Kern County ALS Drug Protocols: Questions With
Reliable Answers
Allergic Reaction/Anaphylaxis Accurate Answer:- -Epinephrine 0.3 mg
IM of 1:1000
-Unresolved Diphenhydramine 50 mg IM OR 25-50 mg slow IVP
-Unresolved May repeat IM EPI
-If severe distress initiate Push Dose Epinephrine 0.5 mL IVP every 1-5
minutes to Systolic B/P > 90 OR Epinephrine drip 2-8 mcg/min. Start at
2mcg/min and titrate to effect.
Asystole/ Pulseless Electrical Activity Accurate Answer:- -Epinephrine
IV drip 2-8 mcg/min repeat as needed. Start at 8mcg/min and titrate down
once ROSC is achieved.
-Suspected Hyperkalemia? If yes, give Calcium Chloride 20mg/kg
-Consider fluid challenge 20mL/kg
Bradycardia Accurate Answer:- -If poor perfusion is present, prepare
for TRANSCUTANEOUS PACING at a rate of 80 bpm
-Consider pain management with 1 mg Midazolam and 50 mcg Fentanyl prior
to TCP if Systolic B/P >90
-Consider Atropine 0.5 mg IV while preparing pacer. May repeat to a max dose
of 3 mg.
-Consider Push Dose Epinephrine 0.5 mL every 1-5 minutes OR Epinephrine
drip 2-8 mcg/min. Start at 2mcg/min and titrate to effect, if pacing ineffective.
Burns Accurate Answer:- -Respiratory compromise or stridor? ET
Intubation administer Midazolam after airway is secured.
-Adult 1 mg Midazolam slow IVP may repeat in 1 mg increments to max of 5
mg.
-(Parkland Formula)
4mL/kg X TBSA burned give 1/2 in first 8hrs then other 1/2 over next 16hr.
-Pain management: Ketamine: 15mg in 100mL N.S. infused over 5 minutes,
may repeat one time in 15 minutes or 25mg IN
-OR Fentanyl: Adult 50 mcg slow IV/IM/IO/IN may repeat in 50 mcg
increments to max of 200 mcg.
-OR Morphine: Adult 5mg IV/IO/IM, may repeat in
5mg increments to a max of 20mg
Reliable Answers
Allergic Reaction/Anaphylaxis Accurate Answer:- -Epinephrine 0.3 mg
IM of 1:1000
-Unresolved Diphenhydramine 50 mg IM OR 25-50 mg slow IVP
-Unresolved May repeat IM EPI
-If severe distress initiate Push Dose Epinephrine 0.5 mL IVP every 1-5
minutes to Systolic B/P > 90 OR Epinephrine drip 2-8 mcg/min. Start at
2mcg/min and titrate to effect.
Asystole/ Pulseless Electrical Activity Accurate Answer:- -Epinephrine
IV drip 2-8 mcg/min repeat as needed. Start at 8mcg/min and titrate down
once ROSC is achieved.
-Suspected Hyperkalemia? If yes, give Calcium Chloride 20mg/kg
-Consider fluid challenge 20mL/kg
Bradycardia Accurate Answer:- -If poor perfusion is present, prepare
for TRANSCUTANEOUS PACING at a rate of 80 bpm
-Consider pain management with 1 mg Midazolam and 50 mcg Fentanyl prior
to TCP if Systolic B/P >90
-Consider Atropine 0.5 mg IV while preparing pacer. May repeat to a max dose
of 3 mg.
-Consider Push Dose Epinephrine 0.5 mL every 1-5 minutes OR Epinephrine
drip 2-8 mcg/min. Start at 2mcg/min and titrate to effect, if pacing ineffective.
Burns Accurate Answer:- -Respiratory compromise or stridor? ET
Intubation administer Midazolam after airway is secured.
-Adult 1 mg Midazolam slow IVP may repeat in 1 mg increments to max of 5
mg.
-(Parkland Formula)
4mL/kg X TBSA burned give 1/2 in first 8hrs then other 1/2 over next 16hr.
-Pain management: Ketamine: 15mg in 100mL N.S. infused over 5 minutes,
may repeat one time in 15 minutes or 25mg IN
-OR Fentanyl: Adult 50 mcg slow IV/IM/IO/IN may repeat in 50 mcg
increments to max of 200 mcg.
-OR Morphine: Adult 5mg IV/IO/IM, may repeat in
5mg increments to a max of 20mg
