PBCFR Protocols - ALS Medical Emergencies Exam
Questions with 100% Correct Answers Graded A+
Allergic Reaction - What two vital signs do we need? __&__ ____, and
_____&____.
15 & 12 (leave cables connected)
ETC02 & SP02
Allergic Reaction - Mild reaction is described as _________ ____?
Treatment is ________?
Urticaria only.
Tx is Benadryl (50mg/1ml, dilute with 9ml of NS, over 2 min IV/IO, >1 MO)
Allergic Reaction - Moderate Reaction is described as ____________ +
__________ ________?
Tx is ___, _______, _________, ____-______?
Normotensive + Additional Symptoms (Airway Swelling, Abd pain, Vomiting, Respiratory
distress, Bronchospasm, Tongue and/or facial swelling)
Tx - Epi (1:1,000 1mg/ml IM, may repeat 2x in 5 min intervals), Benadryl (50mg/1ml,
dilute with 9ml of NS, over 2 min IV/IO, >1 MO), Albuterol (2.5mg via nebulizer prn),
Solu-medrol (125mg IV/IO/IM, over 2 min for IV/IO)
Allergic Reaction - Severe Reaction is described as ___________ + __________
________?
Tx is ____ ____ ___, __, ________, ________, ____-______?
Hypotensive + Addition symptoms (loss of radial pulse or SBP <90 mmHg)
Tx - Push Dose Epi (1:100,000, Titrate to maintain SBP 100mmHg. Max total dose
300mcg (30mL)), Normal Saline (1L IV/IO, assess lung sounds and BP frequently. May
repeat 1x prn), Benadryl (50mg/1ml, dilute with 9ml of NS, over 2 min IV/IO, >1 MO),
Albuterol (2.5mg via nebulizer prn), Solu-medrol (125mg IV/IO/IM, over 2 min for IV/IO)
Allergic Reaction - _________ source of ________ ________, if possible.
Eliminate source of allergic reaction, if possible
Diabetic Emergencies - Vitals to be obtained are ___, __, __ & __ ____?
BGL (Heel stick preferred for <1yo), Establish an IV, 12 & 15 Lead
Diabetic Emergencies - Hypoglycemia is defined as BGL < __?
Tx is ____ ______, and/or _-__?
BGL <60
Tx - Oral glucose (15g, may repeat 1x, must be conscious enough to swallow), D10
(100ml IV/IO, retest glucose, may repeat 1x) IF pt is in cardiac arrest we give 250ml
via 15 gtt set, run wide open, my repeat 1x
Diabetic Emergencies - Hyperglycemia is defined as BGL> ___?
Tx is __?
BGL >300
Tx - Normal Saline (1L IV/IO, titrate to desired effect. Assess lung sounds and BP
frequently. May repeat 1x prn)
Diabetic Emergencies - Symptoms of hypoglycemia are A__, S_____ S____,
D_____ P_____, I_________, S_____?
AMS, Slurred Speech, Dilated Pupils, Irritability, Seizures.
, Diabetic Emergencies - Symptoms of hyperglycemia with DKA are
N_____/V______, A________ P___, G_____ W_______, A__, H_______,
H_________?
N/V, Abdominal pain, General weakness, AMS, Hypotension, Tachycardia.
Dystonic Reaction - General requirements are ______ ____ _____, __&__ ____, __,
_________?
Vital signs, 12 & 15 Lead, IV, Benadryl (50mg/1ml, dilute with 9ml of NS, over 2 min
IV/IO, >1 MO)
Dystonic Reaction - are caused by Anti-_________, Anti-_______, and Anti-
___________. (2 examples for each)
Anti-psychotics (droperidol, haldol, risperdal)
Anti-emetics (compazine, reglan, phenergan)
Anti-depressants (prozac, paxil)
Dysonic Reaction - a dystonic reaction can occur ___________ or be delayed for
_____ to ____?
Immediately
Hours to Days
Fluid Resuscitation/Dehydration - Symptoms (list 5, there are 8)
Hypotension
Fatigue
Dark color urine
Dry mouth
Headache
Prolonged vomiting and/or diarrhea Suspected rhabdomyolysis
Paramedic Discretion
Fluid Resuscitation/Dehydration - Tx?
NORMAL SALINE (1L IV/IO, titrate to desired effect. Assess lung sounds and BP
frequently. May repeat 1x prn)
Hyperkalemia - what three vitals are we looking for initially? _____ & ____, __&__
____, __.
ETC02 & SP02, 12&15 Lead, IV
Hyperkalemia - Consider hyperkalemia in patients with a history of _____-
_______/_______ who are pre-_______ AND present with any of the following:
______ _______ or ______ ___________ (Name 3 of the 5)
Renal-Failure/Dialysis, Pre-Dialysis
General weakness OR Cardiac arrhythmias (Bradycardia, 2nd or 3rd degree heart
blocks, RWCT, Sine Wave, Widening or bizarre QRS complex)
Hyperkalemia - If pt presents with cardiac arrythmias or ECG abnormalities, what
do we give?
CALCIUM CHLORIDE: 1g IV/IO, over 2 minutes (Diff. line than sodium bicarb)
ALBUTEROL: 2.5mg via nebulizer, Continuous treatments (if an advanced airway is
utilized, administer via in-line nebulization)
SODIUM BICARBONATE: 100mEq IV/IO, over 2 minutes (Diff. line than calcium
chloride)
Hyperkalemia - If pt is hypotensive, what do we give?
