1
Q
What is the Address to the Firehouse (55)?
What map page is it on?
Where is the closest hydrant?
A
3716 Rhode Island Ave
Page 14
Side Charlie
2
Q
What Battalion is 55 in?
Who is BC, EMS 800, EMS Duty Officer?
What are the other stations?
A
4th Battalion
BC - Habib
EMS 800 - Ola
EMS DO/North - Reedy
Stations - 12, 34, 44, 55
3
Q
What Roads are
410
500
1
Alt - 1
769b
450
501
202
A
410 - East West Hwy
500 - Queens Chapel Road
1 - Baltimore Ave also Rhode Island Ave
Alt 1 - Bladensburg Road
769b - Edmonton Road
450 Annapolis Road
501 - Chillum Road
202 - Landover Road
4
Q
Out of the Firehouse what are the hundred blocks
R out of the fire house -
L out of the fire house -
A
R out of the fire house - 38xx (goes down) to Eastern Ave
L out of the fire house - 47xx (goes up) to Baltimore Ave Page
5
Q
Out of the firehouse:
- Get to 34th street
- Get to 38th street
A
Right - Get to 34th street
Left - Get to 38th street
6
Q
From the firehouse:
- Get to Bladensburg Road
A
Left out of the firehouse
Right on 38th (follow to Bladensburg Road)
7
Q
From the Firehouse
- Get to Baltimore Ave
A
Left out of the firehouse
(Rhode Island then Meets Baltimore Ave)
8
Q
From the firehouse:
- Get to 2400 Queens Chapel Road
- What is there? What map page?
- How many floors (FDC?)
A
Right out of the Firehouse
Right on Eastern Ave
Right onto Queens Chapel
(Avondale Overlook Apartments, Page 7, 13 floors)
FDC - A, D
9
Q
From the fire house:
- Get to 3104 Queens Chapel Road
- What is there? What map page?
A
Left out of the fire house
Left on 34th St
Left on Queens Chapel Road
Answer: LIDL (formerly Giant) map 12, connection A, sprinkler for LIDL and CVS only, Hydrant side A Parking lot)
10
Q
Name the Streets behind the fire house on 38th Street
(In Order, on the left side of 38th) (10 Total)
A
Shepherd
Taylor
Tilden
Utah
Upshur
Varnum
Volta
Webster
Windom
Allison
11
Q
What is the Range of the Numbered Streets in the First Due
_ _ th Street to _ _ th Street
A
21st Street - Near Corner of Queens Chapel and Eastern Ave (page 6) Right is lower
To
47th Street - Near Baltimore Ave, Rhode Island Ave
(Page 19/20) Left is Higher
12
Q
From the fire house:
- Get to Thomas S. Stone Elementary School
- Where is the Plug, FDC?
- What is the Address?
- What is the Map Page?
A
- right out of the Firehouse, Right on 34th Street (at Circle)
- Plug is on (right side of) Side A, no FDC
- 4500 34th Street
- Page 18
13
Q
From the fire house:
- Get to Mt. Rainier Elementary School
- Where is the Plug, FDC?
- What is the Address?
- What is the Map Page?
A
- Right out of the firehouse, right on 34th St (at the circle), Left on Bunker Hill Road, Right on 32nd Street (school on right)
- Plug is across the street (side A) , FDC is on side A (left side)
- 4011 32nd Street
- Page 18
14
Q
From the fire house:
- Get to Avondale Overlook
- Where is the Plug, FDC?
- What is the Address?
- How many Floors
- What is the Map Page?
A
- Right out of the Firehouse, Right on Eastern Ave, Right on Queens Chapel Road (Avondale on the Left)
- Plug to the left 2302, FDC on A and D
- 2400 Queens Chapel Road
- 13 Floors
- Map Page 7
15
Q
From the fire house:
- Get to Queenstown Apartments
- Where is the Plug, FDC?
- What is the Address?
- What is the Map Page?
A
- Right out of the firehouse, Right on 34th St (34th becomes Chillum Road) Apts on the Left
- Plug on Corner of Chillum and Queenstown Drive, 5 total Plugs, No FDC (2nd Plug on Buchanan Street)
- 3301 Chillum Road (3300 00-13)
- page 13
16
Q
From the fire house:
- Get to Kings Park Apartments?
