Adult Dosages (CPFR Drugs, Shorthand)

Question 1

Adult Dose: Rocuronium

Answer 1

1. 1 mg/kg IV;

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 2

Adult Dose: Albuterol - RAD

Answer 2

1. 2.5 mg INH via SVN; May repeat continuously;

Note: Ipratropium bromide 0.5 mg INH via SVN may be delivered concurrently with albuterol for RAD; May repeat x1;

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 3

Adult Dose: Epinephrine - Anaphylactic Shock

Answer 3

1. 0.3-0.5 mg 1:1k IM; May repeat;
2. 0.5 mg 1:10k IV; May repeat;
3. 2-2.5 mg 1:1k (in 10 mL NS) ET; May repeat;
   * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 4

Adult Dose: Etomidate - Cardioversion

Answer 4

1. 0.1 mg/kg IV;

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 5

Adult Dose: Midazolam - Seizure

Answer 5

Advisory: Use 1/2 doses if patient > 60 y/o;

1. 10 mg IM (> 40 kg);
   * Designated “1st choice” medication / route for seizures;
2. 0.2 mg/kg IN;
   * Designated “2nd choice” medication / route for seizures;
3. 2 mg IV; May repeat q 1+ min (max total 0.1 mg/kg up to 10 mg);
   * Designated “3rd choice” medication / route for seizures;
   * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 6

Adult Dose: Nitroglycerine - CHF, Mild

Answer 6

1. 0.4 mg SL; May repeat q 3+ min (max total 2 mg);

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 7

Adult Dose: Glucagon - Beta Blocker Overdose

Answer 7

1. 3-10 mg IV over 3+ min;

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 8

Adult Dose: Diazepam - Anxiety and Psychological Emergencies

1. General Anxiety
2. Burns
3. CPAP Anxiety
4. Violent Patient
5. ExDs

Answer 8

1. 0.2 mg/kg IV (max dose 10 mg) (O-29);
2. “2-10 mg IV” (p. 63);
3. “5-10 mg IV” (p. 79);
4. “5-10 mg IM/IV” (p. 105);
5. “5-10 mg IM/IV” (p. 109);
   * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 9

Adult Dose: Morphine - Pain, non-ACS

Answer 9

1. 0.1 mg/kg IM/IV; May repeat q 5+ min (max total 20 mg);

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 10

Adult Dose: Acetaminophen

Answer 10

1. 500-1k mg PO;

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 11

Adult Dose: Fentanyl - Pain, non-ACS

Answer 11

1. 25-100 mcg IM/IN/IV; May repeat q 5+ min (max total 300 mcg);

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 12

Adult Dose: Albuterol - CHF

Answer 12

1. 2.5 mg INH (via SVN); May repeat x1;

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 13

Adult Dose: Sodium Bicarbonate 8.4% - CIS

Answer 13

1. 100 mEq (in 1 L NS) IV Drip Infusion over 40 min (i.e., at a rate of 1,500 mL/hr);

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 14

Adult Dose: Morphine - Pain, ACS

Answer 14

1. STEMI - 2-4 mg IV; May repeat with 2-8 mg q 5+ min (max total 10 mg);
2. NSTEMI - 1-5 mg IV; May repeat (max total 10 mg);
   * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 15

Adult Dose: Glucagon - Hypoglycemia

Answer 15

1. 1 mg IM;

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 16

1. Adult Dose: Ondansetron

Answer 16

1. Ondansetron:

• L 8 mg (via ODT);
• IM 4 mg;
• IO/IV (slowly) 4 mg;

Pierce County EMS Procedures and PCPs, Medication / IV Guide, p. O-46, June 2019​​

Question 17

Adult Dose: Etomidate - RSI

Answer 17

1. 0.3 mg/kg IV over 30+ sec;

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 18

Adult Dose: Diazepam - Muscle Spasm

Answer 18

1. “2-10 mg IV” (p. 99);

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 19

Adult Dose: Diazepam - Seizure

Answer 19

1. 0.2 mg/kg IV (max dose 10 mg); May repeat after 1+ min x1 (p. 57, 88);

