Paramedic High■Yield Study Guide
Test Strategy
• Read the question twice.
• Do not overthink. First instincts are often correct when you understand the pathophysiology.
AV Blocks
• 1st Degree: PR interval >0.20 sec, every P followed by QRS, usually asymptomatic.
• 2nd Degree Type I (Wenckebach): progressive PR prolongation then dropped QRS. Treat
symptomatic with atropine.
• 2nd Degree Type II (Mobitz II): constant PR with random dropped QRS. Prepare for pacing.
• 3rd Degree: complete dissociation between P and QRS. Treat with pacing.
Cardiac Axis
• Lead I up / aVF up = Normal axis.
• Lead I up / aVF down = Left axis deviation.
• Lead I down / aVF up = Right axis deviation.
• Lead I down / aVF down = Extreme axis.
Wolff■Parkinson■White
• Delta wave on ECG caused by accessory conduction pathway.
Hyperkalemia
• ECG: peaked T waves, widened QRS.
• Treatments: Calcium chloride/gluconate, sodium bicarbonate, albuterol, insulin with D50.
TCA Overdose
• Amitriptyline (Elavil) toxicity causes sodium channel blockade.
• Wide QRS and ventricular dysrhythmias.
• Treatment: Sodium bicarbonate.
Respiratory
Test Strategy
• Read the question twice.
• Do not overthink. First instincts are often correct when you understand the pathophysiology.
AV Blocks
• 1st Degree: PR interval >0.20 sec, every P followed by QRS, usually asymptomatic.
• 2nd Degree Type I (Wenckebach): progressive PR prolongation then dropped QRS. Treat
symptomatic with atropine.
• 2nd Degree Type II (Mobitz II): constant PR with random dropped QRS. Prepare for pacing.
• 3rd Degree: complete dissociation between P and QRS. Treat with pacing.
Cardiac Axis
• Lead I up / aVF up = Normal axis.
• Lead I up / aVF down = Left axis deviation.
• Lead I down / aVF up = Right axis deviation.
• Lead I down / aVF down = Extreme axis.
Wolff■Parkinson■White
• Delta wave on ECG caused by accessory conduction pathway.
Hyperkalemia
• ECG: peaked T waves, widened QRS.
• Treatments: Calcium chloride/gluconate, sodium bicarbonate, albuterol, insulin with D50.
TCA Overdose
• Amitriptyline (Elavil) toxicity causes sodium channel blockade.
• Wide QRS and ventricular dysrhythmias.
• Treatment: Sodium bicarbonate.
Respiratory
