Critical Care Paramedic Exam
Questions with Verified Answers
Normal pH - ANSWERS7.35-7.45
Normal CO2 - ANSWERS35-45
Normal HCO3 - ANSWERS22-26 (good dating age)
Normal PaO2 - ANSWERS80-100
Normal SaO2 - ANSWERS> 95%
Base (deficit/excess) - ANSWERS(-2) - (+2)
Buffer systems: Bicarb reaction time - ANSWERSseconds
Buffer systems: Lungs reaction time - ANSWERSminutes
Buffer systems: Kidneys reaction time - ANSWERShours to days
Minute volume calculation - ANSWERSTidal volume x respiratory rate
pCO2 >45 - ANSWERSacidotic
pCO2 <35 - ANSWERSalkalotic
HCO3 <22 - ANSWERSacidotic
HCO3 >26 - ANSWERSalkalotic
base deficit of < -4 - ANSWERSindicator for the potential need for blood transfusion
base deficit of < -19 - ANSWERSindicates poor outcome (death likely)
base deficit replacement formula - ANSWERS0.1 x (-BE) x patient weight in kg = bicarb
needed
PO2 of 60 is roughly equivalent to a SaO2 of - ANSWERS90%
critical pH for intubation - ANSWERS< 7.2
critical pCO2 for intubation - ANSWERS> 55
,critical pO2 for intubation - ANSWERS< 60
number one cause of metabolic acidosis - ANSWERSlactic acidosis (lactate > 4)
CO2 is a byproduct of - ANSWERSmetabolism
for every __ change in ETCO2, you should expect the pH to change __ in the
___________ direction. - ANSWERS10, 0.08, opposite
for every __ change in pH, you should expect the HCO3 to change __ in the
___________ direction. - ANSWERS0.15, 10, same
for every __ change in pH, you should expect the potassium to change __ in the
___________ direction. - ANSWERS0.10, 0.6, opposite
LEMON - ANSWERSdifficult intubation
look, evaluate (3-3-2), mallampati, obstructions, neck mobility
HEAVEN - ANSWERSdifficult intubation
Hypoxia, extremes of size, anatomic challenges, vomit/blood/fluid, exsanguination, neck
mobility issues
ramping - ANSWERSear to sternal notch
without ramping during intubation or transport causes a potential for -
ANSWERSdecrease in functional reserve capacity, tidal volume, and preload
Sellick's maneuver and BURP - ANSWERSno longer recommended
External laryngeal manipulation (ELM) - ANSWERScurrent standard of practice
bougie adult size - ANSWERS15 Fr
bougie pediatric size - ANSWERS10 Fr
bougie neonatal size - ANSWERS6 Fr
supraglottic devices - ANSWERSprovide little protection against aspiration
ETT cuff pressure - ANSWERS20-30 mmHg (25 is standard)
gold standard of confirming ET placement - ANSWERSchest X-Ray
distal tip of ET - ANSWERS2-3 cm (1 inch) above carina, at T3 or T4
,7 p's for RSI success - ANSWERSpreparation, preoxygenation, pretreatment, paralysis
with induction, protect/position, placement (with proof), post intubation management
LOAD - ANSWERSpretreatment for RSI
lidocaine, opiates, atropine (infants), defasiculating dose
fentanyl adult dose - ANSWERS1 mcg/kg
fentanyl onset - ANSWERS3-5 mins
fentanyl post intubation management - ANSWERS0.5 - 1.5 mcg/kg every 5 minutes
fentanyl post intubation management infusion - ANSWERS1-3 mcg/kg/hour
fentanyl reversal agent - ANSWERSnarcan
etomidate adult dose - ANSWERS0.3 mg/kg
etomidate onset time - ANSWERS15-45 seconds
etomidate duration - ANSWERS3-12 minutes
etomidate cautions/contraindications - ANSWERShemodynamically unstable patients,
adrenal suppression, shock patients, COPD/asthmatic
ketamine adult dose - ANSWERS1-2 mg/kg
ketamine onset - ANSWERS40-60 seconds
ketamine duration - ANSWERS10-20 minutes
ketamine is preferred for - ANSWERSasthmatic patients
ketamine post intubation management - ANSWERS0.5 - 1 mg/kg
