2017 Nyc Remac - Smoke Inhalation/cyanide Exposure

Front 1

"Patients with symptoms, after exposure to smoke in an _________ where cyanide exposure is suspected, should be administered hydroxocobalamin and sodium thiosulfate."

Back 1

enclosed space

Front 2

"Patients with the following symptoms, after exposure to smoke in an enclosed space or exposure to cyanide, should be administered the medications listed in Table 1, if available."

Back 2

"HACSA"

Hypotension (not from other causes)
AMS
Coma
Seizures
Arrest (respiratory or cardiac)

Front 3

Prior to administration of Hydroxocobalamin...

Back 3

obtain three blood samples using the tubes provided in the cyanide toxicity kit.

Front 4

Whenever Hydroxocobalamin is administered, follow with...

Back 4

a 20 ml flush of saline prior to the administration of any other medication.

Front 5

In 500AB, how many separate age groups are listed for pediatrics?

Back 5

three

Front 6

500AB
Infant/Toddler (___-___ years)
_____ bottle(s) hydroxocobalamin

Back 6

0-2 years
1/4 bottle

Front 7

500AB
Preschool (___-___ years)
_____ bottle(s) hydroxocobalamin

Back 7

3-5 years
1/4 bottle

Front 8

500AB
Grade School (___-___ years)
_____ bottle(s) hydroxocobalamin

Back 8

6-14 years

1/2 bottle

Front 9

500AB
Adult (___ and over)
_____ bottle(s) hydroxocobalamin

Back 9

15 years +
1 bottle

Front 10

All peds (0-14 years)
Sodium Thiosulfate Dosage

Back 10

250 mg/kg IV
(3 cc/kg)
over 10 mins

Front 11

Adults (15 and over)
Sodium Thiosulfate Dosage

Back 11

12.5 gm IV
(150 ml)
over 10 mins

Front 12

Hydroxocobalamin may be mixed with...

Back 12

D5W
Saline
Ringers

(essentially any fluid)

Front 13

Hydroxocobalamin vented macrodrip tubing should be used wide open to ensure correct administration time of _____ mins.

Back 13

15 mins

Front 14

Sodium Thiosulfate should be prepared by adding _____ grams (_____ ml) to a _____ cc bag of D5W.

Back 14

12.5 g
50 ml
100 cc

Front 15

What solution is Sodium Thiosulfate mixed with?

Back 15

D5W

Front 16

Sodium Thiosulfate comes in a _____ cc vial and is mixed with _____ cc of D5W for a total of _____ cc.

Back 16

50
100
150

Front 17

Sodium Thiosulfate is administered over ____ minutes.

Back 17

10

Front 18

Standing order Dopamine dosage in 500AB protocol.

Back 18

5-20 ug/kg/min

Front 19

In patients who meet the criteria set forth in protocols 500AB, begin how many IV lines?

Back 19

2

Front 20

In the event that only one IV is established, administer ______ first before ______.

Back 20

hydroxocobalamin

sodium thiosulfate

Front 21

In 500AB, Dopamine or Norepinephrine are indicated in the event of continued hypotension below _____.

Back 21

90 systolic

Front 22

A general order given by an OMA Medical Director to perform an intervention at a location for a specific time, generally at disasters.

Back 22

Class Order

Front 23

The vented macro drip tubing that accompanies the Cyanokit should be used, ______, to ensure correct administration time of approximately 15 minutes for the kit.

Back 23

wide open

Front 24

There are ____ blood tubes included in the Cyanokit, each with a ____ ml capacity.

Back 24

3 (blood tubes)

2 (ml capacity)

Front 25

Name the three types of blood tubes included in the Cyanokit.

Back 25

(1) Fluoride Oxalate Whole Blood

(2) K2 EDTA

(3) Lithium Heparin

Front 26

For a One Bottle Kit, _____ ml of NS/RL/D5W should be added to the bottle.

Back 26

200 ml

Front 27

The smoke inhalation protocol should be utilized ONLY for the managements of symptomatic patients after exposure to _____ in an _____ and _____ is suspected.

Back 27

smoke

enclosed space

cyanide exposure

Front 28

For the Cyanide Exposure protocol, when the total patient count is _____, a Class Order is required to utilize this protocol.

Back 28

"greater than five"

(This rhetoric conflicts with criteria elsewhere in the protocols, where "five" qualifies as an MCI.)

Front 29

For the Cyanide Exposure protocol, when the total patient count is _____, a Class Order is NOT required to utilize this protocol.

Back 29

"five or less"

(This rhetoric conflicts with criteria elsewhere in the protocols, where "five" qualifies as an MCI.)

Front 30

Treatment in the hot or warm zones may be performed only by appropriately trained personnel wearing appropriate ____ as determined by the ____.

Back 30

Chemical Protective Clothing (CPC)

FDNY Incident Commander

Front 31

For pediatric patients, add 50ml (12.5g) of Sodium Thiosulfate to 100ml of D5W, and administer ____ ml per kilogram of the prepared solution.

Back 31

3 ml/kg

Front 32

A One Bottle Kit contains _____ grams of Hydroxocobalamin in a single bottle.

Back 32

5 grams

Front 33

The adult dose of Hydroxocobalamin is ____ grams.

Back 33

5 grams

Front 34

List the three ways in which the Cyanide Exposure protocol differs from the Smoke Inhalation protocol.

Back 34

Cyanide Protocol:

(1) No SpCO monitoring/CO concerns

(2) Class Order for over 5 patients

(3) Hot/Warm Zone; Leave the area

(otherwise essentially identical)

Front 35

Norepinephrine must be administered via _____ or larger IV I/O, using an IV drip chamber or other suitable metering device.

Back 35

18 gauge

Front 36

What is the dosage range of norepinephrine?

Back 36

2-20 ug/min