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Paramedic Study Guide

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Neonate ETT size?

small finger or weight based tape

Neonate fluid replacement?


Order of Neonate resuscitaion?

Tactile stimulation, BVM etc.

Main concern of child drowning?

Hypoxia and acidosis

How do you mix Dopamine and what is the dose?

Mix 400 mg in 250ml equals 1600mcg; 5-10 mcg/kg/min

What is the maintance drip to lidocane?


If a patient has symptomatic bradycardia with PVC's, what do you give first?

Atropine then lidocane

Side effects of lidocane?

numbness, muscle twitching and seizures

What do you do for 3rd degree heart blocks?


Treatment of Pulmonary Edema?

O2, lasix, NTG, morphine

Why is morphine given in Pulmonary Edema?

to decrease preload and promote vasodilation

What is Stridor?

High pitched sound, upper airway obstruction

What is Wheezing?

whistle sounds, asthma, croup, emphysema

What is Rales?

fluid in the lungs, bubbling type sounds

S&S of Heat exhaustion?

High fever, diaphoretic, tachycardic

S&S of Heat Stroke?

Dry skin, confusion/altered LOC, tachycardic then slowing heart rate, low BP,high body temp, seizures

What is Atropine and side effects?

parasympathetic blocker that may cause blurred vision and given in <0.5mg doses may cause further bradycardia

What is the Pituitary Gland?

pea shaped master gland

When using a BVM on a patient, what may be corrected first?

respiratory acidosis

What is the key to the body's buffering system?


What is abandonment?

leaving a patient without turning them over to someone of equal or higher standard of care

You synchronized cardioverte a patient and that patient becomes pulseless.  What do you do next?

unsync the monitor and defibrillate

After defibrillation the patient shows a NSR on the monitor, what do you do next?

check for a pulse

Where do you place a Macintosh blade?

in front of the valecula

Paralization at the nipple line is at what vertebrae?


S&S of spontaneous pneumothorax?

sudden, sharp chest pain, and dyspnea

S&S of tension pneumothorax?

SQ emphsema, no bfreath sounds, JVD

Treatment for tention pneumothorax?

Needle decompression, midclavicular between 2nd and 3rd rib

What can cause Pericardial tamponade (tramatic asphyxia)?

cause by compressing of the chest

S&S of pericardial tamponade?

JVD, distant heart tones, hypotension  aka Beck's triad

Routes Valiumcan be administered to children?


MVC bus vs chemical truck; what is the first thing you do?

scene size-up

What are the stress responses?

alarm, resistance, exhaustion

The order of packaging a patient wit a pneumothorax?

C-spine, BVM, needle decompression, transport, IV in route

What are the injuries you may see with a MVC when the patient goes "down and under"?

fractured femurs

Patient receiving blood transfusion has a reaction, what should you do?

stop the transfusion

S&S and when will a spontaneous abortion happen?

vaginal bleeding and painful; 1st trimester

S&S of appendicitis?

RLQ pain, low grade fever, nausea, vomiting; Mcburney's Point is common sight for pain, 1-2 inches above iliac crest in a direct line with umbilicus

S&S of spleen injury?

pain radiates to the left shoulder (Kerns)

S&S  and when you might see Abruptio placenta?

Painful dark blood from the vagina and 3rd trimester

Symptomatic patient with A-flutter w/2-1 conduction and patient is on Dig would you cardiovert?

No, because pt is on Dig and you dont know the onset time of A-flutter

Treatment for prolapsed cord?

insert fingers into vaginal opening keeping to cord away from the vaginal wall allowing circulation through the cord

Treatment for a nucal cord?

remove it cause it leads to fetal compromise; asphyxiation

At am MCI what is the first thing you should do?


Who do you treat first at an MCI?

altered mental status first them suspected spinal injuries last

What is Cushing's Triad?

Increased BP, decreased heart rate, irregular respiration

S&S of DKA

Kussmauls respirations(deep and rapid),polyuria, polydipsia, polyphagia, warm and dry skin, fruity breath odor, decreased LOC

What is orthopnea?

difficulty breathing while lying down.  Transport in the sitting position; COPD

What is supine hypotension?

Seen in pregnat women who lay flat on their backs.  Place in left lateral recumbent postion at 15 degrees

Signs of organophosphate poisoning?

salvating, diaphoretic, dilated pupils.  Use 2-5mg of atropine.

How does neonates loose body heat?


Synchronized cardioversion should hit on what wave?

R wave

What problems are associated with salt water drownings?

Salt water is hypertonic so inhalation of salt water draws water from the blood stream into the aveoli causing pulmonary edema.  This in turn causes profound shunting leading to non-oxygenation blod being circulated, metabloic acidosis

What problems are associated with fresh water drowning?

