Set 1

Question 1

8001 Allergic Reaction / Anaphylaxis​​​

Answer 1

ALLERGIC REACTION

Diphenhydramine:
50 mg PO/IM/IV

ANAPHYLAXIS

Epinephrine 1:1,1000:
0.3 mg IM q15 (Max dose 0.9 mg).

Diphenhydramine:
50 mg IV/IO/IM.

Albuterol:
5 mg (6 ml unit dose) HHN for wheezing. Reassess after the first treatment. It may be repeated as needed for respiratory distress.

Consider CPAP.

Epinephrine:
0.01 mg/ml (10mcg/ml)
0.5-2 ml every 2-5 minutes (5-20mcg) IV/IO for stridor and hypotension. Titrate to a minimal systolic B/P > 90 mmHg OR a total of 0.5 mg. is given.

BETA BLOCKER

Glucagon:
1 mg IV/IO given over one (1) minute. May give IM if no vascular access or delay is anticipated.

Question 2

8002 Diabetic Emergencies

Answer 2

HYPOGLYCEMIA

Dextrose:
10-12.5 grams IV. If blood sugar remains ≤ 60 mg/dl, give additional Dextrose 12.5-15 grams IV. May repeat for a total of 50 grams.

Glucagon:
1 mg Intramuscular (IM).

HYPERGLYCEMIA

Initiate vascular access and administer a Normal Saline bolus of 500ml.

Question 3

8003 Seizures

Answer 3

Midazolam:
0.1mg/Kg in 2 mg increments slow IV push or IN-titrate to seizure control (max dose 6 mg).

If IV or IN is not available, Midazolam may be given IM - 0.1 mg/Kg (max dose 6 mg) in a single IM injection (may be split into 2 sites if sufficient muscle mass is not present for a single injection site).

Diazepam:
May substitute Diazepam when there is a recognized pervasive shortage of Midazolam. 5-10 mg IVP to control seizures. If no IV access, 10 mg IM. May repeat
once. Max dose 20 mg.

Question 4

8004 Suspected Narcotic Overdose

Answer 4

Naloxone:
Preferred routes are IV or Intranasal (IN).

1 mg increments IV push, titrated to adequate respiratory status.

2 mg Intranasal (IN). May repeat every 5 minutes, as needed, titrate to adequate respiratory status.

Question 5

8017 Dystonic Reaction

Answer 5

Diphenhydramine:
50 mg IV (preferred) or IM.

Question 6

8018 Overdose and/or Poison Ingestion

Answer 6

BETA BLOCKERS/CALCIUM CHANNEL BLOCKERS

Atropine:
1 mg IV/IO, repeat q5 min. Max dose 3 mg

Push Dose Epinephrine:
0.01 mg/ml (10mcg/ml)
Dose: 0.5-2 ml (5-20mcg) IV/IO every 2-5 minutes.

TCA

Sodium Bicarbonate:
1 mEq/Kg