Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Mnemonics > Acronyms & General Mnemonics > Flashcards

Acronyms & General Mnemonics Flashcards

1
Q

ABC / XABCDE / CAB / CABU / MARCH (PAWS)

MAD FOCS

OTIS CAMPBELL

THE MISFITS

AVPU

Signs of Shock - Early: SHART (skin pale/cool/clamy, HR tachycardic, Anxiety, RR tachypneic), Thirst, Late: B Rash (BP decreased, Respirations shallow, AMS, Skin cyanotic / mottled, HR weak or absent by palpation)

ACS / UA / STEMI / NSTEMI

SEMI-STEMIs (Create a Berdancronym)

COPD / CHF

RSI / DSI

EGD

SAD PUCKER

BMV / BVM

PQRSTU / QRS

FOUR H MEDIC ANA

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does the acronym NO DESAT stand for?

A

NO DESAT

N - Nasal

O - Oxygen

D - During

E - Efforts

S - Securing a

T - Tube

https://epmonthly.com/article/no-desat/

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does LEMONS stand for, with respect to evaluating for a difficult airway?

A

LEMONS

L - Look externally (gestalt)

E - Evaluate 3-3-2

M - Mallampati score

O - Obstruction/Obesity

N - Neck mobility

S - Situation

Manual of Emergency Airway Management, 5th Ed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does ROMAN stand for, with respect to BMV?

A

ROMAN

R - Radiation / Restriction

O - Obesity / Obstruction / Obstructive Sleep Apnea

M - Mask Seal / Mallampati / Male Sex

A - Age (> 55)

N - No teeth

Manual of Emergency Airway Management, 5th Ed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does RODS stand for, with respect to EGD placement?

A

RODS

R - Restriction

O - Obstruction / Obesity

D - Disrupted / Distorted Airway Anatomy

S - Short Thyromental Distance

Manual of Emergency Airway Management, 5th Ed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does SMART stand for, with respect to difficuylt cricothyrotomy?

A

SMART

S - Surgery (recent or remote)

M - Mass

A - Access / Anatomy

R - Radiation (and other deformity or scarring)

T - Tumor

Manual of Emergency Airway Management, 5th Ed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What mnemonic can be used to recall the principle differentiating signs of Unstable Angina?

A

RND UA

Random Urinalysis

R - Rest

N - New

D - Different

UA - Unstable Angina

Note: If the patient’s chest pain occurs at rest, is occurring for the first time, or the intensity, character, or exertion level required to produce the chest pain are different than angina they have experienced in the past (and there is no evidence of a STEMI), the diagnosis is of unstable angina.

-EM Basic Podcast: MI and ACS​

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What acronym can be used to recall where to look on an ECG for reciprocal ST-segment changes?

A

PAILS

P - Posterior

A - Anterior

I - Inferior

L - Lateral

S - Septal

Note: ST elevations in these leads most commonly create reciprocal ST depressions in the corresponding leads of the next letter in the mnemonic. That is to say, posterior ST elevation will usually cause anterior lead ST depressions and anterior lead ST elevations will usually be seen with inferior lead depressions.

-EM Basic Podcast: MI and ACS​​

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What mnemonic is useful in recalling STEMI mimics?

A

ELEVATION

E - Electrolytes (Hyperkalemia)

L - Left Bundle Branch Block

E - Early Repolarization

V - Ventricular Hypertrophy (Left)

A - Aneurysm (Ventricular, Aortic Dissection, AAA)

T - Thailand (Brugada Syndrome)

I - Inflammation (Pericarditis) / Intracranial Hemorrhage

O - Osborne (J) Waves

N - Non-Ischemic Vasospasm

-wikem.org

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does PCI stand for, with regards to a cath lab?

A
  1. Percutaneous Coronary Intervention;

-2015 AHA ECC Handbook

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does IABP stand for with respect to ACS interventions?

A
  1. Intra-aortic balloon pump;

-ACLS for Experienced Providers, 2013 Ed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does MACE stand for, with respect to ACS?

A
  1. Major adverse cardiac event;

-ACLS for Experienced Providers, 2013 Ed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does “SL” stand for in “SL Valve?”

A
  1. Semilunar;

https://en.wikipedia.org/wiki/Heart_valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does “ACS” stand for with regards to heart disease?

A
  1. Acute Coronary Syndrome;

https://en.wikipedia.org/wiki/Acute_coronary_syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does “UA” stand for with regards to heart disease?

A
  1. Unstable angina;

https://en.wikipedia.org/wiki/Acute_coronary_syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What do “NSTEMI” and “STEMI” stand for with regards to heart disease?

A
  1. Non-ST-segment elevation myocardial infarction;
  2. ST-segment elevation myocardial infarction;
    * https://en.wikipedia.org/wiki/Acute_coronary_syndrome*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does “LCA” stand for with regards to the anatomy of the heart?

A
  1. Left coronary artery;

https://en.wikipedia.org/wiki/Coronary_arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The two primary branches of the left main coronary artery (including their acronyms).

A
  1. LAD (left anterior descending, aka anterior interventricular artery);
  2. CX (circumflex);
    * https://en.wikipedia.org/wiki/Coronary_arteries*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What Berdancronym is useful for the analysis of sinus P waves in Lead II?

A

SOUR BS

S - Symmetrical

O - One-to-one with QRS complexes

U - Upright

R - Round

B - Before each QRS complex

S - Similar shape, one to the next

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Name five STEMI equivalents (aka “Semi-STEMIs”).

A

WILDeR

W - Wellen’s Syndrome

I - Isolated posterior STEMI

L - Left Main / Multi-Vessel Disease

De - De Winter T waves

R - Refractory Cardiac Arrest

  • Berdancronym*
  • https://www.strykeremergencycare.com/learn-and-train/online-training/*
  • Beyond ST Elevation, Uncovering Cath Lab Candidates, by Tim Phalen, 09/26/18*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does the acronym START stand for, with respect to triage?

A

START

S - Simple

T - Triage

A - And

R - Rapid

T - Treatment

Pierce County EMS Procedures and PCPs, Table of Contents, p. d, June 2019

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does NSTE - ACS stand for, with regard to cardiology?

A

NSTE - ACS

N - Non-

ST - ST Segment

E - Elevation

A - Acute

C - Coronary

S - Syndrome

HeartCode ACLS 2015, ACLS Patient Cases: Acute Coronary Syndrome Video, 0:55

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does DISS stand for with regard to oxygen connectors on the AutoVent 3000 2.0?

A

DISS

D - Diameter

I - Index

S - Safety

S - System

AutoVent 2000 / 3000 Operating Manual, Version 2.0, p. 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Name nine risk factors for atrial fibrillation.