Fresh water is hypotonic, thus the water crosses the alveolar/capillary membrane into the vascular space, causing hemodilution which causes a decrease in red blood cells.  This also cause damage to the alveoli, causing them to lose surfactant, causing atelectasis, which causes shunting of non-oxygenated blood back into the blood stream

What is the drug of choice for an MI after O2?


You hace a rhythm showing one good QRS then asystole then no electrical activity.  What do you do?

Check pulse then check leads

Trouble with lower shoulder in an OB delivery?

Guide head up gently; shoulder dystocia

Drug given to an adult with minor astma?


Wide complex tachycardia of unknown origin. What do you give?

give lidocane

Not a sign of dehydration in PEDS?

Polyuria (dry diapers)

Wide bizarre rapid QRS is?


No lidocane for bradycardia with PVC's

If you find patient sitting in chair at a 45 degree angle with JVD, what might you have?

right sided heart failure

You should check breath sounds how?

Both anterior and posterior

What part of the brain controls motor skills


S&S of croup?

viral illness, inspiratory and expitatory stridor with seal bark like cough, cough is not a respiratory sound, most common in children under 3

Sign that you have inserted an EOA into the trachea

absent breath sounds

Vomiting commonly occurs after the removal of an EOA

What drug would you use for a hypertensive crisis

procardia (nifedipine)

How would you care for a hypothermic patient during transport

warm IV solution, heat, blankets, and remove any wet clothing

Indications for an NPA

patient needs some airway support, patient with a gag reflex

What is the dosage of Valium for 3rd trimester seizures

5-10 mg (mag sulfate)

Use D5W for medicated infusions and pulmonary edema

A sudden bursting headache during a workout


Known S&S of heat exhaustion

high temp, wet skin, rapid pulse

Ventilate a person with head injury 20-25 times per minute

Pedi has injested lye and is not seizing; what do you give him

milk and/or water

#1 cause of pediatric death


#1 cause of pediatric cardiac arrest

respiratory arrest

Placenta previa

painless third trimester bleeding

Placenta abruptio

painful third trimester bleeding

LUQ pain

spleen related

A coworker is having a normal response to an MCI. What should you do for him

give him a minute to regroup

Amount of air inhaled or exhaled in one breath is called

tidal volume

Chest injury where air exchanges with outside air is called

sucking chest wound

An arrangement between departments for use of resources is called

mutual aid

Main cause of transmitting HIV is

unprotected sex

PH above 7.45 is what


Person in diabetic coma (ketoacidosis) did not take what


When does respirationo begin

When the lungs have achieved a normal expiration and the pressure inside the thoracic cavity equals the atmospheric pressure

How do you stop acute bleeding in a woman who has just given birth

massage the fundus

How do you measure the PR interval

Beginning of the P-wave to the beginning of the QRS

A prolonged P-wave is greater than what

.20 seconds

Taking or needing more of a drug to get the same results is called what


A car windshield is made of what

laminated safety glass

What do you do for a patient in PEA with a rate of 110

IV, fluid challenge, and EPI

Pediatric with sudden onset of fever, drooling, and tripoding


Patient with rumbling breath sounds and a fever is what


When talking on a radio to a doctor and another doctor intervenes, who do you take orders from

the on-line doctor

In a "down and under" accident, what is the most common injury

femur fractures

The most important information to give a doctor about a patient is what

history of illness

How to splint fractures

splint above and below injury, don't straighten elbow injuries, dress wound first

Carpopedal spasm is often seen in hyperventilation syndrome, caused by hypocalcemia and low CO2 levels

A pituitary hormone that stimulates the cortex of the adrenal glands to produce adrenal cortical hormones

ACTH (adrenocortiotropic hormone)


rules and standards governing the activity of a group or profession


written statements about a person that are wrong and injurious

IO infusion

usually performed 2-3 fingers from the tibial tuberosity on the medial side

Sub Q emphysema

crackling sounds found during palpation, air migrating through the tissue from the chest cavity

Flat jugular veins

indicator of hypovolemia


to bleed out to the point where life cannot be sustained

BLS airway management before ALS airway management


the movement of a solvent across a semi-permeable membrane from an area of lesser concentration to an area of greater concentration; purpose is to equal concentration on both sides


capability of self-depolarization. Refers to the pace-maker cells of the heart

S&S of neurogenic shock

injury to the brain or spinal cord causing the arteries to lose tone and dilate, enlarging the "container" and causing a relative hypovolemia. Warm, dry, red skin. Due to lack of compensatory catecholamine release, the patient will have low BP and a slow pulse even in early stages of shock

What protects people with AIDS from discrimination

Americans with Disabilities Act

Atropine blocks what nerve


S&S of ICP

high BP, low heart rate, irregular respiration (Cushings triad)