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 20

1. Adult Dose: Glucose, Oral

Answer 20

1. Glucose: BUC/PO 15 g; May titrate and repeat;

Pierce County EMS Procedures and PCPs, Medical Emergencies, p. 38, June 2019​​

Question 21

Adult Dose: Epi - Asthma

Answer 21

1. 0.3 mg 1:1k IM; May repeat after 20 min x1;

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 22

Adult Dose: Magnesium Sulfate - Pulseless TdP

Answer 22

1. 1-2 g (in 10 mL NS) IV;

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 23

Adult Dose: Magnesium Sulfate - Pulsatile TdP

Answer 23

1. 1-2 g (in 50-100 mL NS) IV Drip Infusion over 15 min;

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 24

Adult Dose: Albuterol - CIS / Hyperkalemia / Anaphylaxis

Answer 24

1. 2.5 mg SVN; May repeat continuously;

Note: The PCPs’ Medication / IV Guide states that a paramedic “can repeat [albuterol] continuously” for each of its given indications. More specifically, p. 30 of the Traumatic Emergencies section states, “give… [albuterol] continuously” for CIS, and p. 40 of the Medical Emergencies section states the same with regard to Hyperkalemia.

- Pierce Co. EMS Procedures and PCPs, January 2017

Question 25

Adult Dose: Glucagon - Epi-Refractory Anaphylaxis 2° to Beta Blockade

Answer 25

1. 1-3 mg IV; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 26

Adult Dose: Atropine - Bradycardia

Answer 26

1. 0.5 mg IV; May repeat q 3+ min (max total 0.04 mg/kg up to 3 mg); 2. 1 mg (in 10 mL NS) ET; * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 27

Adult Dose: Lidocaine - Stable Wide-Complex Tachycardia

Answer 27

1. 1 mg/kg IV; May repeat q 5+ min with 0.5 mg/kg (max total 3 mg/kg); ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 28

Adult Dose: Ketamine - Excited Delirium

Answer 28

1. 4 mg/kg IM; 2. 2 mg/kg IV; * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 29

Adult Dose: Naloxone

Answer 29

1. 0.4-2 mg ET/IM/IN/IV; May repeat q 2+ min (max total 10 mg); Contact Base Station for additional doses; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 30

Adult Dose: Aspirin

Answer 30

1. 324 mg PO (162 mg if already taking aspirin); ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 31

Adult Dose: Succinylcholine

Answer 31

1. 3 mg/kg IM; 2. 1.5 mg/kg IV; * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 32

Adult Dose: Epinephrine - Cardiac Arrest

Answer 32

1. 1 mg 1:10k IV (flushed with 20 mL NS ["elevate arm for 10-20 seconds" per p. O-17]); May repeat q 3+ min; 2. 2-2.5 mg 1:1k (in 10 mL NS) ET; May repeat q 3+ min; * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 33

Adult Dose: Calcium Chloride 10%

Answer 33

1. 1 g IV over 5 min; May repeat after 20 min x1; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 34

Adult Dose: Nitrous Oxide

Answer 34

1. INH (self-administered by patient PRN); ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 35

Adult Dose: Nitroglycerine - ACS

Answer 35

1. 0.4 mg SL; May repeat q 5 min; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 36

Adult Dose: Epinephrine - Bradycardia / Hypotension

Answer 36

1. 2-10 mcg/min IV Infusion; 2. 0.5-2 mL Push-Dose Epi; May repeat q 2+ min; * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 37

Adult Dose: Ketamine - RSI-Induction

Answer 37

1. 4 mg/kg IM; 2. 2 mg/kg IV; * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 38

How can Push Dose Epi be created?

Answer 38

1. Replace 1 mL of a 10 mL NS preload with 1 mL Epi 1:10k (= 10 mcg/mL); ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 39

Adult Dose: Diphenhydramine

Answer 39

1. 25-50 mg deep IM / slow IV; May repeat (max total 100 mg); ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 40

Adult Dose: Fentanyl - ACS Pain

Answer 40

1. 25-50 mcg IV; May repeat q 5+ min (max total 100 mcg); 2. 50 mcg IN; May repeat after 5 min x1; * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 41

Adult Dose: Dextrose 1. D50W 2. D10W

Answer 41

1. 25 g D50W *Slow* IV; Titrate (and repeat if necessary) until BGL \> 80 mg/dL; 2. 25 g D10W IV Drip Bolus/Infusion; Titrate (and repeat if necessary) until BGL \> 80 mg/dL; * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 42

