November Workbook Questions – Annotated Answer Key
BOTH Pg 2
Scope of Practice
BOTH Pg 3
General Patient
Assessment
BOTH Pg 4
General patient
assessment (cont)
BOTH Pg 7
Withholding or
Withdrawing
Resuscitative Efforts
Classify each of these skills
ECG interpretation (ALS)
12-Lead acquisition (BLS)
Hemorrhage control (EMR)
Splinting/bandaging (BLS)
Quality CPR (EMR)
Epinephrine IM (BLS)
Diphenhydramine IV (ALS)
Capnography monitoring (BLS)
Which of the following would NOT part of the scene size-up?
a. Does the patient have a DNR/POLST form?
b. Is this a potential crime scene?
c. Do we need more help?
d. Is the patient’s airway obstructed? (part of ABCs)
A patient that is identified as time-sensitive priority transport means
that the transporting crew has authorization to drive as fast as they
want to reach the hospital.
FALSE
Older DNR forms must be upgraded to the new POLST Form.
FALSE – can use the old forms as well, just need to be signed
appropriately
Components of a valid POLST form MUST contain 3 signatures and:
___________ __________________ _____________
Patient name, resuscitation orders (section A), date
The three signatures must be:
Patient or legal representative signature
Witness signature
Authorized practitioner name and signature
ALS
BLS
Pg 12
Drug-Assisted
Intubation
Pg 13
Allergic Reactions /
Anaphylactic Shock
A son with Power of Attorney authorization wants to change the
POLST form signed by his dying father. Can he do that?
What should the crew do?
He can’t change the original – must excute an updated one. Crew
should follow what they have; if unsure, call OLMC
An adult patient with an abdominal injury needs to be intubated; his
gag reflex is intact. He weighs 180 lbs. Ketamine is packaged 500 mg
in a 10 mL vial. How much should you give? _____mL.
81 kg x 2 mg/kg = 192 mg.
(192 mg x 10 mL) / 500 mg = 3.84 mL
(accept 3.8 or 3.84, not 3)
An adult was stung by a bee. Assessment reveals a runny nose, eyes
tearing and itching and a rash at the site. The patient weighs 160 lbs.
What is the patient’s weight in KG? 72 kg
The EMT should administer what drug? Diphenhydramine
How much? 72 kg x 1 mg/kg = 72 kg MAX is 50 mg so give 50 mg
BOTH
BOTH Pg. 16
Acute Coronary
ALS
Pg. 17
Bradycardia
ALS
Pg. 19
Wide Complex
Tachycardia
An adult patient is having an anaphylactic reaction to eating shellfish.
You need to administer epinephrine.
What concentration? 1 mg/1 mL
How much? 0.5 mg or 0.5 mL
What route? IM Where? Vastus lateralus muscle – thigh
The initial 12-Lead ECG should be acquired with _____ minutes of
patient contact. 5 minutes
A 67-yo has a heart rate of 38, has an altered mental status, BP
70/palp, pale and diaphoretic. No ST elevation seen on the 12-lead
ECG. Patient weighs 154 lbs. Atropine is not working. You decide to
start a drip of norepinephrine.
(STRIP) What is this ECG? Sinus brady with 1st deg block
What is the initial dose? 8 mcg/min or 2 mL/min
How do you mix this? 4 mg/4mL added to 1000 mL bag
Based on using 20 drip/mL administration set, how many drips per
minute should you give? 40 drips/minute
A 72-yo is c/o chest palpitations and says ‘My heart is trying to jump
out of my chest!’ BP 142/88, HR 138, RR 20.
STRIP: Ventricular tachycardia
What drug should you give? AMIODARONE
Dose: 150 mg
How: IVPB over 10 minutes
What size IV Bag? 100 mL
Tubing size? MINI DRIP (60)
A 56-yo is c/o nausea and ‘not feeling right’. BP 160/102.
STRIP: TORSADES
What drug should you give? Magnesium (50%)
Route: IVPB over 5-10 minutes
He suddenly becomes unresponsive. Has a weak carotid pulse.
