Protocols

Question 1

Adult oral glucose =

Answer 1

15g buccal if conscious and able to tolerate

Question 2

adult Naloxone =

Answer 2

2 mg IN 1 mg in each nose hole (IRR x 1 in 5 min)

Question 3

administer glucose at what blood sugar level

Answer 3

< 60 mg/dl both adult and pedi

Question 4

pedi glucose oral dose =

Answer 4

7.5 if conscious/able to tolerate

Question 5

Naloxone pedi dose =

Answer 5

0.1 mg/kg (max dose 0.4) IRR q 5 min to 2 mg max total dose

Question 6

differential diagnosis for hyperglycemia =

Answer 6

Diabetic Ketoacidosis (DKA) ** Hyperosmolar hyperglycemic state ** infection/sepsis **ACS/MI

Question 7

with CO call administer 02 how

Answer 7

NRB + NC (as available) 15 lpm each

Question 8

Dystonias may result from a number of psychiatric and GI medications including

Answer 8

Haloperidol - fluphenazine - fluoxetine - duloxetine - sertraline - metoclopramide

Question 9

respiratory distress - sit pt how - adult

Answer 9

Semi upright for SBP >100 and or signs of adequate perfusion

Question 10

aspirin adult dosage =

Answer 10

324 mg

Question 11

Nitro dosage adult =

Answer 11

.04 mg SL q 5-min ** if previously prescribed**
titrate to SBP > 100
do not administer if pt has taken erectile dysfunction meds

Question 12

albuterol/ipratropium dosage

same for pedi and adult

Answer 12

albuterol - 2.5mg Ipratropium .05 mg in 3 ml of NS

INRR x 2

Question 13

Pts with COPD may have low baseline o 2 stats administer o2 how

Answer 13

Start 2-3 lpm O2 via NC or double pts home o2 flow rate

If known titrate to pts baseline SpO2 (88-92%) and work of breathing

Question 14

respiratory distress treatment for Pulmonary edema/CHF ADULT*

Answer 14

aspirin ** nitro ** albuterol-ipratropium

Question 15

respiratory distress treatment for Asthma/COPD/Wheezing ** ADULT ***

Answer 15

albuterol-ipratropium/CPAP

Question 16

respiratory distress treatment for Pneumonia * ADULT*

Answer 16

albuterol-ipratropium and CPAP

Question 17

Pedi treatment for wheezing

Answer 17

albuterol - ipratropium and CPAP

Question 18

pedi treatment for Croup

Answer 18

position witch is sitting upright and keeping calm

Question 19

seizures – the toxicologic causes of seizure =

Answer 19

Organophosphate/nerve gas ** Sympathomimetic toxidrome ( stuffers/packers, methamphetamine)

Question 20

initial stroke screen is the modified Cincinnati prehospital stroke screen scale - what are the tests

Answer 20

Facial Droop ** Pronator Drift ** Speech/language ( dysarthria or aphasia) ** time pt was last seen prior to onset of symptoms is REQUIRED

Question 21

with syncope/fainting you should consider what conditions or protocols

Answer 21

Ischemic chest pain/acute coronary syndrome/STEMI

• shock/hypotension
• symptomatic bradycardia
• tachycardias
• diabetic emergencies
• seizures/status epilepticus
• stroke/CVA/TIA
• vasovagal (pain management)

Question 22

hyperthermia/heat stroke

mild symptoms are what then what is treatment

Answer 22

heat cramps or heat exhaustion ** no signs of mental status(AMS) and temp < 104
treatment = passive cooling and PO fluids but use caution if nausea/vomiting

Question 23

hyperthermia/heat stroke

sever symptoms and then treatment

Answer 23

heat stroke(AMS) neurologic deficit ** temperature >104 ** sweating may or may not be present.
treatment = active cooling

Question 24

maintain high index of suspicion for heat related illness if these risk factors are present.

Answer 24

elderly ** psychiatric medication ** cardiovascular medications like diuretics or antihypertensives

Question 25

temp of severe Hypothermia

Answer 25

< 90

Question 26

Hypothermia - If AED advised shock what

Answer 26

shock once then no other until temp is >90

Question 27

burns what type of dressings | same of pedi and adult

Answer 27

< 10% BSA use moist dressing | >10 % BSA use dry burn sheet or dry sterile dressing and insulate to prevent hypothermia.

Question 28

rule of nines --- age 1-4

Answer 28

``` trunk = 32 arms = 9 1/2 legs = 15 head = 19 ```

Question 29

rule of nines --- age 5 - 9

Answer 29

``` trunk = 32 arms = 9 1/2 legs = 17 head = 15 ```

Question 30

rule of nines -- age 10 -14

Answer 30

``` trunk = 32 arms = 9 1/2 legs = 18 head = 13 ```

Question 31

rules of nines --- adult

Answer 31

``` trunk = 36 arms = 9 legs = 18 head = 10 ```