ICEMA PROTOCOL STUDY GUIDE EXAM WITH
ACTUAL QUESTIONS AND ANSWERS LATEST UPDATE 2025/2026 RATED A+
Burns-adult #14070 - ✔️✔️CORRECT ANSWER-- Estimate % TBSA burned and
depth using rule of nines.
- Thermal burns: Stop burning process. DO not break blisters. Cover affected
body surface with dry, sterile dressing or sheet.
- Chemical burns: Brush off dry powder, if present. Remove any contaminated
or wet clothing. Irrigate with copious amounts of saline or water.
- Tar burns: Cool with water, do not remove tar
- Electrical burns: Remove from electrical source (without endangering self)
with nonconductive material. Cover affected body surface with dry, sterile
dressing or sheet
- Eye involvement: Continuous flushing with NS during transport. Allow
patient to remove contact lenses if possible
- Advanced airway as clinically indicated. King airway is contraindicated
- Iv access: Unstable- BP less than 90 and/or signs and symptoms of
inadequate tissue perfusion, start 2nd IV line. Give 250mL boluses and repeat
to max of 1L
Stable- BP more than 90 and signs of adequate tissue perfusion, administer
500ml/ hr.
1|Page
,ICEMA PROTOCOL STUDY GUIDE EXAM WITH
ACTUAL QUESTIONS AND ANSWERS LATEST UPDATE 2025/2026 RATED A+
- Respiratory distress: Use BVM as needed. Contact receiving hospital ASAP.
Administer albuterol with Atrovent. High flow oxygen Is essential with known
or potential respiratory injury. Beware of smoke inhalation. Do not apply ice
water directly to skin surfaces, as additional injury will result. Intubate patient
if facial/ oral swelling is present or if respiratory depression or distress
develops due to inhalation injury. CPAP may be considered if indicated after
consultation with BH
- Treat pain with analgesics as indicated
Pain management #14100 - ✔️✔️CORRECT ANSWER-Patients with a GCS of 15 or
at baseline mentation and have a pain score of 5 or higher and have: acute
traumatic injuries, acute abdominal/ flank pain, burn injuries, cancer pain,
or sickle cell crisis
• What drugs/dosages are used?
- Must always monitor and assess vital signs prior to administration of any
analgesic. After administration must continually monitor EKG and place on
capno. Reassess vital signs, capno, and pain scores every 5 minutes.
- Once a pain medication has been administered via route of choice, changing
route (i.e. IM to IV) requires BHO.
- Shifting from one analgesic while treating a patient requires BHO
- For pain and a SBP below 100, administer 0.3mg/kg Ketamine IVPB to a max
single dose of 30 mg. May repeat once in 15 minutes.
- For pain and an SBP above 100, administer 50 mcq Fetanyl slow IV/IO push
over 1 minute. May repeat every 5 minutes titrated to pain but not to exceed
200 mcq OR 100 mcq IM/IN. May repeat 50 mcq every 10 minutes titrated to
pain, not to exceed 200 mcq. Peds dose is 0.5mcq/kg slow IV/IO over 1
minute. May repeat in 5 min titrated to pain, not to exceed 100 mcq OR 1
mcq/kg IM/IN, may repeat every 10 minutes titrated to pain but not to exceed
200 mcq. Can also use 0.3mg/kg of Ketamine IVPB to a max of 30mg as a
,ICEMA PROTOCOL STUDY GUIDE EXAM WITH
ACTUAL QUESTIONS AND ANSWERS LATEST UPDATE 2025/2026 RATED A+
2|Page
, ICEMA PROTOCOL STUDY GUIDE EXAM WITH
ACTUAL QUESTIONS AND ANSWERS LATEST UPDATE 2025/2026 RATED A+
single dose in 50-100mL of NS over 5 minutes. May repeat one time in 15
minutes, if pain is still a 5 or higher. DO not administer IVP, IO, IM, IN
Respiratory emergencies-Peds #14120 - ✔️✔️CORRECT ANSWER-- Maintain
airway with appropriate adjuncts, obtain O2 sat room air if possible.
- Administer 2.5mg Albuterol with 0.5mg of Atrovent nebulized as indicated.
May repeat Albuterol 2 times and Atrovent 1x.
- If no response to Albuterol or Atrovent, consider 0.01mg/kg Epi 1:1000 via
IM no to exceed adult dosage of 0.3mg. Obtain vascular access at TKO rate
- If allergic reaction suspected, administer 1mg/kg diphenhydramine IV/IO,
not to exceed adult dose of 25mg IV or 2mg/kg IM not to exceed adult dose of
50mg IM. Need orders for patients 2 years of age or older
- If apneic and unable to ventilate, consider oral tracheal intubation for
patients who are taller than the maximum length of a pediatric emergency
measuring tape or equivalent measuring from the top of the head to the heel
of the foot. BHO may order additional medications or interventions
- Base hospital: for severe asthma / respiratory distress that has failed to the
other previous treatments, administer 50 mg/kg of Magnesium Sulfate slow IV
drip over 20 minutes. DO not exceed adult dosage of 2gm total. Do not repeat.
Allergic reactions-Peds #14140 - ✔️✔️CORRECT ANSWER-- Maintain airway with
appropriate adjuncts, obtain room air saturation if possible. Administer
2.5mg Albuterol nebulized, may repeat 2x. Combine with 0.5mg of Atrovent.
Only give 1x.