What should you do? Defibrillate
BOTH Pg 20
Ventricular
Fibrillation
Put these events in proper order:
Pause compressions just long enough to determine if shockable #3
Resume chest compressions for 2 minutes #6
Begin quality CPR with compressions #1
Pause compressions just long enough to deliver a shock #5
Apply defib pads when monitor is available #2
Resume compressions while monitor is charging #4
ALS
If cardiac arrest was caused by an overdose of tricyclic
antidepressants, administer: Sodium bicarbonate
ALS
Pg. 21
Asystole/PEA
BLS
Pg. 22
Heart
Failure/Cardiogenic
Shock
BOTH Pg. 23
LVAD
ALS
Pg. 24
Dialysis/Chronic
Renal Failure
BOTH Pg. 26.
Altered Mental
Status
BOTH Pg. 27
Drug
Overdose/Poisoning
ALS
Pg 28
Cyanide Exposure
BOTH Pg 29
Match the possible treatments to the correct contributing factor
(Hs&Ts)
Hypoxia – ventilate / O2
Hypovolemia – Fluid boluses
H ion (acidosis) – Sodium bicarbonate
Hypothermia – core rewarm
Hyperkalemia – Sodium bicarbonate
Hypoglycemia – check sugar - Dextrose
Toxins – opiate – narcan
Tamponade, cardiac – IVF
Thrombosis (coronary/pulmonary) – rapid transport
Tension pneumothorax – pleural decompression
You are treating a CHF patient is CPAP at 10 cm PEEP. Suddenly, the
patient become unresponsive. Pulse is 100/min, BP 102/50.
What should you do with the CPAP? REMOVE IT IMMEDIATELY and
assess the patient’s airway and breathing
A patient with an LVAD is unconscious and not breathing. It is
dangerous to defibrillate the patient without disconnecting the
pump.
FALSE
Your patient is a 48/yo found unresponsive during her dialysis
treatment. She is pulseless and not breathing.
THE CREW BEGINS CPR – AFTER STARTING A LINE, THE PARAMEDIC
SHOULD ADMINISTER:
SODIUM BICARBONATE 50 MEQ IVP SLOW OVER 5 MINUTES.
If your AMS patient has a history of presyncope/syncope, consider
the need for acquired a ______________.
12-lead ECG
T/F: Incontinence is common with syncope; rare with seizures.
FALSE
Your patient may have taken an overdose of Norco. If the patient is
apneic, what is the correct dose of Naloxone that should be
administered?
1 mg
Select the correct treatment for each of these drug overdoses:
Atenolol glucagon
Amitriptyline sodium bicarb
Coricidin Cough & Cold sodium bicarb
Percodan Naloxone
Insecticides atropine
After obtaining authorization from OLMC, if antidotes are available,
you may administer:
Amyl nitrite inhalants 1 per minute
OR
Hydroxocobalamin 5 gm IVPB over 15 minutes
Mild hypothermia 90.6o to 95o F
Moderate hypothermia 82.4o to 90.6o F
ALS
Environmental: Cold
Emergencies
BLS
BOTH Pg. 30
Environmental:
Submersion incident
BOTH Pg. 31
Environmental: Heat
Emergencies
Severe hypothermia < 82.4o F
What ECG changes might you observe in patients with hypothermia?
Osborn or J wave in leads II and V6
Classify each of these rewarming strategies as either passive or active
external rewarming:
Passive: cover with blankets, protect head from heat loss
Active: apply surface warming devices (wrapped hot packs,
warming mattress – if available)
An adult fisherman that fell overboard was brought to shore. He had
a rapid, weak pulse but was apneic. EMS administered BVM
ventilations and the patient began to breathe on his own. He is now
awake, A&O x 4 and doesn’t think he needs to go to the hospital with
you. What do you tell him?
A. As long as he is not alone, you are OK with not transporting
him.
B. Obtain a 12-lead ECG. If it is normal, be does not need to go
to the hospital.
