MICN LA COUNTY FINAL EXAM QUESTIONS AND
ANSWERS VERIFIED 100% CORRECT
What can you give with IO insertion? - ANSWER -Lidocaine 2% 40mg slow IO push.
May repeat once 20mg if pain with infusion
What is the dose for push dose epi? - ANSWER -0.1mg/ml- take 1ml into 9ml of NS.
New concentration is 0.01mg/ml. Give 1 ml Q1-5 minutes for SBP >90
S/S of agitated delirium - ANSWER -Confusion and extreme agitation with one of the
following: Diaphoresis, fever/flushed skin, tachycardia, rapid breathing
*very dangerous- can progress fast to resp/cardiac arrest*
Treatment for agitated delirium? - ANSWER -Midazolam 5mg IV/IM/IN, may repeat x1
in 5 min (max 10mg prior to base contact, max 20mg after base contact)
Treatment for prolonged QT intervals for suspected drug ingestion/agitated delirium? -
ANSWER -CONTACT BASE if QRS >0.12 seconds, QT >500ms, or HR >150 <50 and
consider Sodium Bicarb 50mEq IV with base physician (may repeat x1 if QRS remains
>0.12)
Treatment for mental health crisis? - ANSWER -Olanzapine 10mg ODT x1 (no base
contact required) and Midazolam 5mg IV/IM/IN (base contact required) max 20mg
,Cardiac arrest in PEA treatment - ANSWER -CPR! Epi (0.1mg/ml 1ml) ASAP and can
repeat Q5 min max 3mg, NS 1L rapid
If suspected hyperkalemia= 1g Ca chloride and Sodium Bicarb 50mEq
Cardiac arrest V.Fib/pulseless V. Tach treatment? - ANSWER -CPR! Defib @200J
(repeat Q2 min)! Epi (0.1mg/ml 1ml, max 3 ml) after 2nd defib, amnioderone 300 after
3rd fefib, amnioderone 150mg after 5th, NS 1L rapid
ROSC obtained on scene- when and where do we transport? - ANSWER -After 5
minutes- to SRC
Do we transport medical cardiac arrests? - ANSWER -No- only penetrating traumatic!
Best thing for medical cardiac arrest is high quality CPR with minimal interruptions. Cant
do that in the ambulance/transporting.
Treatment post ROSC with cardiogenic shock? - ANSWER -If SBP <90 NS 1L and push
dose epi if no response after 250ml NS
What is the first priority for a cardiac arrest patient? - ANSWER -CPR!
What is the preferred advanced airway for cardiac arrest patients? - ANSWER -
SGA/iGel- do not have interrupt CPR to place and can monitor capnography throughout
Normal ETCO2 during CPR? - ANSWER ->10 with box shaped waveforms
, An increase in ETCO2= ROSC
Can you do CPR on LVAD patient? - ANSWER -Yes- note no pulse and no BP
Can you do CPR on a TAH patient? - ANSWER -No! No epi, no defib, no cpr- will
destroy that artificial heart
When would you hold nitro? - ANSWER -SBP <100 or sexually enhancing drugs within
the last 48 hours
CANT GIVE IF LVAD
Cardiac chest pain treatment? - ANSWER -O2 PRN, EKG, ASA 325mg (hold if GI
Bleed), Nitro if chest pain 0.4mg (may repeat for total 3 doses), IV, NS 1L if poor
perfusion, zofran 4mg if nausea
Bradycardia treatment? - ANSWER -O2, monitor, EKG, supine, IV (DO NOT DELAY
TCP FOR IV), Atropine 1mg IV repeat Q3-5 min (max 3mg), TCP if no improvement
after 1st dose of atropine
HR <40 with poor perfusion after atropine- consider what treatment? How? - ANSWER
-TCP- Set rate at 70, mA 0, slowly increase until capture. Sedation prior! Midazolm 5mg
IV/IO (max 10mg prior to base)
If poor perfusion s/p TCP- NS 1L rapid and/or push dose epi
ANSWERS VERIFIED 100% CORRECT
What can you give with IO insertion? - ANSWER -Lidocaine 2% 40mg slow IO push.
