REMAC Paramedic 2024/2025 NYC Questions Answered Correctly – Expert Verified | Latest Version (Altered Mental Status - Adult and Pediatric) What interventions are conducted if the glucometer reading is < 60 mg/dl in cases of altered mental status in adult and pediatric patients? - ✔✔Administer Dextrose or Glucagon as follows: ADULT: Dextrose up to 25 g IV PEDIATRIC: Dextrose at 0.5 g/kg IV (maximum 25 g) with varying concentrations based on age. If intravascular access is unavailable, administer Glucagon at 1 mg IM/IN for both adult and pediatric patients experiencing altered mental status. (Altered Mental Status - Adult and Pediatric) What is the initial step in managing altered mental status in both a dult and pediatric patients? - ✔✔Obtain the blood glucose level (BGL) as the initial step in managing altered mental status in both adult and pediatric patients. If the BGL is < 60 mg/dl and the patient is conscious and able to drink without assistance, ad minister a glucose solution or another sugar -
containing beverage. (Altered Mental Status - Adult and Pediatric) What procedural step follows the initial assessment in managing altered mental status in adult and pediatric patients? - ✔✔Obtain intravascular access as the subsequent step in the management of altered mental status in both adult and pediatric cases. (Altered Mental Status - Pediatric) What specific considerations are to be followed when managing altered mental status in pediatric patients, particularly concerning intravascular access and underlying causes? - ✔✔In pediatric cases of altered mental status, no more than 2 attempts at obtai ning intravascular access shall be made before administering Glucagon. The preferred administration route for Glucagon is intranasal (IN). Consider the underlying causes of altered mental status (e.g., trauma, medical, behavioral) and treat appropriate ly. Avoid administering oral solutions to unconscious patients or to patients with head injuries. Diabetic patients with a blood glucose level reading between 60 -80 mg/dl may still exhibit symptoms related to hypoglycemia. In the presence of such signs and symptoms, treat accordingly. (Non -Traumatic Card Arrest - Pediatric, OLMC) What is the recommended administration of crystalloid fluids in pediatric cardiac arrest cases? - ✔✔Administer crystalloid fluids at 20 ml/kg IV (maximum 2 L) in pediatric sit uations. (Non -Traumatic Card Arrest - Pediatric, OLMC) In cases of persistent or recurring ventricular fibrillation or pulseless ventricular tachycardia in pediatric patients, what are the medication options for administration? - ✔✔Administer one of the f ollowing: • OPTION A: Amiodarone 5 mg/kg IV (maximum 150 mg). Repeat as needed (maximum cumulative 3 doses) • OPTION B: Magnesium Sulfate 25 -50 mg/kg IV (maximum 2 g) in pediatric cardiac arrest cases. Magnesium Sulfate must be diluted prior to administ ration. An example method uses Magnesium Sulfate 2 g diluted in 50 ml Normal Saline (final concentration 40 mg/ml). Agitate the solution prior to withdrawing the desired volume (Non -Traumatic Card Arrest - Pediatric, OLMC) In cases of suspected hyperkalem ia or calcium channel blocker overdose in pediatric patients, what is the procedure for administering Calcium Chloride? - ✔✔Administer Calcium Chloride at 20 mg/kg IV (maximum 1 g) slowly, followed by a crystalloid fluid flush. (Non -Traumatic Cardiac Arre st - Adult, OLMC) For suspected tricyclic antidepressant overdose, salicylate toxicity, or hyperkalemia, what medication should be administered intravenously and repeated as needed every 10 minutes? - ✔✔Sodium Bicarbonate 44 -88 mEq IV. Repeat Sodium Bicarb onate 44 mEq IV as needed. (Non -Traumatic Cardiac Arrest - Adult, OLMC) How much crystalloid fluid should be administered intravenously (IV) during resuscitation? - ✔✔Administer 20 ml/kg IV (maximum 2 L) of crystalloid fluids. (Non -Traumatic Cardiac Arre st - Adult, OLMC) In cases of suspected hyperkalemia or calcium channel blocker overdose, what should be administered intravenously and followed by a crystalloid fluid flush? - ✔✔Calcium Chloride 1 g IV slowly, followed by a crystalloid fluid flush.
containing beverage. (Altered Mental Status - Adult and Pediatric) What procedural step follows the initial assessment in managing altered mental status in adult and pediatric patients? - ✔✔Obtain intravascular access as the subsequent step in the management of altered mental status in both adult and pediatric cases. (Altered Mental Status - Pediatric) What specific considerations are to be followed when managing altered mental status in pediatric patients, particularly concerning intravascular access and underlying causes? - ✔✔In pediatric cases of altered mental status, no more than 2 attempts at obtai ning intravascular access shall be made before administering Glucagon. The preferred administration route for Glucagon is intranasal (IN). Consider the underlying causes of altered mental status (e.g., trauma, medical, behavioral) and treat appropriate ly. Avoid administering oral solutions to unconscious patients or to patients with head injuries. Diabetic patients with a blood glucose level reading between 60 -80 mg/dl may still exhibit symptoms related to hypoglycemia. In the presence of such signs and symptoms, treat accordingly. (Non -Traumatic Card Arrest - Pediatric, OLMC) What is the recommended administration of crystalloid fluids in pediatric cardiac arrest cases? - ✔✔Administer crystalloid fluids at 20 ml/kg IV (maximum 2 L) in pediatric sit uations. (Non -Traumatic Card Arrest - Pediatric, OLMC) In cases of persistent or recurring ventricular fibrillation or pulseless ventricular tachycardia in pediatric patients, what are the medication options for administration? - ✔✔Administer one of the f ollowing: • OPTION A: Amiodarone 5 mg/kg IV (maximum 150 mg). Repeat as needed (maximum cumulative 3 doses) • OPTION B: Magnesium Sulfate 25 -50 mg/kg IV (maximum 2 g) in pediatric cardiac arrest cases. Magnesium Sulfate must be diluted prior to administ ration. An example method uses Magnesium Sulfate 2 g diluted in 50 ml Normal Saline (final concentration 40 mg/ml). Agitate the solution prior to withdrawing the desired volume (Non -Traumatic Card Arrest - Pediatric, OLMC) In cases of suspected hyperkalem ia or calcium channel blocker overdose in pediatric patients, what is the procedure for administering Calcium Chloride? - ✔✔Administer Calcium Chloride at 20 mg/kg IV (maximum 1 g) slowly, followed by a crystalloid fluid flush. (Non -Traumatic Cardiac Arre st - Adult, OLMC) For suspected tricyclic antidepressant overdose, salicylate toxicity, or hyperkalemia, what medication should be administered intravenously and repeated as needed every 10 minutes? - ✔✔Sodium Bicarbonate 44 -88 mEq IV. Repeat Sodium Bicarb onate 44 mEq IV as needed. (Non -Traumatic Cardiac Arrest - Adult, OLMC) How much crystalloid fluid should be administered intravenously (IV) during resuscitation? - ✔✔Administer 20 ml/kg IV (maximum 2 L) of crystalloid fluids. (Non -Traumatic Cardiac Arre st - Adult, OLMC) In cases of suspected hyperkalemia or calcium channel blocker overdose, what should be administered intravenously and followed by a crystalloid fluid flush? - ✔✔Calcium Chloride 1 g IV slowly, followed by a crystalloid fluid flush.