S&S of pericardial tamponode

distant or muffled heart sounds, hypotension, and JVD (Beck's triad)


connects muscle to bone

Electrical burns cause damage to what

soft tissue

Early S&S of shock

anxiety, elevated heart rate, cool skin

If you have no feeling below the umbilicus, what vertebrae have you damaged

spinal damage at the T-10 level

What is the first step in extricating a patient

manual C-Spine control

Hypertonic solution (solution of higher osmotic pressure)

when introducing to normal hydrated person will cause a shift of solute from the intracellular to extracellular space


free fluid within the abdominal cavity

Good Samaritan Laws

laws designed to protect people who assist at the scene of an emergency from liability

What organs are contained in the abdominal ULQ

spleen, tail of pancreas, stomach, left kidney, part of colon

Stridor or crowing

high pitched sound caused by restriction or obstruction of upper airway

Rebound tenderness

pain upon sudden release of examiner's hand while palpating the patient's abdomen

Kussmaul's respirations

very deep, gasping respirations associated with diabetic ketoacidosis (DKA)


reduced partial pressure of oxygen in the blood

In conjunction with bicarbonate buffer system, the body regulates acid base balance by respiration and kidney function

Stroke volume x heart rate =

cardiac output

Average tidal volume of an adult is


What are the side effects of atropine

blurred vision, dilated pupils, dry mouth, tachycardia, drowsiness, and confusion

What is the recommended dose for furosemide (lasix)

20-80 mg

What are the indications and recommended dosage for aminophylline

bronchial asthma, CHF, pulmonary edema; 250-500mg over 20-30 minuutes


causes the liver to release stored glycogen to create usable glucose


an injury to the brain on the opposite side of impact

What is the best treatment for a patient with a flail chest

positive pressure ventilation

Blood pressure =

cardiac output x vascular resistance

On EKG graph paper, one small box = how much time

0.04 seconds

What identifies a-fib

irregular rhythm with no discernable p-waves

S&S of hypertensive emergency

rapid increase in diastolic BP accompanied by restlessness, confusion, blurred vision, nausea, and vomiting


occurs when insulin levels are excessive

Grand mal seizure

seizures characterized by tonic/clonic muscle contractions

Focal motor seizures

begin as localized tonic/clonic movements

What organs are located in the URQ

liver, gall bladder, head of pancreas, part of duodenum, right kidney, hepatic flexture of colon

S&S of abdominal aortic aneurysm (AAA)

typically an older person, diffuse abdominal pain, sever back pain with a tearing sensation, pulsating sensation when palpating abdomen

Alcoholic withdrawal (delirium tremors)

may occur within first 48-72 hours of abstinence; seizures may occur within 24-36 hours post-abstinence

S&S of meningitis

malaise, low grade fever, headache, stiff or sore neck

Measles, mumps, and chickenpox are contagious. Shingles are not.

Treatment for heat exhaustion

remove patient from environment and provide fluid replacement with 0.9% sodium chloride or lactated ringers

What is the Vagus nerve neurotransmitter?


Carpal pedal spasm is a result of what


Hyperkalemia causes what on an EKG?

peaked T waves

What perfuses the heart?

Coronary arteries

What is NOT a beta effect?


A 17lb PED, what is the initial dose of lidocaine?


JVD with clear lung sounds and narrow pulse pressure indicates what?

Pericardial Temponade

What is the best method to use on a LSD patient?

talk down

A 110lb patient, what is the initial dose of lidocaine and maintenance dose?

50mg; 2-4mg/min

21 y/o male with asthma, what drug, dose and route?

Albuterol, 2.5mg, nebulizer

81 y/o male cardioverted and now is pulseless and in V-fib or V-tach, whatis the next action?

Defibrillate at 200j

60 y/o male, twisted ankle HR 54, BP 140/80 stable, what is the treatment?

splint and transport

S&S of spontaneous pneumothorax

Sudden "knife like pain", dyspnea

Effects of Verapamil (calcium channel blocker)?

decreases vasoconstriction, decreases conductivity

You clamped and cut the umbilical cord now its bleeding, what do you do?

clamp it again

In pulmonary edema after O2, monitor, IV, what is next?

NTG 0.4mg if BP is good

Whay is the intrinsic rate of the ventricles


What airway problem will cause stridor in PEDS?


PED with flu, not acting right with n/v?

Reye's Syndrome (resulting sometimes after a viral infection)

Wide QRS rhythm with no P wave?


Which airway will cause vomiting when taen out?


MVA patient with HR 120, BP 40/palp.  Patient has?

Hypovolemic shock

What is NOT a sign of kidney stones?

frequent urination

Most critical patient at MCI?

