Epinephrine Auto Injector
A Lifesaving Tool Now In the Hands of the EMT-B
POST TEST
1) N.J.S.A. 26:2K-47.1 and OEMS Policy require the EMT-B has to do which of the following to
be permitted to administer an Epinephrine Auto Injector?
a) Act under the general authority of a physician medical director
b) Must complete an approved training program
c) Be affiliated with a BLS agency that is registered with NJ OEMS for the Epinephrine Auto
Injector Program
d) All of the above
2) Which statement is FALSE about the role of the Medical Director in the Epinephrine Auto
Injector Program?
a)
b)
c)
d)
Provides On-line Medical Control
Will provide the prescriptions for the Epinephrine Auto Injectors
Responsible for all clinical aspects of the MONOC EpiPen Program
Training and Quality Assurance
3) Which statement is TRUE about Anaphylaxis?
a) Anaphylaxis is over reported and occurs in predictable patterns
b) Anaphylaxis is a localized allergic reaction that usually progresses gradually
c) Anaphylaxis leads to 200 deaths a year and most cases are accidental exposures.
Immediate Treatment = Saved Lives
d) Anaphylaxis is easy to avoid if you know what you are allergic to
4) What substance is released by cells into the body and causes the signs and symptoms of an
Anaphylactic Reaction?
a)
b)
c)
d)
Allergen
Histamine
Epinephrine
Carbon Dioxide
5) Which of the following are common triggers of Anaphylaxis?
a)
b)
c)
d)
6)
Foods – Nuts, Fish, Wheat
Stings – Bees, Wasps, Hornets, Fire Ants
Latex – Especially for healthcare workers
All of the above
How many Anaphylaxis patients present with urticaria (hives)?
a)
b)
c)
d)
100% All Anaphylaxis patients
Greater than 80%
Less than 20%
0% Urticaria is not a sign of Anaphylaxis
Epinephrine Auto Injector
A Lifesaving Tool Now In the Hands of the EMT-B
POST TEST (Continued)
7) What conditions might mimic Anaphylaxis?
a)
b)
c)
d)
Foreign Body Airway Obstruction
Acute MI and CHF
Asthma and Other Respiratory Impairments
All of the above
8) Common sympathomimetic Side Effects of Epinephrine are:
a)
b)
c)
d)
Tachycardia, Apprehension, Sweating, Tremors, Dizziness, Pallor, and Nervousness
Bradycardia, Apprehension, Sweating, Tremors, Dizziness, Pallor, and Sleepiness
It is a natural hormone released in response to stress – therefore it has NO side effects
It is a sympathomimetic drug - therefore it has a calming effect on the body
9) The route an Epinephrine Auto Injector delivers medication by is:
a)
b)
c)
d)
SQ – Subcutaneous
IV – Intravenous
IM – Intramuscular
SL – Sublingual
10) The site the EMT-B can use to administer an Epinephrine Auto Injector is:
a)
b)
c)
d)
The Vastus Laeralis muscle of the quadriceps – located on the buttocks
The Vastus Laeralis muscle of the quadriceps – located on the anteriolateral thigh
The Deltoid muscle – located on the medial aspect of the upper arm
The Femoral Vein – located on the anteriomedial aspect of the thigh
11) When should the EMT-B use the EpiPen® Jr according to the New Jersey OEMS?
a)
b)
c)
d)
Only for patients under 33 pounds
Only for patients under of 4
Only for patients under 20 pounds
Only for patients under age of 8
12) How can the EMT-B estimate patient weight or age?
a)
b)
c)
d)
Ask the Parent
Broselow Tape
Pedi-Wheel
All of the Above
13) What maintenance procedure should be followed periodically to assure the Epinephrine Auto
Injector is ready for use?
a) Look for the RED FLAG in the window to see if the drug has expired
b) Keep the Epinephrine Auto Injector refrigerated
c) Check for the expiration date on the side of the Auto Injector and look at the window to
check for drug clarity
d) Check for drug clarity by removing the gray safety cap
Epinephrine Auto Injector
A Lifesaving Tool Now In the Hands of the EMT-B
POST TEST (Continued)
14) You arrive on scene for a patient having “an allergic reaction to a bee sting”. The scene is
safe. You put on appropriate BSI and confirm that ALS is en route for your single patient.
Which of the following is the PROPER ORDER for these steps of patient assessment?
a) Check and Open the Airway, Assess Breathing, Provide Oxygen, Assess Pulse and
Circulation, Obtain Baseline Vital Signs, Perform a SAMPLE History
b) Perform a SAMPLE History, Check and Open the Airway, Assess Breathing, Provide
Oxygen, Assess Pulse and Circulation, Obtain Baseline Vital Signs
c) Provide Oxygen, Check and Open the Airway, Obtain Baseline Vital Signs, Assess
Breathing, Assess Pulse and Circulation, Perform a SAMPLE History
d) Check and Open the Airway, Assess Breathing, Assess Pulse and Circulation, Obtain
Baseline Vital Signs, Perform a SAMPLE History, Provide Oxygen
15) You find the above patient with generalized urticaria, dyspnea and wheezing, and swelling of
the tongue. This patient is an 8 year old male who weighs 90 pounds. You find the patient
has his own Epinephrine Auto Injector with him but has not used it because it expired last
month. He has a pulse of 144 bpm and a BP of 64 systolic. What should you do?