A

ATRIAL FIB

A - Alcohol

T - Thyroid

R - Rheumatic Heart

I - Ischemia

A - Atrial Myxoma

L - Lung (PE, Emphysema)

F - Pheochromocytoma

I - Infection

B - Blood Pressure (HTN)

https://foamcast.org/2014/09/21/episode-15-atrial-fibrillationflutter/

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does RAAS stand for, with respect to blood pressure regulation?

A

RAAS

Renin-Angiotensin-Aldosterone System

R - Renin

A - Angiotensin

A - Aldosterone

S - System

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What does DOAC stand for, with regard to anticoagulation?

A

DOAC

D - Direct

O - Oral

A - Anti

C - Coagulant

https://en.wikipedia.org/wiki/Atrial_fibrillation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What does NOAC stand for, with regard to anticoagulation?

A

NOAC

N - Novel

O - Oral

A - Anti

C - Coagulant

https://www.pharmacytimes.com/contributor/sean-kane-pharmd/2016/09/noac-doac-or-tsoac-what-should-we-call-novel-oral-anticoagulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Name four (of six listed) anticoagulants commonly used for stroke prevention during Atrial Fibrillation.

A
  1. Warfarin (Coumadin);
  2. Heparin (and other drugs ending with the suffix -parin);
  3. Apixaban;
  4. Rivaroxaban;
  5. Edoxaban;
  6. Dabigatran;

Memory Aid for #s 4-6: A pixy flies by a river on the planet Endor, when suddenly da big train whooshes by.

https://en.wikipedia.org/wiki/Atrial_fibrillation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What does BAAM stand for, with regard to a BAAM whistle?

A

BAAM

B - Beck

A - Airflow

A - Airway

M - Monitor

https://epmonthly.com/article/nasal-intubation/

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What does RRC stand for with regard to Pierce County receiving centers?

A

RRC

R - Recovery

R - Response

C - Center

Pierce Co. EMS Procedures and PCPs, January 2017

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What Berdancronym is useful for recalling the blood pressure-related indications for the use of Dopamine?

A

UV SCAN

U - Unknown Origin Hypotension;

V - Vasogenic Shock;

S - Septic Shock;

C - Cardiogenic Shock;

A - Anaphylactic Shock;

N - Neurogenic Shock;

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

The AHA recommends treatment of adult’s experiencing tachydysrhythmias or bradydysrhythmias when they are causing what five signs / symptoms?

A
  1. Hypotension, 2. Acutely altered mental status, 3. Signs of shock, 4. Ischemic chest discomfort, 5. Acute heart failure

Memory Aid: ???

AHA ECC Handbook, 2015 Ed., p. 27-28

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What does the Berdancronym STONED stand for, with regard to common causes of altered mental status?

A

STONED

S - Stroke (activate “Code Neuro”)

T - Trauma (activate Trauma System)

O - Oxygen Deficiency (open airway, provide oxygen, etc.)

N - Narcotics (narcan)

E - Epilepsy (postictal period)

D - Diabetes (note hypo- versus hyperglycemia)

Berdancronym

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What constitutes a “Non-Patient?”

A

No DIMES

A non-patient has no:

D - Desire for care;

I - Injury or Illness (obvious);

M - Mechanism of Injury (significant);

E - Evaluation (medical);

S - Symptoms;

Note: “Non-patients are symptomatic persons without a significant mechanism of injury, no obvious injury or illness, without a desire for care, and are not medically evaluated.”

Pierce County EMS Procedures and PCPs, Administrative Policy, p. 7, June 2019​​

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What eight medications may EMTs in Pierce County carry and administer, and what two medications may they “assist with?”

A

NANO ENIGMA

Underline Indicates EMT May “Assist With” A Patient’s Own Prescribed Medications

N - Narcan (IM/IN; *Contact Base Station for doses exceeding 10 mg total);

A - *Acetaminophen (PO);

N - Nerve Agent Antidote Kit (IM; Includes both Atropine and Pralidoxime Chloride);

O - Oxygen (INH);

E - Epinephrine 1:1,000 (IM; For anaphylaxis only; May use syringe or Epinephrine Auto-Injector; *Contact Base Station for repeated doses);

N - Nitroglycerine (SL);

I - *Ibuprofen (PO);

G - Glucose, Oral (PO or BUC);

M - Metered Dose Inhaler (INH; *Contact Base Station after fifth dose);

A - Aspirin (PO);

Pierce County EMS Procedures and PCPs, Administrative Policy, p. 2, June 2019​​

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Consider transporting a medical patient with CPR in progress if at least one of the following is suspected:

A

DR. CHAD

D - Drug Overdose;

R - Refractory Shockable Rhythm;

C - Circumstances require that the patient be transported;

H - Hypothermia;

A - Age <= 30 years old;

D - Drowning;

Pierce County EMS Procedures and PCPs, Administrative Policy, p. 4, June 2019​​

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

When appropriate, what interventions should be considered for a traumatic cardiac arrest patient?

A

PHAT ST.

P - Pericardiocentesis;

H - Hemorrhage control;

A - Airway (aggressive management);

T - Thoracostomy (bilateral);

S - Sodium Chloride, 0.9% (fluid resuscitation);

T - Transport (if patient shows signs of improvement);

Pierce County EMS Procedures and PCPs, Administrative Policy, p. 4, June 2019​​

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

In cardiac arrest secondary to blunt trauma, resuscitation efforts may be withheld if the patient shows clinical signs of irreversible death or meets the following three conditions:

A

PAW

P - Pluseless;

A - Apneic;

W - Without signs of life (witnessed by EMS responder on arrival);

Pierce County EMS Procedures and PCPs, Administrative Policy, p. 4, June 2019​​

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

In cardiac arrest secondary to penetrating trauma, resuscitation efforts may be withheld if ___.

A

PAW

P - Pluseless;

A - Apneic;

W - Without signs of life (witnessed by EMS responder on arrival);

Note - PAW specifically refers to blunt force traumatic arrest, but is also applicable to penetrating trauma arrest. The PCPs specifically state, “In penetrating trauma, resuscitation efforts may be withheld if there are no signs of life (e.g. no pupillary reflexes, GCS 3, and no organized cardiac rhythm on ECG > 40 bpm).”

Pierce County EMS Procedures and PCPs, Administrative Policy, p. 4, June 2019​​

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

“A medical patient with an unstable airway will be transported to ___.”

A

NeRF ED

N - Nearest;

R - Receiving;

F - Facility’s;

E - Emergency;

D - Department;

Note: “A medical patient with an unstable airway will be transported to the nearest Receiving Facility’s emergency department regardless of the emergency department’s designated capabilities.”

Pierce County EMS Procedures and PCPs, Transport Policy, p. 13, June 2019​​​​

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

“Medical patients should generally be transported to ___.”

A

‘NAM Receiving Facility

The tent from MASH

N - Nearest;

A - Appropriate;

M - Medical;

Receiving Facility;

Note: “Medical patients should generally be transported to the nearest appropriate medical Receiving Facility.”