Amnesia, crying, altered LOC

containdications of Verapamil?

pulmonary edema, cardiogenic shock

Chest pain with "tearing and shearing pain towards the neck", with no pedal pulse?

Disecting Aortic Aneurysm

When palpating the abdomen, you should?

palpate the area of pain last

electrical burns cause what?

superficial and deep damage

When do you perform a Cricothyrotomy?

laryngeal edema and/or facial trauma where no other airway can be established

What do you do before administeration of D50%?

check Glucose

Patient fell through a glass door and has a piece of glass stuck in his neck, what do you do?

C-spine immobilization, airway, occlusive dressing, stabilize the glass, transport

Complications of IV administration

Phlebitis, Emboli

Routes of EPI


List the slowest to fastest routes of administration


Ambulance crashes, what is the court going to prove

lack of due regard

What is child CPR compression depth

1-1.5 inches

Head trauma with signs of shock?

Head trauma does not cause shock; look elsewhere

Respirations for DKA

Kussmaul's respirations

Patient is diabetic with blood glucose of 40. What should you NOT do

IV insulin

Patient is 6 years old with unilateral chest wheezing

Foreign body obstruction

Spleen is located where


Mother gave birth 24 hours ago and has sudden onset of chest pains and dyspnea

pulmonary embolism

Oxygen rich blood leaves the pulmonary veins and goes into the

left atrium

Sympathetic nervous system does what

vasoconstriction and sphincter constriction

2 medics at MCI. 1st on scene finds 20yo in cardiac arrest; backup is 20 minuutes away.. What do you do

continue triage

SQ epi for

mild allergic reaction (IV epi could be used for anaphylaxic shock)

Body's tendency to stay constant


Chief extracellular cation


Chief intracellular cation


Name all cations in body

calcium, magnesium, potassium, and sodium

Woman faints after seeing bad accident


Seizure of one body part

focal-motor seizure

Common fracture of pediatric long bone

green stick

Complication of elbow or knee fracture

loss of distal circulation

Best place for chest needle decompression

mid-clavicular between 2nd and 3rd intercoastal space

Which drowning causes hemodilution and hemolysis

fresh water

What holds do alveoli open


Fever, chills, night sweats, blood in cough

TB (w/o hemoptysis in cough, then HIV)

Endocrine system acts by

release of hormones

What rhythm is being described: irregularly/regular


Toxemia occurs during what trimester


Meconium staining is a sign of what

fetal distress

NOT a symptom of dehydration

decrease in HR

What is Valium dose for Status Epilepticus

2.5-10 mg slow IVP (5-10 mg is correct answer)

Other names for Verapamil

Calan and Isoptin

Sellick's maneuver is what

pressure on cricoid cartilage

Contraindications for EOA

under 16 yo, less than 5 ft or greater than 6'8", ingested caustic fluids, esophageal varices, positive gag reflex

What is lung compliance

elasticity or stiffness of lungs

Old lady thinking neighbors are "out to get her" what do you do

remove her from situation and keep her talking

Bright red blood with cramping in first trimester

spontaneous abortion

Adult in asthma attack, what is treatment

stop bronchial spasms

Pregnant with seizures?

Mag Sulfate drip first, if not successful use 5-10 mg of Valium

Most common cause of aspiration

removal of EOA

Most common place for IO infusion

proximal tibia

What is NOT a sign of infant dehydration


Name of couple of antipsychotic meds

Haldol and Mellaril

What is not a bronchodilator


Secondary assessment does not include

determining life threatening injuries

Writing something derogatory is


Side effects of Verapamil

tachycardia, WPW problems

Patient with history of WPW in PSVT with no S&S, what do you do

Adenosine, 6mg, rapid bolus

Describe v-tach

wide, bizarre, and regular

Describe a-fib

it is irregularly irregular rhythm without discernible p-waves

When is lidocaine not used

bradycardia with PVCs

Headache and stiff neck


How do you transport a patient with epiglotitis

sitting up

Nipple line down?


Umbilicus down?


