Agency Information
Agency Name
NYC Regional Emergency Medical Advisory Committee
County
New York City
State
New York
Protocol Version
Updated Feb 2026
Official Source
What You'll Study
EMT / BLS
BLS EMT protocols for NYC including CPEP and psychiatric emergencies.
Paramedic / ALS
Full ALS protocols including FDNY Paramedic procedures, RSI, and critical care.
Protocol Documents
NYC REMAC ALS Protocols
full manual
External →
NYC REMAC Unified Prehospital Treatment Protocols 2024
full manual
External →
NYC REMAC BLS Protocols
procedures
External →
Sample Questions (Free Preview)
PARAMEDIC
Q1. You are working FDNY EMS and respond to a pulseless 6-year-old (22 kg). Vascular access is IO. What is the correct epinephrine dose and concentration for this pediatric cardiac arrest?
A. 0.22 mg (2.2 mL of 1:10,000 solution)
B. 0.22 mg (0.22 mL of 1:1,000 solution)
C. 1 mg (maximum, given immediately)
D. 0.1 mg (0.1 mL of 1:10,000 solution)
NYC REMAC follows standard ACLS/PALS: Epinephrine 0.01 mg/kg of the 1:10,000 (0.1 mg/mL) solution IO/IV. For 22 kg: 0.22 mg = 2.2 mL of 1:10,000. Max single dose is 1 mg. Repeat every 3–5 min.
PARAMEDIC
Q2. Per NYC REMAC protocol, you need to administer Atropine to a 10 kg pediatric patient with symptomatic bradycardia (HR 38, poor perfusion). What is the correct dose?
A. 0.2 mg IV/IO (0.02 mg/kg, within 0.1–0.5 mg limits)
B. 0.1 mg IV/IO (minimum dose only)
C. 0.5 mg IV/IO (maximum dose)
D. 0.02 mg IV/IO (do not apply minimum rule)
Atropine for pediatric bradycardia is 0.02 mg/kg IV/IO. The minimum dose is 0.1 mg (to avoid paradoxical bradycardia) and the maximum dose per administration is 0.5 mg. For 10 kg: 0.02 × 10 = 0.2 mg. This is within the 0.1–0.5 mg range.
PARAMEDIC
Q3. A 5 kg infant presents with bradycardia (HR 60) and poor perfusion. You calculate the Atropine dose at 0.02 mg/kg = 0.1 mg. You prepare to administer. What rule applies here?
A. 0.1 mg is the minimum — administer 0.1 mg as calculated
B. Reduce the dose to 0.05 mg since the infant weighs 5 kg
C. Do not give Atropine to infants under 10 kg
D. Give 0.5 mg (max dose) since the infant is critically bradycardic
The minimum dose of Atropine in pediatric patients is 0.1 mg — even when weight-based calculation gives less than 0.1 mg. This prevents paradoxical bradycardia from very low doses acting on cardiac muscarinic receptors centrally.
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