AEMT IV Therapy and Fluid Administration 2 — Questions and Answers
Question 1: Intraosseous (IO) access delivers medications and fluids to which anatomical structure?
- The periosteal space around the bone
- The medullary cavity of the bone, which connects to the venous circulation (Correct answer)
- The cortical bone where nutrients diffuse slowly
- The subcutaneous fat layer adjacent to the bone
Correct answer: The medullary cavity of the bone, which connects to the venous circulation
IO needles enter the medullary cavity, which contains a non-collapsible venous network that rapidly delivers fluids and drugs into central circulation.
Question 2: The proximal tibia is a common IO site. It is located approximately:
- 2 cm distal to the tibial tuberosity on the anteromedial flat surface (Correct answer)
- 2 cm proximal to the lateral malleolus
- Over the fibular head laterally
- At the midshaft of the tibia posteriorly
Correct answer: 2 cm distal to the tibial tuberosity on the anteromedial flat surface
The proximal tibial IO site is approximately 2 cm distal to the tibial tuberosity on the flat anteromedial surface of the tibia.
Question 3: Before infusing fluid through an IO needle, you should:
- Flush with 10 mL of normal saline to confirm placement
- Inject lidocaine slowly if the patient is conscious to reduce pain (Correct answer)
- Attach a pressure bag set to 300 mmHg immediately
- Obtain blood cultures from the IO hub
Correct answer: Inject lidocaine slowly if the patient is conscious to reduce pain
In conscious patients, IO infusion is painful; 2% preservative-free lidocaine injected slowly before fluids significantly reduces discomfort.
Question 4: Which of the following is an absolute contraindication to IO placement at a specific site?
- Patient weight over 100 kg
- A fracture in the bone at the intended site (Correct answer)
- Bilateral IV access already established
- Patient under 6 years of age
Correct answer: A fracture in the bone at the intended site
A fracture at the intended IO site is an absolute contraindication because fluid would extravasate into surrounding tissue through the fracture.
Question 5: You are administering a 20 mL/kg fluid bolus to a 70 kg adult in hemorrhagic shock. How many mL should you infuse?
- 700 mL
- 1,000 mL
- 1,400 mL (Correct answer)
- 2,000 mL
Correct answer: 1,400 mL
20 mL/kg × 70 kg = 1,400 mL; this is the standard initial fluid bolus for hypovolemic/hemorrhagic shock resuscitation.
Question 6: A patient in anaphylaxis has an IV established. Which of the following is the FIRST-LINE medication to administer IV?
- Diphenhydramine (Benadryl) 50 mg IV
- Methylprednisolone 125 mg IV
- Epinephrine 1:1,000 IM (or diluted IV per protocol) (Correct answer)
- Albuterol nebulization
Correct answer: Epinephrine 1:1,000 IM (or diluted IV per protocol)
Epinephrine is the first-line treatment for anaphylaxis; while IM is standard, diluted IV epinephrine (1:10,000) may be used per protocol in severe cases.
AEMT IV Therapy and Fluid Administration 2
Intraosseous (IO) access delivers medications and fluids to which anatomical structure?