2021 EMS Protocols bottom top Flashcards
for the hx taking in an assessment what pneumoic is used?
OPPPQRSTA
Pallative
provoke
previous
what is the preferred access fo r pediatrics in cardiac arrest?
IO
what are the sites for IO insertion for an adult and pediatric?
proximal humorous
Proximal Tibia
distal tibia
PEDI: All of the above and Distal Femur.
What type of communication is to be used with a second paramedic to ensure proper drug dose?
closed loop communication
During pregnancy what is the possibe BP drop?
5-15mmhg.
How much can a pregnant female lose with regards to blood volume?
30-35%
Only those person who have completed and approved Incident safety officer course ________ be used as a safety officer.
SHOULD
A safety office should have a working knowledge of what?
Safety concerns for fire rescue in typical incidents
Fire behavior
Building construction
EMS
All safety officers will have the authority to ?
Identify and correct safety and heath hazards
To alter,suspend, or terminate un -safe acts that involve an imminent hazard to personnel
Inform the IC of the 2 items above
Who’s responsibility is it to assign a safety officer?
IC
Time for Breech birth actions
if not delivered in 3 minutes
When can you insert a gloved hand into the vagina for a birth?
Breech birth
Prolapsed cord
Eclampsia is defined as ?
S/S of pre + seizures or coma
Preeclampsia is defined as?
SBP >160 DSP > 110 with :
AMS
Headache
Visual disturbances
PE
3rd Trimester complications include
Placenta previa-painless vaginal bleeding bright red
Abrupto PLacenta-severe pain sudden onset
Uterine rupture- - intense abd pain and Vaginal bledding
1st and 2nd trimester complications include?
Ectopic
Spontaneous
bleeding
hypotensive
Gravida and Para definitions
Gravida- previous pregnancies
Para- Number of Live births
Pregnant 3rd trimester trauma alerts get transported how?
Left side, 4-6 inches of padding to Right side
Maintain BP for peripheral pulses
What are the contraindications for Ceftriaxone or rocephin?
Allergy to cephalosporins
Neonates birth to 30 days
How many attempts to realign for anatomical position
2
Head injuries ETCO2 is?
30-35mmhg
Adult BP maintain BP for Head injuries is what?
SBP 110-120
Intercrainial pressure and herniation signs are?
GCS decline of 2 or more points
sluggish or non reactive pupil
Paralysis or weakness on 1 side of the body
Cushings Triad
What is the secondary site for chest decompression
2 or 3 rd intercostal space mid clavicular
What is the primary site for chest decompression?
5th intercostal space mid axillary
Criteria for chest decompression
Absent or diminshed LS
BP< 90
Respiratory distress or difficulty with BVM
Flail chest sis defined?
2 or more adjacent ribs are fractured
what is Trauma alert criteria for peds with BP?
< 50
The “ P” in Jump start triage means what ?
posturing
Jump start triage initial is ?
Breathing NO- open A/W - breathing - IMMEDIATE
Breathing NO- open A/W - NO PULSE - DECEASED
Breathing NO-open A/W- Pulse - 5 breaths-no- DECEASED
Breathing NO- open A/W- Pulse- 5 breaths- Yes- IMMEDIATE
Breathing YES- <15 or >45- IMMEDIATE
Contraindications for Finger Thoracostomy?
Unwitnessed arrest with blunt trauma
Devestating head trauma
loss of Cardiac output > 10 min
Finger Thoracostomy is done when ?
known or suspected injury to the chest and or abd
Ultrasunds in traumatic arrests are done when?
observation of cardiac motion in PEA
When does bilateral decompression get performed?
Arrest due to penetrating chest trauma
PEA is defined as?
an organized rhythm > 20 BPM
For Trauma patients not to be resuscitated what criteria is needed?
Apneic
Fixed dialted pupils
asystole
NEED ALL 3
or injuries incompatible with life
FAST ultrasounds are used to identify?
