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ALS PCS EXAM WITH ACCURATE ANSWERS 100% VERIFIED
Medical Cardiac Arrest MD: Indications - ANSWER Non-Traumatic Cardiac Arrest
Medical Cardiac Arrest MD: Conditions - ANSWER CPR: Altered LOA; Performed in 2 min intervals Manual Defib: >/= 30 days; Altered LOA; VF or Pulseless VT AED Defib: >/= 30 days; Altered; Defib indicated Epi: Altered LOA; Anaphylaxis suspected as causative event Medical TOR: >/18 y/o; Altered LOA; Arrest not witnessed by EMS & NO ROSC & No Defib Delivered
Medical Cardiac Arrest MD: CI - ANSWER CPR: Obviously Dead as per BLS PCS; Meet conditions of DNR standard Manual Defib: Rhythms other than VF or pulseless VT AED Defib: Non-shockable rhythm Epi: Allergy or Sensitivity to EPI Medical TOR: Arrest through to be of Non-Cardiac origin
Medical Cardiac Arrest: Tx Manual Defib - ANSWER Consider if available & authorized Age:>/= 30 days to <8 y/o Dose: 1 defib Initial dose: 2 J/kg Subsequent dose(s): 4 j/kg Dosing interval: 2 min Max. # of doses: 4 Age: >/= 8 y/o
Dose: 1 defib Initial Dose: As per BH/manufacturer Dosing Interval: 2 min Max. # of doses: 4
Medical Cardiac Arrest: Tx AED Defib - ANSWER Consider if not using Manual Defib Age:>/= 30 days to <8 y/o With or w/out the Pediatric Attenuator cable Dose: 1 defib Max single Dose: As per the BH/Manufacturer Dosing interval: 2 min Max. # of doses: 4 Age: >/= 8 y/o Dose: 1 defib Max single Dose: As per the BH/Manufacturer Dosing interval: 2 min Max. # of doses: 4
Medical Cardiac Arrest: Epi - ANSWER Route: IM Concentration: 1mg/ml=1: Dose: 0.01 mg/kg (may rounded to the nearest 0.05 mg) Max single dose: 0.5 mg Dosing interval: N/A Max # of doses: 1 \
Medical Cardiac Arrest: Mandatory Patch Point - ANSWER Batch to BHP for authorization after the 3rd analysis to consider for a Medical TOR. If Patch fails, or TOR does not apply, transport to the nearest closest appropriate facility following ROSC or
authorized Age:>/= 30 days to <8 y/o Dose: 1 defib Initial dose: 2 J/kg Dosing interval: N/A Max. # of doses: 1 Age: >/= 8 y/o Dose: 1 defib Initial Dose: As per BH/manufacturer Dosing Interval: N/A Max. # of doses: 1
Trauma Cardiac Arrest MD: Tx AED Defib - ANSWER Consider if not using Manual Defib Age:>/= 30 days to <8 y/o With or w/out the Pediatric Attenuator cable Dose: 1 defib Max single Dose: As per the BH/Manufacturer Max. # of doses: 1 Age: >/= 8 y/o Dose: 1 defib Max single Dose: As per the BH/Manufacturer Max. # of doses: 1
Trauma Cardiac Arrest MD: Mandatory Patch Point - ANSWER Patch BHP for authorization to apply the Trauma TOR if applicable. If Patch fails or Trauma Tor does not apply, transport to the nearest appropriate receiving facility following the 1st analysis/defib
Trauma Cardiac Arrest MD: Clinical Considerations - ANSWER No obvious signs of significant blunt trauma, consider medical cardiac arrest and treat according to the appropriate cardiac arrest directive
Hypothermia Cardiac Arrest MD: Conditions - ANSWER CPR: Altered LOA; Performed in 2 min intervals Manual Defib: >/= 30 days; Altered LOA; VF or Pulseless VT AED Defib: >/= 30 days; Altered; Defib indicated
Hypothermia Cardiac Arrest MD: CI - ANSWER CPR: Obviously Dead as per BLS PCS; Meet conditions of DNR standard Manual Defib: Rhythms other than VF or pulseless VT AED Defib: Non-shockable rhythm
