****Critical Care for Paramedics Exam
Review 2026/2027 | Comprehensive Study
Guide, Practice Questions, Answers &
Detailed Rationales**
When should you perform the intubation during RSI?
When the waveform etco2 is flat- meaning the NMBA is working and the diaphragm has
stopped.
NG tube during RSI?
No clamp, continuous suction
Nitrogen washout
Apply high flow 02 to prepare for intubation and washout the N2.
Who gets atropine during RSI and why?
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
0.02 mg/kg. Max dose: 0.5 mg
,What can you do if pediatric patient has Low BP prior to RSI?
Push presssors
Lidocaine RSI dose
1.0- 1.5 mg/kg IV
What is lidocaine used for in RSI?
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?
Etomidate, Versed, Ketamine, and propofol
Etomidate dose
0.2-0.3mg/kg
What is the preferred drug for sedation in RSI?
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?
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?
Causes Adrenocortical supression
Dose for Versed in RSI?
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?
1.5-4.0 mg/kg IV over 1 minute ( 5-10 mg/kg IM)
When is ketamine preferred?
In pediatrics due to halluciations
What receptors does ketamine stimulate?
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?
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
Continued sedation dose: 5-50 mcg/kg/min
Propofol contraindications
OB and < 8 year old peds
What effects will propofol have on the body?
Will lower the BP. Will reduce airway resistance and can be useful inducting patients
with bronchospasm.
Is propofol an analgesic?
No it has sedation and amnesia properties
Is propfol good for patients with intracranial pathology?
Yes, if they are stable.
Review 2026/2027 | Comprehensive Study
Guide, Practice Questions, Answers &
Detailed Rationales**
When should you perform the intubation during RSI?
When the waveform etco2 is flat- meaning the NMBA is working and the diaphragm has
stopped.
NG tube during RSI?
No clamp, continuous suction
Nitrogen washout
Apply high flow 02 to prepare for intubation and washout the N2.
Who gets atropine during RSI and why?
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
0.02 mg/kg. Max dose: 0.5 mg
,What can you do if pediatric patient has Low BP prior to RSI?
Push presssors
Lidocaine RSI dose
1.0- 1.5 mg/kg IV
What is lidocaine used for in RSI?
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?
Etomidate, Versed, Ketamine, and propofol
Etomidate dose
0.2-0.3mg/kg
What is the preferred drug for sedation in RSI?
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?
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?
Causes Adrenocortical supression
Dose for Versed in RSI?
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?
1.5-4.0 mg/kg IV over 1 minute ( 5-10 mg/kg IM)
When is ketamine preferred?
In pediatrics due to halluciations
What receptors does ketamine stimulate?
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?
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
Continued sedation dose: 5-50 mcg/kg/min
Propofol contraindications
OB and < 8 year old peds
What effects will propofol have on the body?
Will lower the BP. Will reduce airway resistance and can be useful inducting patients
with bronchospasm.
Is propofol an analgesic?
No it has sedation and amnesia properties
Is propfol good for patients with intracranial pathology?
Yes, if they are stable.