C. Advise the patient that he really should be transported to the
hospital for evaluation and monitoring.
D. If the patient continues to argue with you, restrain him and
administer midazolam IN.
Answer: C
Classify these patients as having possible heat cramps, heat
exhaustion, or heat stroke:
#1 – 42-yo construction worker, sweating profusely, c/o N/V, A&Ox4
– has been roofing a house, temp in 90s with high humidity
Heat exhaustion
#2 – 22-yo runner that just finished a 10K race on a very warm spring
morning; A&Ox4, mild sweating, c/o severe leg muscle spasms.
Heat cramps
BOTH Pg 32
Glucose/Diabetic
Emergencies
#3 – 38-yo firefighter working a basement fire; his skin is red, hot and
dry, HR 124, he appears confused
Heat stroke
Respond for a 38-yo at local grocery store with AMS. Pt is pale and
diaphoretic, no history available. She is confused and combative. HR
110, RR 20, BP 102/72, lungs clear. Blood glucose is 38. How do you
manage this patient?
BLS – Glucagon 1 mg IM/IN
ALS – Dextrose 10% (25 g/250mL) IVPB rapidly (wide open) entire
bag
ALS
Pg. 33
Hypertension
72-yo c/o severe headache. She denies chest pain and her lungs are
clear. BP 200/108. HR 92, RR 18. As you prepare her for transport,
she asks if she can have “something to help this pain.”
ALS
p. 34
Psych/Behavioral/
Agitated/Violent
BOTH p. 35
Stroke
ALS
p. 38
Shock
What do you administer? Fentanyl 0.5 mcg/kg IVP/IN/IM/IO
Any special considerations when positioning her on the cot?
Maintain head and neck in neutral alignment; do not flex neck or
knees
You are called to the local PD for an extremely agitated subject.
Patient is 23-yo male that is waving his arms, yelling and kicking at
the six police officers that are attempted to restrain him. He appears
to be sweating profusely. He is shouting obscenities and keeps
yelling about people trying to kill him. The officers manage to wrestle
him to the ground and your crew restrains him on a long spine board,
however he continues to struggle and scream. When you try to exam
him, he spits at you and yells incoherently.
What condition do you suspect? Agitated delirium
Treatment? Ketamine 4 mg/kg IN/IM
Fill in the blanks.
Determine the last time the patient was _____. Seen normal
Attempt to limit scene time to _____ 10 minutes
Obtain _____ from reliable historian if not accompanying pt to
hospital call back number
Determine if patient has taken any ____ within the past 48 h ours
Anticoagulants / blood thinners
For patients with a positive EMS stroke screen that are stable and last
know well within 3.5 to 6 hours: transport to a comprehensive stroke
center if: ______ time from scene to CSC is 30 minutes or less
List the three criteria for qSOFA:
AMS (GCS<15), RR≥22, SBP≤100
An EtCO2< _____ correlates to a lactate reading ≥ 4. 25
You have an adult patient that you suspect is septic. His BP is
70/palp. You place the patient on O2 and begin IV fluid boluses. How
much fluid should be infused before you decide to administer a
vasopressor?
500 mL
We now use norepinephrine. What is the initial dose?