Hypothermia Cardiac Arrest MD: Tx Manual Defib - ANSWER Consider if available & authorized Age:>/= 30 days to <8 y/o Dose: 1 defib Initial dose: 2 J/kg Dosing interval: N/A Max. # of doses: 1 Age: >/= 8 y/o Dose: 1 defib Initial Dose: As per BH/manufacturer Dosing Interval: N/A Max. # of doses: 1
Hypothermia Cardiac Arrest MD: Tx AED Defib - ANSWER Consider if not using Manual Defib
FBAO Cardiac Arrest MD: Tx Manual Defib - ANSWER Consider if available & authorized Age:>/= 30 days to <8 y/o Dose: 1 defib Initial dose: 2 J/kg Dosing interval: N/A Max. # of doses: 1 Age: >/= 8 y/o Dose: 1 defib Initial Dose: As per BH/manufacturer Dosing Interval: N/A Max. # of doses: 1
FBAO Cardiac Arrest MD: Tx AED Defib - ANSWER Consider if not using Manual Defib Age:>/= 30 days to <8 y/o With or w/out the Pediatric Attenuator cable Dose: 1 defib Max single Dose: As per the BH/Manufacturer Max. # of doses: 1 Age: >/= 8 y/o Dose: 1 defib Max single Dose: As per the BH/Manufacturer Max. # of doses: 1
FBAO Cardiac Arrest MD: Clinical Considerations - ANSWER If pt is still in cardiac arrest following obstruction removal, initiate management as a medical arrest If obstruction cannot be removed, transport to the closest appropriate facility w/out delay following the 1st analysis
Neonatal Resuscitation MD: Indications - ANSWER Neonatal Pt
Neonatal Resuscitation MD: Conditions - ANSWER <30 days of age
Neonatal Resuscitation MD: Targeted Preductal SpO2 (right hand) - ANSWER 1 min: 60-65% 2 min: 65-70% 3 min: 70-75% 4 min: 75-80% 5 min: 80-85% 10 min: 85-95%
Neonatal Resuscitation MD: Clinical Consideration - ANSWER If neonate resus is req'd, initiate cardiac monitoring & Pulse Ox monitoring
ROSC MD: Indications - ANSWER Pt with ROSC after the resus was initiated
ROSC MD: Conditions - ANSWER 0.9% NaCl Fluid Bolus:
/= 2 y/o HPTN Chest Auscultation is Clear
ROSC MD: CI - ANSWER 0.9% NaCl Fluid Bolus: Fluid Overload SBP >/= 90 mmHg
ROSC MD: Tx Considerations - ANSWER Titrate o2 to 94-98%
Cardiac Ischemia MD: ASA - ANSWER Route: PO Dose: 160-162 mg Max single Dose: 162 mg Dosing interval: N/A Max # of Doses: 1
Cardiac Ischemia MD: Nitro - ANSWER SBP: >/= 100 Route: SL Dose: 0.3 OR 0.4 mg Max single Dose: 0.4 mg Dosing interval: 5 min STEMI: Yes Max # of doses: 3 STEMI: No Max # of Doses: 6
Cardiac Ischemia MD: Clinical Considerations - ANSWER Sus a RV MI in all Inf. STEMIs and perform a 12 lead ECG to confirm (>/= 1 mm elevation in V4R). DO NOT admin Nitro IV condition only applies to PCPs w AIV
Acute Cardiogenic Pulmonary Edema MD: Indications - ANSWER Moderate to severe resp distress AND Sus Acute cardiogenic pulmonary Edema
Acute Cardiogenic Pulmonary Edema MD: Conditions - ANSWER Nitro: >/=18 y/o; Unaltered; HR 60-159 bpm; Normotensive
Acute Cardiogenic Pulmonary Edema MD: CI - ANSWER Nitro: Allergy/sensitivity to nitrates; Use of PDIs w/in the last 48 hrs; SBP drops more than 1/3 of initial value after Nitro is admin'd
Acute Cardiogenic Pulmonary Edema MD: Nitro - ANSWER Route: SL Dosing Interval: 5 min Max # of doses: 6 IV or Hx of Nitro: Yes SBP: >/=100 to < 140 Dose: 0.3 or 0.4 mg Max single dose: 0.4 mg SBP: >/= Dose: 0.6 or 0.8 mg Max single dose: 0.8 mg Iv or Hx of nitro: No SBP: >/= 140 Dose: 0.3 or 0.4 mg Max single Dose: 0.4 mg