Abdominal bleed can take up to several hours to occur after injury

At an MCI, what is the LAST type of injury to go

spinal injury

At an MCI, what is the FIRST type of injury to go

Thirsty, anxious, and altered LOC

Lady sitting up with pink, frothy sputum

left side heart failure

Dopamine dosage and drips

5-10mcg/kg/min; 400mg into 250ml = 1600mcg/ml

Respiration is stimulated by what

increase in PCO2

Part of the myocardium most often damaged during an MI

left ventricle

SVT with WPW, what is the drug of choice


Pulmonary ventilation is very important because

the lungs have the ability to either expel or retain large amounts of CO2

What determines inspiration

decrease in thoracic pressure

Lower abdominal pain, vaginal bleeding, referred pain to shoulder

ectopic pregnancy

What is the length of a normal PR interval

.12-2.0 seconds

What is the measurement of the small square on the EKG graph paper

.04 seconds

Unconscious 3yo with hysterical mom, what DOESN'T the paremedic do

do not try to restrain the mother

What is the dose of Valium for a pregnant mom with eclampsia who is seizing

5-10mg IV

Name side effects of lidocaine

tremors, seizures, slurred speech, and parasthesia

What group of drugs are inotropic

EPI, isuprel, dopamine, dobutamine

How do you examine a toddler

toe to head

SIDS most often occurs at what age

1 week - 12 months

ASA overdose causes what

metabolic acidosis

What is the drug of choice for 3rd degree heart block


TCP would be contraindicated for

BP 120/80, HR 56

EKG shows v-tach, patient is conscious, what is drug of choice


If PVCs manifest after initial bolus of lidocaine and drip has been set, what is the next action to take

give half the initial bolus and increase drip

How many joules for initial defibrilation of a 10kg infant

20 joules (2j per kg, then 4 joules per kg)

What is the most important drug for a bradycardic infant


First thing you do on scene of an MCI MVC with 7 patients

begin triage

Newborn, blue extremities, vigorous cry, poor movement, HR 120, respiration 32, what is APGAR


Order for 25mg of lidocaine, on hand is 10mg/ml. How many ml do you give?


Anaphylaxis septic shock and neurogenic shock: what side effects would they NOT include


The patient's Dr. Is on scene and Wants to take care of the patient, what does the paramedic do?

Give control of the patient to the Dr. If the Dr. Is willing to assume responsibility

What kind of doctors' orders are received over the radio?


Where other respiratory chemoreceptors located?

The medulla

decorticate posturing is indicative of what type of injury?

At or above the upper brainstem

Eye's not moving together is called?


What is the first drug of choice for anaphylaxis?


What does a site effect of lasix


Patient has lost 750 cc of blood.  How much fluid replacement do you give?

2250 cc (3 x 750)

Patient has unequal and sluggish pupils, what is the cause?

Neurological damage

What is the name of the superior part of the uterus?


Bleeding below the dura is called?

subdural hematoma

What controls the heart rate and respiratory rate?

The medulla

What is a sign of over hydration?


What is the best blood replacement in the field?

Lactated ringer's

Patient has MI.  What has the most important historical value?

History of chief complaint

Patient with emphysema.  What has the most important historical value?

The fact that the patient woke up with shortness of breath

What is the pneumonic for pain evaluation?


What is the first sign of shock?


What is the best indicator of patient status?

LOC or change in mental status

Pediatric dose of epi for asthma?

0.01 milligrams per kilogram of 1:1000 SQ or 0.01mg/kg of 1:10,000 IV

What is the standard dose of Benadryl?

50 MG

Baby born with amniotic SAC intact.  What should the paramedic do?

Break the sac and suction

When do you not give a SQ injection?

When patient is in shock, not enough peripheral blood flow

Distant heart sound, JVD, pulsus paradoxes are signs of what?

Cardiac Tamponade

What keeps the alveoli open?


What are the two things to combat after drowning?

Acidosis and Hypoxia

What is Hypoxemia?

Decreased 02 in the blood

What is the name of the sac covering the heart?


Where is adrenalin produced?

In the adrenal gland

Patient refusals IV and the paramedic starts one anyway, what is the legal term?


What is the action of a paramedic at MCI?

Do primary survey then move on (triage)

What do you do when the patient LOC worses?

Go back to a primary survey

Head injury and increased ICP, what are the signs and symptoms?

Increased BP, decreased HR, increased or erratic respiration (cushing's triad)

Shock wave left behind in GSW?


What causes DKA?

Not enough insulin

What is a sign of elder abuse?

Unexplained trauma

Define osmosis

Movement of water from an area of lesser concentration to an area of greater concentrate(attempting to equal the concentration)

What does gestational diabetes?

The onset of diabetes during pregnancy

How does glucagons work?

It stimulate the liver to release it stores of glycogen

What determines completion of the second stage of birth?

Delivery of the baby

Define antepartum?

Before the onset of labor

What does the best way to ensure you always have enough equipment onboard?

Resupply after each run

Esophageal gastric tube airway (EG TA) is used for who?

 unconscious adult

What is the best treatment for DKA?

Lactated ringer's

What is the best drug for cardiogenic shock?


What is compliance?

The stiffness of the lungs

What are the distances to clamp and cut the umbilical cord?

Clamp that 10 cm and 15 cm, cut between

Patient fell from third story window, prioritize steps of treatment

C-Spine immobilization, O2, needle decompress chest, full c-spine package, transport, IV enroute

Cardioversion on the T-wave causes what?


What is biochemical removal across a semi permeable membrane?