- Where is the Plug, FDC?
- What is the Address?
- How many floors
- What is the Map Page?
A
- Right out of the firehouse, Right on Eastern Ave, Right on Queens Chapel Road (building on Left)
- Side A, right side corner, FDC side A
- 2600 Queens Chapel Road
- 10 floors
- page 12
17
Q
From the fire house:
- Get to Malta House
- Where is the Plug, FDC?
- What is the Address?
- What is the Map Page?
A
- Right out of the fire house, right on Eastern ave, cross Queens Chapel Road (Carson Cir) Left on Lasalle Road (building on the Left)
- Plug on island side A, FDC on side A
- 4916 Lasalle Road
- Map page 8
18
Q
From the fire house:
- Get to Complete Care
- Where is the Plug, FDC?
- What is the Address?
- What is the Map Page?
A
- Right out of the fire house, right on Eastern ave, cross Queens Chapel Road (Carson Cir) Left on Lasalle Road (building on the Left)
- Plug on island (in lot), FDC right side A
- 4922 Lasalle Road
- Map Page 8
19
Q
From the fire house:
- Get to Prince Georges Apartments
- Where is the Plug, FDC?
- What is the Address?
- What is the Map Page?
A
- Plug on left side Island Side A, no FDC
- 3900 Hamilton St
- Map Page 17 (middle of page)
20
Q
From the fire house:
- Get to Castle Manor Apartments
- Where is the Plug, FDC?
- What is the Address?
- What is the Map Page?
A
- Plug on 38th Ave/Jefferson Corner, No FDC
- 5311 38th Ave (5300-5407)
- Map Page 17 (middle of page)
21
Q
From the fire house:
- Get to Park Place Condos
- Where is the Plug, FDC?
- What is the Address?
- What is the Map Page?
A
- Left out of the firehouse, Left on 38th street, Right on Hamilton Street (another quick right)
- Across the street?
- 3829 Hamilton St
- Map Page 17
22
Q
From the fire house:
- Get to DaVita Mt. Rainier Dialysis
- Where is the Plug, FDC?
- What is the Address?
- What is the Map Page?
A
- Right out of the firehouse, right on Eastern Ave, Right on Varnum Street
- Plug on the corner of Varnum and Eastern Ave
- 2303 Varnum Street
- Map Page 6
23
Q
From the fire house:
- Get to Studio 3807
- Where is the Plug, FDC?
- What is the Address?
- What is the Map Page?
A
- Left out of the fire house (on right corner)
- Plug across 39th
- 3807 Rhode Island Ave
- Map Page 15 (bottom)
24
Q
From the fire house:
- Get to Artisan 4100
- Where is the Plug, FDC?
- What is the Address?
- What is the Map Page?
A
- Left out of the firehouse, on the left (between Shepherd and Utah)
- Plug on Shepherd
- 4100 Rhode Island Ave
- Map Page 15 (middle)
25
From the fire house:
- Get to Compare Foods / CVS
- Where is the Plug, FDC?
- What is the Address?
- What is the Map Page?
- Left out of the firehouse, Right on 38th, Left on Bladensburg Rd (alt 1) on right
- Plug side A parking, Side C, FDC Side A
- 3831 - 3611 Bladensburg Road
- Map Page 22
26
From the fire house:
- Get to East West Highway
Left out of the fire house follow and veer left onto Baltimore Ave till you get to East West Hwy
27
From the fire house:
- Get to Ager Road
- What is the Map Page?
- Right out of the firehouse, Right on 34th St, Right on Queens Chapel, Left on Ager Road
28
From the fire house:
- Get to Kenilworth Ave
- What is the Map Page?
Left out of the firehouse, right on 38th, Left on Bladensburg (cross water)
till Kenilworth
29
From the fire house:
- Get to Hamilton Street
- What is the Map Page?
Left out of the firehouse, left on 38th, Left onto Hamilton
Map page 16
30
From the fire house:
- Get to Allison Street
Left out of the firehouse, Left on 38th, Left (32xx) or right (39xx) on Allison Street
Map page 19
31
From the fire house:
- Get to Chillum Road
Right out of the firehouse, Right on 34th Street (follow till turns into Chillum Road)
Map Page 13
32
From the fire house:
- Get to Decatur
- Map Page?