Pierce County EMS Procedures and PCPs, Transport Policy, p. 13, June 2019​​​​​

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

“A trauma patient with an unstable airway will be transported to ___.”

A

NeRF ED

N - Nearest;

R - Receiving;

F - Facility’s;

E - Emergency;

D - Department;

Note: “The nearest Receiving Facility’s emergency department regardless of the emergency department’s designated capabilities.”

Pierce County EMS Procedures and PCPs, Transport Policy, p. 14, June 2019​​​​​

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

“Step 3 and Step 4 trauma patients can be taken to ___.”

A

NATRHOAL

The “natural” destination for Step 3-4 trauma patients.

N - Nearest;

A - Available;

T - Trauma;

R - Receiving;

H - Hospital;

O - Of;

A - Any;

L - Level;

Note 1: “Step 3 and Step 4 trauma patients can be taken to the nearest available trauma receiving hospital of any level.”

Note 2: The Prehospital Trauma Triage (Destination) Procedures for Step 3 trauma patients instruct the provider to “take patient to the nearest appropriate trauma center within 30 minutes transport time (Air or Ground), which, depending upon the defined trauma system, need not be the highest level trauma center.” For Step 4 trauma patients the provider is instructed to “contact medical control or receiving facility, and consider transport to a trauma center or a specific resource hospital.”

Pierce County EMS Procedures and PCPs, Transport Policy, p. 14, Appendix B-1, June 2019​​​​​

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What does RRC stand for with regard to Pierce County receiving facilities?

A

RRC

R - Recovery;

R - Response;

C - Center;

Pierce County EMS Procedures and PCPs, Transport Policy, p. 13, June 2019​​​​​

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What does SMR stand for, with regard to spinal precautions?

A

SMR

S - Spinal;

M - Motion;

R - Restriction;

Pierce County EMS Procedures and PCPs, General Principles / Routine Care, p. 20, June 2019

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What does the acronym START stand for, with respect to triage?

A

START

S - Simple;

T - Triage;

A - And;

R - Rapid;

T - Treatment;

Pierce County EMS Procedures and PCPs, Table of Contents, p. d, June 2019

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What does the acronym ATV stand for with respect to airway ventilation?

A

ATV

A - Automatic;

T - Transport;

V - Ventilator;

Pierce County EMS Procedures and PCPs, Administrative Policy, p. 3, June 2019

48
Q

Name the situations which preclude resuscitative efforts, including the clinical signs of irreversibel death.

A

RIDDLED PM

i.e., A Bullet-Riddled Corpse Lies Bloody in the Moonlight

R - Rigor Mortis;

I - Incineration;

D - Decapitation;

D - Decomposition;

L - Livor Mortis (Dependent Lividity);

E - Evisceration of the heart or brain matter;

D - DNR (Including “compelling reasons”);

P - PEA (Traumatic cardiac arrest without PEA > 40 bpm);

M - Mortal Peril (Responders at risk of serious injury or mortal peril);

  • Pierce County EMS Procedures and PCPs, Administrative Policy, p. 3-4, June 2019​*
  • Berdancronym*
49
Q

Crush Injury Syndrome (CIS) is also known as ___.

A

TR

T - Traumatic;

R - Rhabdomyolysis;

Pierce County EMS Procedures and PCPs, Traumatic Emergencies, p. 30, June 2019

50
Q

With relation to IV placement, what does CVC stand for?

A

CVC

C - Central;

V - Venous;

C - Catheter;

Note - the Pierce County EMS Procedures and PCPs, General Principles / Routine Care, p. 19, June 2019​​ state “central vascular catheter.”

https://en.wikipedia.org/wiki/Central_venous_catheter

51
Q

What does AICD stand for with regard to cardiac care?

A

AICD

A - Automatic;

I - Implantable;

C - Cardioverter;

D - Defibrillator;

Pierce County EMS Procedures and PCPs, Cardiac Emergencies, p. 31, June 2019​

52
Q

Generally speaking, once initiated, CPAP therapy should be continuous and should not be interrupted or removed in the field unless a patient: experiences one of the following conditions:

A

OPERA

O - Oral medication indicated;

P - Panic (cannot tolerate CPAP therapy);

E - Emesis;

R - Respiratory arrest;

A - Airway maintenance failure;

Pierce County EMS Procedures and PCPs, General Principles / Routine Care, p. 18, June 2019​

53
Q

Name the five contraindications to CPAP therapy that would preclude its use despite it being otherwise indicated.

A

ERUPT

E - Emesis;

R - Respirations < 8/min;

U - Upper GI bleeding;

P - Pneumothorax (and significant chest trauma excluding pulmonary contusion);

T - Tracheostomy;

Pierce County EMS Procedures and PCPs, General Principles / Routine Care, p. 17-18, June 2019​​

54
Q

What does HIPAA stand for?

A

HIPAA

H - Health;

I - Insurance;

P - Portability;

and

A - Accountability;

A - Act;

Pierce County EMS Procedures and PCPs, Administrative Policy, p. 10, June 2019​​

55
Q

What does PHI stand for?

A

PHI

P - Protected;

H - Health;

I - Information;

Pierce County EMS Procedures and PCPs, Administrative Policy, p. 10, June 2019​​

56
Q

A patient or their representative may sign an ROR if the following five conditions are met:

A

SOLID

S - Six hours expected to pass before recurrence;

O - Observation available for a reasonable amount of time by a competent person;

L - Loss of life or limb unlikely;

I - Interventions of medical significance unrendered;

D - Decision making capacity demonstrated by patient or caregiver;

“1. No substantial medical intervention has been rendered.

2. There is no potential risk for loss of life or limb.

3. It is reasonable not to expect a recurrence of the condition within the next 6 hours.

4. There is an individual with adequate decision-making capacity who can observe the patient for a reasonable amount of time.

5. The adult patient or his/her caregiver meet all elements of the Pierce County Decision-Making Capacity Checklist and agrees to sign an ROR form.”

Pierce County EMS Procedures and PCPs, Administrative Policy, p. 7-8, June 2019​​

57
Q

What does EMR stand for, with respect to EMS Scope of Practice?

A

EMR

E - Emergency;

M - Medical;

R - Responder;

Pierce County EMS Procedures and PCPs, Administrative Policy, p. 1, June 2019​​

58
Q

What does NICU stand for ?

A

NICU

N - Neonatal;

I - Intensive;

C - Care;

U - Unit;

Pierce County EMS Procedures and PCPs, Transport Policy, p. 13, June 2019​​​

59
Q

What does the acronym SUID stand for, with respect to death?

A

SUID

S - Sudden;

U - Unexplained;

I - Infant;

D - Death;

  • Pierce County EMS Procedures and PCPs, Administrative Policy, p. 6, June 2019​​​​​*
  • Berdancronym*
60
Q

Name the clinical signs of irreversible death.