Adult Dose: Epinephrine - Upper Airway Obstruction 2° to Angioedema / Epiglottitis

Answer 42

1. 0.3 mg 1:1k IM; 2. 0.3 mg 1:10k IV; * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 43

Adult Dose: Lidocaine - IO Anesthesia

Answer 43

1. 20-50 mg IO; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 44

Adult Dose: Sodium Bicarbonate 8.4% - Non-CIS

Answer 44

1. 1 mEq/kg IV; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 45

What is the Parkland Formula?

Answer 45

1. 4 mL x Patient's bodyweight in kg x (% of body surface area affected by 2nd & 3rd degree burns, as expressed by a whole number) = Amount in mL of NS to be infused over 24 hours (1/2 of which is to be infused over the first 8 hours); ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 46

Adult Dose: Ketamine - Refractory Pain

Answer 46

1. 0.2 mg/kg IM/IN/IV; May repeat q 10 min; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 47

Adult Dose: Oxygen - CO Poisoning

Answer 47

1. INH at High Flow with 100% O2 (p. O-50); ## Footnote *- Pierce Co. EMS Procedures and PCPs, April 2019*

Question 48

Adult Dose: Lidocaine - Cardiac Arrest

Answer 48

1. 1-1.5 mg/kg IV; May repeat q 5+ min x3 w/ 0.5-0.75 mg/kg (max total 3 mg/kg); 2. 2-3 mg/kg (in 10 mL NS) ET; * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 49

Adult Dose: Midazolam - Anxiety & Procedural Sedation

Answer 49

Use 1/2 doses if patient \> 60 y/o; 1. 5 mg IM; May repeat after 10 min x1; 2. 0.2 mg/kg IN; 3. 2 mg IV; May repeat q 1+ min (max total 0.1 mg/kg up to 10 mg); * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 50

How can a D10W be mixed for IV drip infusion from a D50W preload?

Answer 50

1. Replace 50 mL of a 250 mL NS bag with 25g D50W (full 50 mL preload); ## Footnote *- Math!*

Question 51

Adult Dose: Fentanyl - Post-RSI

Answer 51

1. 1 mcg/kg IV; May repeat q 10 min; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 52

Adult Dose: Sodium Chloride 0.9% - Uncontrolled Internal Hemorrhage

Answer 52

1. IV Drip Infusion Titrated to Maintain Systolic BP 80-90 mm Hg; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 53

Adult Dose: Epinephrine - Allergic Reaction

Answer 53

1. 0.3-0.5 mg 1:1k IM; May repeat after 5+ min x1 with 0.3 mg if airway involved and no improvement, or after 15+ min if other signs such as urticaria persist; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 54

Adult Dose: Midazolam - Excited Delerium

Answer 54

Use 1/2 doses if patient \> 60 y/o; 1. 10 mg IM/IN/IV; * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 55

Adult Dose: Ketamine - Post-RSI

Answer 55

1. 0.5 mg/kg IV; May repeat q 10 min; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 56

Adult Dose: Adenosine

Answer 56

1. 6 mg Rapid IV Push (flushed rapidly with 20 mL NS, then elevate extremity); May repeat after 1+ min x1 with 12 mg; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 57

Adult Dose: Methylprednisolone

Answer 57

1. 125 mg IV; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 58

Adult Dose: Hydroxycobalamin (Cyanokit)

Answer 58

1. 5 g IV Drip Infusion over 15 min; May repeat x1; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 59

Adult Dose: Ipratropium Bromide

Answer 59

1. 0.5 mg (together with 2.5 mg albuterol) INH via SVN; May repeat x1; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 60

Adult Dose: Amiodarone - Polymorphic VT / Wide Tachycardia

Answer 60

1. 150 mg (in 100 mL D5W) IV Drip Infusion over 10 min; May repeat q 10 min; Contact Base after 2nd dose; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 61

Adult Dose: Oxymetazoline (Afrin)

Answer 61

1. 2-3 sprays in each nostril; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 62