Left out of the fire house, reach Baltimore ave turn right then immediately left onto Decatur Street
33
From Complete Care
Get to Washington Hospital Center
Curve around then Right on Lasalle Road, veer right (curve)
Right on Michigan Ave (follow)
Right into hospital (Hospital Center Dr)
34
From Thomas Stone Elementary
Get to Children’s Hospital
Take 34th (away from firehouse),
Left on Allison,
Right on 30th,
Left on Queens Chapel Road (Turns into Michigan Ave)
Right into Hospital
35
From Mt. Rainier Elementary
Get to Children’s Hospital
Right on 32nd, Right on Shepherd Street,
Right on 34th Street,
Right on Rhode Island (Circle),
Right on Franklin Street, Left on Michigan Ave,
Right into Hospital
36
From the fire house:
- Get to Volta
- What is the Map Page?
37
From the fire house:
- Get to 40th Ave
- What is the Map Page?
38
From the fire house:
- Get to 31st Street
- What is the Map Page?
39
From the fire house:
- Get to Edmonton Road
- What is the Map Page?
40
From the fire house:
- Get to BW Parkway
- What is the Map Page?
41
From the fire house:
- Get to Med Star Trauma/Burn Center
42
From the fire house:
- Get to Doctors
Turn left out of the fire house
left onto Baltimore ave
43
From the fire house:
- Get to Cap Regional
44
From the fire house:
- Get to 44
45
From the fire house:
- Get to Riverdale Station
46
From the fire house:
- Get to Howard University Hospital
47
48
From the fire house:
- Get to Howard University Hospital
49
What's the Height, Length, Weight of PE841?
Height: 9'7" Length: 29'5" Weight: 44,000 lbs
50
What kind of Engine does PE855 Have?
Cummins X12, 500HP
51
What is the Make Model of PE855?
E-ONE Tyhphoon
52
What is the Tank Size of PE855?
500 Gals
53
What type of Transmission does PE855 have?
Allison EVS 4000 Automatic
54
(PE855) Type of Trans Fluid, How much?
TES 295 Synth, 26 Quarts, (Refill at dip stick mid-engine)
55
(PE855) What type of Coolant, How much?
Oat ELC, 56 Quarts
56
(PE841) What type of Oil, How much?
15w 40, 40 Quarts
57
(PE855) What type of Fuel, How much?
Diesel, 50 Gals
58
(PE855) What type of Pump?
Hale Q Max, Single Stage
1500 GPM
59
Temp 32 Degrees or below, what should you do?
Bleed all air tanks on all apparatus, daily and after each use, slowly, partially, then close
60
(PE855) What type of primer?
Hale Electric
61
(PE841) What type of front intake?
5” Front Intake Valve ?
62
(PE855) How much DEF?
5 Gals
63
(PE855) Tire Size, PSI?
Wheel Dia 22.5", 110 PSI
315/80r
64
(PE855) Tread Depth?
6/32nds Front, 4/32nds Rear
65
(PE855) What type of Breaks
Jacob’s Engine Brakes
66
(PE841) How do you tell when front breaks are due?
Front NOTCH measure lines up, call AMD
67
(PE841) How do you tell when rear breaks are due?
By "cotter" pin, when pin gets to last indicator, call AMD
68
(PE841) Proper Brake Procedure
30 stops, 30mph, 30 sec intervals, takes 5 seconds to stop, 30,30,30,5
69
(PE841) What are the ladder sizes?
10" attic, 14" roof, 28" extension, visual inspected once a month
70
What are the parts of the Halligan
Shaft, Fork, Pike, Bevel Adze
71
When does the Vibe alert go off on the SCOTT PAK
1800psi, 33%
72
(PE841) How many SCOTT PAK's are on the Engine
8 Total, 1 Officer, 1 Driver, 3 in the Back, 6 Spares
73
(PE841) What are the lines in the back?
400" Leader Line -200 1 3/4 200" 3 inch
200" - 1 3/4
250" - 1 1/16th Straight (2 inch)
300" - 1 3/4
74
Whats the Nozzle Pressure for Straight Stream, Master Stream, Fog Stream
Straight - 50 psi
Master - 80 psi
Fog - 100 psi
75
Belts should have no more then ___ inch delfection at center point
½ inch
76
What is does CDLBS stand for?
