Adult Flashcards
1
Q
ACS Suspected
A
- Nitro .4mg SL, may repeat q 5 min, BP>120
- BP<90, Fluid Bolus 20 ml/kg, may repeat at 40 ml/kg
- Morphine 10 mg OR Fentanyl 100 mcg for chest pain
2
Q
ALS Adult Care
A
UNSTABLE PT.
- HR<50 or >110
- BP <90 or >180
- RR <8 or >29
- Persistent chest pain
- Persistent respiratory distress
- Post Cardiac Arrest and Respiratory Arrest
- Multi system or p[enetrating trauma
- Assist Airway and Breathing
- C-Spine as needed
- Pt. Assessment
- O2
- IV
- Monitor
- BGL
3
Q
ACS Syndrome
A
- BLS
- Aspirin 324 mg PO
- Monitor, 12-lead
- IV
4
Q
Adult Advanced Airway
A
- BLS airway
- BLS foreign body techniques
- SpO2, Waveform Cap., Monitor
- ETT or Supreglottic
- Magill Forceps to remove foreign body
- Needle Cric if unrelieved
- MFI or RSI
- Vent
5
Q
Adult Behavioral emergency/ agitation
A
- ABC’s, Vitals
- Additional Assistance
- Humane restraints, check distal pulses
- BGL
- Midazolam 5 mg IV or 10 mg IM/IN
OR - Ketamine 2 mg/kg IV up to 4 mg/kg IM
OR - Haloperidol 5 mg IM
- Diphenhydramine 25 mg IM/IV for dystonic reactions
6
Q
Medication Facilitated Intubation
A
- Position Patient
- SpO2
- Prepare equipment
- Pre-Oxygenate
- IV
- Etomidate .3 mg/kg over 30-60 seconds IV
- Intubate and check
- If failed, Supraglottic
- If unable to ventilate, Needle Cric
- EtCO2 Monitor
- Midazolam 5 mg IV
OR - Ketamine 2 mg/kg IV
- Vent
7
Q
Altered Mental Status
A
- ABC’s, Vitals
- Airway
- SpO2, ETCO2
- IV
- BGL
- Monitor
8
Q
Anaphylactic Shock/ Allergic Reaction
A
- Epi .3 mg (1:1,000) IM
- Diphenhydramine 50 mg IM/IV
- Methylprednisolone 125 mg IM/IV
- if wheezing, Combivent x 2
- IV
- Monitor
- BP<90, Fluid Bolus 20ml/kg, may repeat 40ml/kg
MEDICAL CONTROL - Dopamine
- Epi Infusion 1:10,000
- ETT
- MFI/RSI
9
Q
Asthma
A
- Combivent
- IV
- Methylprednisolone 125 mg IV
- Monitor
- If respiratory failure or distress, Epi .3 mg (1:1,000) IM
- Mag Sulfate Infusion 2g in 100 ml over 10 minutes
MEDICAL CONTROL - Albuterol
- CPAP
- ETT
- MFI/RSI
10
Q
Asystole/ PEA
A
- BLS
- Airway
- Monitor
- IV, 20 ml/kg, repeated at 40 ml/kg
- Epi 1 mg (1:10,000) q 3-5 min
- H’s and T’s
- If Renal Failure, TCA OD, Hyperkalemia, Sodium Bicarb 1 mEq/kg IV
- If Tension Pneumo, Needle D
11
Q
A-Fib/ A-Flutter
A
UNSTABLE - HR>150, BP<90, Unresponsive - Cardiovert 100, 200, 300, 360, MED CONTROL UNSTABLE - W/o decompensation - Diltiazem .25mg/kg MAX 20mg IV over 2 minutes MED CONTROL - Amiodarone - Diazepam - Midazolam - Fentanyl - Morphine - Metoprolol - ETT - MFI/RSI