Patient hits steering wheel with signs and symptoms of cardiac tamponade

Distant heart tones, hypotension, JVD

Treatment for patient that hold dry ice in his hand?

Run water with two of 100-108° F over hand

Next treatment for each patient that has been cardioverted from V-fib?

Lidocaine Bolus start the maintenance drip

Patient has been hit in the cheek, eyes won't go up.  What kind of injury?

orbital blowout

Hepatoxin vs Hemotoxin

Hepatoin effects liver, Hemotoxin effects blood

Kinematics in collosion from?

vehicle to occupant to organ

Volume replacement for PEDS?


Injury to C-1 thru C-4 causes what?

Respiratory paralysis

What are S&S of CVA?

Slurred speach, hemi paresis, confussion

Untreated hypoglycemia results in?

brain damage

What is a serious concern when giving D-50


What is a sign of pneumothroax?


What is pulse pressure?

the differance in systolic diastolic pressures

Patient is riding a bike, showing S&S of heat exhaustion. What are they?

temp 101. sweating, tachycardia

Patient with S&S of heat stroke?

temp 106, dry skin, seizures

What is the peritoneal?

the lining of the stomach

Where is the spleen located?


Fluid choice for hypovolemia?

LR wide open not TKO

What connects muscles to bones?


What is the proper placement of an IO?

Two fingers below the Tibial tuberosity

Proper placement of IO in PEDS?

Proximal tibia

What is atelectisis?

Alveoli collapse

What is the pattern and reason for Kussmaul's respirations?

Deep slow or rapid gasping respirations;the body is attempting to blow-off CO2

What is not a sign of sever shock?

Regular deep breathing

What is the most common cause of PEDS deaths?


What dose an Inotropic drug do?

Increase contractility

What is Frank Starling reflex?

The greater the ventricle is stretched, to a point, the stronger the contraction will be.

O2 reaches the heart by what?

Coronary arteries

What causes prolonged PR interval?

Some type of delay in the AV node or ventricular ischemia

Where do you interview an emotionally disturbed patient?

Away from the family

Elavil and Tofanil are what type of drugs?


What are common hazards with defibrillating a patient on Digoxin?

You may cause an emboli or clot

What will a decrease in Stroe volume do?

Decrease cardiac output

Know the characteristics of Alpha and Beta

Alpha 1:vasoconstriction, peripheral resistance, increase cardiac after load.
Alpha 2: inhibits further release of norepinepherine.
Beta 1: Increase HR, Increase in contractility, increase in cardiac muscle conductivity.
Beta 2:bronchodilator, dilation of smooth muscle in bowel.

A clot from deep vein thrombosis is likely to end up where?

The lungs

If you want to reduce to workload of the heart, what do you do?

decrease the afterload

Best drug therapy for SVT is what?

Adenosine and Verapamil

What are the effects of Coumadin?

Reduces blood clotting

If you administer 2mg of Narcan, what might the patient do?

Become aggressive

Unconscious Patient showing S&S of seizure and incontenance?

Grand Mal seizure

What don't you do for patient that is bleeding from nose and ears?

Don't stop the bleeding, it helps reduce ICP

What is the best position for a patient with ABD pain?

Lateral recumbent

What is the best position to trans port a patient with orthopnea?

Sitting up

What is the best position to detect JVD?

45 degree angle

Patient is vomiting green vomitus, suspect what?

Gall bladder

Stridor is common sign for (best answer)?


When do you use syrup of ipecac?

OD on tricyclic antidepressent

Pleural effusion is what?

the escape of fluids into the lungs

In Florida the EMS is governed by what?

FS 401

Tort is what?

Wrongful act leading to a Civil suit, person vs person

What is the safest way to gain access to a patient of an MVC?

through the door

What is Conversion Reaction (Conversion Disorder)?

Patient sustains loss of function, usually the nervous system (blindness, paralysis) unexplained by any medical illness

What is most important to include in a patient report?

patient condition and treatment

Who has the most authority on the scene?

online Physician

If a paramedic suffers a normal stress reaction, you should what?

Assign them a simple, specific task

What is the treatment of PED with febrile seizures?

Use cool water not cold water or ice packs

What is the PED dose for Atropine?


S&S of hemothroax?

Tracheal deviation to one side on inspiration, dull thoracic sound. Blood in the thoracic cavity

S&S of pericardial temponade?

Narrowing pulse pressure, JVD, distant heart sounds

Angina that begins with exercise or stress, but stops upon rest is what?

Stable angina

Is appropriate confinement considered elder abuse?


Will Narcan reverse the respritory depression caused by Darvon?


Mother of 4, RUQ pain?


What is PEDS defibrillation settings?

2,4 and 4j/kg

Most MI result in damage to what part of the heart?