Acute Cardiogenic Pulmonary Edema MD: Clinical Considerations - ANSWER Consider 12 lead ECG and interpretation IV condition only applies to PCPs w AIV
Hypoglycemia MD: Indications - ANSWER Altered LOA OR Agitation OR Seizure OR Symptoms of Stroke
Hypoglycemia MD: Conditions - ANSWER Dextrose: >/= 2 y/o; Altered; Hypoglycemic Glucagon: Altered; Hypoglycemic
Hypoglycemia MD: Clinical Considerations - ANSWER If pt is responsive to dextrose or glucagon, they may receive oral glucose or other simple carbs If only mild S&S are exhibited, the pt may receive oral glucose or other simple carbs instead of glucose or dextrose If the pt initiates an informed refusal of transport, a final set of VS including BGL must be attempted and documented IV admin only applies to PCPs w AIV (EXTRA: Dextrose is very osmotically strong can cause cerebral edema)
Bronchoconstriction MD: Indications - ANSWER Respiratory distress AND Sus bronchoconstriction
Bronchoconstriction MD: Conditions - ANSWER Salbutamol: N/A through all Epi: BVM vents req'd; Hx of Asthma
Bronchoconstriction MD: CI - ANSWER Salbutamol: Allergy/sensitivity to Salbutamol Epi: Allergy/Sensitivity to Epi
Bronchoconstriction MD: Salbutamol - ANSWER Dosing interval: 5-15 min prn Max # of Doses: 3 Weight: <25kg Route: MDI Dose: Up to 600mcg (6 puffs) Max single dose: 600 mcg Route: NEB Dose: 2.5mg Max single dose: 2.5mg Weight: >/=25kg
Route: MDI Dose: Up to 800mcg (8 puffs) Max single dose: 800mcg Route: NEB Dose: 5 mg Max single dose: 5 mg
Bronchoconstriction MD: Epi - ANSWER Route: IM Concentration: 1mg/ml=1: Dose: 0.01 mg/kg (may rounded to the nearest 0.05 mg) Max single dose: 0.5 mg Dosing interval: N/A Max # of doses: 1
Bronchoconstriction MD: Clinical Considerations - ANSWER Epi should be the 1st med administered of the pt is apneic. Salbutamol MDI may be admin'd at the same time using a BVM adapter NEB is CI'd in pts w a known or sus fever or in the setting of a declared resp illness outbreak by local medical officer of health When admin'ing salbutamol MDI, rate of admin should be 100 mcg approx q 4 breaths Spacer should be used with the admin of salbutamol MDI
Moderate to Severe Allergic Reaction MD: Indications - ANSWER Exposure to a probable allergen (Hx or sus of exposure) AND S&S of a moderate to severe allergic reaction (including anaphylaxis)
Moderate to Severe Allergic Reaction MD: Conditions - ANSWER Epi: For anaphylaxis only
Croup MD: Conditions - ANSWER <8y/o; HR < 200 bpm
Croup MD: CI - ANSWER Allergy/sensitivity to Epi
Croup MD: Epi - ANSWER Route: NEB Dosing interval: N/A Max # of doses: 1 Concentration: 1 mg/ml = 1: Age: <1y/o Weight: <5kg Dose: 0.5 mg Max single dose: 0.5 mg Weight: >/=5kg Dose: 2.5 mg Max single dose: 2.5 mg Age: >/=1 y/o to <8 y/o Dose: 5 mg Max single dose: 5 mg
Croup MD: Clinical Considerations - ANSWER A minimum of 2.5 ml of fluid volume is req'd for NEB EXTRA: (Child may feel better, but must still load and go)
Analgesia MD: Indications - ANSWER Pain
Analgesia MD: Conditions - ANSWER Acetaminophen: >/= 12 y/o; Unaltered
Ibuprofen: >/= 12 y/o; Unaltered Ketorolac: >/= 12 y/o; Unaltered; Normotensive; Restricted to pts Unable to tolerate PO meds;