- If no response to Albuterol, consider 0.01mg/kg of Epi 1:1000 IM, not to
exceed adult dose of 0.3mg IM
- Administer 1mg/kg Benadryl IV/IO not to exceed 25mg IV or 2mg/kg IM, not
to exceed 50mg IM
ACTUAL QUESTIONS AND ANSWERS LATEST UPDATE 2025/2026 RATED A+
Burns-adult #14070 - ✔️✔️CORRECT ANSWER-- Estimate % TBSA burned and
depth using rule of nines.
- Thermal burns: Stop burning process. DO not break blisters. Cover affected
body surface with dry, sterile dressing or sheet.
- Chemical burns: Brush off dry powder, if present. Remove any contaminated
or wet clothing. Irrigate with copious amounts of saline or water.
- Tar burns: Cool with water, do not remove tar
- Electrical burns: Remove from electrical source (without endangering self)
with nonconductive material. Cover affected body surface with dry, sterile
dressing or sheet
- Eye involvement: Continuous flushing with NS during transport. Allow
patient to remove contact lenses if possible
- Advanced airway as clinically indicated. King airway is contraindicated
- Iv access: Unstable- BP less than 90 and/or signs and symptoms of
inadequate tissue perfusion, start 2nd IV line. Give 250mL boluses and repeat
to max of 1L
Stable- BP more than 90 and signs of adequate tissue perfusion, administer
500ml/ hr.
1|Page
,ICEMA PROTOCOL STUDY GUIDE EXAM WITH
ACTUAL QUESTIONS AND ANSWERS LATEST UPDATE 2025/2026 RATED A+
- Respiratory distress: Use BVM as needed. Contact receiving hospital ASAP.
Administer albuterol with Atrovent. High flow oxygen Is essential with known
or potential respiratory injury. Beware of smoke inhalation. Do not apply ice
water directly to skin surfaces, as additional injury will result. Intubate patient
if facial/ oral swelling is present or if respiratory depression or distress
develops due to inhalation injury. CPAP may be considered if indicated after
consultation with BH
- Treat pain with analgesics as indicated
Pain management #14100 - ✔️✔️CORRECT ANSWER-Patients with a GCS of 15 or
at baseline mentation and have a pain score of 5 or higher and have: acute
traumatic injuries, acute abdominal/ flank pain, burn injuries, cancer pain,
or sickle cell crisis
• What drugs/dosages are used?
- Must always monitor and assess vital signs prior to administration of any
analgesic. After administration must continually monitor EKG and place on
capno. Reassess vital signs, capno, and pain scores every 5 minutes.
- Once a pain medication has been administered via route of choice, changing
route (i.e. IM to IV) requires BHO.
- Shifting from one analgesic while treating a patient requires BHO
- For pain and a SBP below 100, administer 0.3mg/kg Ketamine IVPB to a max
single dose of 30 mg. May repeat once in 15 minutes.
- For pain and an SBP above 100, administer 50 mcq Fetanyl slow IV/IO push
over 1 minute. May repeat every 5 minutes titrated to pain but not to exceed
200 mcq OR 100 mcq IM/IN. May repeat 50 mcq every 10 minutes titrated to
pain, not to exceed 200 mcq. Peds dose is 0.5mcq/kg slow IV/IO over 1
minute. May repeat in 5 min titrated to pain, not to exceed 100 mcq OR 1
mcq/kg IM/IN, may repeat every 10 minutes titrated to pain but not to exceed
200 mcq. Can also use 0.3mg/kg of Ketamine IVPB to a max of 30mg as a
,ICEMA PROTOCOL STUDY GUIDE EXAM WITH
ACTUAL QUESTIONS AND ANSWERS LATEST UPDATE 2025/2026 RATED A+
2|Page
, ICEMA PROTOCOL STUDY GUIDE EXAM WITH
ACTUAL QUESTIONS AND ANSWERS LATEST UPDATE 2025/2026 RATED A+
single dose in 50-100mL of NS over 5 minutes. May repeat one time in 15
minutes, if pain is still a 5 or higher. DO not administer IVP, IO, IM, IN
Respiratory emergencies-Peds #14120 - ✔️✔️CORRECT ANSWER-- Maintain
airway with appropriate adjuncts, obtain O2 sat room air if possible.
- Administer 2.5mg Albuterol with 0.5mg of Atrovent nebulized as indicated.
May repeat Albuterol 2 times and Atrovent 1x.
- If no response to Albuterol or Atrovent, consider 0.01mg/kg Epi 1:1000 via
IM no to exceed adult dosage of 0.3mg. Obtain vascular access at TKO rate
- If allergic reaction suspected, administer 1mg/kg diphenhydramine IV/IO,
not to exceed adult dose of 25mg IV or 2mg/kg IM not to exceed adult dose of
50mg IM. Need orders for patients 2 years of age or older
- If apneic and unable to ventilate, consider oral tracheal intubation for
patients who are taller than the maximum length of a pediatric emergency
measuring tape or equivalent measuring from the top of the head to the heel
of the foot. BHO may order additional medications or interventions
- Base hospital: for severe asthma / respiratory distress that has failed to the
other previous treatments, administer 50 mg/kg of Magnesium Sulfate slow IV
drip over 20 minutes. DO not exceed adult dosage of 2gm total. Do not repeat.
Allergic reactions-Peds #14140 - ✔️✔️CORRECT ANSWER-- Maintain airway with
appropriate adjuncts, obtain room air saturation if possible. Administer
2.5mg Albuterol nebulized, may repeat 2x. Combine with 0.5mg of Atrovent.
Only give 1x.
- If no response to Albuterol, consider 0.01mg/kg of Epi 1:1000 IM, not to
exceed adult dose of 0.3mg IM
- Administer 1mg/kg Benadryl IV/IO not to exceed 25mg IV or 2mg/kg IM, not
to exceed 50mg IM