12
Q
Burns
A
- O2
- PPV, if needed
- ETT, if needed
- IV, 20 ml/kg
- Monitor
- BP>90, no AMS
- Morphine 10 mg IV
OR - Fentanyl 100 mcg IV/IM
OR - Midazolam 5 mg IV or 10 mg IM/IN
- Zofran 4 mg IV/IM
MED CONTROL - Ketamine
- MFI/RSI
13
Q
COPD
A
- Combivent x 2
- CPAP
- IV
- Monitor
- 12-lead
- Methylprednisolone 125 mg IV
MED CONTROL - Mag Sulfate
- ETT
- Epi 1:1,000
- MFI/RSI
14
Q
Cardiac Disrhythmia Entry
A
- O2
- Monitor, 12-lead
- SpO2
- IV
15
Q
Chest Trauma
A
- BLS
- For decompensated shock/Cardiac Arrest, Needle D
- IV, 60ml/kg titrated to BP>90
MED CONTROL - Hypovolemia/Hypotnesion
- ETT
- MFI/RSI
16
Q
Crush
A
- Monitor, 12-lead
- IV, 20ml/kg
- 1 extremity for 2 hours, 2 extremities for 1 hour with s/s of hyperkalemia, Sodium Bicarb 50 mEq IV slow push over 5 min every 30 minutes
MED CONTROL - Calcium Chloride
- Midazolam
- Fentanyl
- Albuterol
- Morphine
- Diazepam
17
Q
Hypoglycemia
A
- BGL<60
- Dextrose 50% 25g IVP or 10% 250cc IV Bolus
- 2nd dose of Dextrose if symptomatic after 5 min
- Resolved, Monitor/Transport/34 MED CONTROL
18
Q
Head Trauma
A
- Vitals, LOC
- GCS, Pupils
- If inadequate ventilations, BVM
- Consider ETT
- If unable to intubate RSI
19
Q
Hypoperfusion/Hypovolemia
A
- COMPENSATED SHOCK
- IV, 20 ml/kg
- DECOMPENSATED SHOCK
- IV 60 ml/kg
MED CONTROL - Dopamine Drip
- Norepi Drip
20
Q
Medical Shock/ Hypoperfusion
A
- Monitor
- IV, 20 ml/kg
- Norepi 5 mcg/min, max 20 mcg/min if BP<90
MED CONTROL - Epi Infusion
- ETT
- MFI/RSI
21
Q
OB/GYN
A
- ABC’s/ Vitals
- Monitor
- IV
- Left Lateral Recumbent
PRETERM LABOR (24-37 wks) - IV 20 ml/kg
S/S PREECLAMPSIA - Mag Sulfate 4g IV over 2 min
- If pt. activelly seizing, Midazolam 5 mg IV or 10 mg IM
MED CONTROL - Metoprolol
22
Q
Organophosphate/ Nerve Agent
A
- Decon
MED CONTROL - SLUDGEM
- Mark 1 Kit or 1 DuoDote Kit, reasses q 5 min, MAX 3 kits
- SLUDGEM+ dyspnea, Incontinence, Seizure, Paralysis
- 3 x Mark 1 kit or 3 x DuoDote kit
- IV 250ml Bolus
- Repeat Atropine until secretions dry to max ind. dose of 20 mg
- Diazepam 10 mg IV
- Midazolam 1-2mg IV or 5 mg IM/IN
23
Q
Overdose
A
OPIATE
- unconscious/unresponsive
- Narcan .4mg IV MAX 6 mg or 2mg IM/IN MAX 4mg
BETA BLOCKER
- MED CONTROL
SYMPATHOMIMETIC - Midazolam 5mg IV or 10mg IM/IN OR - Ketamine 2 mg/kg IV or 4 mg/kg IM - 12 lead
MED CONTROL
- Glucagon
- Sodium Bicarb
- Diazepam
- AMS Protocol
- Symptomatic Brady Protocol
- ETT
24
Q
Pain Management
A