Analgesia MD: CI - ANSWER Acetaminophen: Allergy/sensitivity to acetaminophen; No use of acetaminophen w/in the last 4 hrs; Hx of Liver disease; Active vomiting; Unable to tolerate oral meds; Sus Ischemic Chest pain Ibuprofen: No use of ibuprofen or NSAIds w/in the last 6 hrs; Allergy/sensitivity to ASA or NSAIDS; No prior use of ASA if asthmatic; Anticoagulation therapy; Active bleeding; CVA/TBI w/in the last 24 hrs; GI bleed or Hx of peptic ulcer disease; Pregnancy; Known Renal Impairment; Active vomiting; Unable to tolerate oral meds; Sus ischemic Chest pain Ketorolac: No use of ibuprofen or NSAIds w/in the last 6 hrs; Allergy/sensitivity to ASA or NSAIDS; No prior use of ASA if asthmatic; Anticoagulation therapy; Active bleeding; CVA/TBI w/in the last 24 hrs; GI bleed or Hx of peptic ulcer disease; Pregnancy; Known Renal Impairment; Sus ischemic Chest pain
Analgesia MD: Acetaminophen - ANSWER Route: PO Dosing interval: N/A Max # of doses: 1 Age: >/=12y/o to <18y/o Dose: 500-650mg Max single dose: 650 mg Age: >/=18 y/o Dose: 960-1000mg Max single dose: 1000 mg
Analgesia MD: Ibuprofen - ANSWER Age: >/=12 y/o Route: PO Dose: 400 mg Max single dose: 400 mg
Route: IV Dose: 0.4 mg Max single dose: 0.4 mg Dosing interval: Immediate Max # of doses: 3 (titrate naloxone only to restore the pt's respiratory status)
Opioid Toxicity MD: Clinical Considerations - ANSWER IC admin is only applicable for PCPs w AIV Naloxone may unmask alternative toxidromes in mixed OD situations that may lead to possible seizures, HTN crisis, etc. Naloxone is shorter acting than most narcotics, and these pts are at a high risk of recurring narcotic effect. Make the effort to transport the pt to the appropriate facility for monitoring Anticipate combative behaviour and protect yourself accordingly. The desired clinical effect is to titrate (if IV) to a RR >/=10, adequate a/w and ventilation, not full alertness. If adequate ventilation can be performed w a BVM and basic a.w management, this is preferred
Home dialysis Emergency Disconnect MD: Indications - ANSWER Pt receiving home dialysis (hemo or peritoneal) and connected to dialysis machine and req's transport to the closest appropriate receiving facility AND pt is unable to disconnect AND there is no fam member or care giver who is available and knowledgeable in dialysis disconnect
Home dialysis Emergency Disconnect MD: Conditions - ANSWER N/A through out
Home dialysis Emergency Disconnect MD: CI - ANSWER N/A throughout
Home dialysis Emergency Disconnect MD: Clinical considerations - ANSWER Usually, emergency disconnect kit w materials and instructions can be found hanging from the dialysis machine or nearby on the wall
Ensure both the pt side side and machine side of connection are clamped BEFORE disconnecting and attaching end caps
Suspected Adrenal Crisis MD: Indications - ANSWER Pt w primary adrenal insufficiency who experiencing clinical signs of an adrenal crisis
Suspected Adrenal Crisis MD: Conditions - ANSWER Paramedics presented w a vial of hydrocortisone for the id'd pt AND Age related hypoglycemia OR Age related HPTN OR Age related TachyHR OR GI symptoms (N/V/D, abdo pain) OR Fever >38C or sus/hx of fever OR Altered LOA OR Syncope
Suspected Adrenal Crisis MD: CI - ANSWER Allergy/sensitivity to Hydrocortisone
Suspected Adrenal Crisis MD: Hydrocortisone - ANSWER Route: IM/IV Dose: 2mg/kg (can be rounded to the nearest 10 mg) Max single dose: 100mg Dosing interval: N/A
