ICEMA PARAMEDIC PROTOCOLS/ INTERNSHIP
When do you use Lidocaine with an adult? - Answer -intubation, king airways, NG or
OG tubes, I.C.P., Arrest protocol, and symptomatic V-tack with pulses.
When do you use Lidocaine with a pediatric? - Answer -King airway 15 years old and
above, NG/ OG tube, I.C.P., and cardiac arrest.
What is your adult Lidocaine dose for all situations (except for follow up dose in arrest)?
- Answer -Lidocaine 1.5 milligrams per kilogram, I.V. or I.O. for all adult situations, with
the exception of your second dose in an arrest.
When is the only time you have a max dose of Lidocaine? - Answer -Only in wide-
complex tachycardia or v-tack with pulses, and your second dose in an arrest.
When do you give Mag Sulfate? - Answer -1. Polymorphic V-tach at 2 grams, only if
polymorphic wide-complex v-tach is seen after cardioversion. 2. Eclampsia at 4 grams
in slow-push, or at 10 milligrams per minute with a drip.
On what ages can you start an E.J.? - Answer -Anyone above 8 years old.
What is the max for CPAP pressure? - Answer -15 cm H20.
What ages can you insert an IO in numerous other sites, like the distal tibia, humeral
head, and anterior distal femur? - Answer -9 years old and above
When do you use the king airway on adults? - Answer -If they meet ALL of these
criteria: 15 years old or older, over 4 feet tall, unresponsive with agonal respirations.
When do you use a king airway on pediatrics? - Answer -If they meet ALL of these
criteria: Under 15 years old, agonal respirations, unresponsive, no gag reflex, and has
proper tube size.
What rate do you start pacing a patient and at what amp setting? - Answer -Start at a
rate of 60, start at lowest amp and increase to a max of 100 amps until capture, asses
radial pulses and perfusion.
What do you do with a symptomatic (POOR PERFUSION) Brady patient? - Answer -12
lead, fluids, Atropine at .5mg (MAX OF 3MG). If Atropine is ineffective, patient has ST
elevation, has a 3rd degree heart block with wide complex, or has 2nd degree type 2
heart block, begin pacing.
What do you do if you see a patient having SVT on the monitor? - Answer -Start 300
mL bolus, vagal maneuvers if ASYMPTOMATIC, Adenosine in right AC, cardioversion if
, refractory to Adenosine, call base. Remember to PUT PADS ON THE PATIENT
BEFORE GIVING ADENOSINE.
What do you do if a patient is in V-Tack with pulses? - Answer -If the V-tack is regular
and monomorphic, give Adenosine. Polymorphic V-tack would mean the patient is in
cardiac arrest.
What do you do for a patient in A-Fib? - Answer -If a patient is in A-Fib or A-flutter and
are hemodynamically unstable, cardiovert the patient and contact base.
What is considered altered trauma criteria in Trauma Triage? - Answer -GCS 13 and
below resulting from trauma.
What is under Mechanism Criteria for Trauma Triage? - Answer -For adults, falls over
20 feet, pediatric falls over 10 feet or two times the height of child. Intrusion, ejection,
death in passenger seat, telemetry data, and 20-20. Contact base, but if Mechanism
Criteria is met ALONG WITH signs of poor perfusion, immediately transport to Trauma
Center.
What is under Age and Co-Morbid for Trauma Triage? - Answer -(Remember acronym:
"65 SLAB PP"). Over 65 years old, systolic under 110 and over 65 years old, low impact
fall or MOI that result in severe injury, patients on anti-coagulants, burn patients
involved in trauma, pregnancy trauma over 20 weeks, paramedic judgment.
You see SVT on the monitor or wide complex tackycardia. What drug would you give? -
Answer -Adenosine, 6, 12, and 12 in the right a.c., flushed each time, and after putting
pads on the patient.
You hear wheezes in an alert and oriented adult patient's lung sounds, and he is
struggling to breathe. What is your treatment? - Answer -Albuterol 2.5 milligrams
nebulized with C-PAP.
Patient is salivating and has lacrimation after mowing the lawn or working with
insecticide. What do you give? - Answer -Atropine 2 milligrams I.V., repeating with 4
milligrams.
What is the age of a neonate? - Answer -Birth to 4 weeks old.
What is the proper sugar range for a neonate? - Answer -35 to 300.
What is the proper sugar range for pediatrics over four weeks old? - Answer -60 to 400.
What is your dose of Diphenhydramine I.M. in an adult patient with urticaria? - Answer -
50 milligrams. Only give once.