Cracked
Damaged
Loose
Broken
Secured
77
List Outside of Vehicle Check
1 Exterior Lights
2 Windshield
3 Doors
78
PE841 Parts
Steering
Frame
Springs/Shocks
Wheels
Engine - Oil, Coolant, Belts
Transmission, Water Pump
Drive Shaft
Brakes
Exhaust/Fuel Tank, Reservoir
Power steering, Alternator, Radiator, Air Compressor
79
When driving opposting traffic lane or one way street what is the max speed
20mph
80
What is the max speed for driving with snow chains
30mph
81
When road barrier how many warning devices (cones) should be used
3
82
What is the Q formula for the
1 ¾" attack lines
12Q2
83
When calculating hydrant performance, if you open an additional line and get 10% drop how much residual water is still available
x1 or same amount
84
What is the max gpm for 4" supply line
2000gpm
85
Do not exceed __ mph when laying supply line
5mph
86
Avoid drafting a height greater than \_\_
10ft
87
With a full tank flowing a fog nozzle how long until you run out of water
4.5 mins
88
What are the hose couplers aka Glad hands used for
Connecting airlines, and towing
89
The Engine is governed to what max speed?
68mph
90
What size are the fittings on the hard suction hose
6"
91
How many gpm does a Bresnan distributor flow?
450gpm
92
What is the friction loss on the wagon pipe
20psi
93
What is Drivers job on first due fire
Flake line, to the door
Charge line
Obvious rescues
Prepare for defensive ops
Secure utilities
Throw ladders, lights
Maintain water supply
94
How many seconds do you hold the Regen button
5 seconds
95
Why do you pull the engine out of station for regen?
High exhaust temp, keep emissions out
96
What is the diameter of the standpipe pack hose
2"
97
What psi is the intake pressure relief set to?
125psi
98
Where is the manual override for the front intake valve?
OIC side, pump panel area, bottom corner door, has wheel to turn for valve
99
In whlat situation is it ok to apply water to hot or overheating brakes?
Never
100
With red showing in the window of the crossfire air fittings what does that indicate?
Overpressure
101
What is the Q Formula for the 4" supply line?
Q2/5
102
What is the number of feet allowable on the discharge side of a foam eductor with 1.5" line
150ft
103
What do you need when calling to have unit towed?
Hours, Miles
M Number
Location
104
What is the formula for (customary) discharge rate on a solid stream nozzle?
GPM = 29.7 * d^2 * ✔️NP
```
GPM = Discharge in gallons per minute
29.7 = A constant
d = Diameter of the orifice in inches
NP = Nozzle Pressure in pounds per square inch (psi)
```
p 195
105
Master Stream Nozzles:
Smooth bore streams are generally operated at _____ psi nozzle pressure, while fog appliances are generally operated at _____ psi.
80 psi / 100 psi
p 199
106
A simple guideline for the Customary system of measurement for approximate solid stream nozzle reaction is ?
NR = Q/3
Q equals the total flow of water in gpm flowing through the nozzle
p 203
107
What is the formula for calculating nozzle reaction for fog stream nozzles?
```
NR = 0.0505 * Q * ✔️NP
NR = nozzle reaction in pounds
0.0505 = A constant
Q = Total flow through the nozzle in gallons per minute (gpm)
NP = Nozzle Pressure in pounds per square inch (psi)
```
p 204
108
Which nozzles are best suited for wildland fires and are not recommended for structural fire fighting due to their low water flow of only 8 to 15 gpm?
High pressure fog nozzles
p 199
109
The two basic pressurized water supply sources that a driver/operator will encounter are a ?
fire hydrant or supply hose from another pumper
p 339
110
Pumping at a low residual pressure (below _____ psi) while being supplied by other apparatus is dangerous. This may cause the supply hose to __________, interrupting the supply of water. It may also lead to cavitation of the pump.
20 psi / collapse
p 339
111
Driver/Operators should maintain a residual pressure of at least ______ psi on their master intake gauge at all times during pumping operations.
20 psi
p 340
112
The initial water source is often the apparatus ________ _______.
water tank
p 337
113
Typically the least desirable hydrants are those located on "________ ______ ________" that are served by smaller mains from only one direction.