8 mcg/min (2 mL/min)
How often should you retake the BP? Every 2 minutes
Target? SBP≥90 (MAP≥65)
Maintenance dose? 2 to 4 mcg/min (0.5 mL to 1 mL/min)
BOTH Pg. 41
Trauma Triage /
Transport criteria
Classify each injury as to ideal transport destination:
A> Level I – Time Sensitive
B> Nearest Trauma Center, Level I or II
C> Nearest hospital – trauma or non-trauma center
Traumatic arrest A
Open skull fracture A
Blunt chest injury/stable patient B
Single long bone injury/stable patient C
Stab wound to the abdomen A
GCS 14-15 B or C
Amputation distal to wrist B
Motorcycle crash > 20 mph B
BOTH Pg. 42
Post-Taser Care
Pg. 43
Burns
BOTH
BOTH
ALS
ALS
BOTH Pg 44
Thermal Burns
Both
Pg 45
Chest Trauma
Open pneumothorax
Your patient is a 3-yo with scald burns to the abdomen and the front
of both legs. Patient is awake & crying; BP 100/60, HR 120, RR 22
Using the Rule of Nines, what is the TBSA? 17%
Burns appear red, moist with blisters. Classify: Partial thickness
Initial NS IVF? 125 mL/hr
Drip rate using 20-drip set? ~42 drips/minute (1 drip every 1-1/2
seconds)
To minimize contamination, cover burns with ______ and apply dry
sterile dressings
Plastic wrap
Why? ↓ air movement over burn, ↓ pain; ↓ fluid loss, prevent
hypothermia and contamination
Wound covering preferred? Gloved hand followed by vented
commercial device
What else? Vaseline gauze or defib pad
Pericardial
Tamponade
What is the target systolic BP? 80 (permissive hypotension)
Blunt Aortic Injury
And Cardiovascular
Injury
List four (4) S&S of aortic injury
Chest pain, intrascapular pain, difficulty breathing or swallowing,
upper extremity HTN, bilateral femoral pulse deficit
ALS
ALS
If patient has not had _____ in the last 10 years, advise them to
acquire it. Tetanus immunization
Pg. 47
Head Trauma/TBI
Which of these arrhythmias might you see in patients with blunt
cardiac injury?
A. New atrial fib/flutter
B. Right BBB
C. Ventricular tachycardia
D. All of these are possible
For patients with multi-system trauma with TBI, target a systolic
blood pressure range of:
110-120
Patients with TBI should not be on capnography.
FALSE – ETCO2 readings can assist in achieving appropriate
ventilatory rates
BOTH Pg 49
Spine Trauma
Which of these are considered positive mechanisms resulting in
higher risk for injury?
A 43-yo falling 5 feet off a ladder onto the grass – NO
A 65-yo knocked off their bicycle by a car backing up in a parking lot –
YES
A 23-yo with an arrow impaled in his neck, both ends visible – YES
A 12-yo fell 6 ft off a swing set– NO
A 19-yo that crashed a motorcycle into a parked car at 35 mph – YES
A 50-yo that sustained a 3” laceration to the lateral forehead when
he walked into a light fixture – NO
ALS
Neurogenic Shock
A 19-yo was thrown from a roll-over MVC; his faced is pale &
diaphoretic and tells you he can’t move his legs. On exam, you notice
warm, dry skin below the waist. After spinal immobilization, you
move him to the ambulance and begin transport. Vitals: BP 74/50,
HR 40, RR 20. The crew starts the patient on oxygen, establishes an
IV and begin 200 mL fluid challenges. After 500 mL of fluid, the
patient’s vital remain unchanged. You should administer:
Atropine 0.5 mg rapid IVP.
The patient has received the maximum dose of the previous
medication. His BP is 78/52. What should you administer next?
Norepinephrine 8 mcg/min (2 mL/min) IVPB
Both
Pg. 51
MPR
When arriving on the scene of a MPI, while EMS Responder #1
notifies dispatch, EMS Responder #2 should:
Begin triaging all patients using START/JumpSTART Triage
BOT
Pg 55
Active Shooter
Response
While triaging patients at an MCI., your next patient is a 4-yo that is
not breathing. What should you do next?
A. Tag the child ‘DECEASED’ at move on
B. Deliver 5 rescue breaths
C. Position the airway and check for breathing
D. Have another rescuer begin chest compressions
Answer: C
Matching – definitions with terms
Active shooter event
Cold zone
Hot zone
Soft lockdown
Hard lockdown
Contact team
Concealment
Pg 57
Both
Both
Pg 57
Widespread
Disease Outbreak
Pg 58
Abuse
Pg 59
Trauma in
Pregnancy
What is the phone # for the 24 hour dispatch for IEMA?