Questions with 100% Correct Answers Graded A+
Allergic Reaction - What two vital signs do we need? __&__ ____, and
_____&____.
15 & 12 (leave cables connected)
ETC02 & SP02
Allergic Reaction - Mild reaction is described as _________ ____?
Treatment is ________?
Urticaria only.
Tx is Benadryl (50mg/1ml, dilute with 9ml of NS, over 2 min IV/IO, >1 MO)
Allergic Reaction - Moderate Reaction is described as ____________ +
__________ ________?
Tx is ___, _______, _________, ____-______?
Normotensive + Additional Symptoms (Airway Swelling, Abd pain, Vomiting, Respiratory
distress, Bronchospasm, Tongue and/or facial swelling)
Tx - Epi (1:1,000 1mg/ml IM, may repeat 2x in 5 min intervals), Benadryl (50mg/1ml,
dilute with 9ml of NS, over 2 min IV/IO, >1 MO), Albuterol (2.5mg via nebulizer prn),
Solu-medrol (125mg IV/IO/IM, over 2 min for IV/IO)
Allergic Reaction - Severe Reaction is described as ___________ + __________
________?
Tx is ____ ____ ___, __, ________, ________, ____-______?
Hypotensive + Addition symptoms (loss of radial pulse or SBP <90 mmHg)
Tx - Push Dose Epi (1:100,000, Titrate to maintain SBP 100mmHg. Max total dose
300mcg (30mL)), Normal Saline (1L IV/IO, assess lung sounds and BP frequently. May
repeat 1x prn), Benadryl (50mg/1ml, dilute with 9ml of NS, over 2 min IV/IO, >1 MO),
Albuterol (2.5mg via nebulizer prn), Solu-medrol (125mg IV/IO/IM, over 2 min for IV/IO)
Allergic Reaction - _________ source of ________ ________, if possible.
Eliminate source of allergic reaction, if possible
Diabetic Emergencies - Vitals to be obtained are ___, __, __ & __ ____?
BGL (Heel stick preferred for <1yo), Establish an IV, 12 & 15 Lead
Diabetic Emergencies - Hypoglycemia is defined as BGL < __?
Tx is ____ ______, and/or _-__?
BGL <60
Tx - Oral glucose (15g, may repeat 1x, must be conscious enough to swallow), D10
(100ml IV/IO, retest glucose, may repeat 1x) IF pt is in cardiac arrest we give 250ml
via 15 gtt set, run wide open, my repeat 1x
Diabetic Emergencies - Hyperglycemia is defined as BGL> ___?
Tx is __?
BGL >300
Tx - Normal Saline (1L IV/IO, titrate to desired effect. Assess lung sounds and BP
frequently. May repeat 1x prn)
Diabetic Emergencies - Symptoms of hypoglycemia are A__, S_____ S____,
D_____ P_____, I_________, S_____?
AMS, Slurred Speech, Dilated Pupils, Irritability, Seizures.
, Diabetic Emergencies - Symptoms of hyperglycemia with DKA are
N_____/V______, A________ P___, G_____ W_______, A__, H_______,
H_________?
N/V, Abdominal pain, General weakness, AMS, Hypotension, Tachycardia.
Dystonic Reaction - General requirements are ______ ____ _____, __&__ ____, __,
_________?
Vital signs, 12 & 15 Lead, IV, Benadryl (50mg/1ml, dilute with 9ml of NS, over 2 min
IV/IO, >1 MO)
Dystonic Reaction - are caused by Anti-_________, Anti-_______, and Anti-
___________. (2 examples for each)
Anti-psychotics (droperidol, haldol, risperdal)
Anti-emetics (compazine, reglan, phenergan)
Anti-depressants (prozac, paxil)
Dysonic Reaction - a dystonic reaction can occur ___________ or be delayed for
_____ to ____?
Immediately
Hours to Days
Fluid Resuscitation/Dehydration - Symptoms (list 5, there are 8)
Hypotension
Fatigue
Dark color urine
Dry mouth
Headache
Prolonged vomiting and/or diarrhea Suspected rhabdomyolysis
Paramedic Discretion
Fluid Resuscitation/Dehydration - Tx?
NORMAL SALINE (1L IV/IO, titrate to desired effect. Assess lung sounds and BP
frequently. May repeat 1x prn)
Hyperkalemia - what three vitals are we looking for initially? _____ & ____, __&__
____, __.
ETC02 & SP02, 12&15 Lead, IV
Hyperkalemia - Consider hyperkalemia in patients with a history of _____-
_______/_______ who are pre-_______ AND present with any of the following:
______ _______ or ______ ___________ (Name 3 of the 5)
Renal-Failure/Dialysis, Pre-Dialysis
General weakness OR Cardiac arrhythmias (Bradycardia, 2nd or 3rd degree heart
blocks, RWCT, Sine Wave, Widening or bizarre QRS complex)
Hyperkalemia - If pt presents with cardiac arrythmias or ECG abnormalities, what
do we give?
CALCIUM CHLORIDE: 1g IV/IO, over 2 minutes (Diff. line than sodium bicarb)
ALBUTEROL: 2.5mg via nebulizer, Continuous treatments (if an advanced airway is
utilized, administer via in-line nebulization)
SODIUM BICARBONATE: 100mEq IV/IO, over 2 minutes (Diff. line than calcium
chloride)
Hyperkalemia - If pt is hypotensive, what do we give?