Adult Dose: Midazolam - Post-RSI

Answer 62

Use 1/2 doses if patient \> 60 y/o; 1. 2 mg IV; May repeat q 10 min; * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 63

Adult Dose: Magnesium Sulfate - Eclampsia

Answer 63

1. 4 g IV over 5 min; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 64

Adult Dose: Dopamine - General Range

Answer 64

1. 2-20 mcg/kg/min Continuous IV Drip Infusion; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 65

Adult Dose: Atropine - Poisoning

Answer 65

1. 1 mg IV (full preload); May repeat q 1 min (max total 10 mg); ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 66

Adult Dose: Magnesium Sulfate - Asthma

Answer 66

1. 2 g (in 10 mL NS) IV over 15 min; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 67

Adult Dose: Lidocaine - Maintenance Infusion

Answer 67

Use 1/2 doses for liver disease or severe CHF; 1. 1-4 mg/min Continuous IV Drip Infusion; * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 68

Adult Dose: Ibuprofen

Answer 68

1. 400-800 mg PO with 8 oz water; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 69

Adult Dose: Diltiazem

Answer 69

1. 15-20 mg IV over 2 minutes; May repeat after 15 min x1 with 20-25 mg; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 70

Adult Dose: Amiodarone - Cardiac Arrest

Answer 70

1. 300 mg IV; May repeat after 3+ min x1 with 150 mg; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 71

Adult Dose: Sodium Bicarbonate 8.4% - ExDs

Answer 71

1. 50 mEq IV for each liter of (cooled) NS bolused (max total 100 mEq); ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 72

How can a syringe of D10W be created from a syringe of D50W?

Answer 72

1. Waste 40 mL from the D50W preload and replace with 40 mL NS; ## Footnote *- Math!*

Question 73

Adult Dose: Nitroglycerine - CHF, Moderate/Severe

Answer 73

1. 0.4 mg SL; May repeat q 3+ min with 1 tablet or 1-2 sprays (max total 2 mg); ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 74

How may Sodium Bicarbonate 8.4% be prepared for administration to treat CIS in an adult?

Answer 74

1. Add 100 mEq (two full preloads: 100 mL) Sodium Bicarbonate 8.4% to 1 L NS, attach a 10-drop admin set and deliver at a rate of 250 gtt/min over 44 minutes (achieving the prescribed delivery rate of 1,500 mL/hr); ## Footnote * - Pierce Co. EMS Procedures and PCPs, January 2017* * - Math!*

Question 75

Adult Dose: Xylocaine 2% Jelly

Answer 75

1. Apply moderate amount to external surfaces of endotracheal / nasogastric tubes prior to placement; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 76

Per the PCPs, for what patient presentations may diazepam be administered IM?

Answer 76

1. Violent Patients (PPP p. 46); 1. ExDs (PPP p. 48); * - Pierce Co. EMS Procedures and PCPs, April 2019*

Question 77

How may magnesium sulfate be prepared for IV drip infusion, and at what rate should it be delivered?

Answer 77

1. Add 2 g magnesium sulfate to 50 mL NS in a Buret Set (60-drop admin set); 2. 216 gtt/min (to achieve the prescribed 15 minute infusion); * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 78

How may epinephrine be prepared for IV drip infusion, and at what rate should it be delivered?

Answer 78

1. Add 1 mg epinephrine 1:1k to 250 mL NS and attach a 60-drop admin set; 2. 30-150 gtt/min (2-10 mcg/min; 15 gtt/min = 1 mcg/min); * - Pierce Co. EMS Procedures and PCPs, January 2017*

Question 79

What is the procedure recommended by TeleFlex for IO anesthesia using lidocaine?

Answer 79

1. Flush a loose IO extension set with NS and attach it to the IO port; 2. Pull up 60 mg lidocaine (3 mL) in a 3 mL syringe; 2. Inject 20 mg (1 mL) into the IO extension set (this fills the extension set); 3. Push an additional 20 mg (1 mL) lidocaine over 60 seconds; 4. Connect a 10 mL NS preload to the extension set and push 1 mL over 60 seconds (thereby pushing in the 20 mg licocaine remaining in the extension set), then flush the rest of the NS preload rapidly; 5. Reconnect the lidocaine syringe to the extension set and fill it with the remaining 20 mg (1 mL); 6. Attach a NS flush to extension set and push 1 mL over 60 seconds (thereby pushin in the last 20 mg lidocaine remaining in the extension set); Note: For pediatrics, use 0.5 mg/kg (max dose 60 mg), divide into three parts, and use a similar delivery technique; *Teleflex EZ-IO Cadaver Lab*