"dead end mains"
p 340
114
- Water main that is not looped and in which water can flow in only one direction.
Dead End Mains
p 340
115
One of the most common ways for a pumper to be supplied with water from a hydrant is by making a ?
forward hose lay
p 341
116
- Method of laying hose from the water supply to the fire scene.
Forward Lay
p 341
117
- Method of laying hose from the fire scene to the water supply.
Reverse Lay
p 344
118
Load hose with a _________ coupling to come out of the bed first when using hose with threaded couplings for a reverse lay.
male
p 344
119
Use double _________ adapters at the hydrant and double ________ adapters at the pump panel to execute a reverse lay using hose with threaded couplings if the hose bed has been set up for a forward lay.
female / male
p 344
120
Executing a reverse lay is a common method for setting up a water supply operation or relay pumping using __________ diameter hose as a supply line.
medium
p 344
121
With medium diameter hose, it is necessary to position a pumper at the ___________ to supplement the pressure to the supply hose.
hydrant
p 344
122
The reverse lay is the most direct method of supplementing _____________ ____________ or performing ____________ _____________.
hydrant pressure or performing drafting operations
p 344
123
- 2 1/2 or 3 inch hose used for both fire fighting attack and relay supply purposes.
Medium Diameter Hose (MDH)
p 344
124
- (1) Pumper that is positioned at the fire scene and is directly supplying attack lines. (2) Light truck equipped with a small pump and water tank. Also know as Midi-pumper or Mini-pumper.
Attack Pumper
p 344
125
- Pumper that takes water from a source and sends it to attack pumpers operating at the fire scene.
Water Supply Pumper
p 344
126
If water is allowed to enter the tank _________ _____________, the venting may not be adequate to allow the pressure to dissipate, resulting in damage to the tank.
under pressure
p 345
127
Regardless of whether a particular apparatus is equipped with a check valve in the tank to pump line or a shutoff valve on the intake, the driver/operator should close the tank to pump valve after transitioning to an ?
external water supply
p 345
128
When the pump is full of water and the pressure in the system has stabilized with no water flowing, a reading of the pressure on the master intake gauge indicates the ___________ _____________ in the water supply system. The reading is important for estimating the remaining _________ of the hydrant as the water begins to move.
static pressure / capacity
p 346
129
Open all valves slowly, especially when using ________ ____________ hose. The hose must be __________ before pressure can be established.
large diameter / filled
p 346
130
While observing the master intake and discharge gauges, the D/O should increase the engine ______. If the master intake gauge drops below _____ psi, the throttle must not be ____________ any further because the pump may begin to cavitate.
rpm / 20 psi / increased
p 346
131
Several methods for preventing overheating are as follows:
* Establish a continuous minimum _______ during intermittent use of water in fireground operations to keep the pump from overheating.
* Pull a length of ___________ line or other _________ ___________ line off the reel and fasten it to a sturdy object.
* Open the valve that supplies the booster reel and ___________ __________ in a direction that will not interfere with the operation or damage to other property. The booster line may also be directed back into the ________ to circulate water continuously.m
* flow
* booster / small diameter
* discharge water / tank
p 347
132
During prolonged pumping operations, a bypass circulator may not provide sufficient cooling under some conditions and additional measures will be required to avoid overheating.
* Open a ____________ _________ valve.
* Partially open the ______-______ valve or ______-___-_______ line. Even if the water tank becomes full and _____________ through the tank vent, this result is preferable to the pump overheating.
* discharge drain
* tank-fill / tank-to-pump / overflows
p 347
133
When a pumper is connected to a hydrant and is not discharging water, the pressure shown on the intake gauge is __________ pressure. When the pumper is discharging water, the intake gauge displays the ___________ pressure. The difference between the two pressures is used to determine how much more water the ___________ can supply.
static / residual / hydrant
p 347
134
Available Water from Hydrant Percent Method:
Percent Drop = ( _________ - ___________ )(100) / ___________
Percent Drop = (Static - Residual)(100) / Static
p 348
135
Available Water from Hydrant Percent Method:
If the percent is ____ or less, three additional lines with the same flow as the line being supplied may be added. For ____-____ percent, two lines may be added, and for ____-_____ percent one line. When the result is over _____ percent, more water may be available, but not as much as is flowing through the first line.
