2026 PARAMEDIC FISDAP AIRWAY QUESTIONS AND
ANSWERS SURE A+
✔✔Sedation - ✔✔Used in airway management to reduce a pt's anxiety, induce
amnesia, and decrease the gag reflex. It is useful for pt's who are anxious, combative,
or agitated. Complications with sedation include over sedating/under sedating.
✔✔Butyrophenones - ✔✔Potent, effective sedatives. Two of these drugs are
haloperidol (Haldol), and droperidol (Inapsine), are frequently used for relief of anxiety.
They do not produce apnea and have little effect on the cardiovascular system.
✔✔Benzodiazepines - ✔✔Sedative-hypnotic drugs. Diazepam (Valium), and midazolam
(Versed), provide muscle relaxation and mild sedation and are used for anxiety and
antiseizure medications. They also provide anterograde amnesia, which is beneficial for
invasive and uncomfortable procedures; the pt will not likely recall the event. Resp
depression and hypotension are potential side effects.
✔✔Midazolam (Versed) - ✔✔Two-four times more potent as diazepam, is faster acting,
and has a shorter duration of action. Because large doses of midazolam are necessary
to achieve the desired effect, it should not be used as a induction agent.
✔✔Barbiturates - ✔✔Sedative-hypnotic medications that have a long history of use.
Barbiturates can cause significant respiratory depression and a drop in BP of approx
, 10% in normovolemic pt's. The drop in BP can be profound and potentially irreversible
in hypovolemic pt's.
✔✔Opioids/Narcotics - ✔✔Potent analgesics with sedative properties. They can be
used in emergency airway management as a premedication, during induction, and in
maintenance of a sedation/amnesia. Most common are Fentanyl (sublimaze) and
alfentanil (alfenta). Opioids can cause profound respiratory and CNS depression, and
produce severe hypotension and bradycardia, esp in hemodynamically unstable pt's.
These effects can be reversed with naloxone (narcan).
✔✔Fentanyl - ✔✔It is 70-150 more potent than morphione. It has a rapid onset of action
and relatively short duration of action.
✔✔Non-narcotic/Non-barbiturate - ✔✔Etomidate (amidate) is a non-narcotic, non-
barbiturate, hypnotic-sedative drug often used in the induction of general anesthesia. It
is fast acting agent of short duration. This drug has little effect on pulse rate, BP and
ICP, and does not cause histamine release and bronchoconstriction that may occur with
other agents. Useful induction agent in pt's with coronary artery disease, increased ICP,
or boderline hypotension/hypovolemia.
✔✔Paralytics - ✔✔A safer, more effective approach is "chemical paralysis" with
neuromuscular blocking agents. With the pt chemically sedated and paralyzed, his or
her protective airway reflexes are lost; you can effectively perform oxygenation and
ventilation, and the pt will not gag during insertion of an ET tube. Paralytics, unlike
sedatives do not affect the LOC. Pt can still hear/think/and feel!
✔✔Acetylcholine (ACh) - ✔✔Paralytic medications function at the neromuscular junction
and relax the muscle by impeding the action of ACh.
✔✔Depolarizing Neuromuscular Blocker - ✔✔Competitively binds with the ACh receptor
sites but is not affected as quickly by acetylcholinesterase. Therefore, it causes
depolarization of the muscle and prevents future signals for depolarization from have an
effect because all of ACh receptor sites have been occupied. Very rapid onset (60-90
seconds) of total paralysis and short duration of action (5-10 minutes).
✔✔Succinylcholine - ✔✔(Anectine): 1.15mg/kg via IV push (initial dose); repeated
doses can be given based on the pt's clinical response. It is the only depolarizing
neuromuscular blocking agent. Because it causes depolarization, fasciculations can be
observed during its administration. Often used as a initial paralytic. Should be used in
caution with pt's that have burns, crush injuries, and blunt trauma. Can cause
bradycardia. *If you administer this without administering a long-acting paralytic
(norcuron, pavulon), you will have to re-administer by IV bolus every 5 minutes.
✔✔Fasciculations - ✔✔Brief, uncoordinated twitching of small muscle groups in the
face, neck, trunk and extremities.