Intrabdominal hemorrage
Intrathoracic hemorrage
pericardial hemorrage
PEA motion
FAST ultrsound can be performed during transport for the following injuries?
Blunt ABD and thorax trauma
penetrating ABD and thborax traum
Undifferentiated hypotension in trauma
What does the MARCH acronym mean?
Massive hemorrage
Airway control
Respiratory
Circulation
Head injury / Hypothermia
The cyano kit uses how much? at what rate?
5g diluted in 200ml and at 5 gtts/sec
If SPCO is above what %?
>20%
Who carries a rainbow sensor ?
EMS captains and SPLOPS
CO poisoning is at what level?
35ppm
Heat stroke is classified as ?
Temp > 103 or AMS
When treating Heat stroke?
Cool First, transport second
How much NS admin for Decompression sickness?
500ml
What is the time frame for decompression sickness?
48 hours
Lidocaine in an IO for pedi dwell?
2 min
Pedi Ketamine for pain is indicated for what age and pain scale?
< 3 yrs and 7 or greater pain
How long does Lidocaine dwell in an IO for an adult?
1min
What is the sequence for Combative pts and Ketamina
400mg IM
BVM or supplemental 02 for Laryngospasms
0.5mg Atropine for Salivations x3
Ice packs, 1L cold saline and 100meq Sodium Bicarb
What are the special populations for Ketamine and the dose?
Age 65 and older
<50kg
Head trauma
Already took sedatives
200mg
What must TCA ODs be treated with immediately ?
Sodium Bicarb
Mad as a hatter
Red as a beet
Dry as bone refer to S/S of ?
TCA OD
What are the criteria to administer narcan?
RR below 10
Etco2 >45
02 sat < 92%
if not meeting above Supplemental 02 or BVM 2 min
Pedi cocaine OD get treated with what?
Versed
Adult Cocaine OD get treated with what?
Versed
What type of arrests are to be transported to a trauma center?
Electrouctions and lighning strikes
What are the indications for Esmolol and doses?
Immediately after Double sequential
40 mg IV/IO initially over 1 min
Then:
60mg on 15gtts over 10min 1,25gtts/sec
All drug overdoses are treated as what type of arrest with the exception of?
All OD’s except for Cocaine
What type of arrest is a third trimester female considered?
Secondary - and displace the uterus to the left
What are the amiodarone contraindications
Qtc >500
Blocks
Bradycardia
Hypotension
cardiogenic shock
What is the o2 setting for initial arrest
8L/min for 6 min on oxygen port
What are five protocols where on 500ml NS are used?
Decompression sickness
Calling an arrest.
2nd > 15% or 3rd > 5% degree burns
Hyperkalemia
Cardizem induced hypotension
When can an arrest be called?
EMS captain on scene
persisent asystole for >15min
ALS interventions
Etco2< 10
H and T’s or reversible causes treated
1 defib
500 ml NS
Normothermic
support group
Electrocution and LIghtning strikes are what type of arrests
Primary b/c of A/C current
Secondary due to DC current
What if the death criteria are not there what can be used?
Known down time of >30min
Apneic
Without mechanism for Hypothermia
Asystolic
Fixed and dilated pupils
What are the determination of death criteria
- Lividity
- Rigor mortis
- tissue decomposition
- Valid DNRO
which cardiac arrest patients MUST be transported
Witnesed
Treatment for an LVAD ?
locate emergency bag
take all equipment to ER
verify device is working by lack of pulse or measurable BP.
LIsten for continuous humming.
Hypotensive Fluids 1L
Compressions if unresponsive and unable to restart device or not working.
LVAD patients go to which facility
JFK
Compressions for an LVAD device are ?
Not using the LUCAS
The Right of the sternum.
AEIOU TIPS ?
Alcohol, Epilepsy, Insulin, OD, underdose
Trauma, infection, pyschosis, stroke