KERN COUNTY PROTOCOLS EXAM
QUESTIONS AND ANSWERS
Seizure adult - Answers -BG, No IV access then 5mgIM if <40kg if >40kg 10mg IM.
IF IV access versed 0.1mg/kg max 5mg
IF actively seizing and pregnent/postpartem (30days post delivery) mag sulfate 4-6
grams slow IV over 5-10minutes IF the patient continues to seize give versed 10mg if
>40kg and 5mg if <40kg IM or IN, max 1mg per nare
combative adult patient - Answers -midazolam 5mg IM or 2mgIV
Hypoglycemia - Answers -If unable to swallow(15mg oral glucose) then 10% dextrose
5mL/kg max 250mL
If unable to establish administer 1mg of glucagon IM
Same for pediatric over 8 years old
if <8 yrs old and no IV access 0.5 glucagon
adult crush injury - Answers -If unable to establish vascular access while entrapped
place tourniquet PRIOR to extrication. If patient is at risk for crush injury syndrome or if
there is evidence of hyperkalemia (peaked T‐ waves in multiple leads, absent p‐waves,
and/or widened QRS complex) administer: Calcium Chloride 20mg/kg slow IV/IO push,
Repeat x1 for persistent ECG abnormalities. Sodium Bicarbonate 1 mEq/kg slow IV/IO
push, Repeat x1 for persistent ECG abnormalities. Albuterol 5mg via neb, repeat
continuously until hospital arrival.
adult allergic reaction - Answers -• IV/Monitor • Administer Epinephrine 0.3 mg IM of
1:1000 to lateral thigh.
• If signs and symptoms unresolved administer Diphenhydramine 50 mg IM OR 25-50
mg slow IVP
• If unresolved, may repeat IM Epinephrine
• If severe distress initiate Push Dose Epinephrine 0.5 mL IVP every 1-5 minutes to
Systolic B/P > 90 OR Epinephrine drip 2-8 mcg/min. Start at 2mcg/min and titrate to
affect.
• If any signs of airway compromise or complaint of difficulty breathing initiate transport
early.
SVT STABLE - Answers -narrow QRS <0.12 SEC.>150 With Regular Pulse. Attempt
Vagal Maneuvers, if no change Give Adenosine 6 mg Rapid IVP if no change repeat
Adenosine at 12 mg rapid IVP X 2 as needed
QUESTIONS AND ANSWERS
Seizure adult - Answers -BG, No IV access then 5mgIM if <40kg if >40kg 10mg IM.
IF IV access versed 0.1mg/kg max 5mg
IF actively seizing and pregnent/postpartem (30days post delivery) mag sulfate 4-6
grams slow IV over 5-10minutes IF the patient continues to seize give versed 10mg if
>40kg and 5mg if <40kg IM or IN, max 1mg per nare
combative adult patient - Answers -midazolam 5mg IM or 2mgIV
Hypoglycemia - Answers -If unable to swallow(15mg oral glucose) then 10% dextrose
5mL/kg max 250mL
If unable to establish administer 1mg of glucagon IM
Same for pediatric over 8 years old
if <8 yrs old and no IV access 0.5 glucagon
adult crush injury - Answers -If unable to establish vascular access while entrapped
place tourniquet PRIOR to extrication. If patient is at risk for crush injury syndrome or if
there is evidence of hyperkalemia (peaked T‐ waves in multiple leads, absent p‐waves,
and/or widened QRS complex) administer: Calcium Chloride 20mg/kg slow IV/IO push,
Repeat x1 for persistent ECG abnormalities. Sodium Bicarbonate 1 mEq/kg slow IV/IO
push, Repeat x1 for persistent ECG abnormalities. Albuterol 5mg via neb, repeat
continuously until hospital arrival.
adult allergic reaction - Answers -• IV/Monitor • Administer Epinephrine 0.3 mg IM of
1:1000 to lateral thigh.
• If signs and symptoms unresolved administer Diphenhydramine 50 mg IM OR 25-50
mg slow IVP
• If unresolved, may repeat IM Epinephrine
• If severe distress initiate Push Dose Epinephrine 0.5 mL IVP every 1-5 minutes to
Systolic B/P > 90 OR Epinephrine drip 2-8 mcg/min. Start at 2mcg/min and titrate to
affect.
• If any signs of airway compromise or complaint of difficulty breathing initiate transport
early.
SVT STABLE - Answers -narrow QRS <0.12 SEC.>150 With Regular Pulse. Attempt
Vagal Maneuvers, if no change Give Adenosine 6 mg Rapid IVP if no change repeat
Adenosine at 12 mg rapid IVP X 2 as needed
