ICEMA CERTIFICATION FINAL PAPER 2026
SOLVED QUESTIONS AND ACCURATE
ANSWERS GRADED A+
● Needle cricothyrotomy procedure ? Answer: - Absolute
contraindication: Transection of the distal trachea.
- Monitor EtCO2 and wave form capnography.
- Monitor pulse oximetry.
- Contact base hospital if unable to ventilate adequately and transport
immediately to the closest hospital for airway management.
● If patient transfer of care and patient offloading from the ambulance
gurney exceeds 25 mins what happens to the hospital? Answer: It is
documented and tracked as APOD (ambulance patient offload delay)
● APOD unusual event procedures for immediate offloading criteria:
Answer: - Stable V/S
- Alert and Oriented
- No ALS interventions in place
- Is not on a Welfare and Institutions Code (WIC) 5150 hold
● When is vascular access clinically indicated (8100) ? Answer: -
Administration of IV medication(s), or
,- Administration of IV fluid bolus or fluid resuscitation.
- In the judgement of the attending paramedic the patient's condition
could worsen and either (a) or (b) noted above may become necessary
prior to arrival at the receiving hospital ED.
- Discontinue ECG monitoring before removing the patient from the
ambulance if there are no clinical indications for cardiac monitoring.
● 8010 IFT Guidelines "What not to do" Answer: - Paramedics may not
transport a patient with IV drips that are not in the EMT-P scope of
practice.
- EMT-Ps may not transport patients with blood or blood products.
● 8010 IFT Guidelines "What to do" Answer: - Monitor peripheral lines
delivering fluids in any combination/concentration of NS, LRs or
dextrose and water.
- Transport intravenous solution with added medication(s) as follows:
- Lidocaine
-Dopamine
-Magnesium sulfate
- Monitor and administer medications through a pre-existing vascular
access.
- Monitor heparin lock or saline lock.
- Monitor IV solutions containing potassium < or = 40 mEq/L
, - Monitor thoracostomy tubes to water or dry sealed drainage.
- Monitor nasogastric tubes.
-
● Who receives (0.1 mg/ml), 0.005 mg/kg IV/IO every 10 minutes for
persistent hypotension as a base hospital order or in radio
communication failure? Answer: Newborns
● Who receives epinephrine (0.1 mg/ml), 0.01 mg/kg IV/IO if heart rate
is less than 60 after one (1) minute after evaluating airway for hypoxia
and assessing body temperature for hypothermia? Answer: Newborns
● 6010 Physician on Scene requirements in order to take over the call:
Answer: - The physician must be informed that base hospital contact
must be made, and the final decision regarding the assumption of
medical responsibility for patient care will be made by the base hospital
physician.
- The physician must show proper identification and a current California
physician's license.
- The physician must agree to sign the patient care report agreeing to
take full responsibility for the care and treatment of the patient(s)
involved in the incident and accompanies the patient(s) in the ambulance
to the most appropriate receiving facility.
- Care of the patient must be transferred to a physician at receiving
facility.
SOLVED QUESTIONS AND ACCURATE
ANSWERS GRADED A+
● Needle cricothyrotomy procedure ? Answer: - Absolute
contraindication: Transection of the distal trachea.
- Monitor EtCO2 and wave form capnography.
- Monitor pulse oximetry.
- Contact base hospital if unable to ventilate adequately and transport
immediately to the closest hospital for airway management.
● If patient transfer of care and patient offloading from the ambulance
gurney exceeds 25 mins what happens to the hospital? Answer: It is
documented and tracked as APOD (ambulance patient offload delay)
● APOD unusual event procedures for immediate offloading criteria:
Answer: - Stable V/S
- Alert and Oriented
- No ALS interventions in place
- Is not on a Welfare and Institutions Code (WIC) 5150 hold
● When is vascular access clinically indicated (8100) ? Answer: -
Administration of IV medication(s), or
,- Administration of IV fluid bolus or fluid resuscitation.
- In the judgement of the attending paramedic the patient's condition
could worsen and either (a) or (b) noted above may become necessary
prior to arrival at the receiving hospital ED.
- Discontinue ECG monitoring before removing the patient from the
ambulance if there are no clinical indications for cardiac monitoring.
● 8010 IFT Guidelines "What not to do" Answer: - Paramedics may not
transport a patient with IV drips that are not in the EMT-P scope of
practice.
- EMT-Ps may not transport patients with blood or blood products.
● 8010 IFT Guidelines "What to do" Answer: - Monitor peripheral lines
delivering fluids in any combination/concentration of NS, LRs or
dextrose and water.
- Transport intravenous solution with added medication(s) as follows:
- Lidocaine
-Dopamine
-Magnesium sulfate
- Monitor and administer medications through a pre-existing vascular
access.
- Monitor heparin lock or saline lock.
- Monitor IV solutions containing potassium < or = 40 mEq/L
, - Monitor thoracostomy tubes to water or dry sealed drainage.
- Monitor nasogastric tubes.
-
● Who receives (0.1 mg/ml), 0.005 mg/kg IV/IO every 10 minutes for
persistent hypotension as a base hospital order or in radio
communication failure? Answer: Newborns
● Who receives epinephrine (0.1 mg/ml), 0.01 mg/kg IV/IO if heart rate
is less than 60 after one (1) minute after evaluating airway for hypoxia
and assessing body temperature for hypothermia? Answer: Newborns
● 6010 Physician on Scene requirements in order to take over the call:
Answer: - The physician must be informed that base hospital contact
must be made, and the final decision regarding the assumption of
medical responsibility for patient care will be made by the base hospital
physician.
- The physician must show proper identification and a current California
physician's license.
- The physician must agree to sign the patient care report agreeing to
take full responsibility for the care and treatment of the patient(s)
involved in the incident and accompanies the patient(s) in the ambulance
to the most appropriate receiving facility.
- Care of the patient must be transferred to a physician at receiving
facility.
