coding B. Patient condition designation C. Trauma triage D. Cardiac alerting

Answer 42

B. Patient condition designation

Question 43

The MOST critical exam concept in OPS-046 is: A. Transport speed B. Hospital destination to nearest stroke center C. Accurate BEFAST/RACE with LKW D. IV access with large gauge

Answer 43

C. Accurate BEFAST/RACE with LKW