A
  1. Rigor Mortis;
  2. Incineration;
  3. Decapitation;
  4. Decomposition;
  5. Livor Mortis (Dependent Lividity);
  6. Evisceration of the heart or brain matter;

Note: These are components of the Berdancronym “RIDDLED PM,” a memory aid for the situations which preclude rescuscitative efforts.

Pierce County EMS Procedures and PCPs, Administrative Policy, p. 3-4, June 2019​

61
Q

What does DMCC stand for with regard to triage?

A

DMCC

D - Disaster;

M - Medical;

C - Control;

C - Center;

Pierce County EMS Procedures and PCPs, Communication Policy, p. 11, June 2019

62
Q

What does BEFAST stand for with regard to stroke care (as per the PCPs)?

A

BEFAST

B - Balance;

E - Eyes;

F - Facial droop;

A - Arm drift;

S - Speech changes;

T - Time since LKW;

Pierce County EMS Procedures and PCPs, Appendix D - Prehospital Stroke Triage Procedure, p. D-2, June 2019

63
Q

What does ExDs stand for?

A

ExDs

Ex - Excited;

D - Delirium;

s - Syndrome;

Pierce County EMS Procedures and PCPs, Behavioral Emergencies, p. 48, June 2019​

64
Q

Generally speaking, for whom should transport to the RRC be considered?

A
  1. Any patient with a psychiatric or behavioral health presentation who is ≥ 18 years old, or emancipated;

Memory Aid: PB-HP: Psychiatric or Behavioral Health Presentation. Anyone crazy enough to eat a PB-HP sandwich (peanutbutter and HP sauce) qualifies for the RRC!

Pierce County EMS Procedures and PCPs, Behavioral Emergencies, p. 48, June 2019​

65
Q

What does DMHP stand for, with respect to psychiatric emergencies?

A

DMHP

D - Designated;

M - Mental;

H - Health;

P - Professional;

Pierce County EMS Procedures and PCPs, Behavioral Emergencies, p. 49, June 2019​​

66
Q

What does the acronym LKW stand for, with respect to CVA?

A

LWK

L - Last;

K - Known;

W - Well;

Pierce County EMS Procedures and PCPs, Pierce County Prehospital Stroke Triage (Destination) Procedures, Appendix D-2, June 2019​​

67
Q

An Against Medical Advice (AMA) designation may be considered only if the following four conditions exist:

A

The ​BARD

Shakespear can do as he pleases!

B - Base Station advised;

A - Alternative to treatment / transport offered;

R - Risks of refusal, benefits of treatment / transport, and condition explained;

D - Decision-making capacity demonstrated by patient;

Note:

“1. The patient meets all elements of the Pierce County Decision-Making Capacity Checklist (including being >= 18 years old or an emancipated minor).

2. The patient has been told of his or her condition, the risks of refusing and the benefits of seeking medical treatment / transport.

3. The patient has been offered a reasonable alternative.

4. The Base Station has been consulted (a physician should speak to the patient whenever possible).”

  • Pierce County EMS Procedures and PCPs, Administrative Policy, p. 8, June 2019​​​​​*
  • Berdancronym*
68
Q

Berdancronym for the principle pre-hospital treatments to consider for Crush Injury Syndrome.

A

CBD FOAM

C - Calcium Chloride 10% (hyperkalemia);

B - Sodium Bicarbonate 8.4% (hyperkalemia);

D - Dextrose (hypoglycemia);

F - Fentanyl (analgesia; consider substitutes);

O - Oxygen (PCPs: 15 LPM INH via NRB);

A - Albuterol (hyperkalemia);

M - Midazolam (anxiolysis; only variant mentioned in PCPs);

-Berdancronym

69
Q

Berdancronym for the principal pre-hospital treatments for traumatic cardiac arrest.

A

PHAT ST

(Phat St.)

P - Pericardiocentesis;

H - Hemorrhage control;

A - Airway (aggressive management);

T - Thoracostomies (bilateral);

S - Sodium Chloride 0.9% (fluid resuscitation)

T - Transport (if patient shows signs of improvement);

-Berdancronym

70
Q

Berdancronym for the principle pre-hospital treatments for anaphylaxis.

A

DD GAMES

(Double-D Games)

D - Diphenhydramine;

D - Dopamine (BP < 90/S);

G - Glucagon (epi-refractory anaphylaxis 2° to beta-blockade);

A - Albuterol (“can be given continuously”);

M - Methylprednisolone;

E - Epinephrine;

S - Sodium Chloride 0.9% (BP < 90/S);

  • Pierce County EMS Procedures and PCPs, Environmental Emergencies, p. 44-45, June 2019​*
  • Berdancronym*
71
Q

Berdancronym for the principle pre-hospital treatments for croup.

A

get SOME!

S - Sodium Chloride 0.9% (Blow-By via SVN);

O - Oxygen (Blow-By);

M - Methylprednisolone (only dexamethasone [w/ ondansetron] mentioned in PCPs);

E - Epinephrine (Blow-By via SVN);

Berdancronym

72
Q

Berdancronym for the principle pre-hospital treatments for obstructive upper airway edema.

A

EKO

E - Epinephrine (IM);

K - Ketamine (anxiolysis; consider alternatives);

O - Oxygen (Blow-By);

-Berdancronym

73
Q

Berdancronym for the principle pre-hospital treatments for asthma / COPD.

A

A MOM’S CAKE

A - Albuterol;

M - Methylprednisolone or dexamethasone (moderate-to-severe reactions);

O - Oxygen;

M - Magnesium Sulfate (asthma);

S - Sodium Chloride 0.9% (fluid resuscitation; Adult patients: mentioned for all reaction severities; Pediatric patients: mentioned for severe reactions only);

C - CPAP;

A - Atrovent;

K - Ketamine (CPAP anxiolysis; PCPs only recommend diazepam and midazolam);

E - Epinephrine (status asthmaticus);

Berdancronym

74
Q

Berdancronym for the principle pre-hospital treatments for smoke inhalation.

A

OH Blood!

O - Oxygen (carbon monoxide poisoning; high flow @ 100% FiO2);

H - Hydroxocobalamin (cyanide poisoning);

Blood Samples (prior to use of hydroxocobalamin);

-Berdancronym

75
Q

Berdancronym for the principle pre-hospital treatments for cardiac arrest.

A

CLAM BEDS

C - Calcium Chloride 10% (suspected hyperkalemia 2° renal failure);

L - Lidocaine (arrest 2° VF / pVT; alternative to amiodarone);

A - Amiodarone (shock & vasopressor refractory VF or pVT);

M - Magnesium Sulfate (TdP & VF refractory to all other therapies [hypomagnesemia]);

B - Sodium Bicarbonate 8.4 % (acidosis);

E - Epinephrine;

D - Defibrillation;

S - Sodium Chloride 0.9% (fluid resuscitation);

-Berdancronym

76
Q

Berdancronym for the principle pre-hospital treatments for neonatal resuscitation.