10 / 11-15 / 16-25 / 25
p 348
136
All fire department pumpers should be capable of pumping water from a _________ _________ supply source. In most cases, this source is located some distance below the level of the ?
static water / fire pump
p 352
137
It is not possible to ______ water into the pump. However, it is possible to evacuate some of the air inside the pump creating a ____________ ___________ (__________ __________), which allows atmospheric pressure acting on the surface of the water to force the water into the fire pump.
pull / pressure differential ( partial vacuum)
p 352
138
- Effect of altering the atmospheric pressure within a confined space by mechanical means. When air is exhausted from within the space, a low pressure environment is created and replacement air will be drawn in; when air is blown into the space, a high-pressure environment is created and air within will to the outside.
Pressure Differential
p 352
139
Severe Agitation - Adult
Treatment: Sedation with Midazolam (2.5-5 mg IV/IO)
140
CHF
signs your looking for
treatment
Key Signs: Edema, Hypertension, PND, SOB, Wheezing, Crackles on Lung Auscultation.
Differentials: Rule out inferior STEMI with a 12-lead ECG.
Treatment: CPAP, Nitro 0.4 mg, Nitro Paste, Transport to Cardiac Center.
141
Mild Allergic Reation - Adult
signs for mild
treatment
Signs: Rash, Itching, Hives.
Treatment: Diphenhydramine 25-50 mg IV/IM).
142
Severe Allergic Reaction - Adult
signs for Severe
treatment
Signs: Respiratory Distress, Swelling.
Treatment: Epinephrine (0.3 mg IM) - may repeat every 5-15 minutes.
143
Anaphylaxis - Adult
signs for moderate
treatment
Possible Causes: Allergic reaction to food, insect sting.
Key Signs: Urticaria, angioedema, respiratory distress.
Vital Signs: Hypotension.
Treatment: Epinephrine 0.5 mg IM; consider diphenhydramine and Dexamethasone
144
Hypoglycemia - Adult
sign your looking for
treatment
Signs: Confusion, Sweating, Blood Glucose below 70 mg/dL.
Treatment: Dextrose 25 g IV/IO or Glucagon
145
Hyperkalemia - Adult
signs your looking for
treatment
Possible Causes: Renal failure, some meds cause it like Beta blockers, Sartans, Prills, diuretics.
Key Signs: Muscle weakness, peaked T waves on ECG.
Vital Signs: Bradycardia, hypotension.
Treatment: Cal Chloride 0.5-1gram slow 5 mins IVP flush then Sodium BiCarb 50 mEq IV over 5 mins
146
Seizures - Pregnancy
signs
treatment
Give 5mg IM Midazolam/Versed
then
4mg Mag Sulfate IV over 10mins mixed in 100mL LR
147
Asthma Exacerbation
signs
treatment
Signs: Wheezing, accessory muscles, Shark fin capno
Treatment:
148
CHF
signs your looking for
treatment
Signs: Crackles, PND, Edema, HTN, capno might be norm. Check 12 lead
Treatment: IV, CPAP, SL Nitro 0.4, check bp 150
Note: Check for Inf Wall MI before Nitro
149
Croup - Peds
signs your looking for
treatment
Signs: Inspiratory Stridor, Barking Cough
Treatment: Neb Epi
150
Opioid Overdose
signs your looking for /possible drugs
treatment
Signs: Pinpoint, resp depress, AMS
151
Chest Pain
signs
&
treatment
S: chest pressure, discomfort, sob, diaphoretic (sys abv 90, hr 60-150)
T:
aspirin 325mg
12 lead EKG (asap)
IV access
Nitro 0.4mg SL
(may repeat 90 sys, hr 60-150bpm)
2 more tabs, max 1.2mg
note: watch for bp drop of 20
withhold nitro - Inf MI, ED drugs
152
ST Elevation - MI STEMI
signs
&
treatment
Signs:
sob, cp, arm/jaw pain, diaphoretic, nausea
(st elevation, 1mm in 2 leads)
Treatment:
IV-Aspirin/Nitro
Cardiac Ctr/Transmit, STEMI Alert
Inferior (R) - get V4r - if elevation do NOT give nitro
if hypotensive/clear lungs -
give LR 250mL IV
note: depression in v1-v3, get posterior EKG
153
Sync Cardio Vert
signs of when
and how
Hr over 150
UnStable
SVT - NARROW- 100, 200, 300, 360
Afib/Aflutter - 200, 300, 360
154
Sepsis
Possible Causes: Infection, pneumonia, urinary tract infection.
