Paramedic Protocols: Questions and Answers for Neonates and Pediatrics, Exams of Pediatrics

Download Paramedic Protocols: Questions and Answers for Neonates and Pediatrics and more Exams Pediatrics in PDF only on Docsity! Paramedic Protocols Questions And Answers Neonate - correct answer Birth to 28 days Pediatric - correct answer < 37kg Fits on LBRT (Medical) Under 14 years old (Trauma) Adult - correct answer 37kg & > (Medical) 14 and > (Trauma) Medical Patient Care Guidelines - correct answer 1. Scene Size Up 2. BSI 3. ABCs (on CPR it is CAB) 4. IV/Fluids/Meds 5. History & Exam Trauma Patient Care Guidelines - correct answer 1. Scene Size Up 2. BSI 3. General Guidelines Paramedic Protocols Questions And Answers 1. Primary Survey (w/in 2 min) 2. Secondary Survey (en-route if critical) 3. Reassessment Trauma Reassessment - correct answer 1. Primary Survey 2. Vital Signs & GCS 3. Reassess injuries and interventions Trauma Fluid Replacement Hypotensive - correct answer Adult- 500 mL NS bolus repeated once Pedi- NS Bolus based off LBRT repeated once Hypotensive Numbers - correct answer Adult - Systolic < 90 mmHg Pediatric- < 70 + (2 x age) When to IO Trauma - correct answer after two failed IV attempts Significant or Multisystem trauma IV - correct answer 2 large bore IVs Paramedic Protocols Questions And Answers Expired Meds can keep for how long - correct answer 1 year past with approval Airway Confirmation - correct answer 1. Visualization past vocal cords 2. Auscultation of Epigastrium (bad) and Thorax (good) 3. Physiological (chest, condensation, improvements) 4. EtCO2 (most confirmation step) EtCO2 & Intubation - correct answer If EtCo2 is not confirmed then must remove the tube. If unable then must use colorimetric EtCO2. If stay purple we pull it. If turn yellow we good. Right or Left Stem Bronchi - correct answer retract 1 cm, check retract 1-2 cm How to secure ET tube - correct answer Tube Holder & C- Collar Allergic Reaction / Anaphylaxis Adult - correct answer *Min./Local Reaction Paramedic Protocols Questions And Answers -----Diphenhydramine 50mg IM/IV/IO -----Prednisone PO (60mg >16)(40mg 12-16) *Minor Wheezing -----Albuterol 2.5mg & Ipratropium .5mg *If Continue -----Epi .5mg IM 1:1 *Anaphylaxis W/ Hypotension -----Epi .5mg IV/IO 1:10 -----NS Bolus 500 mL IV/IO *Acute Laryngeal Edema Refractory to Epinephrine -----Epi .5mg 1:10 nebulized Allergic Reaction / Anaphylaxis Pedi - correct answer *Min./Local Reaction -----Diphenhydramine 1mg/kg IM/IV/IO (max 25 mg) *Minor Wheezing -----Albuterol 2.5mg & Ipratropium .5mg *If Continue -----Epi .01mg/kg 1:1 IM *Anaphylaxis W/ Hypotension -----Epi .01mg/kg IV/IO 1:10 -----NS Bolus 20mL/kg IV/IO (500mL max) Paramedic Protocols Questions And Answers *Acute Laryngeal Edema Refractory to Epinephrine -----Epi .5mg 1:10 nebulized Amputations - correct answer use a CAT tourniquet use a second beside and proximal if needed moist, sterile dressings and bring parts in ziplock bag or in cool towel. Parkland if replant potential otherwise 1-2 trauma center No IV in extremities with amputations Anxiety Adult/Pedi - correct answer EtCo2 Monitoring Calm w/ verbal coaching *Adult (Midazolam up to 2.5mg) (I) / V.O.M.N *Pedi (Contact OLMCP) Behavorial Emergencies - Adult - correct answer *Hyperventilation --EtCo2 & Try to coach/calm *Chemical Restraint --Midazolam 5-10mg (Repeat 1x) Paramedic Protocols Questions And Answers Ketamine 10mg if weigh > 10kg ACS/Chest Pain - correct answer Aspirin 324mg Consider: Fentanyl 50mcg for pain