A 3 year-old patient is found lying on the ground in cardiac arrest. The patient’s ECG is shown below: PALS ECG.png  Which of the following interventions are most important for the survival of this patient? Select the three answer options that are correct. 

Match each overdosed medication (Column A) with its correct antidote (Column B).

Clinical Judgement: Enroute phase You are dispatched to a residential neighborhood for a 6-year-old male; 36 pound who was struck by a vehicle while crossing the street. Bystanders reported the child was thrown several feet and hit his head on the pavement. What is the greatest concern in a pediatric pedestrian struck by a vehicle?

Scenario:You are treating a 5-year-old (40 lbs) patient in status asthmaticus who is not responding adequately to nebulized treatments. Medical control standing orders Dexamethasone IV/IM. You have a vial of Dexamethasone with a concentration of 10 mg/mL.?How many mL of Dexamethasone should you administer?

Clinical Judgement: Enroute phase You are dispatched to a residence for a 4-month-old male patient; 15 pound experiencing a prolonged seizure. The caregiver reports the child has been seizing for over 10 minutes and is unresponsive. What is the most concerning finding in a seizing pediatric patient?

Clinical Judgement: On scene phase You are dispatched to a residence for a 4-month-old male patient; 15 pound experiencing a prolonged seizure. The caregiver reports the child has been seizing for over 10 minutes and is unresponsive. The apartment is dimly lit, and the caregiver single father, 22 years old, he appears anxious but inconsistent in their story. No visible signs of trauma in the environment. The father reports the baby was “acting weird,” then started convulsing. No known medical conditions, Full term birth, no complication. Vaccination is up to date, no known medication allergies. Patient is currently seizing with irregular, periods of apnea, respiratory rate 20 breaths/min, SpO2 90% on room air. Patient is warm, pale, weak pulse at 160 bpm, capillary refill >3 seconds, and Glasgow Coma Scale 6. The caregiver states, “I just shook him a little because he wouldn’t stop crying.” What should your priority action be?

You are called to transport a 24-year-old female G2P1 – 9 weeks gestation with no other previous medical history. On arrival, you note that the patient has been vomiting clear emesis and appears weak and pale. Her husband tells you she has been vomiting off and on since becoming pregnant, but for several days now it has become uncontrollable and she cannot keep food or water down. You note that your patient has poor skin turgor and a capillary refill of 3 seconds. Your partner tells you her vitals are. Blood Pressure – 94/72, Pulse – 100, Respirations – 22. She is alert and well oriented. With the information provided, you suspect your patient is suffering from which one of the listed disorders?

You are dispatched to a residential home for a 25-year-old female, 36 weeks pregnant, experiencing significant vaginal bleeding. The patient appears pale, diaphoretic, and is reporting dizziness and weakness. BP is 78/50, HR 132, RR 24, SpO₂ 94% on room air. The patient has a history of placenta previa and is in a supine position on the couch. Immediate IV fluid resuscitation is required. The paramedic establishes a large-bore IV with normal saline (NS) at 500 mL/hr to stabilize the patient. The IV tubing has a drip factor of 15 gtt/mL. What is the correct drops per minute (gtt/min) to deliver the ordered IV fluids? 

Scenario: Enroute  The Paramedic is dispatched to a birthing center for a 29-year-old patient who is in active labor. The time of the call is 0600. The response time will be 10 minutes.   The Paramedic is partnered with an EMT, and a BLS fire department engine crew is dispatched with an ambulance. The patient is located inside the birthing center. It’s a clear spring afternoon, and the temperature is 88°F (31°C). A small hospital is located 15 minutes away, and the nearest comprehensive medical facility is 30 minutes away.  Scenario: Scene  The patient (70 kilograms) is sitting awake in the birth center water room inside a bathtub. The midwife states the patient has been in labor for 5 hours and started having imminent delivery 10 minutes ago. The infant’s head is delivered, but you notice the umbilical cord is tightly wrapped around the neck. The patient has a history of 39-week gestation, gravida 4, parity 3, and no abortions. Prenatal care is up to date, and no complication reported with previous and current pregnancy. Patient’s birth plan was a water birth, and no complications were indicated prior to labor. The patient has allergies to penicillin and iodine. The patient’s skin is cool, clammy, and diaphoretic. The amniotic sac has ruptured with 200 mL of vaginal bleeding visible; patients obey motor commands. Eyes are open, and the pupils are 5 mm and reactive to light. The vital signs are BP 110/60, P 118, R 20, SpO2 96% on room air, and T 98.6°F (37°C). The blood glucose is 80 mg/dL.  Scenario: Post-Scene  Despite successful nuchal cord delivery, the newborn has central cyanosis, limp, with a heart rate of 60 bpm and thick meconium-stained amniotic fluid is noted. The mother remains weak and dizzy after birth. The patient is alert and has normal, warm, and dry skin. The patient is following commands and is asking for her baby. Eyes are open, and the pupils are 5 mm and reactive to light. The vital signs are BP 100/68, P 110, R 16, SpO2 98% on oxygen, and T 98°F (37°C). The blood glucose is 80 mg/dL.  Post-Scene  What is your first intervention? 

You are called to the home of a six-month-old male infant with an irregular breathing pattern and poor feeding for the past couple of days. Upon your arrival, you find the small patient in his mother’s arms. The mother is attempting to feed the child from a bottle. Primary (Initial) assessment reveals lethargy, hyperpnea, and pallor. Mother reports a two-day history of poor feeding, vomiting, and diarrhea. Based upon your primary (initial) assessment and history of present illness, you suspect this young patient may be suffering from.