NREMT Paramedic Cognitive ExamOperationsHard
A paramedic is called to a nursing home for an 85-year-old female patient with a suspected hip fracture after a fall. Upon arrival, the paramedic performs a rapid assessment and finds the patient conscious, alert, and in severe pain. The patient has a valid Physician Orders for Life-Sustaining Treatment (POLST) form indicating 'Comfort Measures Only.' How should the paramedic proceed with pain management?
- AAdminister opioid analgesics as needed to alleviate suffering.
- BAdminister only non-pharmacological pain relief measures.
- CWithhold all pain medication due to the 'Comfort Measures Only' order.
- DConsult medical control for clarification before administering any medication.
Show answer & explanationAnswer & explanation
Correct answer: A. Administer opioid analgesics as needed to alleviate suffering.
A 'Comfort Measures Only' order, such as on a POLST form, explicitly allows for and often prioritizes aggressive pain and symptom management to ensure the patient's comfort. Withholding appropriate pain medication would be contrary to the intent of such an order. Opioid analgesics are often necessary and appropriate for severe pain in these situations.
Why the other options are wrong
- B. While non-pharmacological measures are helpful, they are often insufficient for severe pain, and the order does not preclude pharmacological relief.
- C. This is a misinterpretation of 'Comfort Measures Only'; this order specifically allows for aggressive symptom management, including pain relief.
- D. While medical control can always be consulted, the 'Comfort Measures Only' order typically gives clear guidance to treat pain aggressively without delay.
POLST 'Comfort Measures Only'
A medical order indicating that the patient desires interventions focused solely on symptom management, pain relief, and maximizing comfort, without initiating life-prolonging treatments.
- Prioritizes patient comfort and dignity.
- Does NOT mean withholding pain medication; often means aggressive pain management.
- Respects patient's wishes for end-of-life care.
- Is a legally binding medical order.
Memory trick: POLST for Comfort Means Pain Relief is a Must.