- Airway
- Monitor
- SpO2
- IV
- Morphine 10 mg IV
OR - Fentanyl 100 mcg IV
- Zofran 4 mg IV/IM
MED CONTROL - Keterolac
- Ketamine
25
Q
Pulmonary Edema BP>120
A
- Vitals
- Nitro .4mg
- CPAP, Waveform
- IV
- CHF Suspected, Nitro .4mg q 5 min, MAX 3 NTG BP>120 prior to each administration
- Monitor, 12-lead
- Morphine 10 mg IV
MED CONTROL - Nitro
- Furosemide
- Fentanyl
- Albuterol
- MFI/RSI
- ETT
26
Q
Seizure
A
- Diazepam 10 mg IV OR - Midazolam 5 mg IV or 10 mg IM/IN MED CONTROL - AMS Protocol - ETT - MFI/RSI
27
Q
Shock/ Hypoperfusion after ROSC
A
- O2
- Monitor, 12-lead
- IV, 20 ml/kg, may be repeated to 40 ml/kg
- 2nd Iv if needed
- Norepi 5 mcg/min up to 20 mcg/min
MED CONTROL - Sodium Bicarb
- ETT
- Calcium Chloride
- Glucagon
- Epi infusion
- MFI/RSI
28
Q
Stroke/CVA
A
- Time of onset
- Facial Droop
- Arm Drift
- Speech
- Time last seen well
MED CONTROL - Destination Decision
- AMS Protocol
- ETT
- MFI/RSI
29
Q
SVT
A
- Adenosine 6mg, 12mg UNSTABLE/DECOMPENSATED/UNRESPONSIVE - Cardiovert 100,200,300,360, MED CONTROL UNSTABLE/DECOMPENSATED/AWAKE - Diazepam 10 mg IV OR - Midazolam 5 mg IV or 10 mg IM/IN OR - Fentanyl 100 mcg IV/IM/IN - Cardiovert 50J, may repeat 100J, if after 4 attempts no result, MED CONTROL MED CONTROL - Amiodarone - Morphine - Diltiazem - Zofran - ETT - MFI/RSI
30
Q
Cyanide/ Smoke Inhalation
A
- Decon
- IV
- Monitor
- SpO2
- If in cardiac arrest or hypotensive
- 2nd IV
Hydroxocobalamin 5g/200ml NS over 15 min (15ml/min)
31
Q
Syptomatic Bradycardia
A
UNSTABLE, chets pain, 1st degree HB, 2nd degree Type 1 - Atropine .5 mg - Repeat Atropine .5 mg UNSTABLE, 2nd degree type 2, Junctional, 3rd degree - Diazepam 10 mg OR - Midazolam 5 mg IV/IM or 10 mg IM/IN OR - Fentanyl 100 mcg IV/IM/IN - Transcutaneous Pacing
32
Q
V-Fib/ V-Tach
A
- BLS
- Airway
- Monitor
- D-fib 360
- IV
- D-fib 360
- Epi 1 mg (1:10,000) q 3-5 min
- D-fib 360
- If suspected renal failure, TCA OD, Hyperkalemia
- Sodium Bicarb 1 mEq/kg IV
- If Torsades suspected
- Mag Sulfate 2g IV
- Amiodarone 300 mg IV, may repeat 150 mg in 3-5 min
33
Q
V-Tach w/ Pulse
A
UNSTABLE/UNRESPONSIVE - Cardiovert 100,200,300,360, MED CONTROL STABLE - QRS wide, polymorphic - Mag Sulfate 1 g in 100 ml NS over 10 min - Amiodarone 150 mg in 100 ml over 10 min UNSTABLE/AWAKE - Diazepam 10 mg IV OR - Midazolam 5 mg IV or 10 mg IM/IN OR - Fentanyl 100 mcg IV/IM/IN Cardiovert 100,200,300,360, MED CONTROL MED CONTROL - Mag Sulfate - ETT - MFI/RSI - Adenosine - Zofran