ICEMA Standard Operating Procedures for
Emergency Response
When do you use Lidocaine with an adult? - correct answers ✔️✔️intubation, king airways, NG or OG
tubes, I.C.P., Arrest protocol, and symptomatic V-tack with pulses.
When do you use Lidocaine with a pediatric? - correct answers ✔️✔️King airway 15 years old and
above, NG/ OG tube, I.C.P., and cardiac arrest.
What is your adult Lidocaine dose for all situations (except for follow up dose in arrest)? - correct
answers ✔️✔️Lidocaine 1.5 milligrams per kilogram, I.V. or I.O. for all adult situations, with the
exception of your second dose in an arrest.
When is the only time you have a max dose of Lidocaine? - correct answers ✔️✔️Only in wide-complex
tachycardia or v-tack with pulses, and your second dose in an arrest.
When do you give Mag Sulfate? - correct answers ✔️✔️1. Polymorphic V-tach at 2 grams, only if
polymorphic wide-complex v-tach is seen after cardioversion. 2. Eclampsia at 4 grams in slow-push, or at
10 milligrams per minute with a drip.
On what ages can you start an E.J.? - correct answers ✔️✔A
️ nyone above 8 years old.
What is the max for CPAP pressure? - correct answers ✔️✔️15 cm H20.
, What ages can you insert an IO in numerous other sites, like the distal tibia, humeral head, and anterior
distal femur? - correct answers ✔️✔️9 years old and above
When do you use the king airway on adults? - correct answers ✔️✔️If they meet ALL of these criteria:
15 years old or older, over 4 feet tall, unresponsive with agonal respirations.
When do you use a king airway on pediatrics? - correct answers ✔️✔️If they meet ALL of these criteria:
Under 15 years old, agonal respirations, unresponsive, no gag reflex, and has proper tube size.
What rate do you start pacing a patient and at what amp setting? - correct answers ✔️✔S️ tart at a rate
of 60, start at lowest amp and increase to a max of 100 amps until capture, asses radial pulses and
perfusion.
What do you do with a symptomatic (POOR PERFUSION) Brady patient? - correct answers ✔️✔️12 lead,
fluids, Atropine at .5mg (MAX OF 3MG). If Atropine is ineffective, patient has ST elevation, has a 3rd
degree heart block with wide complex, or has 2nd degree type 2 heart block, begin pacing.
What do you do if you see a patient having SVT on the monitor? - correct answers ✔️✔S️ tart 300 mL
bolus, vagal maneuvers if ASYMPTOMATIC, Adenosine in right AC, cardioversion if refractory to
Adenosine, call base. Remember to PUT PADS ON THE PATIENT BEFORE GIVING ADENOSINE.
What do you do if a patient is in V-Tack with pulses? - correct answers ✔️✔️If the V-tack is regular and
monomorphic, give Adenosine. Polymorphic V-tack would mean the patient is in cardiac arrest.
What do you do for a patient in A-Fib? - correct answers ✔️✔️If a patient is in A-Fib or A-flutter and are
hemodynamically unstable, cardiovert the patient and contact base.
What is considered altered trauma criteria in Trauma Triage? - correct answers ✔️✔️GCS 13 and below
resulting from trauma.
What is under Mechanism Criteria for Trauma Triage? - correct answers ✔️✔F️ or adults, falls over 20
feet, pediatric falls over 10 feet or two times the height of child. Intrusion, ejection, death in passenger
seat, telemetry data, and 20-20. Contact base, but if Mechanism Criteria is met ALONG WITH signs of
poor perfusion, immediately transport to Trauma Center.
Emergency Response
When do you use Lidocaine with an adult? - correct answers ✔️✔️intubation, king airways, NG or OG
tubes, I.C.P., Arrest protocol, and symptomatic V-tack with pulses.
When do you use Lidocaine with a pediatric? - correct answers ✔️✔️King airway 15 years old and
above, NG/ OG tube, I.C.P., and cardiac arrest.
What is your adult Lidocaine dose for all situations (except for follow up dose in arrest)? - correct
answers ✔️✔️Lidocaine 1.5 milligrams per kilogram, I.V. or I.O. for all adult situations, with the
exception of your second dose in an arrest.
When is the only time you have a max dose of Lidocaine? - correct answers ✔️✔️Only in wide-complex
tachycardia or v-tack with pulses, and your second dose in an arrest.
When do you give Mag Sulfate? - correct answers ✔️✔️1. Polymorphic V-tach at 2 grams, only if
polymorphic wide-complex v-tach is seen after cardioversion. 2. Eclampsia at 4 grams in slow-push, or at
10 milligrams per minute with a drip.
On what ages can you start an E.J.? - correct answers ✔️✔A
️ nyone above 8 years old.
What is the max for CPAP pressure? - correct answers ✔️✔️15 cm H20.
, What ages can you insert an IO in numerous other sites, like the distal tibia, humeral head, and anterior
distal femur? - correct answers ✔️✔️9 years old and above
When do you use the king airway on adults? - correct answers ✔️✔️If they meet ALL of these criteria:
15 years old or older, over 4 feet tall, unresponsive with agonal respirations.
When do you use a king airway on pediatrics? - correct answers ✔️✔️If they meet ALL of these criteria:
Under 15 years old, agonal respirations, unresponsive, no gag reflex, and has proper tube size.
What rate do you start pacing a patient and at what amp setting? - correct answers ✔️✔S️ tart at a rate
of 60, start at lowest amp and increase to a max of 100 amps until capture, asses radial pulses and
perfusion.
What do you do with a symptomatic (POOR PERFUSION) Brady patient? - correct answers ✔️✔️12 lead,
fluids, Atropine at .5mg (MAX OF 3MG). If Atropine is ineffective, patient has ST elevation, has a 3rd
degree heart block with wide complex, or has 2nd degree type 2 heart block, begin pacing.
What do you do if you see a patient having SVT on the monitor? - correct answers ✔️✔S️ tart 300 mL
bolus, vagal maneuvers if ASYMPTOMATIC, Adenosine in right AC, cardioversion if refractory to
Adenosine, call base. Remember to PUT PADS ON THE PATIENT BEFORE GIVING ADENOSINE.
What do you do if a patient is in V-Tack with pulses? - correct answers ✔️✔️If the V-tack is regular and
monomorphic, give Adenosine. Polymorphic V-tack would mean the patient is in cardiac arrest.
What do you do for a patient in A-Fib? - correct answers ✔️✔️If a patient is in A-Fib or A-flutter and are
hemodynamically unstable, cardiovert the patient and contact base.
What is considered altered trauma criteria in Trauma Triage? - correct answers ✔️✔️GCS 13 and below
resulting from trauma.
What is under Mechanism Criteria for Trauma Triage? - correct answers ✔️✔F️ or adults, falls over 20
feet, pediatric falls over 10 feet or two times the height of child. Intrusion, ejection, death in passenger
seat, telemetry data, and 20-20. Contact base, but if Mechanism Criteria is met ALONG WITH signs of
poor perfusion, immediately transport to Trauma Center.