ketamine post intubation management infusion - ANSWERS1-2 mg/kg/hour
versed adult dose - ANSWERS2.5-5 mg
versed onset - ANSWERS30-60 seconds
versed duration - ANSWERS15-30 minute duration
versed post intubation management - ANSWERS2-5 mg
versed post intubation management infusion - ANSWERS0.05 - 0.1 mg/kg/hour
, versed reversal agent - ANSWERSflumazenil (romazicon) 0.2 mg
propofol (diprivan) adult RSI dose - ANSWERS1-2 mg/kg
propofol (diprivan) adult maintenance dose - ANSWERS25-50 mcg/kg/min
propofol (diprivan) onset - ANSWERS15-45 seconds
propofol (diprivan) duration - ANSWERS5-10 minutes
propofol (diprivan) cautions - ANSWERShemodynamically unstable patients
succinylcholine (anectine) - ANSWERSdepolarizing neuromuscular blocker agent
succinylcholine (anectine) can cause - ANSWERSfasciculations
hyperkalemia
succinylcholine (anectine) requires - ANSWERSrefrigeration
succinylcholine (anectine) contraindications - ANSWERScrush injuries, eye injuries,
narrow-angle glaucoma, malignant hyperthermia, burns >24 hours old, hyperkalemia,
Guillain- Barre, Myasthenia gravis
succinylcholine (anectine) adult dose - ANSWERS1-2 mg/kg (max 150)
succinylcholine (anectine) onset - ANSWERS< 1 minute
succinylcholine (anectine) duration - ANSWERS4-6 minute duration
malignant hyperthermia - ANSWERSrapid body temperature increase and increased
ETCO2
malignant hyperthermia treatment - ANSWERSDantrolene Sodium (Dantrium) 2.5
mg/kg rapid
Rocuronium (Zemeron) - ANSWERSnon-depolarizing neuromuscular blocking agent
Rocuronium (Zemeron) adult RSI dose - ANSWERS0.6 - 1.2 mg/kg
Rocuronium (Zemeron) maintainance dose - ANSWERS0.1 - 0.2 mg/kg every 20-30
minutes
Rocuronium (Zemeron) onset - ANSWERS< 2 minutes
Rocuronium (Zemeron) duration - ANSWERS30 - 60 minutes
Questions with Verified Answers
Normal pH - ANSWERS7.35-7.45
Normal CO2 - ANSWERS35-45
Normal HCO3 - ANSWERS22-26 (good dating age)
Normal PaO2 - ANSWERS80-100
Normal SaO2 - ANSWERS> 95%
Base (deficit/excess) - ANSWERS(-2) - (+2)
Buffer systems: Bicarb reaction time - ANSWERSseconds
Buffer systems: Lungs reaction time - ANSWERSminutes
Buffer systems: Kidneys reaction time - ANSWERShours to days
Minute volume calculation - ANSWERSTidal volume x respiratory rate
pCO2 >45 - ANSWERSacidotic
pCO2 <35 - ANSWERSalkalotic
HCO3 <22 - ANSWERSacidotic
HCO3 >26 - ANSWERSalkalotic
base deficit of < -4 - ANSWERSindicator for the potential need for blood transfusion
base deficit of < -19 - ANSWERSindicates poor outcome (death likely)
base deficit replacement formula - ANSWERS0.1 x (-BE) x patient weight in kg = bicarb
needed
PO2 of 60 is roughly equivalent to a SaO2 of - ANSWERS90%
critical pH for intubation - ANSWERS< 7.2
critical pCO2 for intubation - ANSWERS> 55
,critical pO2 for intubation - ANSWERS< 60
number one cause of metabolic acidosis - ANSWERSlactic acidosis (lactate > 4)
CO2 is a byproduct of - ANSWERSmetabolism
for every __ change in ETCO2, you should expect the pH to change __ in the
___________ direction. - ANSWERS10, 0.08, opposite
for every __ change in pH, you should expect the HCO3 to change __ in the
___________ direction. - ANSWERS0.15, 10, same
for every __ change in pH, you should expect the potassium to change __ in the
___________ direction. - ANSWERS0.10, 0.6, opposite
LEMON - ANSWERSdifficult intubation
look, evaluate (3-3-2), mallampati, obstructions, neck mobility
HEAVEN - ANSWERSdifficult intubation
Hypoxia, extremes of size, anatomic challenges, vomit/blood/fluid, exsanguination, neck
