MICN LA County Final Test Questions
and Answers
Treatment for mental health crisis? - Answer-Olanzapine 10mg ODT x1 (no base
contact required) and Midazolam 5mg IV/IM/IN (base contact required) max 20mg
Cardiac arrest in PEA treatment - Answer-CPR! Epi (0.1mg/ml 1ml) ASAP and can
repeat Q5 min max 3mg, NS 1L rapid
If suspected hyperkalemia= 1g Ca chloride and Sodium Bicarb 50mEq
Cardiac arrest V.Fib/pulseless V. Tach treatment? - Answer-CPR! Defib @200J (repeat
Q2 min)! Epi (0.1mg/ml 1ml, max 3 ml) after 2nd defib, amnioderone 300 after 3rd fefib,
amnioderone 150mg after 5th, NS 1L rapid
ROSC obtained on scene- when and where do we transport? - Answer-After 5 minutes-
to SRC
Do we transport medical cardiac arrests? - Answer-No- only penetrating traumatic! Best
thing for medical cardiac arrest is high quality CPR with minimal interruptions. Cant do
that in the ambulance/transporting.
Treatment post ROSC with cardiogenic shock? - Answer-If SBP <90 NS 1L and push
dose epi if no response after 250ml NS
What is the first priority for a cardiac arrest patient? - Answer-CPR!
What is the preferred advanced airway for cardiac arrest patients? - Answer-SGA/iGel-
do not have interrupt CPR to place and can monitor capnography throughout
Normal ETCO2 during CPR? - Answer->10 with box shaped waveforms
An increase in ETCO2= ROSC
Can you do CPR on LVAD patient? - Answer-Yes- note no pulse and no BP
Can you do CPR on a TAH patient? - Answer-No! No epi, no defib, no cpr- will destroy
that artificial heart
When would you hold nitro? - Answer-SBP <100 or sexually enhancing drugs within the
last 48 hours
CANT GIVE IF LVAD
, Cardiac chest pain treatment? - Answer-O2 PRN, EKG, ASA 325mg (hold if GI Bleed),
Nitro if chest pain 0.4mg (may repeat for total 3 doses), IV, NS 1L if poor perfusion,
zofran 4mg if nausea
Bradycardia treatment? - Answer-O2, monitor, EKG, supine, IV (DO NOT DELAY TCP
FOR IV), Atropine 1mg IV repeat Q3-5 min (max 3mg), TCP if no improvement after 1st
dose of atropine
HR <40 with poor perfusion after atropine- consider what treatment? How? - Answer-
TCP- Set rate at 70, mA 0, slowly increase until capture. Sedation prior! Midazolm 5mg
IV/IO (max 10mg prior to base)
If poor perfusion s/p TCP- NS 1L rapid and/or push dose epi
Contraindication for Atropine - Answer-2nd type 2 and 3rd degree heart block
Tachycardia treatment? - Answer-NS 1L if poor perfusion, treat causes
SVT treatment if stable with adequate perfusion? - Answer-Valsava, Adenosine 6-12
with second dose of 12
SVT treatment if unstable with poor perfusion? - Answer-Adenosine 12mg, repeat
12mg, cardioversion 120-150-200
Contraindications for Adenosine? - Answer-WPW, sick sinus, heart transplant, tegretol
CHF treatment? - Answer-O2, monitor, IV, CPAP if alert in mod/severe respiratory
distress and SBP >90, nitro if BP >100, if wheezing persists despite CPAP give
Albuterol 5mg neb
Contraindications for CPAP - Answer-Cardiac/respiratory arrest, unable to protect
airway, unable to follow commands, SBP <90, trach, vomiting, pneumothorax,
respiratory distress d/t trauma.
Must be longer than broselow!
CHF nitro dosing - Answer-0.4 if SBP >100
0.8 if SBP >150
1.2 if SBP >200
Repeat Q3-5 min x3
OB patients with trauma - Answer-High flow O2, L lateral position
Destination for a patient who delivered a baby <34 weeks? >34 weeks? - Answer-<34
weeks- perinatal with EDAP and NICU
>34 weeks- perinatal with EDAP
