County Protocols: Questions With Appropriate
Solutions
10% Dextrose Therapeutic Effect Accurate Answer:- Simple sugar
which the body can rapidly metabolize while in a hypoglycemic state
10% Dextrose Indication Accurate Answer:- Hypoglycemia as
suggested by lethargy or coma in a known diabetic with documented blood
sugar < 60
10% Dextrose Dose (A) Accurate Answer:- D10 (10% in 250 mls NS) up
to 25 grams IV/IO push/drip, Repeat x1 in 5 minutes if necessary.
10% Dextrose Dose (P) Accurate Answer:- D10 (10% in 250 mls NS) 5
ml/kg. Max dose 250 ml
Aspirin Therapeutic Effects Accurate Answer:- an antipyretic, anti-
inflammatory analgesic with properties reducing platelet aggregation that
may reduce the size of a blood clot within the coronary artery causing an AMI
Aspirin Contraindications Accurate Answer:- Hypersensitivity to
aspirin or nonsteroidal anti-inflammatory analgesics
Aspirin Dose (A) Accurate Answer:- 160- 325 mg chewable adults only
Adenosine (Adenocard) Therapeutic Effect Accurate Answer:- Slows
conduction time through atrioventricular (AV) node.
Interrupts reentry pathways through AV node.
Restores sinus rhythm in patients with supraventricular tachycardia (SVT)
Adenosine (Adenocard) Indications Accurate Answer:- Conversion of
PSVT to sinus rhythm. This includes the initial diagnosis and treatment of
stable, undifferentiated, regular, monomorphic wide complex tachycardia and
excludes known Wolf Parkinson White Syndrome
Adenosine (Adenocard) Contraindications Accurate Answer:- -Second-
or third- degree AV block (if no pacemaker is present)
-sick sinus syndrome
,-hypersensitivity to drug
Adenosine (Adenocard) Precautions/Side Effects Accurate Answer:-
May exacerbate asthma. Reduce initial dose to 3 mg in pts receiving
Persantine (dipyridamole), Carbamazepine, Aggrenox , and heart transplant
pt
Adenosine (Adenocard) Dose (A) Accurate Answer:- 6 or 12mg rapid
IVP (per protocol), within 1-3 seconds, followed by a rapid flush of 10mL of
NS
If no conversion after 1-2 minutes, may repeat 12mg rapid IVP followed by
rapid flush of 10mL of NS.
Adenosine (Adinocard) Dose (P) Accurate Answer:- 0.1 mg/kg IV/IO
bolus over 1-2 seconds (max
dose of 6 mg). If no response; administer 0.2 mg/kg IV/IO bolus over 1-2
seconds ( max dose of 12 mg). All dose should be given through the most
proximal IV and followed with a 10 cc normal saline rapid bolus.
Albuterol Therapeutic Effects Accurate Answer:- synthetic
sympathomimetic which causes bronchodilatation with less cardiac effects
then epinephrine. The duration effect is about 4 hours
Albuterol Indications Accurate Answer:- 1 adult asthma/pediatric
respiratory wheezes
2 bronchospasm in emphysema
3 chronic bronchitis
4 Wheezing associated with toxic smoke inhalation
5 Renal failure with hypotension and bradycardia associated with EKG
evidence of hyperkalemia
6 Crush Syndrome prior to release of compression or if the pt has hypotension
and bradycardia associated with EKG evidence of hyperkalemia
Albuterol Precautions Accurate Answer:- caution with cardiac or
hypertensive pt.
Albuterol Dose (A) Accurate Answer:- Breathing related: 2.5 mg in 3 ml
NS via SVN
, Renal failure or crush injury: 5mg in 6 ml NS via SVN
albuterol Dose (P) Accurate Answer:- Breathing related: 2.5 mg in 3 ml
NS via SVN
Renal failure or crush injury: 2.5 mg in 3 ml NS via SVN
Amiodarone Therapeutic Effects Accurate Answer:- prolongs
myocardial cell action potential duration, and refractory period, and
noncompetitively inhibits alpha and beta-adrenergic simulation.
Amiodarone Indications Accurate Answer:- 1- recurrent ventricular
fibrillation or recurrent pulseless ventricular tachycardia
2- recurrent hemodynamically unstable ventricular tachycardia
3 - Stable ventricular tachycardia in consultation with online medical control
Amiodarone Contraindications Accurate Answer:- hypersensitivity
Amiodarone Precautions/Side Effects Accurate Answer:- -may prolong
QT interval
-may increase risk of Torsades
-increase risk of AV block and hypotension when taking a calcium channel
blocker.
Amiodarone Dose (A) - VF or pulseless VT Accurate Answer:- 300 mg
diluted in 20 ml of NS IVP/IO Repeat once after 3-5 at 150 mg in 10 ml
Amiodarone Dose (A)- unstable VT Accurate Answer:- 150 mg in 10 ml
NS, IV over 10 minutes and may repeat q 10 minutes as needed
Amiodarone Dose (A)- stable VT Accurate Answer:- medical control-
150 mg diluted on 10 ml NS, IV over 10 minutes
Amiodarone Dose (P) - VF or pulseless VT Accurate Answer:- 5mg/kg
with 4ml NS for every 50 mg of amio. IVP/IO Max single dose of 300 mg. May
repeat 5mg/kg 3-5 minutes to a total dose of 15mg/kg in 24 hours
Amiodarone Dose (P) - unstable VT or stable VT Accurate Answer:- 5
mg/kg diluted with 4ml of NS for every 50 mg of amio. IV/IO over 20-60
minutes Max single dose of 300 mg.
