SNHD EMT EMS PROTOCOLS EXAM SCRIPT
2026 QUESTIONS WITH SOLUTIONS GRADED
A+
◉ What is the treatment for Moderate-Agitated and danger to
self/others patient with a IMC-RASS score of +3 or +4?
(Behavioral Emergency Protocol 21, 22). Answer: - MIDAZOLAM 2.5-
5 mg IN/IM/IV/IO; may repeat x1 after 5 min at 2.5 mg
OR
- DROPERIDOL 2.5- 5 mg IV/IO or 5 mg IM
- Cardiac/ETCO2 monitoring
- Restraints
◉ What is the treatment for Severe-Significantly agitated and
presents serious imminent danger to self/others patient with a IMC-
RASS score of +3 or +4?
(Behavioral Emergency Protocol 21, 22). Answer: SELECT ONE
- KETAMINE 3-4 mg IM max total dose 400 mg
- MIDAZOLAM 2.5-10 mg IM and/or DROPERIDOL 5-10 mg IM
- Cardiac/ETCO2 monitoring
,- Restraints
◉ What position should you never transport/restrain a patient in?
(Behavioral Emergency Protocol 21, 22). Answer: Prone position
◉ What is a dystonic reaction and the treatment for it?
(Behavioral Emergency Protocol 21, 22). Answer: - Condition that
causes involuntary muscle movements or spasms in the face, neck
and upper extremities
- Typically an adverse reaction to antipsychotic drugs such as
Haloperidol
Treatment:
- DIPHENHYDRAMINE 50 mg IM/IV/IO
◉ What are underlying causes of bradycardia should you consider
and treat if identified?
(Bradycardia Protocol 23, 24). Answer: - Hypoxia
- Hyperkalemia
- Hypothermia
,- ACS
- Drug toxicity
◉ What kind of patients may have a slow heart rate as their
baseline?
(Bradycardia Protocol 23, 24). Answer: Athletes, patients on beta
blockers, and young healthy patients
◉ Should you delay pacing while waiting for IV access?
(Bradycardia Protocol 23, 24). Answer: NO
◉ What medication is unlikely to be effective and should be avoided
in patients who have had a heart transplant?
(Bradycardia Protocol 23, 24). Answer: Atropine
◉ According to the bradycardia protocol, what is considered
symptomatic bradycardia?
(Bradycardia Protocol 23, 24). Answer: Persistent HR < 50 causing:
- Altered mental status
, - Hypotension
- Chest pain
- Signs of shock
◉ What is the treatment for Stable bradycardia with no high grade
AV block or wide complex?
(Bradycardia Protocol 23, 24). Answer: - ATROPINE 1 mg IV/IO
** if the treatment is effective
→ ATROPINE 1 mg IV/IO q3-5 min, total max dose 3 mg
** if the treatment is NOT effective
→ PUSH DOSE EPINEPHRINE 10 mcg IV/IO, may repeat q2-5 mins to
maintain HR/BP
◉ What is the treatment of Unstable bradycardia and/or high grade
AV block and/or wide complex?
(Bradycardia Protocol 23, 24). Answer: - Transcutaneous pacing
*consider sedation and analgesia medications*
- PUSH DOSE EPINEPHRINE 10 mcg IV/IO, may repeat q2-5 mins to
maintain HR/BP
2026 QUESTIONS WITH SOLUTIONS GRADED
A+
◉ What is the treatment for Moderate-Agitated and danger to
self/others patient with a IMC-RASS score of +3 or +4?
(Behavioral Emergency Protocol 21, 22). Answer: - MIDAZOLAM 2.5-
5 mg IN/IM/IV/IO; may repeat x1 after 5 min at 2.5 mg
OR
- DROPERIDOL 2.5- 5 mg IV/IO or 5 mg IM
- Cardiac/ETCO2 monitoring
- Restraints
◉ What is the treatment for Severe-Significantly agitated and
presents serious imminent danger to self/others patient with a IMC-
RASS score of +3 or +4?
(Behavioral Emergency Protocol 21, 22). Answer: SELECT ONE
- KETAMINE 3-4 mg IM max total dose 400 mg
- MIDAZOLAM 2.5-10 mg IM and/or DROPERIDOL 5-10 mg IM
- Cardiac/ETCO2 monitoring
,- Restraints
◉ What position should you never transport/restrain a patient in?
(Behavioral Emergency Protocol 21, 22). Answer: Prone position
◉ What is a dystonic reaction and the treatment for it?
(Behavioral Emergency Protocol 21, 22). Answer: - Condition that
causes involuntary muscle movements or spasms in the face, neck
and upper extremities
- Typically an adverse reaction to antipsychotic drugs such as
Haloperidol
Treatment:
- DIPHENHYDRAMINE 50 mg IM/IV/IO
◉ What are underlying causes of bradycardia should you consider
and treat if identified?
(Bradycardia Protocol 23, 24). Answer: - Hypoxia
- Hyperkalemia
- Hypothermia
,- ACS
- Drug toxicity
◉ What kind of patients may have a slow heart rate as their
baseline?
(Bradycardia Protocol 23, 24). Answer: Athletes, patients on beta
blockers, and young healthy patients
◉ Should you delay pacing while waiting for IV access?
(Bradycardia Protocol 23, 24). Answer: NO
◉ What medication is unlikely to be effective and should be avoided
in patients who have had a heart transplant?
(Bradycardia Protocol 23, 24). Answer: Atropine
◉ According to the bradycardia protocol, what is considered
symptomatic bradycardia?
(Bradycardia Protocol 23, 24). Answer: Persistent HR < 50 causing:
- Altered mental status
, - Hypotension
- Chest pain
- Signs of shock
◉ What is the treatment for Stable bradycardia with no high grade
AV block or wide complex?
(Bradycardia Protocol 23, 24). Answer: - ATROPINE 1 mg IV/IO
** if the treatment is effective
→ ATROPINE 1 mg IV/IO q3-5 min, total max dose 3 mg
** if the treatment is NOT effective
→ PUSH DOSE EPINEPHRINE 10 mcg IV/IO, may repeat q2-5 mins to
maintain HR/BP
◉ What is the treatment of Unstable bradycardia and/or high grade
AV block and/or wide complex?
(Bradycardia Protocol 23, 24). Answer: - Transcutaneous pacing
*consider sedation and analgesia medications*
- PUSH DOSE EPINEPHRINE 10 mcg IV/IO, may repeat q2-5 mins to
maintain HR/BP