217-782-7860
T/F – EMS providers are required by Illinois law to give suspected
abuse victims information on services available to them.
True
Your patient is a 24-yo pregnant patient that was in a motor vehicle
collision. She is complaining of neck and back pain; her neck is tender
to palpating. The crew has applied a C-collar. The gestational age is
28 weeks. When transporting this patient, the EMS provider should:
A. Know that a long spine board is contraindicated; allow
the patient to sit up
B. Secure the patient to a long spine board and tilt the
patient to one side
C. Place the patient in the Trendelenburg position for best
perfusion
D. Allow the patient to assume a position of comfort after
removing the C-collar
Both
Pg 62
Delivery
Complications
Answer: B
Your crew responds for a woman in labor at home. On arrival, the
patient is in the middle of a contraction. Her husband says that her
‘bag of waters broke about 10 minutes ago’ and her contractions are
about 2 minutes apart. When you inspect for crowning, you notice a
loop of umbilical cord hanging outside her vaginal opening. The EMS
provider should:
A. Cover the exposed cord with a moist dressing and keep
it warm.
B. Place the patient supine on the cot and elevate her hips.
Both BLS & ALS
T/F – EMS providers are required by Illinois law to give suspected
abuse victims information on services available to them.
True
P 59 – Trauma in Pregnancy
Both BLS & ALS
Your patient is a 24-yo pregnant patient that was in a motor vehicle
collision. She is complaining of neck and back pain; her neck is tender
to palpating. The crew has applied a C-collar. The gestational age is
28 weeks. When transporting this patient, the EMS provider should:
A. Know that a long spine board is contraindicated; allow
the patient to sit up
B. Secure the patient to a long spine board and tilt the
patient to one side
C. Place the patient in the Trendelenburg position for best
perfusion
D. Allow the patient to assume a position of comfort after
removing the C-collar
Answer: B
P 62 – Delivery complications
Both
Your crew responds for a woman in labor at home. On arrival, the
patient is in the middle of a contraction. Her husband says that her
‘bag of waters broke about 10 minutes ago’ and her contractions are
about 2 minutes apart. When you inspect for crowning, you notice a
loop of umbilical cord hanging outside her vaginal opening. The EMS
provider should:
A. Cover the exposed cord with a moist dressing and keep
it warm.
B. Place the patient supine on the cot and elevate her hips.
C. Keep pressure off the cord with a gloved hand inserted
into the vagina, applying steady upward pressure on the
presenting part
D. All of these are appropriate to do.
Both
Pg 63
Newborn
Resuscitation
Answer: D
A newborn that was delivered approximately 10 minutes ago. HR 150
and strong, RR 40. The skin is pink centrally but she has cyanosis in
her distal extremities.The EMS provider should know that:
A. This is a true emergency – transport the patient and the
newborn immediately
B. The newborn is severely hypoxic and needs BVM
ventilation.
C. This is a common finding in the newly born infant –
continue to monitor
D. This is a sign of severe hypovolemia – begin fluid
challenges immediately
Answer: C
ALS
Your pregnant patient (32 weeks) called 911 for a severe headache
and diplopia. You note that her hand and feet are severely
edematous. Her initial BP is 190/100. You establish an IV and
suddenly, she begin to have a seizure. You need to administer
Drug:_____________. Dose____________ Route_____________
Time frame
Magnesium 50%.
2 Gm. IVPB. Over 5-10 minutes
ALS
Pg 64
Pre-Eclampsia or
Hypertension of
Pregnancy
BOTH Pg 65 - 68
Pediatric Patients
Fill in the blanks regarding IMC special considerations:
1. GENTLE handling, QUIET environment
2. Position the patient on their SIDE and manually
DISPLACE the uterus.
3. Anticipate SEIZURES; prepare suction, MAGNESIUM and
MIDAZOLAM.