TIPS:If 12 lead shows Inferior MI or ST depression in contiguous leads perform a 15 lead. ---ST elevation >1mm in atleast 2 contiguous leads or a new LBBB ---No aspirin if pt. took 324mg prior 1 hours Narrow Complex Tachycardia (SVT)- adult - correct answer *QRS < .12 & Rate > 150 bpm stable -valsalva maneuver -Adenosine 12mg Rapid IV or Diltiazem 20mg over 2 min REPEAT ONCE *Unstable Synchronized Cardioversion 100-200-300-360J Max of 4 attempts Narrow Complex Tachycardia (SVT)- pedi - correct answer *QRS <.08 & Rate > 180 bpm Child Paramedic Protocols Questions And Answers *QRS <.08 & Rate >220 bpm Infant -Adenosine .1mg/kg if no response -Adenosine .2mg/kg *Unstable Cardiovert 1-2-2-2 J/KG Max of 4 attempts Wide Complex Tachycardia w/ pulse (V-Tach)- Adult - correct answer *Rate >150 min and QRS > .12ms -Amiodarone 150mg (repeat once in 10 min) -Cardiovert 100-200-300-360 J IF no response to above or it consists -Amiodarone 150mg (repeat once in 10 min) -Cardiovert 360J if needed Wide Complex Tachycardia w/ pulse (V-Tach)- Pedi - correct answer *Rate >150 min and QRS >.08 ms -Amiodarone 5mg/kg (up to 150mg) Repeat once -Cardiovert 1-2-2-2 J/KG IF no response to above or it consists Paramedic Protocols Questions And Answers -Amiodarone 5mg/kg (up to 150mg) (Repeat once) Torsade de Pointes - correct answer Mag Sulfate 2 grams mixed into < 500ml saline infused over 5 minutes Cardiac Arrest (Asystole/PEA) - correct answer 2 minutes of manual compression 100- 120 min Oral airway and NRB Continuous chest compressions EPI 1mg every 3-5 minutes up to 3mg -<1yr its <60hr For Pedi; Epi is .01mg/kg 100-120 bpm 8-10 respirations V-Fib/pVT Adult - correct answer -IF EMS witnessed v fib then defibrillate immediately at 360J then follow protocol- -2 Minutes manual CPR rate 100-120 then continuous chest compression Oral Airway & NRB- -After every 2 minutes of CPR Defib at 360J Paramedic Protocols Questions And Answers -HR >100 & SBP < 90mmHg -ETCO2 <25 -Witnessed arrest <5 min -GCS < 14 and head trauma TXA Dose - correct answer 1 Gram over 10/min. in 500 NS (Adult) 15mg/kg (< 1Gram) over 10/min. in 500 NS (Pedi) Nausea/Vomit - correct answer Ondansetron 4mg Oral or IV For Pedi 4mg PO or 2mg IV/IM/IO Neonatal Resuscitation - correct answer 1. Warm/Dry/Tactile Stimulation for 30 seconds <100 HR- BVM ventilation <60 HR- Intubate, Epi .01mg/kg, NS bolus 20ml/kg Neonatal Hypoglycemia (< 70mg/dl) - correct answer 5ml/kg - Dextrose 10% Paramedic Protocols Questions And Answers Suspected/Confirmed Narcotic Related Depression - correct answer Naloxone .1mg/kg up to 2mg Non-traumatic Shock Fluid Doses - correct answer Adult- 500ml NS Pedi- 20ml/kg NS Pain Management Adult - correct answer Fentanyl 2mcg/kg --- Max 300mcg Morphine 4mg --- Max 10mg Ketamine 25mg --- Repeat once Pain Management Pedi - correct answer Fentanyl 2mcg/kg --- Max 150mcg Morphine .1mg/kg --- Max 2mg Ketamine 10mg --- Repeat once (only if >10kg) Pre-Eclampsia (> BP in pregnancy) - correct answer BP > 140mmHg Left lateral recumbent position -Magnesium Sulphate 4-5grams/500ml NS Paramedic Protocols Questions And Answers Eclampsia (Seizure from high BP) - correct answer Magnesium Sulphate 4-5grams / 500ml NS Midazolam 5mg (Max 20mg) Seizure - correct answer Midazolam 5mg (Max 20mg) --- Adult Midazolam .1mg/kg IV/IO (Pedi) Midazolam .2mg/kg IM/IN (Pedi) Sepsis - correct answer NS 1 Liter- Adult (> 14 years) NS 20 ml/kg- Pedi Meds that may be administered Intra Nasally - correct answer Midazolam, Naloxone, Ketamine, Fentanyl.