MEP clinical care exam with complete
solutions 2024/2025
move to i gel after how many failed intubation attempts? - ANSWER- 2
sedation meds for post intubation - ANSWER- ketamine or versed plus fentanyl
when is drug assisted airway indicated in peds? - ANSWER- only after all less
invasive procedures have failed
4 reasons to consider RSI - ANSWER- - failure to protect airway (GCS < 9)
-failure to ventilate/ oxygenate (severe copd/ asthma)
- anticipated clinical course (airway burns) (head injury)
- to facilitate safety (combative or excited delerium)
bradycardia protocol criteria - ANSWER- HR < 60 with symptoms of ALOC, chest
pain ,SOB, or hemodynamic instability
symptomatic bradycardia protocol - ANSWER- -place pads on PT
- obtain BGL, vitals, iv access, and 12-lead
- atropine if 1st degree, 2nd degree type 1, or increased vagal tone
- pacing if persistent bradycardia with evidence of cardiopulmonary compromise
- use fentanyl + versed to sedate if BP allows
- consider push dose epi if arrest is imminent
consider lucas placement after _______ minutes of cpr? - ANSWER- 6
pediatric arrest when should io access be considered? - ANSWER- first
adult arrest when should io access be used? - ANSWER- use iv access if you
have a good site first
move to io after 2 failed iv attempts
, if still in v-fib/ v-tach after 3 shocks consider... - ANSWER- changing pad
placement or
use dual sequential defibrillation
if pt wakes up during lucas cpr and still don't have a pulse consider... - ANSWER-
ketamine 2 mg/kg max 200 mg iv
when should you not resuscitate in location found? - ANSWER- if scene is not
safe
preferred vasopressor for post rosc management - ANSWER- norepi
chest pain / stemi protocol - ANSWER- - 12 lead within 10 minutes
- iv access
- aspirin, nitro, fentanyl as indicated
- pads on if stemi
- st agnes
difficulty breathing protocol - ANSWER- -titrate oxygen to 93-98
- always utilize etco2
- if bronchospasm give duoneb (> 20 kg)
- if suspected croup give racemic epi
- 12 lead iv access
- if pulmonary edema consider nitro + cpap as indicated
- if severe asthma consider IM epi
- moderate to severe asthma/ copd give dex
- severe asthma/ copd with no improvements give mag sulfate
- if imminent arrest consider push dose epi
tachycardia protocol (bpm> 100) - ANSWER- -iv access, bgl, 12 lead
- place pads on pt
- vagal maneuver if rhythm is regular
- stable narrow give adenosine
- print monitor during administration
- stable wide give amiodarone
- if irregular give diltiazem (not peds)
- if torsades give mag sulfate
-unstable give sedation as indicated and cardiovert
if pt crowning... - ANSWER- do not transport, prepare ppe/ ob kit and deliver
solutions 2024/2025
move to i gel after how many failed intubation attempts? - ANSWER- 2
sedation meds for post intubation - ANSWER- ketamine or versed plus fentanyl
when is drug assisted airway indicated in peds? - ANSWER- only after all less
invasive procedures have failed
4 reasons to consider RSI - ANSWER- - failure to protect airway (GCS < 9)
-failure to ventilate/ oxygenate (severe copd/ asthma)
- anticipated clinical course (airway burns) (head injury)
- to facilitate safety (combative or excited delerium)
bradycardia protocol criteria - ANSWER- HR < 60 with symptoms of ALOC, chest
pain ,SOB, or hemodynamic instability
symptomatic bradycardia protocol - ANSWER- -place pads on PT
- obtain BGL, vitals, iv access, and 12-lead
- atropine if 1st degree, 2nd degree type 1, or increased vagal tone
- pacing if persistent bradycardia with evidence of cardiopulmonary compromise
- use fentanyl + versed to sedate if BP allows
- consider push dose epi if arrest is imminent
consider lucas placement after _______ minutes of cpr? - ANSWER- 6
pediatric arrest when should io access be considered? - ANSWER- first
adult arrest when should io access be used? - ANSWER- use iv access if you
have a good site first
move to io after 2 failed iv attempts
, if still in v-fib/ v-tach after 3 shocks consider... - ANSWER- changing pad
placement or
use dual sequential defibrillation
if pt wakes up during lucas cpr and still don't have a pulse consider... - ANSWER-
ketamine 2 mg/kg max 200 mg iv
when should you not resuscitate in location found? - ANSWER- if scene is not
safe
preferred vasopressor for post rosc management - ANSWER- norepi
chest pain / stemi protocol - ANSWER- - 12 lead within 10 minutes
- iv access
- aspirin, nitro, fentanyl as indicated
- pads on if stemi
- st agnes
difficulty breathing protocol - ANSWER- -titrate oxygen to 93-98
- always utilize etco2
- if bronchospasm give duoneb (> 20 kg)
- if suspected croup give racemic epi
- 12 lead iv access
- if pulmonary edema consider nitro + cpap as indicated
- if severe asthma consider IM epi
- moderate to severe asthma/ copd give dex
- severe asthma/ copd with no improvements give mag sulfate
- if imminent arrest consider push dose epi
tachycardia protocol (bpm> 100) - ANSWER- -iv access, bgl, 12 lead
- place pads on pt
- vagal maneuver if rhythm is regular
- stable narrow give adenosine
- print monitor during administration
- stable wide give amiodarone
- if irregular give diltiazem (not peds)
- if torsades give mag sulfate
-unstable give sedation as indicated and cardiovert
if pt crowning... - ANSWER- do not transport, prepare ppe/ ob kit and deliver