Key Signs: Fever, altered mental status, hypotension.
Vital Signs: Fever > 100.4°F, heart rate > 90 bpm.
Treatment: Antibiotics; crystalloid fluid resuscitation; vasopressors if hypotensive.
155
Ped patient is defined as
up to 40kg or up to 14 years of age
Appear, Wob, Circulation
156
GCS M, V, E
M (6) Motor
Localizes - 5
withdraw - 4
core - 3
V (5) voice
confused - 4
inappropriate - 3
incomprehensible - 2
E (4) eyes
to speech - 3
to pain - 2
none - 1
157
Stable SVT (nat registry)
Perform vagal maneuvers
Adenosine 6 mg IV (proximal site) followed by 10 mL fluid bolus
If tachycardia continues, give adenosine 12 mg IV
A third dose of adenosine, 12 mg IV, can be given
Diltiazem 0.25 mg/kg slowly IV over 2 minutes
fter 15 minutes, a second dose of diltiazem 0.35 mg/kg IV may be given
For patients older than 65 years old, recommend maximum initial dose of diltiazem 10 mg IV and a maximum second dose of 20 mg
Metoprolol 5 mg IV given over 1–2 minutes. May repeat as needed q 5 minutes for a total of 3 doses
Verapamil 2.5–5 mg IV given over 2 minutes. May repeat with verapamil 5–10 mg
after 15–30 minutes
158
Stable Brady (nat registry)
HR less than 60 bpm with CP, AMS, CHF, Seizure, syncope, diaphoretic
VOMIT
O2 over 94%
12 lead
IV
BGL
Atropine 1 mg IV q 3–5 minutes (maximum total dose of 3 mg)
then if that doesn't work
Epinephrine IV drip 0.02–0.2 mcg/kg/min titrated to a MAP greater than 65 mmHg
159
Stable Tachy - Afib, AFlutter
HR over 100, palpitations, dyspnea, syncope, ams, cp
O2 over 94%, 12 lead, IV (vomit)
Diltiazem (Cardizem) 0.25 mg/kg slowly IV over 2 minutes
After 15 minutes, a second dose of diltiazem 0.35 mg/kg IV may be given if needed
For patients older than 65 years old, recommend maximum initial dose of 10 mg IV and a maximum second dose of 20 mg
Metoprolol 5 mg IV given over 1–2 minutes. May repeat as needed q 5 minutes for a total of 3 doses
160
Wide Complex Tachy - Stable
Amiodarone 150 mg IV over 10 minutes. May repeat once as needed
Procainamide 20–50 mg/min until arrhythmia suppressed, hypotension ensues, QRS duration increases greater than 50%, or maximum dose 17 mg/kg given Maintenance infusion: 1–4 mg/min, Avoid if prolonged QT or CHF
Lidocaine 1–1.5 mg/kg IV
May be repeated at 5-minute intervals for a maximum dose of 3 mg/kg IV
Adenosine 6 mg IV (proximal site) followed by 10 mL fluid bolus, If monomorphic tachycardia continues, give adenosine 12 mg IV
161
Wide Complex Tachy - unstable
Synchronized cardiovert 100j
162
ROSC Protocol
Obtain 12 lead
10 breaths a min
Titrate Fluids and or Vasopressors to 90 systolic / map 65
TARGET TEMP MANAGEMENT
H and Ts
163
Name beta blockers and calcium channel blockers
Beta Blockers:
Atenolol
Metoprolol
Propranolol
Carvedilol
Calcium Channel Blockers:
Amlodipine
Nifedipine
Verapamil
Diltiazem
(may give for SVT)
Beta Blockers (e.g., Metoprolol): Decrease heart rate and contractility.
Calcium Channel Blockers (e.g., Diltiazem): Dilate vessels and slow AV node conduction.