A

BEDS

B - Sodium Bicarbonate 4.2% (following ROSC);

E - Epinephrine;

D - Dextrose 10% (max 12.5%);

S - Sodium Chloride 0.9% (fluid resuscitation);

-Berdancronym

77
Q

Berdancronym for the principle pre-hospital treatments for symptomatic bradycardia.

A

SEDATE with Ketamine

S - Sodium Chloride 0.9% (fluid resuscitation);

E - Epinephrine ​(PCP 4th choice for symptomatic bradycardia);

D - Dopamine ​(PCP 3rd choice for symptomatic bradycardia);

A - Atropine (PCP/AHA 1st choice for symptomatic bradycardia);

T - Transcutaneous Pacing ​(PCP/AHA 2nd choice for symptomatic bradycardia);

E - Expert Consultation

K - Ketamine (procedural sedation; only diazepam and midazolam mentioned in PCPs);

Berdancronym

78
Q

Berdancronym for the principle pre-hospital treatments for asymptomatic tachycardia.

A

SAD VEAL

S - Sodium Chloride 0.9% (fluid resuscitation);

A - Amiodarone (polymorphic VT & wide complex of uncertain origin);

D - Diltiazem (narrow QRS);

V - Vagal Maneuvers (narrow complex);

E - Expert Consultation;

A - Adenosine (for both regular narrow complex and wide IF monomorphic);

L - Lidocaine (stable VT);

-Berdancronym

79
Q

Berdancronym for the principle pre-hospital treatments for symptomatic tachycardia.

A

MAD SEAS

M - Magnesium Sulfate (TdP)

A - Adenosine (regular, narrow complex)

D - Defibrillation (TdP with a pulse)

S - Sodium Chloride 0.9% (fluid resuscitation)

E - Etomidate (procedural sedation; consider other agents)

A - Amiodarone (hemodynamically-unstable VT when cardioversion ineffective)

S - Synchronized Cardioversion

-Berdancronym

80
Q

Berdancronym for the principle pre-hospital treatments for ACS.

A

MONA’S O

(The sexual nature of this acronym is a reminder to ask about erectile dysfunction medications prior NTG administration.)

M - Morphine (pain not relieved by NTG & NTG-refractory pain);

O - Oxygen (SpO2 < 94%);

N - Nitroglycerine;

A - Aspirin;

S - Sodium Chloride 0.9% (fluid resuscitation);

O - Ondansetron;

-Berdancronym

81
Q

Berdancronym for the principle pre-hospital treatments for hypotensive shock.

A

SED

(thirst)

S - Sodium Chloride 0.9% (fluid resuscitation);

E - Epinephrine;

D - Dopamine;

-Berdancronym

82
Q

Berdancronym for the principle pre-hospital treatments for hyperkalemia.

A

P-QRS-T Brady? ABC!

A - Albuterol;

B - Sodium bicarbonate 8.4%;

C - Calcium chloride 10% or calcium gluconate 10%;

  • Pierce County EMS Procedures and PCPs, April 2020, p. 40*
  • Berdancronym*
83
Q

Berdancronym for the principle pre-hospital treatments for ExDs.

A

Lobster BiSK

Bi - Sodium Bicarbonate 8.4%;

S - Sodium Chloride 0.9% (cooled);

K - Ketamine;

-Berdancronym

84
Q

Berdancronym for the principle pre-hospital treatments for calcium channel blocker and/or beta blocker overdose.

A

SEDATE with Ketamine in a GluM CaB

S - Sodium chloride 0.9% (fluid resuscitation);

E - Epinephrine (PCPs’ 4th choice treatment for symptomatic bradycardia);

D - Dopamine (PCPs’ 3rd choice treatment for symptomatic bradycardia);

A - Atropine (AHA’s and PCPs’ 1st choice treatment for symptomatic bradycardia);

T - Transcutaneous pacing (AHA’s and PCPs’ 2nd choice treatment for symptomatic bradycardia);

E - Expert consultation;

K - Ketamine (TCP sedation; PCPs only mention diazepam);

Glu - Glucagon;

M - Magnesium sulfate (TdP caused by sotalol-induced long QTI);

Ca - Calcium chloride 10% or calcium gluconate 10%;

B - Sodium bicarbonate (wide QRS caused by propanolol-induced sodium channel blockade);

Berdancronym

85
Q

Berdancronym for the principle pre-hospital treatments for sequenced intubation.

A

FREAKS

F - Fentanyl (post-sedation anesthesia adjunct)

R - Rocuronium (pre- and post-intubation paralysis)

E - Etomidate (pre-sedation)

A - Apneic Oxygenation

K - Ketamine (pre- and post-intubation sedation)

S - Succinylcholine (pre-intubation paralysis)

-Berdancronym

86
Q

Berdancronym for the types of pain which indicate treatment with Morphine Sulfate.

A

BEAM

B - Burns

E - Extremity Injury (Isolated)

A - Abdominal Pain

M - Myocardial Infarction

  • Pierce County EMS Protocols & PCPs, June 2019, p. O-42*
  • Berdancronym*
87
Q

What treatments should be considered for an allergic reaction?

A

A DAME

A - Albuterol (wheezing);

D - Diphenhydramine (antihistamine);

A - Atrovent (wheezing);

M - Methylprednisolone (anti-inflammatory, indicated for moderate-to-severe reactions);

E - Epinephrine (anti-anaphylactic, indicated for airway involvement);

  • Pierce County EMS Procedures and PCPs, Environmental Emergencies, p. 44, Medication / IV Guide, p. O-39, June 2019*
  • Berdancronym*
88
Q

A patient or their representative may sign an ROR if the following five conditions are met:

A

SOLID

S - Six hours expected to pass before recurrence;

O - Observation available for a reasonable amount of time by a person of adequate decision-making capacity;

L - Loss of life or limb reasonably unexpected;

I - Intervention of medical significance unrendered;

D - Decision-making capacity demonstrated by patient or caregiver;

“1. No substantial medical intervention has been rendered.

2. There is no potential risk for loss of life or limb.

3. It is reasonable not to expect a recurrence of the condition within the next 6 hours.

4. There is an individual with adequate decision-making capacity who can observe the patient for a reasonable amount of time.

5. The adult patient or his/her caregiver meet all elements of the Pierce County Decision-Making Capacity Checklist and agrees to sign an ROR form.”

  • Pierce County EMS Procedures and PCPs, Administrative Policy, p. 7-8, June 2019​​*
  • Berdancronym*
89
Q

Name the situations which preclude resuscitative efforts, including the clinical signs of irreversible death.