May repeat once 20mg if pain with infusion
What is the dose for push dose epi? - ANSWER -0.1mg/ml- take 1ml into 9ml of NS.
New concentration is 0.01mg/ml. Give 1 ml Q1-5 minutes for SBP >90
S/S of agitated delirium - ANSWER -Confusion and extreme agitation with one of the
following: Diaphoresis, fever/flushed skin, tachycardia, rapid breathing
*very dangerous- can progress fast to resp/cardiac arrest*
Treatment for agitated delirium? - ANSWER -Midazolam 5mg IV/IM/IN, may repeat x1
in 5 min (max 10mg prior to base contact, max 20mg after base contact)
Treatment for prolonged QT intervals for suspected drug ingestion/agitated delirium? -
ANSWER -CONTACT BASE if QRS >0.12 seconds, QT >500ms, or HR >150 <50 and
consider Sodium Bicarb 50mEq IV with base physician (may repeat x1 if QRS remains
>0.12)
Treatment for mental health crisis? - ANSWER -Olanzapine 10mg ODT x1 (no base
contact required) and Midazolam 5mg IV/IM/IN (base contact required) max 20mg
,Cardiac arrest in PEA treatment - ANSWER -CPR! Epi (0.1mg/ml 1ml) ASAP and can
repeat Q5 min max 3mg, NS 1L rapid
If suspected hyperkalemia= 1g Ca chloride and Sodium Bicarb 50mEq
Cardiac arrest V.Fib/pulseless V. Tach treatment? - ANSWER -CPR! Defib @200J
(repeat Q2 min)! Epi (0.1mg/ml 1ml, max 3 ml) after 2nd defib, amnioderone 300 after
3rd fefib, amnioderone 150mg after 5th, NS 1L rapid
ROSC obtained on scene- when and where do we transport? - ANSWER -After 5
minutes- to SRC
Do we transport medical cardiac arrests? - ANSWER -No- only penetrating traumatic!
Best thing for medical cardiac arrest is high quality CPR with minimal interruptions. Cant
do that in the ambulance/transporting.
Treatment post ROSC with cardiogenic shock? - ANSWER -If SBP <90 NS 1L and push
dose epi if no response after 250ml NS
What is the first priority for a cardiac arrest patient? - ANSWER -CPR!
What is the preferred advanced airway for cardiac arrest patients? - ANSWER -
SGA/iGel- do not have interrupt CPR to place and can monitor capnography throughout
Normal ETCO2 during CPR? - ANSWER ->10 with box shaped waveforms
, An increase in ETCO2= ROSC
Can you do CPR on LVAD patient? - ANSWER -Yes- note no pulse and no BP
Can you do CPR on a TAH patient? - ANSWER -No! No epi, no defib, no cpr- will
destroy that artificial heart
When would you hold nitro? - ANSWER -SBP <100 or sexually enhancing drugs within
the last 48 hours
CANT GIVE IF LVAD
Cardiac chest pain treatment? - ANSWER -O2 PRN, EKG, ASA 325mg (hold if GI
Bleed), Nitro if chest pain 0.4mg (may repeat for total 3 doses), IV, NS 1L if poor
perfusion, zofran 4mg if nausea
Bradycardia treatment? - ANSWER -O2, monitor, EKG, supine, IV (DO NOT DELAY
TCP FOR IV), Atropine 1mg IV repeat Q3-5 min (max 3mg), TCP if no improvement
after 1st dose of atropine
HR <40 with poor perfusion after atropine- consider what treatment? How? - ANSWER
-TCP- Set rate at 70, mA 0, slowly increase until capture. Sedation prior! Midazolm 5mg
IV/IO (max 10mg prior to base)
If poor perfusion s/p TCP- NS 1L rapid and/or push dose epi