mobility issues
ramping - ANSWERSear to sternal notch
without ramping during intubation or transport causes a potential for -
ANSWERSdecrease in functional reserve capacity, tidal volume, and preload
Sellick's maneuver and BURP - ANSWERSno longer recommended
External laryngeal manipulation (ELM) - ANSWERScurrent standard of practice
bougie adult size - ANSWERS15 Fr
bougie pediatric size - ANSWERS10 Fr
bougie neonatal size - ANSWERS6 Fr
supraglottic devices - ANSWERSprovide little protection against aspiration
ETT cuff pressure - ANSWERS20-30 mmHg (25 is standard)
gold standard of confirming ET placement - ANSWERSchest X-Ray
distal tip of ET - ANSWERS2-3 cm (1 inch) above carina, at T3 or T4
,7 p's for RSI success - ANSWERSpreparation, preoxygenation, pretreatment, paralysis
with induction, protect/position, placement (with proof), post intubation management
LOAD - ANSWERSpretreatment for RSI
lidocaine, opiates, atropine (infants), defasiculating dose
fentanyl adult dose - ANSWERS1 mcg/kg
fentanyl onset - ANSWERS3-5 mins
fentanyl post intubation management - ANSWERS0.5 - 1.5 mcg/kg every 5 minutes
fentanyl post intubation management infusion - ANSWERS1-3 mcg/kg/hour
fentanyl reversal agent - ANSWERSnarcan
etomidate adult dose - ANSWERS0.3 mg/kg
etomidate onset time - ANSWERS15-45 seconds
etomidate duration - ANSWERS3-12 minutes
etomidate cautions/contraindications - ANSWERShemodynamically unstable patients,
adrenal suppression, shock patients, COPD/asthmatic
ketamine adult dose - ANSWERS1-2 mg/kg
ketamine onset - ANSWERS40-60 seconds
ketamine duration - ANSWERS10-20 minutes
ketamine is preferred for - ANSWERSasthmatic patients
ketamine post intubation management - ANSWERS0.5 - 1 mg/kg
ketamine post intubation management infusion - ANSWERS1-2 mg/kg/hour
versed adult dose - ANSWERS2.5-5 mg
versed onset - ANSWERS30-60 seconds
versed duration - ANSWERS15-30 minute duration
versed post intubation management - ANSWERS2-5 mg
versed post intubation management infusion - ANSWERS0.05 - 0.1 mg/kg/hour
, versed reversal agent - ANSWERSflumazenil (romazicon) 0.2 mg
propofol (diprivan) adult RSI dose - ANSWERS1-2 mg/kg
propofol (diprivan) adult maintenance dose - ANSWERS25-50 mcg/kg/min
propofol (diprivan) onset - ANSWERS15-45 seconds
propofol (diprivan) duration - ANSWERS5-10 minutes
propofol (diprivan) cautions - ANSWERShemodynamically unstable patients
succinylcholine (anectine) - ANSWERSdepolarizing neuromuscular blocker agent
succinylcholine (anectine) can cause - ANSWERSfasciculations
hyperkalemia
succinylcholine (anectine) requires - ANSWERSrefrigeration
succinylcholine (anectine) contraindications - ANSWERScrush injuries, eye injuries,
narrow-angle glaucoma, malignant hyperthermia, burns >24 hours old, hyperkalemia,
Guillain- Barre, Myasthenia gravis
succinylcholine (anectine) adult dose - ANSWERS1-2 mg/kg (max 150)
succinylcholine (anectine) onset - ANSWERS< 1 minute
succinylcholine (anectine) duration - ANSWERS4-6 minute duration
malignant hyperthermia - ANSWERSrapid body temperature increase and increased
ETCO2
malignant hyperthermia treatment - ANSWERSDantrolene Sodium (Dantrium) 2.5
mg/kg rapid
Rocuronium (Zemeron) - ANSWERSnon-depolarizing neuromuscular blocking agent
Rocuronium (Zemeron) adult RSI dose - ANSWERS0.6 - 1.2 mg/kg
Rocuronium (Zemeron) maintainance dose - ANSWERS0.1 - 0.2 mg/kg every 20-30
minutes
Rocuronium (Zemeron) onset - ANSWERS< 2 minutes
Rocuronium (Zemeron) duration - ANSWERS30 - 60 minutes