Solutions
10% Dextrose Therapeutic Effect Accurate Answer:- Simple sugar
which the body can rapidly metabolize while in a hypoglycemic state
10% Dextrose Indication Accurate Answer:- Hypoglycemia as
suggested by lethargy or coma in a known diabetic with documented blood
sugar < 60
10% Dextrose Dose (A) Accurate Answer:- D10 (10% in 250 mls NS) up
to 25 grams IV/IO push/drip, Repeat x1 in 5 minutes if necessary.
10% Dextrose Dose (P) Accurate Answer:- D10 (10% in 250 mls NS) 5
ml/kg. Max dose 250 ml
Aspirin Therapeutic Effects Accurate Answer:- an antipyretic, anti-
inflammatory analgesic with properties reducing platelet aggregation that
may reduce the size of a blood clot within the coronary artery causing an AMI
Aspirin Contraindications Accurate Answer:- Hypersensitivity to
aspirin or nonsteroidal anti-inflammatory analgesics
Aspirin Dose (A) Accurate Answer:- 160- 325 mg chewable adults only
Adenosine (Adenocard) Therapeutic Effect Accurate Answer:- Slows
conduction time through atrioventricular (AV) node.
Interrupts reentry pathways through AV node.
Restores sinus rhythm in patients with supraventricular tachycardia (SVT)
Adenosine (Adenocard) Indications Accurate Answer:- Conversion of
PSVT to sinus rhythm. This includes the initial diagnosis and treatment of
stable, undifferentiated, regular, monomorphic wide complex tachycardia and
excludes known Wolf Parkinson White Syndrome
Adenosine (Adenocard) Contraindications Accurate Answer:- -Second-
or third- degree AV block (if no pacemaker is present)
-sick sinus syndrome
,-hypersensitivity to drug
Adenosine (Adenocard) Precautions/Side Effects Accurate Answer:-
May exacerbate asthma. Reduce initial dose to 3 mg in pts receiving
Persantine (dipyridamole), Carbamazepine, Aggrenox , and heart transplant
pt
Adenosine (Adenocard) Dose (A) Accurate Answer:- 6 or 12mg rapid
IVP (per protocol), within 1-3 seconds, followed by a rapid flush of 10mL of
NS
If no conversion after 1-2 minutes, may repeat 12mg rapid IVP followed by
rapid flush of 10mL of NS.
Adenosine (Adinocard) Dose (P) Accurate Answer:- 0.1 mg/kg IV/IO
bolus over 1-2 seconds (max
dose of 6 mg). If no response; administer 0.2 mg/kg IV/IO bolus over 1-2
seconds ( max dose of 12 mg). All dose should be given through the most
proximal IV and followed with a 10 cc normal saline rapid bolus.
Albuterol Therapeutic Effects Accurate Answer:- synthetic
sympathomimetic which causes bronchodilatation with less cardiac effects
then epinephrine. The duration effect is about 4 hours
Albuterol Indications Accurate Answer:- 1 adult asthma/pediatric
respiratory wheezes
2 bronchospasm in emphysema
3 chronic bronchitis
4 Wheezing associated with toxic smoke inhalation
5 Renal failure with hypotension and bradycardia associated with EKG
evidence of hyperkalemia
6 Crush Syndrome prior to release of compression or if the pt has hypotension
and bradycardia associated with EKG evidence of hyperkalemia
Albuterol Precautions Accurate Answer:- caution with cardiac or
hypertensive pt.
Albuterol Dose (A) Accurate Answer:- Breathing related: 2.5 mg in 3 ml
NS via SVN
, Renal failure or crush injury: 5mg in 6 ml NS via SVN
albuterol Dose (P) Accurate Answer:- Breathing related: 2.5 mg in 3 ml
NS via SVN
Renal failure or crush injury: 2.5 mg in 3 ml NS via SVN
Amiodarone Therapeutic Effects Accurate Answer:- prolongs
myocardial cell action potential duration, and refractory period, and
noncompetitively inhibits alpha and beta-adrenergic simulation.
Amiodarone Indications Accurate Answer:- 1- recurrent ventricular
fibrillation or recurrent pulseless ventricular tachycardia
2- recurrent hemodynamically unstable ventricular tachycardia
3 - Stable ventricular tachycardia in consultation with online medical control
Amiodarone Contraindications Accurate Answer:- hypersensitivity
Amiodarone Precautions/Side Effects Accurate Answer:- -may prolong
QT interval
-may increase risk of Torsades
-increase risk of AV block and hypotension when taking a calcium channel
blocker.
Amiodarone Dose (A) - VF or pulseless VT Accurate Answer:- 300 mg
diluted in 20 ml of NS IVP/IO Repeat once after 3-5 at 150 mg in 10 ml
Amiodarone Dose (A)- unstable VT Accurate Answer:- 150 mg in 10 ml
NS, IV over 10 minutes and may repeat q 10 minutes as needed
Amiodarone Dose (A)- stable VT Accurate Answer:- medical control-
150 mg diluted on 10 ml NS, IV over 10 minutes
Amiodarone Dose (P) - VF or pulseless VT Accurate Answer:- 5mg/kg
with 4ml NS for every 50 mg of amio. IVP/IO Max single dose of 300 mg. May
repeat 5mg/kg 3-5 minutes to a total dose of 15mg/kg in 24 hours
Amiodarone Dose (P) - unstable VT or stable VT Accurate Answer:- 5
mg/kg diluted with 4ml of NS for every 50 mg of amio. IV/IO over 20-60
minutes Max single dose of 300 mg.