Question 80

Adult Dose: Oxygen - Routine Care

Answer 80

1. INH titrated to \> 94% SpO₂ (p. O-50); ## Footnote *- Pierce Co. EMS Procedures and PCPs, April 2019*

Question 81

Adult Dose: Oxygen - COPD

Answer 81

1. INH titrated to 92-94% SpO₂ (p. O-50; Note that PPP p. 36 states "90-94%"); ## Footnote *- Pierce Co. EMS Procedures and PCPs, April 2019*

Question 82

Adult Dose: Oxygen - ROSC

Answer 82

1. INH titrated to 94% SpO₂ (acceptable range 94-99%; p. O-50); ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 83

Adult Dose: Oxygen - CNS and Facial Trauma

Answer 83

1. INH titrated to ≥ 95% SpO2 (PPP p. 25); ## Footnote *- Pierce Co. EMS Procedures and PCPs, April 2019*

Question 84

For what *procedures* is Midazolam overtly prescribed in the PCPs for use as a sedative (i.e., procedural sedation)?

Answer 84

1. CPAP (PPP p. 35); 2. Synchronized Cardioversion (p. O-40); 3. Post RSI (p. O-41) * - Pierce Co. EMS Procedures and PCPs, April 2019*

Question 85

For what *conditions* is midazolam overtly prescribed for anxiolysis in the PCPs (i.e. acute anxiety states)?

Answer 85

1. CPAP (PPP p. 35); 2. Burns (PPP p. 28); 3. CIS (PPP p. 30); 4. Violent patients (PPP p. 46); 5. ExDs (PPP p. 48); * - Pierce Co. EMS Procedures and PCPs, April 2019*

Question 86

Adult Dose: Sodium Chloride 0.9% - General Medical Emergencies

Answer 86

1. IV Drip Infusion titrated to BP \> 90/S (PPP p. 38); ## Footnote *- Pierce Co. EMS Procedures and PCPs, April 2019*

Question 87

Adult Dose: Sodium Chloride 0.9% - ROSC

Answer 87

1. 1-2 L IV Bolus; ## Footnote *- AHA ECC Handbook, 2015 Ed., Adult Immediate Post-Cardiac Arrest Care Algorithm*

Question 88

Adult Dose: Sodium Chloride 0.9% - Burns

Answer 88

1. IV Drip Infusion over 24 hours using Parkland Formula (1/2 over first 8 hours, 1/2 over remaining 16 hours; PPP p. 29); ## Footnote *- Pierce Co. EMS Procedures and PCPs, April 2019*

Question 89

Adult Dose: Sodium Chloride 0.9% - Shock (Anaphylactic / Vasogenic / Neurogenic)

Answer 89

1. 250-500 mL IV Bolus if BP \< 90/S; May repeat; ## Footnote *- Pierce Co. EMS Procedures and PCPs, April 2019*

Question 90

Adult Dose: Sodium Chloride 0.9% - HoTN of Unknown Etiology

Answer 90

1. 250-500 mL IV Bolus if BP \< 90/S; May repeat; ## Footnote *- Pierce Co. EMS Procedures and PCPs, April 2019*

Question 91

Adult Dose: Sodium Chloride 0.9% - TBI

Answer 91

1. IV Infusion titrated to \> 90/S; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 92

How should hydroxocobalamin be prepared and delivered to an adult patient?

Answer 92

1. Reconstitute w/ 200 mL NS and use the included 20-drop admin set to administer the solution at 5 gtt/sec (delivering the entire solution over 15 minutes); ## Footnote *- Cyanokit Instructions*

Question 93

How may amiodarone be prepared and delivered for administration to an adult patient suffering from polymorphic ventricular tachycardia / wide tachycardia?