A

MP RIDDLED

A Military Policeman Stands Over a Bullet-Riddled Corpse

M - Mortal peril (responders at risk of serious injury or mortal peril);

P - PEA (traumatic cardiac arrest without PEA > 40 bpm);

R - Rigor Mortis;

I - Incineration;

D - Decapitation;

D - Decomposition;

L - Livor mortis (dependent lividity);

E - Evisceration of the heart or brain matter;

D - DNR orders (as well as POLSTs, Advance Directives and “compelling reasons”)

  • Pierce County EMS Procedures and PCPs, Administrative Policy, p. 3-4, June 2019​*
  • Berdancronym*
90
Q

Name the Level I Cardiac Centers in Pierce County.

A
  1. Good Samaritan Hospital;
  2. Madigan Army Medical Center;
  3. St. Anthony Hospital;
  4. St. Joseph Medical Center;
  5. Tacoma General Hospital;

Note: There are five Level I Cardiac Centers in Pierce County, the same as the number of fingers on one hand. Picture Levine’s Sign as a memory aid, a five-fingered hand clutching the chest.

Pierce County EMS Procedures and PCPs, Transport Policy, p. 12, June 2019​​​​​

91
Q

“A patient who has a mental disorder with any ___ of their psychiatric illness is a ___ patient and is the responsibility of ___.”

A
  1. Decompensation;
  2. Medical;
  3. EMS;

Memory Aid: MD/PI - Mental Disorder / Psychiatric Illness. A mental patient loony enough to dress up as an MD/PI (Medical Doctor / Private Investigator) needs to be cared for by EMS. “A patient who has a mental disorder with any decompensation of their psyciatric illness is a medical patient and is the responsibility of EMS.”

Pierce County EMS Procedures and PCPs, Transport Policy, p. 14, June 2019​​​​​

92
Q

Which receiving facilities in Pierce County are capable of caring for OB / GYN patients?

A
  1. Good Samaritan Hospital;
  2. Madigan Army Medical Center;
  3. St. Joseph Medical Center;
  4. Tacoma General Hospital;

Note: These are also the only four receiving facilities in Pierce County which feature NICUs.

Memory Aid: There are four letters in the acronym NICU, just as there are only four receiving facilities in Pierce County which feature NICUs.

Pierce County EMS Procedures and PCPs, Transport Policy, p. 12, June 2019​​​​​

93
Q

Which receiving facilities in Pierce County have NICUs? Name their levels.

A
  1. Good Samaritan Hospital - Level 2 NICU;
  2. Madigan Army Medical Center - Level 3 NICU;
  3. St. Joseph Medical Center - Level 2 NICU;
  4. Tacoma General Hospital - Level 3 NICU;

Note: These are also the only four receiving facilities in Pierce County that provide obstetrical care.

Memory Aid: Just as there are four letters in the acronym “NICU”, there are four hospitals in Pierce County with NICUs.

Pierce County EMS Procedures and PCPs, Transport Policy, p. 12, June 2019​​​​​

94
Q

Name the three basic types of dialysis access sites.

A
  1. Fistula;
  2. Graft;
  3. Catheter;

Memory Aid: Picture a patient’s arm with a tightly clenched fist (fistula), a kidney grafted onto the forearm (graft) and an IV placed in the AC (catheter).

https://www.freseniuskidneycare.com/ckd-treatment/in-center-hemodialysis/hemodialysis-access-options

95
Q

Name all the medications which the PCPs indicate should be administered IO / IV “slow(ly)”.

A

C-DOM

(Condom)

C - Calcium chloride 10% / Calcium gluconate 10%;

D - Diphenhydramine;

O - Ondansetron;

M - Morphine;

  • Pierce County EMS Procedures and PCPs, Medication / IV Guide, p. O-11, O-12, O-20, O-42, O-49, June 2019*
  • Berdancronym*
96
Q

With what PCP medication(s) is sodium bicarbonate 10% incompatible?

A

ACED IV

A - Atropine;

C - Calcium chloride 10% / Calcium gluconate 10%;

E - Epinephrine;

D - Dopamine;

I - Isoproterenol;

V - Vecuronium;

  • Pierce County EMS Procedures and PCPs, Medication / IV Guide, p. O-12, O-53, June 2019*
  • Berdancronym*
97
Q

With regard to a POLST, communication with the ___ should be considered if there is concern about the patient’s wishes.

A
  1. Legal surrogate;

Memory Aid: Think of the “LS” in POLST as an acronym for “legal surrogate”.

Pierce County EMS Procedures and PCPs, Administrative Policy, p. 4, June 2019

98
Q

“Living wills ___ be honored if present.”

A
  1. Should;

Memory Aid: Think of the “s” in living wills as an acronym for “should”.

Pierce County EMS Procedures and PCPs, Administrative Policy, p. 5, June 2019

99
Q

In the Treatment Emergencies sections of the PCPs, for what two adult medical conditions is midazolam only explicitely suggested for sedation as follows?:

  • Midazolam: IO / IV 2 mg; May repeat q 1-2 min (max total 0.1 mg/kg up to 10 mg)
A
  1. Respiratory emergencies requiring CPAP therapy;
  2. Crush Injury Syndrome (CIS);

Memory Aid: Treatment algorithms for each of these medical conditions require covering the mouth and nose with a mask, making intranasal midazolam delivery less convenient. When nose access is inconvenient, the PCPs mention only the IO / IV routes for midazolam.

Pierce County EMS Procedures and PCPs, Respiratory Emergencies, p. 36, Traumatic Emergencies, p. 30, June 2019​

100
Q

All patients evaluated by EMS and transported from an MCI will be identified using the ___ bar code triage tag. This should be applied to the patient _(when)_, and the ___ and ___ recorded on a transportation log.

A
  1. StatBand;
  2. Prior to transport;
  3. Tracking number;
  4. Patient’s destination;

Memory Aid I: “StatBand” and “JumpSTART,” both terms associated with triage, are both compound words.

Memory Aid II: Picture the StatBand as a criminal GPS tracking bracelet in order to recall that the tracking number must be recorded prior to transport.

Pierce County EMS Procedures and PCPs, General Principles / Routine Care, p. 23, June 2019

101
Q
  1. What is the definition of “*severe* distress” in the Adult Respiratory Distress Acuity Reference?
A
  1. “One word sentences, diaphoretic, altered mental status (AMS).”

Memory Aid: OWS DAMS: One Word Sentences, Diaphoretic, Altered Mental Status (AMS).

Pierce County EMS Procedures and PCPs, Respiratory Emergencies, p. 35, June 2019​​

102
Q

What six contraindications are listed for Succinylcholine in the RSI appendix?