4. Do not check PUPIL LIGHT REFLEX
5. LIGHTS and SIRENS may be contraindicated.
Complete the table on ages:
Newborn: neonate in first minutes to hours following birth
Neonate: infants in the first 28 days of life
Infant: neonates to 12 months
Child: 1 to 12 years
List the three components of the Pediatric Assessment Triangle:
General appearance, work of breathing, circulation to the skin
Size of child can be estimated using a ___ length-based tape
Target SpO2 should be ___% to ____%. 94 – 98
Complete this list of conditions that require rapid cardiopulmonary
assessment and/or potential cardiopulmonary support:
1. Respiratory rate > 60 breaths/min
2. Increased work of breathing (retractions, nasal flaring,
grunting), respiratory fatigue and/or failure.
3. Heart rates (weak, thready, or absent peripheral pulses)
Child ≤ 8 yrs: <80 BPM or >180 BPM
Child > 8 yrs: <60 BPM or >160 BPM
4. Poor perfusion, dysrhtyhmias, chest pain
5. Altered LOC (syncope, unusual Irritability or lethargy or
failure to respond to parents or painful procedures.
6. Seizures
7. Trauma
8. Post-ingestion of toxic substances
9. Fever with petechiae
10. Burns involving > 10% BSA
11. Hypoglycemia
Which of the following is considered appropriate non-pharmacologic
pain management for the pediatric patient?
A.
B.
C.
D.
Use of cold packs
Parental presence
Distraction
All of these are appropriate
Answer: D
While it is best to transport infants and children in an approved child
restraint system, exception should be made for the newborn if the
mother needs to nurse the child during transport.
FALSE
ALS
Pg 70
Ped Airway Adjuncts
Complete the statement:
Children < 12 shall have airways secured using BLS adjuncts and
interventions
An 10-yo is apneic and pulseless after falling out of a boat. Chest
compressions were begun immediately. An oropharyngeal airway
has been inserted and that patient’s airway manually opened and
suctioned, but BVM ventilations are not successful. What should a
paramedic do to secure the airway?
Call OLMC and get permission to make 1 attempt at an advanced
airway
You are attempting to intubate a pediatric patient weighs 60 lbs.
What medication should be used to premedicate this patient?
Benzocaine 1-2 sec spray, 30 sec apart x 2
What drug is used to sedation? Ketamine
You have a vial on hand with 500 mg in 10 mL.
How many mL should you administer IVP?
60 lbs = 27 Kg; 2 mg/kg x 27 kg = 54 mg.
54 mg x 10 mL / 500 mg = 1.08 mL or 1.1 mL
BOTH P 73
Peds Allergic
Reaction
BOTH Pg 74
Peds Asthma
ALS
A 5-yo was bit by ‘some kind of bug’. The patient has a runny nose,
eyes are tearing and he is sneezing. What is an appropriate dose of
diphenhydramine for this patient if the weight 40 lbs?
40 lbs = 18 kg. 18 mg.
It comes in a preload with 50 mg in 1 mL. How many mL should you
give? 0.36 mL (0.4 mL)
For the pediatric patient experiencing wheezing with an asthma
attack, they should be given only albuterol via HHN; ipratropium is
only for patients older than 10 years old.
FALSE
Your pediatric patient has not responded to epinephrine and you
need to give Magnesium (50%). The child weighs 20 kg. What is
appropriate dose? 500 mg
You have 2 Gm of Magnesium in a 50 mL IV bag that you need to
administer using a 60-drip set. How much of the bag do you need to
infuse? 12.5 mL over 10 minutes
500 mg x 50 mL / 2000 mg = 12.5 mL
What is the drip rate?