Left ventricle

Alpha receptors control what?

Peripheral vasconstriction, mild bronchoconstriction, and metabolism

Beta receptor stimulation results in what?

Increased HR, contraction, conduction, and bronchodilation

Complete heart block (3rd degree)IS ATTRIBUTED TO WHAT?

The absence of conduction between the atria and ventricles, at or below the AV node

What is the best splint for an ankle fracture?

Pillow splint

Treatment for stable patient with (mild discomfort) with dysrythmias?

Monitor, observe and transport without NO drug therapy

61 y/o female unconscious with a pulse and stable vitals, what is treatment?

O2, monitor, IV, transport

62 y/o female taking digitalis, c/o weak and dizzy. She is awake, alert, normal vitals. What is treatment?

O2, monitor, IV, Transport

What can lasix cause?


What is a clinical sign of a tension pneumothorax?

Increased movement of the cheast on the effected side

What is Primagravita?

First time pregnant

Measles, mumps, varocella are most commonly spread by what?

Air droplets

Chemoreceptors are found where?


Baroreceptors are found where?

Aortic arch

When transporting an aggressive behavioral patient, the position of the patient should be what?

One arm restrained at its side and the other arm restraind above the head

Indications for Verapamil are all except?

Patient with V-tach

Thin person with barrel chest?


Define pneumothorax?

Air in the pleural space

Trauma patient with tension pneumothorax?

BVM, needle decompress, IV enroute

1 oz.=30cc
1 tsp=5cc
1 tbsp=15cc

Person ingested lye, what is treatment?

Give milk or water

Am ambulance driver has high heart rate and sweaty palms, this is a result of what?

Catecholamine release

51 y/o farmer has cramps and diarrhea, this indicates what?

Organophosphatet poison ( remember he's a farmer)

2nd stage of labor begins when?

From the dilation of the cervix and ends with deliver of the fetus

Air in the stomach makes ETT difficult due to what?


Male patient with partial airway obstruction, what do you do?

Leave him alone and encougre him to cough

An old lady is delusional, what do you do?

Remove her from the situation

21 y/o diabetic male with headache, what is first question?

How long ago did it start

Immobilize shoulder injury with what?

Sling and swath

Patient with one blown pupil and the other slow to react represents what?

Neurological crisis

What are ethics?

Set of rules tha govern the conduct of members of a group

Most common MVA?

Frontal impact

What is drug given to COPD patient?


COPD with JVD, hypertenion, difficulty breathing on exertion?


Cardiac arrest with NSR and low BP, what drug do you use?


What drug do you give a patient in cardiogenic shock?


What question is important is patient is having trouble breathing?

When did the dyspnea start

What is the worst complication of RETAVASE?


Patient with epiglotitus, avoid lying them down

Patient with fever?

Use tepid towels

What are S&S of croup?

Slow onset, generally wants to sit up, barking cough, NO drooling.

What are S&S of epiglotitus?

Rapid onset, wants to sit up, NO barking cough, drooling, fever 102-104, occasional stridor

What is the primary location for IM injection?


What is the #1 priority at an emergency scene?

The rescuer's safety

Name a parasympathetic blocker


Name the 3 section of Glscow Coma Scale?

Eyes, verbal, motor

If you do not defibrillate due to a dead battery and the family finds out, what might you be sued for?


What is the key to effective management at a disaster scene?

Coordination of all activities

Name 2 types of frequencies used for medical communication?

UHF 450-470; VHF 150-170

You begin assessment of a call when?

As soon as the call comes in

A patient complains of SOB, pursed lips and barrel chest?


Chronic bronchitis is some times called what?

Blue bloaters

Ecchymosis over the mastoid process is called what?

Battle signs

What are the S&S of ICP?

Elevated BP, Dereased HR, irregular respirations

The purple lesions on the body of an AIDS patient are what?

Karposi Sarcoma

A mini drip set delivers how many drops per minute?


Most complicated problem associated with IV therapy is what?

Air embolism

Patient in motorcycle accident with tension pneumothorax, BP 80/40, piulse 110. What is order of treatment?

C-spine, decompress, transport, IV enroute

What is a major side effect of certain types of diaretic therapy?


How does Atropine work?

By blocking the effects of the vegus nerve

60 y/o patient weights 110 lbs and complains of palpations, pulse 140, BP 110/60, resiration 24. He has wide complex tachcardia, what is treatment?

Lidocaine 1-1.5mg/kg, then maintance drip

What is treatment for anaphylactic shock?

Epi 0.3mg and Benadryl 50mg

You give 25g of dextrose from a 100cc amp of 50% dextrose, how many cc did you give?

50 cc

What kind of drugs are Mellaril and Thoraxina?