A
  1. Suspected hyperkalemia - renal failure and missed dialysis;
  2. From 5 days post significant burn or crush injury until healed;
  3. From 5 days post severe intra-abdominal infection until treated;
  4. From 5 days - 6 months post spinal cord injury or severe stroke;
  5. Neuromuscular diseases such as Multiple Sclerosis and Muscular Dystrophy;
  6. Personal or family history of malignant hyperthermia;

Memory Aid: A man lounges in an threadbare dialysis treatment recliner, surrounded by obsolete equipment (hyperkalemia). A red-hot boulder sizzles on his abdomen (significant burns), squashing his internal organs (crush injury). The super-heated viscera boil and churn within his belly (severe intra-abdominal infection). The boulder is so heavy that it fractures the spine (spinal cord injury), sending a lightning bolt up the cord to short-circuit the brain (severe stroke). The man’s hands tremble uncontrollably (neuromuscular diseases), and finally his entire body lights on fire (malignant hyperthermia).

Pierce County EMS Procedures and PCPs, Appendix F, June 2019​

103
Q

For what presentations in the PCPs is the concept of “≤” applicable with regard to the differentiation of care based on age or weight?

A
  1. ≤:
  • Transport partial and full-thickness burn injuries affecting > 10% of total body surface area (TBSA) to HMC when patient is ≤ 8 y/o (as opposed to all patients when such burns affect > 20% of TBSA);
  • CPAP contraindicated when ≤ 12 y/o;
  • Utilize JumpSTART Triage (as opposed to START Triage) when patient is ≤ 8 y/o;
  • Administer ibuprofen at pediatric doses (as opposed to adult) when ≤ 10 y/o;
  • No age-related EMS Sepsis Score awarded when patient is ≤ 54 y/o;
  • Consider transporting a medical patient with CPR in progress when patient is ≤ 30 years old;
  • Ondansetron prescribed at pediatric doses (as opposed to adult) when ≤ 11 y/o (4 - 11 y/o administered L via ODT 4 mg or IO / IV 0.15 mg/kg);
  • Administer glucagon at 0.5 mg IM (as opposed to 1 mg) when patient is ≤ 20 kg ;
  • Administer sodium bicarbonate 4.2% (as opposed to 8.4%) when patient is ≤ 5 kg (or neonate);
  • Administer midazolam IM for seizures at 5 mg (as opposed to 10 mg) when patient is ≤ 40 kg (13 - 40 kg);

Memory Aid (for differentiation of care based on age or weight being ≤ a specified figure): A yound boy jumps (JumpStart Triage) over a burning CPAP (burns > 10% TBSA) in order to catch a flying tablet of ibuprofen in his mouth. An “OG” (ondansetron / glucagon) lies next to the fire supine, head resting on a Sepsis Scorecard (no age score if ≤ 54), with CPR compressions being performed on his chest (transport if ≤ 30 y/o). The gangster’s pants lie low on his thighs, showing evidence of a BM (sodium bicarbonate 8.4% / midazolam).

Pierce County EMS Procedures and PCPs, Administrative Policy, p. 4, Appendix DD, Traumatic Emergencies, p. 29, Appendix M-2, Medication / IV Guide, p. O-28, O-30, O-40, O-53, June 2019

104
Q

For what presentations in the PCPs is the concept of “≥” applicable with regard to the differentiation of pediatric care from adult care?

A
  1. ≥:
  • D50W (as opposed to lower concentrations) permitted offline when ≥ 8 y/o;
  • Adult medical and “injured” patients (as opposed to pediatric) designated when ≥ 18 y/o;
  • Nitrous oxide permitted offline when ≥ 18 y/o;
  • Lidocaine permitted offline for IO anesthesia when ≥ 18 y/o;
  • Adult Step Trauma patients (as opposed to pediatric) designated when ≥ 15 y/o;
  • Epinephrine 1:1,000 IM for anaphylaxis prescribed at 0.3-0.5 mg (as opposed to 0.15 mg) when ≥ 66 lbs;
  • Epinephrine 1:1,000 INH via SVN (blow-by) for Croup prescribed at 3 mg (as opposed to 2 mg) when ≥ 6 y/o;
  • RSI medications prescribed at adult doses (as opposed to pediatric) when ≥ 10 y/o;
  • Midazolam IM for seizures permitted offline at 5 mg (as opposed to 10 mg for > 40 kg) when 13-40 kg (i.e., ≥ 13 kg);
  • Nasal intubation permitted offline when ≥ 8 y/o;
  • Afrin permitted offline when ≥ 6 y/o;
  • Ibuprofen permitted offline when ≥ 6 m/o (6 m/o - 10 y/o administered at 10 mg/kg as opposed to 400-800 mg for > 10 y/o);
  • Ondansetron permitted offline when ≥ 4 y/o (4 - 11 y/o administered L via ODT 4 mg or IO / IV 0.15 mg/kg as opposed to adult doses);
  • Pharmacologic treatment for angina permitted offline when ≥ 18 y/o (e.g., aspirin, nitroglycerin, morphine, fentanyl);
  • Glucagon permitted offline for all indications (as opposed to only hypoglycemia) when ≥ 18 y/o;

Memory Aid: A boy sits on top of a large pile of sugar (D50W). The boy’s right ankle is in a brace (“injured” / medical) and an IO (lidocaine) has been placed in his proximal tibia. His foot is glued (glucagon) on top of a bottle of nitrous oxide. The boy’s left foot has been amputated above the ankle (Step Trauma). An EpiPen protrudes from the boy’s right shoulder (epinephrine 1:1,000 for anaphylaxis), an NRB delivers nebulized fog in front of the boy’s face (epinephrine 1:1,000 blow-by for croup), and a syringe of Versed protrudes from his left shoulder (midazolam IM for seizures / RSI medications). An ET tube protrudes from the boy’s right nostril (nasal intubation) while a bottle of Afrin juts from his left nostril. A caplet of ibuprofen and a tablet of ondansetron hang precariously from the tip of his tongue like a set of testicles. He wears a shirt with a large red heart over the center of his chest (ACS medications).​

Pierce County EMS Procedures and PCPs, Communication Policy, p. 11, General Principles / Routine Care, p. 18, Appendix F, Medication / IV Guide, p. O-8, O-16, O-24, O-28, O-30, O-34-35, O-48, June 2019

105
Q

How should magnesium sulfate be administered to adult patients for the treatment of asthma / COPD?

A
  1. Magnesium sulfate: IO / IV (15 min) 2 g in 10 mL sodium chloride 0.9%;

Note: Consider mixing 2 g magnesium sulfate (0.5 g/mL end concentration, i.e., 4 mL) in 250 mL sodium chloride 0.9% and administering over 15 minutes with a 10-drop administration set (167 gtt/min).

Memory Aid (for the drip rate of magnesium sulfate when administered to adult patients for the treatment of asthma / COPD): Magnum PI (magnesium sulfate) drives his open-top convertible Ferrari through heavy smog on Hwy 167 (167 gtt./min), wheezing and coughing heartily (asthma / COPD).

Pierce County EMS Procedures and PCPs, Respiratory Emergencies, p. 36, June 2019​

106
Q

Name all the medications which the PCPs indicate should be administered IO / IV over a specified time period.