12.5 mL x 60 drips/mL /10 min = 75 drips/min (a drip about every
1.25 seconds)
ALS
Pg 75
Peds Croup/
Epiglottitis /
RSV/Bronchiolitis
You respond for an 18 month old that was having cold-like symptoms
for last 24 hours; when his parents woke him from his nap, they
noticed the child was having severe difficulty breathing. Your
assessment reveals fever, retractions, wheezing and rapid shallow
respirations. HR = 70. The paramedic should:
A. Administer 0.01 mg/kg epinephrine (1 mg/1 mL) IM
B. Begin an breathing treatment of albuterol via BVM
ventilation
C. Nebulize epinephrine(1 mg/10 mL) 0.5 mg, aiming the
mist at the child’s face
D. Administer 0.02 mg/kg atropine and intubate
immediately
ANSWER: C
ALS
Pg 78 & 79
PEDS Wide complex
Tachycardia with
A pulse
AND Ventricular
fibrillation
A 2-yo has congenital heart disease and palpitations. Vitals are
within normal limits, child is not altered. ECG shows ventricular
tachycardia. OLMC has ordered you to administer amiodarone 5
mg/kg IVPB over 20 minutes. The patient weighs 10 kg.
How many mg should you administer? 50 mg
Suddenly the child becomes unresponsive. A weak carotid pulse is
present. What is the appropriate energy setting for synchronized
cardioversion?
0.5 – 1 J/Kg
10 to 20 J
The ECG monitor still shows ventricular tachycardia, but you cannot
detect a pulse. What is your next action?
Immediate defibrillate
It’s time to give the patient epinephrine (1 mg/10mL) How much?
0.1 mg or 1 mL
ALS
Pg. 82
Peds Glucose/
Diabetic Emergencies
Your patient is a 8-yo diabetic with an altered mental status.
Assessment reveals pale and diaphoretic skin. His blood glucose is
36. What is the correct dose of Dextrose 10% to give this patient?
0.5 g/kg 5 mL/kg
The patient weighs 28 kg. How much to administer?
140 mL
Same problem but with glucagon
1 mg IN/IM
Where is the preferred site? Vastus lateralus muscle
Where is that located? Thigh
BLS
ALS
Pg 83
Peds Drug Overdose
A 3-yo has taken a handful of his grandmother’s atenolol. What is
the appropriate ‘antidote’ for this medication?
Glucagon
The child weighs 16 kg. How much should you administer?
16 kg x 0.03 mg/kg = 0.48 mg 0.48 mL (0.5 mL)
A 4-yo was found chewing on a flea collar. Caregiver tells you the
child has been drooling, had diarrhea and vomited x 2. What is the
appropriate medication to give this child?
Atropine 0.02 mg/kg
The child weighs 30 lbs. How much do you administer?
32 lbs = 14.4 kg. 14.4 x 0.02 = 0.28 mg or 2.8 mL
A 9-yo has possibly ingested some ephedrine. He is agitated and
hallucinating. BP 130/88, HR 134, RR 24. OLMC has ordered you to
administer midazolam. He weighs 30 kg. What is an appropriate IN
dose for this patient?
0.2 mg/kg slow IVP
6 mg = 1.2 mL
ALS
Drug references
What class of drug is Ketamine?
DEA schedule 3 controlled substance
Under what circumstances should you withhold ketamine?
A.
B.
C.
D.
E.
Aortic dissection
Hypertensive crisis
Acute MI
Conditions where elevated BP is a serious hazard
All of these are appropriate reasons to withhold
ketamine
Ketamine is indicated for drug assisted intubation for what two types
of patients?
Asthma, pediatrics
What is the standard initial dose of norepinephrine for the adult
patient?
8 mcg/min (2 mL/min) IVPB
How is norepinephrine mixed for IVPB administration?
4 mg/4mL added to 1000 bag of NS
What type of IV tubing should be used?
Macro tubing
Norepinephrine is contraindicated for what type of shock?
A.
B.
C.
D.
Septic
Neurogenic
Hypovolemic
Anaphylactic
Answer: C
BLS
Drug References
Which of the following is an action of diphenhydramine?
A.
B.
C.
D.
Antihistamine
Catecholamine
Hypoglycemic
Peripheral vasoconstrictor
Answer: A
What is a common side effect of diphenhydramine?
A.
B.
C.
D.
Decreased heart rate
Drooling
Drowsiness
Pinpoint pupils
Answer: C
What is a common side effect of glucagon administration?
Vomiting