Critical care paramedic Exam Questions with Correct Answers

Critical care paramedic Exam Questions with Correct Answers When should you perform the intubation during RSI? - Answer-When the waveform etco2 is flat- meaning the NMBA is working and the diaphragm has stopped. Nitrogen washout - Answer-Apply high flow 02 to prepare for intubation and washout the N2. Who gets atropine during RSI and why? - Answer-Pediatric patients 2-3 y/o prior to RSI. Pediatric patients cardiac output is rate dependent. Pediatric patients are not able to raise inotropy. Atropine will help prevent with bradycardia. Atropine dose - Answer-0.02 mg/kg. Max dose: 0.5 mg What can you do if pediatric patient has Low BP prior to RSI? - Answer-administer vasopresssors Lidocaine RSI dose - Answer-1.0- 1.5 mg/kg IV What is lidocaine used for in RSI? - Answer-For patients with suspected increased ICP. Lidocaine will decrease vagal nerve stimulation. It will cause blunting of the airway reflexes and prevent coughing, gagging, which will raise ICP. What are the drug options for sedation in RSI? - Answer-Etomidate, Versed, Ketamine, and propofol Etomidate dose - Answer-0.2-0.3mg/kg What is the preferred drug for sedation in RSI? - Answer-Etomidate. Has rapid onset of 10-20 seconds, short duration of 4-10 mins, can be used in peds, has no histamine release. What are the downsides to giving etomidate for RSI? - Answer-Causes a mild increase in airway resistance, Myoclonus may be seen, and you must avoid in septic patients. Why can you not give etomidate for septic patients? - Answer-Causes Adrenocortical supression Dose for Versed in RSI? - Answer-2.5-5.0 Mg Iv or .1-.3 mg/kg. Has a rapid onset of .5- 2 mins, and a short duration of 20-30 mins. Pediatric infusion dose: 0.05-0.4mg/kg per hour Ketamine dose for RSI? - Answer-1.5-4.0 mg/kg IV over 1 minute ( 5-10 mg/kg IM) When is ketamine preferred? - Answer-In pediatrics due to halluciations What receptors does ketamine stimulate? - Answer-Stimulates the opiod receptor causing analgesia. Will stimulate the catecholamine receptors and release cateccholamines leading to increased HR, contractility, MAP, and BP. Does ketamine increase ICP? - Answer-No evidence shows that ketamine increases ICP in hypotensive or normotensive patients. Best not to give ketamine in patients who have suspected IC with high blood pressure. Propofol dose - Answer-Continued sedation dose: 5-50 mcg/kg/min Propofol contraindications - Answer-OB and 8 year old peds What effects will propofol have on the body? - Answer-Will lower the BP. Will reduce airway resistance and can be useful inducting patients with bronchospasm. Is propofol an analgesic? - Answer-No it has sedation and amnesia properties Is propfol good for patients with intracranial pathology? - Answer-Yes, if they are stable. What side effects can all neuromuscular blocking agents cause? - Answer-They all can cause Low BP and Malignant hyperthermia. Succinylcholine dose - Answer-1-1.5 mg/kg Higher doses may reduce occurance of myalgia.