164
SVT hr and Tach hr
SVT - over 150
tachy - over 100
165
Steps for Pacing
unstable under 50 bpm
set rate to 80
set CURRENT till both electrical capture and mechanical
166
CP
if o2 is less than 90% give 4ltrs nc
no nitro if systolic less than 90
hr less than 50
Inferior wall MI Right sided involvement
PD drugs within 24 hrs
give nitro
then give Morphine: 2-4mg IV then 2-8mg after 5 mins
167
Bradycardia how much Atropine can you give?
1mg IV Atropine
every 3-5 mins (total 3mg)
note: with hold on type II 2nd degree and 3rd degree
168
What do you give for TCA over dose
what are signs
name some TCA drugs
give Sodium Bicarb
signs:
ams, seizures, wides QRS, hypotension, Dry, dilated
Amitriptyline
169
What is the Ped dose for Dextrose D10
5 mL/kg IV
170
what is the Ped dose for Benadryl
1mg /kg IV SLOWQ
171
What is the Ped dose for Neb Epi and when
Croup treatment
0.01mg/kg EPI IM (max 0.5mg)
Dexamethasone 0.5mg/kg IV (max 10mg)
then neb epi 2.5mL of 1mg - 2.5mg
stridor, labored
Transport to the closest medical - neb epi
172
Whats the compression rate for PED
30:2 - 1 person
15:2 - 2 people
173
What is the Defib J setting for PED code
2, 4, 6, 8, 10
174
PED svt, what is the bad hr for infant and Child
what is the J setting for cardioversion
what is the Drug and dose
infant - over 220
child - over 180
J setting - 1j/kg, then 2j/kg
Adenosine - 0.1mg/kg rapid
then 0.2 mg/kg rapid (max dose 12mg)
Regular Narrow Complex Tachycardia – Stable (SVT)
1. Perform vagal maneuvers
2. Adenosine 0.1 mg/kg (maximum of 6 mg)
a. If unsuccessful, may repeat with 0.2 mg/kg (maximum of 12 mg)
ii. Regular Narrow Complex Tachycardia – Unstable
1. Deliver a synchronized shock: 0.5–1 J/kg for the first dose
2. Repeat doses should be 2 J/kg
iii. Regular, Wide Complex Tachycardia — Stable
1. Consider adenosine 0.1 mg/kg (maximum of 6 mg) for SVT with aberrancy
2. Otherwise give amiodarone 5 mg/kg IV (maximum of 150 mg) over 10 minutes
iv. Regular, Wide Complex Tachycardia – Unstable
1. Synchronized cardioversion 0.5–1.0 J/kg
175
CHF treatment
12 lead ekg (if inferior wall MI consult first)
IV
O2 less than 94% give O2
BP before each dose
nitro 0.4mg q 3-5mins max 1.2mg and 1 inch nitro paste
CPAP
if systolic drops below 90 give 250mL bolis may repeat once
if hypo still give 1mg of epi in 100mL 60 drops/min titrate to 90sys
geriatric, hypertension, sob, resp dis, wheezing,
176
What is the Min age for CPAP
13 years old
177
From the fire house:
- Get to Rainier Manor
- Where is the Plug, FDC?
- What is the Address?
- How many floors
- What is the Map Page?
- Right out of the firehouse, Right on 34th Street, Left on Rainier, Right on 30th, (Apt on Right)
- Plug on 30th Side A, FDC on side A
- 3001 Queens Chapel Road
- 4 Floors
- Page 13 (top left)
178
How many intakes, how many discharges on PE855?
3 intakes (front, 2 sides)
6 discharges? (1 front, 4 rear, plus side)
179
What is the priority when forcing a door with multi locks
highest lock first and work downward
180
What should the driver do if the hydrant is not operational
notify command and attempt to establish an alternative water supply
181
What must the driver do before engaging the pump
parking brake, neutral, pump gear
182
What is the drivers role in standpipe operations during a high-rise fire
Connect to FDC, establish water flow and monitor system
183
What steps must the Driver take when switching from tank water to hydrant water
open the intake valve slowly, close the tank to pump, and confirm water pressure from the hydrant
184
What is the correct pump pressure for supplying a high rise Stand pipe?
150psi, plus 5psi per floor above the ground floor
185
What is the formula for determining pump pressure when supplying an attack line, and how does it account for nozzle pressure, friction loss, special appliances, and elevation?
PP = NP + FL + SA +/- E,
186
Fire Study
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