2026 BEST EMS PROTOCOL
PRACTICE TEST QUESTIONS AND
ANSWERS WITH COMPLETE
SOLUTIONS ALREADY PASSED!!!
Question: What is the specific adult dosing regimen for Ketamine when managing
status epilepticus or a refractory seizure that persists after administering two
distinct rounds of Midazolam (Versed)?
Answer: ✔✔ Administer 1 kg up to a maximum single dose threshold of 100 mg.
Question: If a competent patient with decision-making capacity wishes to execute
a refusal of care, medical control does not need to be contacted even if which
specific advanced life support (ALS) or supportive medications were already
administered?
Answer: ✔✔ Field providers may handle the refusal without a mandatory online
medical control consult if the interventions were limited to:
Dextrose
Intravenous (IV) maintenance fluids
Antiemetic (nausea) medications
Acetaminophen (Tylenol / Ofirmev)
Diphenhydramine (Benadryl)
Corticosteroids (steroids)
Nebulized bronchodilator treatments
Question: True or False: When managing an end-of-life or hospice patient,
narcotic opioids should be strictly withheld or under-dosed out of an immediate
fear of causing clinical respiratory depression.
Answer: ✔✔ False. Maximizing patient comfort and achieving effective pain
management represent the primary clinical objectives during end-of-life palliative
care.
,Question: What specific pharmacological intervention and dosing strategy is
indicated during end-of-life care to manage terminal agitation, air hunger, or severe
anxiety?
Answer: ✔✔ Administer Midazolam (Versed) using the following parameters:
IV/IO/IN Routes: 5 mg; may repeat a second dose after 5 minutes if
symptoms persist.
IM Route: 5 mg; may repeat a second dose after 10 minutes if symptoms
persist.
What are the two vital signs and their goals that are recommended to stabilize
before moving an unstable pt? (page 28)
1. SpO2>94%
2. SBP>=90 (adults) or SBP>= 70 + 2xage (peds)
What is the pedi ketamine dose for seizure after 2 rounds of versed?
1mg/kg (max of 50mg)
What are the 3 drugs to consider for hyperkalemia with a pulse?
Calcium gluconate (1 G), sodium bicarbonate (1 mEq/kg), Albuterol (2.5mg)
What is the age for a distal femur IO?
All ages
,Adult Zofran dose for N/V?
4mg, may repeat once after 10 mins
Preferred IO site for cardiac arrest?
Distal femur
What is the pedi Solumedrol dose? What is max dose?
2 mg/kg (Max 100 mg)
What is the fall height to consider C-spine immobilization?
3 feet or 5 stairs
Which drugs have pregnancy as either a contraindication, relative contraindication,
or precaution?
Amio, Ketamine, Epi 1:1 and Cyanokit
T/F - Narcan is an antidote to ketamine
False
What is the adult Narcan dose?
, 0.4 - 2 mg IV/IO/IM/IN/Neb
What is the pediatric Narcan dose?
0.1 mg/kg (max 2 mg)
What is the drug and dose for a suspected TCA overdose? Sodium Channel
Blocker overdose?
Sodium bicarbonate - 1 mEq/kg (if widening QRS > 100ms)
At what age is nebulized Epi 1:1000 no longer weight based?
4 years old (0.05 ml/kg for <4, 0.5 ml for >4)
How do you determine hypotensive BP for a pedi?
70 + 2xAge
What is the amiodarone dose for a pediatric in v fib?
5 mg/kg
What is the pediatric Mag sulfate dose for a pedi in torsades de pointes?
25 - 50 mg/kg (Max 2 G)
PRACTICE TEST QUESTIONS AND
ANSWERS WITH COMPLETE
SOLUTIONS ALREADY PASSED!!!
Question: What is the specific adult dosing regimen for Ketamine when managing
status epilepticus or a refractory seizure that persists after administering two
distinct rounds of Midazolam (Versed)?
Answer: ✔✔ Administer 1 kg up to a maximum single dose threshold of 100 mg.
Question: If a competent patient with decision-making capacity wishes to execute
a refusal of care, medical control does not need to be contacted even if which
specific advanced life support (ALS) or supportive medications were already
administered?
Answer: ✔✔ Field providers may handle the refusal without a mandatory online
medical control consult if the interventions were limited to:
Dextrose
Intravenous (IV) maintenance fluids
Antiemetic (nausea) medications
Acetaminophen (Tylenol / Ofirmev)
Diphenhydramine (Benadryl)
Corticosteroids (steroids)
Nebulized bronchodilator treatments
Question: True or False: When managing an end-of-life or hospice patient,
narcotic opioids should be strictly withheld or under-dosed out of an immediate
fear of causing clinical respiratory depression.
Answer: ✔✔ False. Maximizing patient comfort and achieving effective pain
management represent the primary clinical objectives during end-of-life palliative
care.
,Question: What specific pharmacological intervention and dosing strategy is
indicated during end-of-life care to manage terminal agitation, air hunger, or severe
anxiety?
Answer: ✔✔ Administer Midazolam (Versed) using the following parameters:
IV/IO/IN Routes: 5 mg; may repeat a second dose after 5 minutes if
symptoms persist.
IM Route: 5 mg; may repeat a second dose after 10 minutes if symptoms
persist.
What are the two vital signs and their goals that are recommended to stabilize
before moving an unstable pt? (page 28)
1. SpO2>94%
2. SBP>=90 (adults) or SBP>= 70 + 2xage (peds)
What is the pedi ketamine dose for seizure after 2 rounds of versed?
1mg/kg (max of 50mg)
What are the 3 drugs to consider for hyperkalemia with a pulse?
Calcium gluconate (1 G), sodium bicarbonate (1 mEq/kg), Albuterol (2.5mg)
What is the age for a distal femur IO?
All ages
,Adult Zofran dose for N/V?
4mg, may repeat once after 10 mins
Preferred IO site for cardiac arrest?
Distal femur
What is the pedi Solumedrol dose? What is max dose?
2 mg/kg (Max 100 mg)
What is the fall height to consider C-spine immobilization?
3 feet or 5 stairs
Which drugs have pregnancy as either a contraindication, relative contraindication,
or precaution?
Amio, Ketamine, Epi 1:1 and Cyanokit
T/F - Narcan is an antidote to ketamine
False
What is the adult Narcan dose?
, 0.4 - 2 mg IV/IO/IM/IN/Neb
What is the pediatric Narcan dose?
0.1 mg/kg (max 2 mg)
What is the drug and dose for a suspected TCA overdose? Sodium Channel
Blocker overdose?
Sodium bicarbonate - 1 mEq/kg (if widening QRS > 100ms)
At what age is nebulized Epi 1:1000 no longer weight based?
4 years old (0.05 ml/kg for <4, 0.5 ml for >4)
How do you determine hypotensive BP for a pedi?
70 + 2xAge
What is the amiodarone dose for a pediatric in v fib?
5 mg/kg
What is the pediatric Mag sulfate dose for a pedi in torsades de pointes?
25 - 50 mg/kg (Max 2 G)
