Agency Information
Agency Name
Philadelphia Fire Department EMS
County
Philadelphia County
State
Pennsylvania
Official Source
What You'll Study
EMT / BLS
EMT protocols for Philadelphia.
Paramedic / ALS
ALS protocols for Philadelphia EMS.
Sample Questions (Free Preview)
PARAMEDIC
Q1. A 5 kg neonate presents unresponsive and apneic. After initial 30 seconds of PPV, the heart rate is 50 bpm. Per neonatal protocols, what is the NEXT intervention?
A. Begin chest compressions at 3:1 compression-to-ventilation ratio
B. Administer epinephrine 0.01 mg/kg IV/IO immediately
C. Increase PPV rate and continue for another 30 seconds before reassessment
D. Establish IV access for fluid bolus of 10 mL/kg NS
Neonatal resuscitation: If HR <60 bpm after 30 seconds of effective PPV, begin chest compressions at 3:1 ratio (3 compressions to 1 ventilation = 90 compressions and 30 breaths per minute). Use two-thumb encircling technique if possible. Reassess HR after 60 seconds.
PARAMEDIC
Q2. A 16 kg pediatric patient has a severe allergic reaction with urticaria, wheezing, and hypotension. Per pediatric protocols, what is the correct epinephrine dose for anaphylaxis?
A. 0.16 mg (0.16 mL) IM of 1:1,000 solution in anterolateral thigh
B. 0.16 mg (1.6 mL) IM of 1:10,000 solution in anterolateral thigh
C. 0.5 mg (0.5 mL) IM of 1:1,000 solution (adult dose — always give max)
D. 0.3 mg IM using pediatric auto-injector (EpiPen Jr)
Pediatric anaphylaxis epinephrine: 0.01 mg/kg of 1:1,000 solution IM (anterolateral thigh), maximum 0.5 mg. For a 16 kg child: 0.01 × 16 = 0.16 mg IM of 1:1,000 (0.16 mL). This is different from cardiac arrest dosing (1:10,000 IV/IO). IM is preferred route for anaphylaxis.
PARAMEDIC
Q3. You intubate a pediatric patient and confirm tube placement. After 2 minutes, the ETCO2 waveform is normal but SpO2 drops from 98% to 84%. Lung sounds are diminished on the left side. What is the MOST likely cause?
A. Right mainstem bronchus intubation — withdraw tube 1-2 cm and reassess
B. Esophageal intubation — remove tube immediately and ventilate with BVM
C. Tension pneumothorax — needle decompression of left chest wall
D. Tube obstruction with mucus — suction catheter through ETT
A sudden drop in SpO2 with diminished left-sided lung sounds after intubation suggests a right mainstem bronchus intubation. The ETT has advanced too far into the right mainstem, excluding the left lung. Correction: deflate cuff, withdraw tube 1-2 cm, and reassess. Note: ETCO2 remains positive even with mainstem intubation.
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