Tricyclic antidepressants

What is the treatment for tricyclic OD?

Sodium Bicarb

Magnesium Sulfate is used to treat what conditions?

Calcium channel blocker OD, Torsades de Pointes, Eclampsia

What should you do if an arm or leg presents at birth?

transport immediatley

Treatment for 5 y/o with dyspnea and drooling are all EXCEPT?

Lying him flat

What do you do to avoid supine hypertensive syndrome?

Transport the patient on her left side

Pulsating mass in the ABD with back pain is most likely what?

Abdominal Aortic Aneurysm (AAA)

What is the primary concern with near drowning?

Hypoxia and acidosis

What is the purpose of Kussmal's respirations in a diabetic patient?

To combat metabolic acidosis

The biggest concern with angulated fracture is what?

Pinching and cutting of nerves and blood vessels, distal circulation

In a blast, where are the primary injuries?

To the hollow organs

A bullet wound is called a cavitation

Why should you not remove an impaled object from the eye?

Because fluid loss will occur

A patient has an evisceration, should you try to replace exposed ABD organs?


What is common to all forms of shock?

In adequate tissue perfusion

What is a possible consequence to high cervical fractures (C-1,C-2)?

Interrupt or stop the respiratory system

How should you manage a patient with a jugular laceration and suspected air embolism?

Apply direct pressur to the wound and place the patient on their left side

A fractured clavical presents how?

With the shoulder on the injured side bent foward

A patients left pupil is fixed, dilated, and slow to respond to light. This represents what?

Neurological crisis

What is a more common name for the thyroid cartilage?

Adams apple

The most severe burns are caused by what?

Alkali's such as Drano and oven cleaners

Hypovolemic shock from major burns is a result of what?

Loss of blood plasma

What is definite necessary treatment for flail chest?

Positive pressure ventilations

A hemothorax is associated with hypovolemic shock why?

Because there is a pump problem, and loosing blood into the chest cavity

What is the correct order of inspection for the abdomen?

Auscultate before you palpate

Define cell

The smallest living unit of structure and function of the body

Define system

Group of related organs that work together to perform specific functions

What is the purpose of cerebral spinal fliud (CSF)?

To cushion the brain and spinal cord

Dilated pupils can be a response to what?

Epi, Atropine, cocaine, amphetamines, and cerebral hypoxia

Pinpoint pupils (miosis) can be a result of what?

Organophosphate poisoning and narcotic use

Define Cullen's Sign

Hematoma or bruising around the umbilicus, indicating internal abdominal injury

Kern's sign is what?

Referred pain to the left shoulder; may indicate an ectopic pregnancy or an injury to the spleen

The smaller the child the more likely the vital signs are how?

The lower the BP, the higher the pulse and respirations

In a patient with a head injury, how should the patient be transported?

With the head elevated

How many lobes do the lungs have?

3 on the right and 2 on the left

Suctioning can cause what?

Abnormal EKG's and hypoxia

Neurogenic shock can present how?

Warm dry skin, decreased BP and NON tachycardia

The first signs of shock are what?

Anxiousness and restlessness

The end of an EOA should be where?

Just below the carina

The adrenal gland secretes what?

Epi and norepi

What do the kidneys rely on for perfusion?

Systolic BP

The normal patients respirations are triggered by what?

An increase in atrial CO2

The Heimlich Maneuver is performed where?

The epigastrium region of the abdomen

COPD patients respiratory is triggered by what?

A decrease in O2

What is one result of Beta stimulation?


Oxytocin and ATCH are excreated by what gland?

The pituitary gland

What is the order MAST Pants are inflated?

Left leg, right leg the abdomen

A subaracchnoid bleed occurs where?

Below the arachnoid

An epidural hematoma is where?

Between the skull and the dura

What are the possible S&S of a subarachnoid bleed?

Sudden onset of headache, blurred vision, and possible unconsciousness due to the vessel rupture

What is the usual progression of a subdural bleed?

The subdural bleed is usually slow due to it being a venous bleed

What is the progression of an epidural bleed?

Usually fast due to it being an arterial bleed

Why is decerebrate posturing ususally a worse sign than decorticate posturing?

Decerebrate posturing is usually indicative of a main brain stem injury, where decorticate posturing inducates an injury to the brain ABOVE the brain stem.

What are S&S of traumatic Asphyxia?

Bulging tongue and eyes, and cyanosis of the upper body

What is the movement of a flail chest?

Moves in on inspiration and out on exhalation

What ligament holds the thoracic aorta in place?

The Ligamentum Arteriosum

A SPRAIN is an injury to what?


A STRAIN is an injury to what?


A traction splint is indicated for and used why?

A mid-shaft, closed femur fracture.  To maintain stabilization, maintain distal perfusion and pain relief