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Stable, monomorphic wide-complex tachycardia is often ventricular tachycardia. Amiodarone is recommended antiarrhythmic. Adenosine is for narrow-complex SVT. Atropine treats bradycardia. Nitroglycerin treats angina, not arrhythmias. Paramedics must differentiate wide vs narrow, stable vs unstable, and select appropriate therapy.

The alpha cells of the pancreas secrete glucagon, which raises blood glucose by promoting glycogenolysis and gluconeogenesis in the liver. The liver is the target, not the source. Kidneys regulate electrolytes and acid-base balance; the adrenal cortex secretes cortisol and aldosterone. Paramedic objectives stress physiology knowledge for interpreting diabetic emergencies and pharmacology of insulin and glucagon.

Mass-casualty triage seeks the greatest good for the greatest number. First-in crews perform rapid physiologic triage—often using simple algorithms that prioritize ability to walk, respiratory rate, perfusion (radial pulse/cap refill), and mental status—to categorize patients into immediate, delayed, minor, or expectant. This approach allocates limited resources to those most likely to benefit quickly, rather than focusing all care on the sickest single patient. Mechanism helps anticipate injury but does not replace physiologic assessment. Pediatric incidents employ age-appropriate systems (e.g., JumpSTART). Paramedic operations objectives emphasize scene safety, establishing command, resource requests, triage tags, casualty collection points, and clear radio communications. Avoid prolonged treatments on scene; provide lifesaving interventions that take seconds (airway opening, hemorrhage control, chest needle decompression if indicated), then move on. Effective triage facilitates coordinated transport and hospital distribution, improving overall survival in resource-scarce situations.

Alveoli allow O₂ diffusion into capillaries and CO₂ out. Upper airway warms and filters. RBCs are produced in bone marrow, not alveoli. Pathogen trapping occurs in nasal mucosa and cilia. Gas exchange is essential to life and central to paramedic respiratory management.

For shock-refractory VF/pulseless VT, evidence-based algorithms support amiodarone 300 mg IV/IO bolus after the second shock and epinephrine administration, followed by a possible additional 150 mg dose if VF/VT persists. The goal is to stabilize myocardial membranes and facilitate defibrillation success while uninterrupted, high-quality CPR remains the cornerstone. Lidocaine is an alternative antiarrhythmic if amiodarone is unavailable, but infusion dosing is inappropriate during cardiac arrest; a bolus (e.g., 1–1.5 mg/kg) would be considered instead. Adenosine treats AV-nodal dependent supraventricular tachycardias, not ventricular fibrillation. Slow amiodarone infusions are used for stable wide-complex tachyarrhythmias, not pulseless rhythms where rapid bolus delivery is indicated. Paramedic pharmacology objectives stress correct indications, dosing, sequence relative to defibrillation and epinephrine, and the importance of minimizing pauses in compressions. Continuous rhythm analysis, attention to reversible causes (H’s and T’s), and prompt defibrillation attempts drive outcomes more than drug choice, but appropriate antiarrhythmic use can improve termination of malignant ventricular rhythms.