ANSWERS SURE A+
✔✔Sedation - ✔✔Used in airway management to reduce a pt's anxiety, induce
amnesia, and decrease the gag reflex. It is useful for pt's who are anxious, combative,
or agitated. Complications with sedation include over sedating/under sedating.
✔✔Butyrophenones - ✔✔Potent, effective sedatives. Two of these drugs are
haloperidol (Haldol), and droperidol (Inapsine), are frequently used for relief of anxiety.
They do not produce apnea and have little effect on the cardiovascular system.
✔✔Benzodiazepines - ✔✔Sedative-hypnotic drugs. Diazepam (Valium), and midazolam
(Versed), provide muscle relaxation and mild sedation and are used for anxiety and
antiseizure medications. They also provide anterograde amnesia, which is beneficial for
invasive and uncomfortable procedures; the pt will not likely recall the event. Resp
depression and hypotension are potential side effects.
✔✔Midazolam (Versed) - ✔✔Two-four times more potent as diazepam, is faster acting,
and has a shorter duration of action. Because large doses of midazolam are necessary
to achieve the desired effect, it should not be used as a induction agent.
✔✔Barbiturates - ✔✔Sedative-hypnotic medications that have a long history of use.
Barbiturates can cause significant respiratory depression and a drop in BP of approx
, 10% in normovolemic pt's. The drop in BP can be profound and potentially irreversible
in hypovolemic pt's.
✔✔Opioids/Narcotics - ✔✔Potent analgesics with sedative properties. They can be
used in emergency airway management as a premedication, during induction, and in
maintenance of a sedation/amnesia. Most common are Fentanyl (sublimaze) and
alfentanil (alfenta). Opioids can cause profound respiratory and CNS depression, and
produce severe hypotension and bradycardia, esp in hemodynamically unstable pt's.
These effects can be reversed with naloxone (narcan).
✔✔Fentanyl - ✔✔It is 70-150 more potent than morphione. It has a rapid onset of action
and relatively short duration of action.
✔✔Non-narcotic/Non-barbiturate - ✔✔Etomidate (amidate) is a non-narcotic, non-
barbiturate, hypnotic-sedative drug often used in the induction of general anesthesia. It
is fast acting agent of short duration. This drug has little effect on pulse rate, BP and
ICP, and does not cause histamine release and bronchoconstriction that may occur with
other agents. Useful induction agent in pt's with coronary artery disease, increased ICP,
or boderline hypotension/hypovolemia.
✔✔Paralytics - ✔✔A safer, more effective approach is "chemical paralysis" with
neuromuscular blocking agents. With the pt chemically sedated and paralyzed, his or
her protective airway reflexes are lost; you can effectively perform oxygenation and
ventilation, and the pt will not gag during insertion of an ET tube. Paralytics, unlike
sedatives do not affect the LOC. Pt can still hear/think/and feel!
✔✔Acetylcholine (ACh) - ✔✔Paralytic medications function at the neromuscular junction
and relax the muscle by impeding the action of ACh.
✔✔Depolarizing Neuromuscular Blocker - ✔✔Competitively binds with the ACh receptor
sites but is not affected as quickly by acetylcholinesterase. Therefore, it causes
depolarization of the muscle and prevents future signals for depolarization from have an
effect because all of ACh receptor sites have been occupied. Very rapid onset (60-90
seconds) of total paralysis and short duration of action (5-10 minutes).
✔✔Succinylcholine - ✔✔(Anectine): 1.15mg/kg via IV push (initial dose); repeated
doses can be given based on the pt's clinical response. It is the only depolarizing
neuromuscular blocking agent. Because it causes depolarization, fasciculations can be
observed during its administration. Often used as a initial paralytic. Should be used in
caution with pt's that have burns, crush injuries, and blunt trauma. Can cause
bradycardia. *If you administer this without administering a long-acting paralytic
(norcuron, pavulon), you will have to re-administer by IV bolus every 5 minutes.
✔✔Fasciculations - ✔✔Brief, uncoordinated twitching of small muscle groups in the
face, neck, trunk and extremities.