When do you use Lidocaine with an adult? - Answer -intubation, king airways, NG or
OG tubes, I.C.P., Arrest protocol, and symptomatic V-tack with pulses.
When do you use Lidocaine with a pediatric? - Answer -King airway 15 years old and
above, NG/ OG tube, I.C.P., and cardiac arrest.
What is your adult Lidocaine dose for all situations (except for follow up dose in arrest)?
- Answer -Lidocaine 1.5 milligrams per kilogram, I.V. or I.O. for all adult situations, with
the exception of your second dose in an arrest.
When is the only time you have a max dose of Lidocaine? - Answer -Only in wide-
complex tachycardia or v-tack with pulses, and your second dose in an arrest.
When do you give Mag Sulfate? - Answer -1. Polymorphic V-tach at 2 grams, only if
polymorphic wide-complex v-tach is seen after cardioversion. 2. Eclampsia at 4 grams
in slow-push, or at 10 milligrams per minute with a drip.
On what ages can you start an E.J.? - Answer -Anyone above 8 years old.
What is the max for CPAP pressure? - Answer -15 cm H20.
What ages can you insert an IO in numerous other sites, like the distal tibia, humeral
head, and anterior distal femur? - Answer -9 years old and above
When do you use the king airway on adults? - Answer -If they meet ALL of these
criteria: 15 years old or older, over 4 feet tall, unresponsive with agonal respirations.
When do you use a king airway on pediatrics? - Answer -If they meet ALL of these
criteria: Under 15 years old, agonal respirations, unresponsive, no gag reflex, and has
proper tube size.
What rate do you start pacing a patient and at what amp setting? - Answer -Start at a
rate of 60, start at lowest amp and increase to a max of 100 amps until capture, asses
radial pulses and perfusion.
What do you do with a symptomatic (POOR PERFUSION) Brady patient? - Answer -12
lead, fluids, Atropine at .5mg (MAX OF 3MG). If Atropine is ineffective, patient has ST
elevation, has a 3rd degree heart block with wide complex, or has 2nd degree type 2
heart block, begin pacing.
What do you do if you see a patient having SVT on the monitor? - Answer -Start 300
mL bolus, vagal maneuvers if ASYMPTOMATIC, Adenosine in right AC, cardioversion if
, refractory to Adenosine, call base. Remember to PUT PADS ON THE PATIENT
BEFORE GIVING ADENOSINE.
What do you do if a patient is in V-Tack with pulses? - Answer -If the V-tack is regular
and monomorphic, give Adenosine. Polymorphic V-tack would mean the patient is in
cardiac arrest.
What do you do for a patient in A-Fib? - Answer -If a patient is in A-Fib or A-flutter and
are hemodynamically unstable, cardiovert the patient and contact base.
What is considered altered trauma criteria in Trauma Triage? - Answer -GCS 13 and
below resulting from trauma.
What is under Mechanism Criteria for Trauma Triage? - Answer -For adults, falls over
20 feet, pediatric falls over 10 feet or two times the height of child. Intrusion, ejection,
death in passenger seat, telemetry data, and 20-20. Contact base, but if Mechanism
Criteria is met ALONG WITH signs of poor perfusion, immediately transport to Trauma
Center.
What is under Age and Co-Morbid for Trauma Triage? - Answer -(Remember acronym:
"65 SLAB PP"). Over 65 years old, systolic under 110 and over 65 years old, low impact
fall or MOI that result in severe injury, patients on anti-coagulants, burn patients
involved in trauma, pregnancy trauma over 20 weeks, paramedic judgment.
You see SVT on the monitor or wide complex tackycardia. What drug would you give? -
Answer -Adenosine, 6, 12, and 12 in the right a.c., flushed each time, and after putting
pads on the patient.
You hear wheezes in an alert and oriented adult patient's lung sounds, and he is
struggling to breathe. What is your treatment? - Answer -Albuterol 2.5 milligrams
nebulized with C-PAP.
Patient is salivating and has lacrimation after mowing the lawn or working with
insecticide. What do you give? - Answer -Atropine 2 milligrams I.V., repeating with 4
milligrams.
What is the age of a neonate? - Answer -Birth to 4 weeks old.
What is the proper sugar range for a neonate? - Answer -35 to 300.
What is the proper sugar range for pediatrics over four weeks old? - Answer -60 to 400.
What is your dose of Diphenhydramine I.M. in an adult patient with urticaria? - Answer -
50 milligrams. Only give once.