Answer 93

1. Add 150 mg (one vial) to 100 mL D5W, and with a 10-drop admin set administer at 103 gtt/min (delivering the entire solution over 10 min); ## Footnote * - Pierce Co. EMS Procedures and PCPs, January 2017* * - Math!*

Question 94

Adult Dose: Dopamine - CHF

Answer 94

1. 10 mcg/kg/min; Titrate from 2-20 mcg/kg/min to maintain BP \> 90/S; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 95

Adult Dose: Dopamine - HoTN of Unknown Etiology

Answer 95

1. 10 mcg/kg/min; Titrate from 2-20 mcg/kg/min to maintain BP \> 90/S; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 96

Adult Dose: Dopamine - Shock (Anaphylactic / Neurogenic / Vasogenic)

Answer 96

1. 10 mcg/kg/min; Titrate from 2-20 mcg/kg/min to maintain BP \> 90/S; ## Footnote *- Pierce Co. EMS Procedures and PCPs, January 2017*

Question 97

How should dopamine be prepared and delivered to an adult patient?

Answer 97

1. Use a pre-mixed bag (1,600 mcg/mL) with a 60-drop admin set; It is acceptable to use the Duggan Formula (set the drip rate to [Patient's bodyweight in pounds with the last digit removed]) to achieve 5-6 mcg/kg/min; For best accuracy set the drip rate using the formula: _60 gtt/mL x kg x desired mcg/min_ 1,600 mcg/mL * - Pierce Co. EMS Procedures and PCPs, January 2017* * - Math!*

Question 98

How may magnesium sulfate be prepared and delivered to a patient suffering from asthma?

Answer 98

1. Add 2 g magnesium sulfate to 50 mL NS in a Buret Set [60-drop admin set] and deliver at 216 gtt/min (delivering the entire solution over 15 min); ## Footnote * - Pierce Co. EMS Procedures and PCPs, January 2017* * - Personal Solution;*

Question 99

How may lidocaine be prepared and delivered as a continuous IV drip infusion for an adult patient requiring a "mainenance infusion"?

Answer 99

1. Add 100 mg lidocaine [one full preload] to a 250 mL NS bag and connect a 10-drop admin set; 26 gtt/min = 1 mg/min, so titrate the drip rate between 26-104 gtt/min (13-52 gtt/min for patients suffering from liver disease or severe CHF); ## Footnote * - Pierce Co. EMS Procedures and PCPs, January 2017* * - Personal Solution*

Question 100

How many medications are currently available for use by paramedics at CPFR?

Answer 100

1. 37; ## Footnote *- Pierce Co. EMS Procedures and PCPs, April 2019*

Question 101

What is the difference between the adult dosing of Diazepam for violent patients and the dosing for patients experiencing ExDs?

Answer 101

1. There is no difference, as both conditions conditions permit dosing at 5-10 mg IM / IV; ## Footnote *Pierce Co. EMS Procedures and PCPs, June 2019, p. O-46, 48*

Question 102

What is the difference between the adult dosing of Ketamine for violent patients and the dosing for patients experiencing ExDs?

Answer 102

1. There is no difference, as both conditions conditions permit dosing at4 mg/kg IM or 2 mg/kg IV/IO; ## Footnote *Pierce Co. EMS Procedures and PCPs, June 2019, p. O-46, 48*

Question 103

What is the difference between the adult dosing of Midazolam for violent patients and the dosing for patients experiencing ExDs, as expressed in the Behavioral Emergencies section of the PCPs?

Answer 103

1. The dosing of Midazolam for violent patients is as follows: A. Give 0.2 mg/kg of a 5 mg/mL concentration IN, or 2 mg increments to a maximum dose of 0.1 mg/kg or 10 mg (whichever is less) IM/IV; B. Wait 1-2 minutes between IN/IV doses to evaluate response; C. Give half doses if patient is \> 60 years old; 2. The dosing of Midazolam for ExDs is as follows: A. Midazolam 10 mg IN/IM/IV; *Pierce Co. EMS Procedures and PCPs, June 2019, p. O-46, 48*

Question 104

Oxygen A. Adult Dose: Chest Pain / ACS when SPO₂ is \< 94% and / or respiratory distress

Answer 104

1. 4 lpm INH via NC, titrated to raise and maintain SPO₂ to 94-99%; ## Footnote *Pierce County EMS Procedures and PCPs, April 2020, p. 31*