a)
b)
c)
d)
You cannot treat this patient without the parents consent – Wait until ALS arrives
Use the patient’s expired Epinephrine Auto Injector
Use the Epinephrine .3 mg “Adult” dose Auto Injector for this patient from your stock
Use the Epinephrine .15 mg “Junior” dose Auto Injector for this patient from your stock
16) You are preparing to administer an Epinephrine Auto Injector to an Anaphylaxis patient. This
patient’s reaction is from something he ate. Which of the following is the PROPER ORDER
for these steps of Epinephrine Auto Injector administration?
a) Massage the area, Remove the Safety Cap, Check for expiration and drug clarity, Insert
into the Vastus Laeralis muscle of the quadriceps and remove immediately
b) Check for expiration and drug clarity, Remove the Safety Cap, Insert into the Vastus
Laeralis muscle of the quadriceps and hold for 10 seconds, Massage the area
c) Check for expiration and drug clarity, Insert into the Femoral Vein and hold for 10
seconds, Remove the Safety Cap, Massage the area
d) Check for expiration and drug clarity, Remove the Safety Cap, Massage the area, Insert
into the Vastus Laeralis muscle of the quadriceps and remove immediately
17) You just removed the Safety cap and are ready to administer an Epinephrine Auto Injector to
an Anaphylaxis patient. How should you hold the Auto Injector when placing it on the site for
the Epinephrine injection?
a) Wrap your hand in a fist around the Auto Injector being careful to keep your fingers away
from both ends. Place against the site and press firmly.
b) Hold your finger over the black end opposite from where the Safety cap was removed.
Place against the site and press firmly.
c) Do not remove the safety cap until you place the Epinephrine Auto Injector against the
site and press firmly. Hold for 10 seconds and then remove the Safety cap.
d) Hold your finger over the end from where the Safety cap was removed. Place against the
site and press firmly on the activation button with your thumb.
Epinephrine Auto Injector
A Lifesaving Tool Now In the Hands of the EMT-B
POST TEST (Continued)
18) Which statement is TRUE about Anaphylaxis?
a) ALS care is not necessary once the EMT-B administers an Epinephrine Auto Injector
b) There is no need for prompt transport if an EMT-B can administer an Epi Auto Injector
c) ALS and prompt transport are essential elements of good patient care for Anaphylaxis
d) The EMT-B must have on line Medical Control to administer an Epinephrine Auto Injector
19) Which statement is FALSE? After administering an Epinephrine Auto Injector:
a) Do not move the patient until ALS arrives
b) Perform an Ongoing Assessment - Monitor with Vigilance
c) Biphasic reactions are treacherous and more difficult to treat than the initial episode
d) Repeat second Epinephrine dose if signs and symptoms persist after 10-15 minutes
20) Which statement is FALSE? Elements of Documentation after administering an Epinephrine
Auto Injector include:
a) Document on the PCR Location of the Injection Site, Medication Name and Dose, Time
Epi was Administered, Vital Signs Pre and Post Epi, and changes in patient’s condition
b) Leave a copy of the PCR at hospital, mail a copy to MONOC, and mail a copy to OEMS
c) The PCR is reviewed by the Medical Director for Quality Assurance
d) There is no requirement to give anyone a copy of your PCR unless subpoenaed
21) After administering an Epinephrine Auto Injector the EMT-B should:
a) Not be concerned since the needle retracts automatically
b) Be careful of the exposed needle and take the used Auto Injector to the hospital
c) Discontinue the use of oxygen
d) Casually monitor the patient – The emergency will soon be over
22) Your Initial Assessment shows a 20 year old male with Agonal Respirations at 6 breaths a
minute. He has a radial pulse at 120 a min. How should the EMT-B manage this patient?
a) Use a 2 rescuer BVM technique and ventilate at 10 to 12 times a minute
b) Use a 1 rescuer BVM technique and ventilate at greater than 20 times a minute
c) Ventilate at 8 times a minute until ALS arrives
d) Place a non rebreather mask on the patient at 10 to 15 lpm
23) You are doing 2 rescuer CPR on a 40 year male. How should the team perform Quality CPR?
a) 15 compressions to 2 ventilations at a rate of 60 a minute
b) 30 compressions to 2 ventilations at a rate of 60 a minute
c) 30 compressions to 2 ventilations at a rate of 100 a minute
d) 15 compressions to 2 ventilations at a rate of 100 a minute
24) The ALS team has arrived on location with your 40 year old CPR in progress. How can the
EMT-B work with the Paramedics?
a) Perform the Sellick Maneuver (Cricoid Pressure)
b) Once an ET tube is in place deliver continuous compressions and ventilate the patient at
a rate of 8 to 10 times a minute
c) Maintain Quality CPR – Make every compression count to maintain maximum CPP
d) All of the Above
25) TRUE or FALSE? The EMT-B can find additional information on Anaphylaxis on the internet
at Anaphylaxis.com and EpiPen.com:
a) TRUE
b) FALSE