A

MAD BACH GEM

M - Midazolam (pediatric: 2 min);

A - Adenosine (1-3 sec “rapid IV push”);

D - Diltiazem (2 min);

B - Sodium Bicarbonate 8.4% (Crush Injury Syndrome: 44 min);

A - Amiodarone (wide complex tachycardia: 10 min);

C - Calcium chloride 10% / Calcium gluconate 10% (adult: 5 min);

H - Hydroxocobalamin (15 min);

G - Glucagon (beta-blocker or calcium channel blocker overdose: 3-5 min);

E - Etomidate (induction: 30-60 sec);

M - Magnesium sulfate (asthma / COPD / wheezing: 15 min, seizure: 5 min, Torsades de Pointes: 15 min);

Note: There are 11 medications in this group, just as there are 11 medications permitted for EMT utilization in Pierce County.

Memory Aid: Picture the Mad Bach Gem swinging back and forth to the steady tick of a metronome.

Pierce County EMS Procedures and PCPs, Medication / IV Guide, p. O-3, O-7, O-11, O-12, O-13, O-19, O-26, O-28, O-36, O-41, O-53, June 2019

107
Q

Identify the overdose variants mentioned in the PCPs which produce bicarbonate-responsive acidosis.

A

TADA! Cocaine!

TA - Tricyclic Antidepressants

D - Diphenhydramine

A - Aspirin

Cocaine!

Note: Diabetic Ketoacidosis is also identified as a bicarbonate-responsive acidosis.

  • Pierce Co. EMS Procedures and PCPs, June 2019, Medication / IV Guide, p. O-53*
  • Berdancronym*
108
Q
  1. Oral Glucose: Indication(s)
A

1.

  • Symptomatic hypoglycemia;
  • Altered mental status;

Note: These are components of “SHAMS”, a Berdancronym for conditions which indicate the use of oral glucose.

SHAMS

The indications for oral glucose are so general they should be considered a sham!

S - Symptomatic

H - Hypoglycemia

A - Altered

M - Mental

S - Status

  • Pierce County EMS Procedures and PCPs, Medication / IV Guide, p. O-29, June 2019​​*
  • Berdancronym*
109
Q
  1. Sodium Chloride 0.9%: Indication(s)
A

1.

  • Mixing / dilution of medications;
  • To keep vein open (AKA KVO or TKO);
  • Fluid resuscitation:
    • Childbirth (p. 51);
    • Vaginal bleeding (p. 53);
    • Asthma / COPD (p. 36);
    • Burns (thermal and electrical; p. 28-29);
    • Excited Delirium Syndrome (p. 48);
    • Shock
      • Due to status of pulse and blood pressure (i.e., Shock Index; p. 19);
      • Vasogenic shock (p. 41);
      • Anaphylactic shock (p. 44);
      • Neurogenic shock (p. 31);
      • Septic shock (Appendix DD);
      • Traumatic hypovolemic shock (p. 24);
        • Uncontrolled internal hemorrhage (p. 24);
        • TBI (p. 24);
        • Controlled hemorrhage with shock (p. 24);
    • Trauma (p. 24-26);​
      • Traumatic cardiac arrest (p. 4);
      • CNS (p. 24-25);
      • Facial (p. 24-25);
      • Spinal (p. 25);
      • Neck (p. 26);
      • Chest (26);
      • Abdominal (p. 26);
      • Femur / hip / pelvic fractire (p. 27);
      • HoTn of unknown origin (p. 41);

Note: These are components of “BEST CVA”, a Berdancronym for the general indications for fluid resuscitation with sodium chloride 0.9%.

BEST CVA

B - Burns

E - ExDs

S - Shock

T - Trauma

C - Childbirth

V - Vaginal bleeding

A - Asthma / COPD

Pierce Co. EMS Procedures and PCPs, p. Administrative Policy, p. 4, General Principles / Routine Care, p. 19, Traumatic Emergencies, p. 24-28, Respiratory Emergencies, p. 36, Medical Emergencies, p. 41, Environmental Emergencies, p. 44, Behavioral Emergencies, p. 48, OB / GYN Emergencies, p. 51, 53, Appendix DD, Medication / IV Guide, p. O-42, April 2020

110
Q

Berdancronym for the principle pre-hospital treatments for CHF.

A

CA DANK

C - CPAP (moderate / severe distress)

A - Albuterol (wheezing [e.g., cardiac asthma])

D - Dopamine (BP < 90/S)

A - Aspirin (ACS)

N - Nitroglycerin (mild / moderate / severe distress with BP > 100/S)

K - Ketamine (CPAP anxiolysis; PCPs only mention diazepam and midazolam);

Berdancronym

111
Q

CBD FOAM

A

CBD FOAM

C - Calcium chloride (or carbonate) 10% (hyperkalemia);

B - Sodium bicarbonate 8.4% (hyperkalemia);

D - Dextrose (hypoglycemia);

F - Fentanyl (analgesia [consider substitutes]);

O - Oxygen (INH via NRB 10-15 LPM);

A - Albuterol (hyperkalemia);

M - Midazolam (anxiolysis [only variant specifically mentioned in the Traumatic Emergencies section {IO/IV route uniquely suggested}]);

Pierce County EMS Procedures and PCPs, Traumatic Emergencies, p. 30, Medication / IV Guide, p. O-16, June 2019​​​

112
Q

Mystery VAN

A

Mystery VAN

Scooby and Shaggy roast bowls in the Mystery Van

Mystery - Hypotension of unknown etiology;

V - Vasogenic shock;

A - Anaphylactic shock;

N - Neurogenic shock;

113
Q

A Berdancronym for the blood pressure-related indications for the use of dopamine.

A

UV SCAN

U - Unknown-origin hypotension;

V - Vasogenic Shock;

S - Septic Shock;

C - Cardiogenic Shock;

A - Anaphylactic Shock;

N - Neurogenic Shock;

Pierce Co. EMS Procedures and PCPs, June 2019, Medical Emergencies, p. 41, O-21

114
Q

Decipher the EMS acronym:

HEAVEN

The HEAVEN criteria were found valid to predict difficult airways during

https://www.clinicaltrials.gov/ct2/show/NCT04764799

A

HEAVEN

H - Hypoxemia;

E - Extremes of size;

A - Anotomic challenge;

V - Vomit / Blood / Fluid;

E - Exanguination / Anemia;

N - Neck mobility;

115
Q
  1. What does the acronym PICA stand for with respect to the establishment of an emergency airway?
A

PICA

P - Peri-;

I - Intubation;

C - Cardiac;

A - Arrest;

https://publications.aap.org/aapgrandrounds/article-abstract/44/5/59/88174/Peri-intubation-Cardiac-Arrest-in-the-Cardiac-ICU?redirectedFrom=fulltext

Mnemonics (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions