Critical Care Paramedic Test Questions
With Complete Solutions
Laryngoscopy CORRECT ANSWERS Step1-Appropriate Sniffing Position: head back,
neck flexed (ear hole/external auditory eatus is at same plane as sternal notch. Need to
elevate head 5-7inches up (once elevated, tilt head all the way back).
Step2-translate mandibular process by opening mouth, two finger technique
Step3-Insert scope, inch down tongue until you see epiglottis
Step4-Make Vallecula actual space with ELM, and with no force yet, put blade under
vallecula
Step5-Lift until see posterior notch, or until head moves up
CVA HTN Tx if over Sys: 210 or Dia: 120 CORRECT ANSWERS Start with Nicardipine,
5mg/hr and titrate up with adding 2.5mg/hr every 5 minsnprior to dropping back down,
up to 15mg
Bougie Cricothyrotomy CORRECT ANSWERS Step1-Equipment (6cuffed,
syringe,scalpel, bvm w/Etco2, dressing, bougie)
Step2-Landmarks (between cricoid ring and thyroid cartilage)-can't find, then vertical
incision
Step3-1.5-2cm incision into cricothyroid membrane, immediately placing finger into
incision to augment/keep location.
Step4-insert bougie, feel for tracheal clicks
Step5-insert 6 ETT, make have to put pressure/back&forth, and once balloon in, your
good to blow up cuff
hypotension with ACS CORRECT ANSWERS Consider 1-2L NS, and then inotropes:
dopamine/dobutamine
For AMS and hx Alcoholism/Malnutrition CORRECT ANSWERS Give Thiamine IV
100mg
Options for Combative Patient CORRECT ANSWERS 1)Versed 2-5mg IV
2)Ativan 1-2mg IV, q/3mins can repeat
3)Valium 5-10mg can repeat 15min
4)Haldol same as Valium but IM also
5)Ketamine .2mg/kg
For adult anaphylaxis don't forget CORRECT ANSWERS corticosteroid: Solumedrol,
helps with late phase
200mg Anaphylaxis, 125mg Hace and Resp. Distress
History of WPW, treat like CORRECT ANSWERS V-Tach Protocol, not Afib-RVR
so Ami 150mg in ten mins, may repeat
, Afib RVR Stable vs. Unstable CORRECT ANSWERS Dilt IV 5-10 mins =Stable (can
repeat in 5-10) .25mg/kg (repeat at .35)
Cardiovert 100J=Unstable
don't forget 12 leads
Positioning for CVA pts CORRECT ANSWERS 20-30 degree head elevation
Cincinnati Stroke Scale CORRECT ANSWERS Droop, Drift, Speech
On CVAs don't forget? CORRECT ANSWERS 12-lead, over 185/110 & candidate, over
185 2x give 10mg labetalol, titrate to effect but don't drop more than 15%
Blood Glucose should not be dropped? CORRECT ANSWERS 50-100 mg/dl per hour
In DKA patients, avoid? CORRECT ANSWERS intubation, if you have to, set RR @30,
help breath off acid
Sepsis Patient Induction CORRECT ANSWERS Use Ketamine over Etomidate due to
adrenal suppression,
Fun Facts of Sepsis CORRECT ANSWERS 1-raise HOB 30-45 degrees
2-CVPs goal=8-12mmHg
3-MAP goal= greater than 65
4-fluid challenges, 3l crystalloid over 45 mins
Levels of hyperkalemia CORRECT ANSWERS 1-Tall peaked T waves (6mEq/l)
2-Prolonged PR interval (6.5mEq/l)
3-Loss of p-wave (6.5-7)
4-Widening of qrs (7-7.5)
5-Sine wave, v-fib/tach (8-10)
Hyperkalemia Treatment CORRECT ANSWERS 1-CaCl 500mg IV over 3 mins (EKG
changes or K+ greater than 6.2),
2-NaHCO3 50meq/or 1meEq/kg over 5 mins (especially if acidotic)
3-Albuterol 5-20mg over 15 mins
4-Glucose/Insulin: 10 units reg. insulin IV push, and 25 grams D50W IV push (just give
the 10U of insulin is BS more than 200)
Significant Sepsis Prognostic CORRECT ANSWERS Lactate greater than 4, ticking
time bombs
GI Hemorrhage CORRECT ANSWERS -NG/OG
-Octreotide: decreases GI Motility/Acid Prod., decreases hepatic portal pressures,
relieves venous congestion, 25-50mcg IV Push, and then 25-50 mcg/hr IV
With Complete Solutions
Laryngoscopy CORRECT ANSWERS Step1-Appropriate Sniffing Position: head back,
neck flexed (ear hole/external auditory eatus is at same plane as sternal notch. Need to
elevate head 5-7inches up (once elevated, tilt head all the way back).
Step2-translate mandibular process by opening mouth, two finger technique
Step3-Insert scope, inch down tongue until you see epiglottis
Step4-Make Vallecula actual space with ELM, and with no force yet, put blade under
vallecula
Step5-Lift until see posterior notch, or until head moves up
CVA HTN Tx if over Sys: 210 or Dia: 120 CORRECT ANSWERS Start with Nicardipine,
5mg/hr and titrate up with adding 2.5mg/hr every 5 minsnprior to dropping back down,
up to 15mg
Bougie Cricothyrotomy CORRECT ANSWERS Step1-Equipment (6cuffed,
syringe,scalpel, bvm w/Etco2, dressing, bougie)
Step2-Landmarks (between cricoid ring and thyroid cartilage)-can't find, then vertical
incision
Step3-1.5-2cm incision into cricothyroid membrane, immediately placing finger into
incision to augment/keep location.
Step4-insert bougie, feel for tracheal clicks
Step5-insert 6 ETT, make have to put pressure/back&forth, and once balloon in, your
good to blow up cuff
hypotension with ACS CORRECT ANSWERS Consider 1-2L NS, and then inotropes:
dopamine/dobutamine
For AMS and hx Alcoholism/Malnutrition CORRECT ANSWERS Give Thiamine IV
100mg
Options for Combative Patient CORRECT ANSWERS 1)Versed 2-5mg IV
2)Ativan 1-2mg IV, q/3mins can repeat
3)Valium 5-10mg can repeat 15min
4)Haldol same as Valium but IM also
5)Ketamine .2mg/kg
For adult anaphylaxis don't forget CORRECT ANSWERS corticosteroid: Solumedrol,
helps with late phase
200mg Anaphylaxis, 125mg Hace and Resp. Distress
History of WPW, treat like CORRECT ANSWERS V-Tach Protocol, not Afib-RVR
so Ami 150mg in ten mins, may repeat
, Afib RVR Stable vs. Unstable CORRECT ANSWERS Dilt IV 5-10 mins =Stable (can
repeat in 5-10) .25mg/kg (repeat at .35)
Cardiovert 100J=Unstable
don't forget 12 leads
Positioning for CVA pts CORRECT ANSWERS 20-30 degree head elevation
Cincinnati Stroke Scale CORRECT ANSWERS Droop, Drift, Speech
On CVAs don't forget? CORRECT ANSWERS 12-lead, over 185/110 & candidate, over
185 2x give 10mg labetalol, titrate to effect but don't drop more than 15%
Blood Glucose should not be dropped? CORRECT ANSWERS 50-100 mg/dl per hour
In DKA patients, avoid? CORRECT ANSWERS intubation, if you have to, set RR @30,
help breath off acid
Sepsis Patient Induction CORRECT ANSWERS Use Ketamine over Etomidate due to
adrenal suppression,
Fun Facts of Sepsis CORRECT ANSWERS 1-raise HOB 30-45 degrees
2-CVPs goal=8-12mmHg
3-MAP goal= greater than 65
4-fluid challenges, 3l crystalloid over 45 mins
Levels of hyperkalemia CORRECT ANSWERS 1-Tall peaked T waves (6mEq/l)
2-Prolonged PR interval (6.5mEq/l)
3-Loss of p-wave (6.5-7)
4-Widening of qrs (7-7.5)
5-Sine wave, v-fib/tach (8-10)
Hyperkalemia Treatment CORRECT ANSWERS 1-CaCl 500mg IV over 3 mins (EKG
changes or K+ greater than 6.2),
2-NaHCO3 50meq/or 1meEq/kg over 5 mins (especially if acidotic)
3-Albuterol 5-20mg over 15 mins
4-Glucose/Insulin: 10 units reg. insulin IV push, and 25 grams D50W IV push (just give
the 10U of insulin is BS more than 200)
Significant Sepsis Prognostic CORRECT ANSWERS Lactate greater than 4, ticking
time bombs
GI Hemorrhage CORRECT ANSWERS -NG/OG
-Octreotide: decreases GI Motility/Acid Prod., decreases hepatic portal pressures,
relieves venous congestion, 25-50mcg IV Push, and then 25-50 mcg/hr IV
