ICEMA FINAL STUDY GUIDE Latest Update -

ICEMA FINAL STUDY GUIDE Latest Update -

150 Questions and Verified Correct Answers Golden Ticket to Guaranteed A+ Verified by Professor

• Procedure-Standing Orders

NG and OG tubes - CORRECT ANSWER: -Use a water-soluble lubricating jelly

• Required for all full arrest patients, burn, trauma, newborns

• Seizure - Pediatric

Interventions - CORRECT ANSWER: - Assure and maintain airway patency after

cessation of seizure

• Establish advanced airway as clinically indicated

• Remove excess clothing and begin cooling measures if the patient is febrile

• Place on cardiac monitor

• Obtain vascular access

• Obtain blood glucose level

▫ Dextrose: Neonates (0 - 4 weeks) with blood glucose less than 35 mg/dL or pediatric patients 1 / 4

(more than 4 weeks) with glucose less than 60 mg/dL: Dextrose 10%/250 ml (D10W 25 gm) 0.5 gm/kg (5 ml/kg) IV/IO

▫ Glucagon (if unable to establish IV) 0.03 mg/kg IM/IN, if unable to start an IV. May be repeated one (1) time after 20 minutes for a combined maximum dose of 1 mg

- For tonic/clonic type seizure activity administer:

▫ Midazolam: 0.1 mg/kg IV/IO with maximum dose 2.5 mg. May repeat Midazolam in five (5) minutes, OR Midazolam, 0.2 mg/kg IM/IN with maximum dose of 5 mg. May repeat Midazolam in 10 minutes for continued seizure, Maximum of three (3) doses using any combination

12 Lead recognition of an MI - CORRECT ANSWER: - 2 contiguous leads with ST

elevation

• If signs of inadequate tissue perfusion or if inferior wall infarct is suspected, obtain a

right-sided 12-lead (V4R)

• If right ventricular infarct (RVI) is suspected with signs of inadequate tissue perfusion,

consider 300 ml NS bolus, may repeat. (Nitrates are contraindicated in the presence of RVI or hypotension.)

• Repeat 12-lead ECG at regular intervals, but do not delay transport of patient.

• EMS field personnel shall ensure that a copy of the 12-lead ECG is uploaded or

attached as a 2 / 4

permanent part of the patient's ePCR

14100R1 pain management

Interventions (Acute traumatic injuries, acute abdominal flank pain, burns, sickle cell, cancer

pain) - CORRECT ANSWER: - Consider early vascular access

• Place on cardiac monitor. Obtain capnography

• Monitor and assess patient vital signs prior to administration of any analgesic

• For treatment of pain as needed with a blood pressure of greater than 100 systolic:

Fent

- For treatment of pain as needed with a blood pressure less than 100 systolic:

ketamine or Tylenol

• Continuous monitoring of patients ECG and capnography is required for administration

of Ketamine or fentanyl

• Reassess and document vital signs, capnography, and pain scores every five (5)

minutes

• Once a pain medication has been administered via route of choice, changing route

(i.e., from IM to IV) requires base hospital order

• Shifting from one analgesic while treating a patient requires base hospital contact 3 / 4

14150R1 cardiac arrest peds

Interventions - CORRECT ANSWER: - Initiate HP CPR and continue appropriate BLS

Interventions while applying the cardiac monitor and capno without interruption to chest compressions

• Obtain IO/IV access (IO is preferred)

• NS bolus may be repeated two times

- 1 day to 8 years: 20 ml/kg NS

- 9 to 14 years: 300 ml NS

• Endotracheal intubation is the advanced airway of choice if BLS airway does not

provide adequate ventilation. Endotracheal intubation may only be performed on patients who are taller than maximum length of a pediatric emergency measuring tape

• Insert NG/OG tube

ACUTE ASTHMA/BRONCHOSPASM/ALLERGIC REACTION/ANAPHYLAXIS: -

CORRECT ANSWER: Treatment

Maintain airway with appropriate adjuncts, obtain oxygen saturation on room air if possible

▫ Place patient on Continuous Positive Airway Pressure, (Start at lowest setting and increase

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