Make Me Sweat, Make Me Water
Difference between heat exhaustion and heat stroke
AMS, internal body temp 104F
Time frame for pre-eclamspia and eclampsia to occur in pregnant patients.
20 weeks pregnant up to 1 month post-partum.
A patient transport position that should NEVER be utilized under any circumstances.
Prone
Tylenol dose for a 7kg child
Acetaminophen 15mg/kg (105mg)
This municipal agency operated NYC's EMS system before FDNY
NYC Health + Hospitals (HHC)
Name the blood test used to quantify muscle breakdown in rhabdomyolysis.
CK (Creatine Kinase)
You have a pregnant patient that starts seizing. Name medication and dose you are giving.
Magnesium Sulfate 4 g IV (diluted in 50-100 ml Normal Saline) over 10 minutes
You have an awake patient who requires procedural sedation for cardioversion. Name dose and route of etomidate.
Etomidate 0.15mg/kg (7.5mg)
Morphine can be given to a patient if SBP is above this value
SBP >110
Name the year NYC EMS merged with FDNY and the name of the mayor who executed it
1996, Guiliani
A patient starts seizing after taking molly on a hot summer night. Name the electrolyte abnormality.
Hyponatremia
Define severe pre-eclampsia:
Systolic blood pressure ≥ 160 mm Hg OR a diastolic blood pressure ≥ 110 mm Hg AND headache, visual disturbances, pulmonary edema or lower extremity edema
In order to sedate the patient under standing orders to perform advanced airway management, the patient must meet ALL of the following criteria:
• Adult • Altered mental status • Respiratory rate < 10 breaths/min • SpO2 < 90% without supplemental oxygen • No immediate reversible cause of symptoms (e.g. opiate overdose responding to Naloxone)
Compare morphine, fentanyl, and ketamine's effect on BP
morphine decrease, fentanyl neutral, ketamine increase
This federally funded pilot program helped launch one of the first paramedic services in NYC in 1974.
Bellevue/Harlem Hospital Paramedic Pilot Program
• Asymptomatic patient with SpCO > 25% • Patients with a high index of suspicion for carbon monoxide poisoning AND any of the following symptoms: altered mental status, headache, or syncope • Pregnant patients with SpCO > 15%
A maneuver, named after an obstetrician, used to deliver a baby when there is concern for shoulder dystocia. (Must demonstrate).
McRoberts
This life-threatening airway emergency is an adverse reaction to ketamine. Name and management.
Laryngospasm. Jaw thrust, BVM, intubate.
Contraindications for Toradol
• Renal failure and/or hemodialysis • Age ≥ 65 years • Pregnancy • Abdominal pain • Injuries with a risk for bleeding or suspected fracture
FDNY EMS’s Citywide Incident Management System (CIMS) was first fully tested during this 2005 MCI, involving hazardous materials in the subway.
Fulton Street mercury spill
Pediatric dose of hydroxocobalamin
Hydroxocobalamin 75 mg/kg IV (3 ml/kg of prepared solution) (maximum 5 g) over 15 minutes
Normal O2 saturation for a neonate 1 minute after birth.
60-65%
You have a 50kg patient who requires sedation for intubation. You choose to induce with etomidate then use fentanyl and midazolam for post-intubation sedation. Name doses.
Etomidate 0.3mg/kg (15mg). Fentanyl 1mcg/kg (50mcg). Midazolam 0.2mg/kg (5mg).
IN ketamine dose for a 45kg female
ketamine IN 0.4mg/kg (18mg)
This 2006 NYC MCI involved the crash of a small aircraft into a Manhattan apartment building by a New York Yankees player, drawing both local and federal response.
Cory Liddle plane crash