DCAS Pharmacology and Drug Administration 2 — Questions and Answers
Question 1: What is the DCAS protocol for glucose administration in hypoglycemia?
- Only provide oral glucose regardless of consciousness
- Give oral glucose if conscious, or IV dextrose 10% if unable to swallow, or IM glucagon if no IV access (Correct answer)
- Wait until arrival at hospital
- Only administer insulin
Correct answer: Give oral glucose if conscious, or IV dextrose 10% if unable to swallow, or IM glucagon if no IV access
DCAS hypoglycemia management varies by consciousness: oral glucose for conscious patients, IV dextrose 10% for unconscious patients with IV access, or IM glucagon when IV access is not available.
Question 2: What is the role of amiodarone in DCAS cardiac arrest protocols?
- It is the first-line treatment
- It is administered after the third defibrillation shock for shockable rhythms (VF/pVT) at 300mg IV bolus (Correct answer)
- It replaces CPR
- It is only used for bradycardia
Correct answer: It is administered after the third defibrillation shock for shockable rhythms (VF/pVT) at 300mg IV bolus
Amiodarone 300mg IV is administered after the third unsuccessful defibrillation attempt for VF/pVT, followed by a further 150mg after the fifth shock if needed, to help stabilize the cardiac rhythm.
Question 3: What are the contraindications for morphine administration by DCAS paramedics?
- There are no contraindications
- Respiratory depression, hypotension, head injury with altered consciousness, known allergy, and MAOI use (Correct answer)
- Only allergy to morphine
- Morphine is never used pre-hospital
Correct answer: Respiratory depression, hypotension, head injury with altered consciousness, known allergy, and MAOI use
Morphine contraindications include respiratory depression (rate <10/min), significant hypotension, head injury with altered consciousness (masks neurological signs), known allergy, and concurrent MAOI medication use.
Question 4: What is the correct dose of atropine for symptomatic bradycardia in DCAS protocols?
- 100mcg single dose
- 500mcg IV, repeated every 3-5 minutes to maximum 3mg (Correct answer)
- 1mg IM once
- 5mg IV single dose
Correct answer: 500mcg IV, repeated every 3-5 minutes to maximum 3mg
Atropine is given at 500mcg IV for symptomatic bradycardia, which can be repeated every 3-5 minutes up to a maximum total dose of 3mg (6 doses) to increase heart rate.
Question 5: What is the DCAS protocol for midazolam administration for seizure management?
- Only oral administration
- IM or buccal midazolam at weight-appropriate doses for prolonged or repeated seizures unresponsive to initial management (Correct answer)
- IV at 50mg bolus
- Only rectal administration
Correct answer: IM or buccal midazolam at weight-appropriate doses for prolonged or repeated seizures unresponsive to initial management
DCAS protocols allow IM or buccal midazolam for status epilepticus or prolonged seizures, at appropriate doses (typically 10mg IM for adults), when seizures are not self-terminating.
Question 6: What drug calculations must DCAS paramedics be competent in performing?
- No calculations are needed
- Weight-based dosing, concentration calculations, infusion rate calculations, and drug dilution calculations (Correct answer)
- Only counting tablets
- Only reading pre-filled syringe labels
Correct answer: Weight-based dosing, concentration calculations, infusion rate calculations, and drug dilution calculations
DCAS paramedics must competently perform weight-based dose calculations (mg/kg), drug concentration calculations, IV infusion rate calculations (ml/hr or drops/min), and dilution calculations for safe medication administration.
DCAS Pharmacology and Drug Administration 2
What is the DCAS protocol for glucose administration in hypoglycemia?