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EMS Protocols 2015 > Adult Cardiac Protocols > Flashcards

Adult Cardiac Protocols Flashcards

1
Q

According to the Chest Pain protocol what 6 serious causes should you consider?

A
  1. Acute pericarditis/ myocarditis
  2. Aortic dissection
  3. Pulmonary embolism
  4. Esophageal rupture
  5. Angina/ MI
  6. Spontaneous pneumothorax
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2
Q

According to the Chest Pain protocol what should you obtain on the chest pain pt?

A

IV access
O2 to keep sats >94% (COPD>92%)
Cardiac Monitoring
12 Lead EKG

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3
Q

According to the Chest Pain protocol how many IV access should you get if the Chest Pain pt is a STEMI?

A

2 large bore

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4
Q

According to the Chest Pain protocol what are angina equivalents you should be aware of?

A 
Nausea
Indigestion
Back pain
Diaphoresis
Dyspnea
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5
Q

According to the Chest Pain protocol if your 12 lead reveals a STEMI what should you do immediately?

A

Notify accepting cardiac facility to activate the cath lab

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6
Q

According to the Chest Pain protocol if your 12 lead reveals ST elevation or depression what should you obtain next?

A

15 Lead

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7
Q

According to the Chest Pain protocol what is your first treatment option for a pt experiencing Chest Pain?

A

Aspirin

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8
Q

According to the Chest Pain protocol by what route is Aspirin given?

A

PO

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9
Q

According to the Chest Pain protocol what is the PO adult dose of Aspirin?

A

324/325mg

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10
Q

According to the Chest Pain protocol for what reason should Aspirin be withheld from the Chest Pain pt?

A

History of GI bleed in the past 24 hours

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11
Q

According to the Chest Pain protocol if a right ventricular infarct is suspected on 15 lead what should be withheld from the Chest Pain pt?

A

Nitroglycerin

Morphine

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12
Q

According to the Chest Pain protocol instead of administering Nitroglycerin and/or Morphine in the Chest pain pt with a suspected right ventricular artifact what should instead be administered?

A

NS fluid bolus to maintain SBP>100

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13
Q

According to the Chest Pain protocol after Aspirin what is your next treatment option for suspected Cardiac Chest Pain?

A

Nitroglycerin or Nitrospray

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14
Q

According to the Chest Pain protocol by what route is Nitroglycerin or Nitrospray given?

A

Sublingual

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15
Q

According to the Chest Pain protocol what is the sublingual adult dose of Nitroglycerin or Nitrospray?

A

0.4mg

May repeat every 5 minutes if improving

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16
Q

According to the Chest Pain protocol what are the conditions for giving Nitroglycerin?

A

SBP >100

Not suspected right ventricular infarct

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17
Q

According to the Chest Pain protocol what is the condition for giving Nitroglycerin prior to IV access and/or 12 lead?

A

1 dose

SBP>110

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18
Q

According to the Chest Pain protocol after Nitroglycerin what are the treatment options for residual Chest Pain?

A

Morphine Sulfate
Hydromorphone
Fentanyl

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19
Q

According to the Chest Pain protocol by what routes can Morphine Sulfate be given for residual Chest Pain?

A

IV

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20
Q

According to the Chest Pain protocol what is the IV adult dose of Morphine Sulfate given for residual Chest Pain

A

2-4mg
May repeat every 5 minutes as needed for pain
Max 3 doses

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21
Q

According to the Chest Pain protocol what is the adult dose of Hydromorphone given for residual Chest Pain?

A

1mg

Every 5 minutes as needed for pain

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22
Q

According to the Chest Pain protocol what is the adult dose of Fentanyl given for residual Chest Pain?

A

50-100mcg

Every 5 minutes as needed for pain

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23
Q

According to the Chest Pain protocol what medication used in pain management should be avoided in the Chest Pain pt?

A

Ketamine

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24
Q

According to the Chest Pain protocol for blood pressure not responding to fluid bolus what treatment option should be considered?

A

Epinephrine Push Dose Presser

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25
Q

According to the Chest Pain protocol by what route is the Epinephrine Push Dose Presser given?

A

IV

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26
Q

According to the Chest Pain protocol what is the IV adult dose of the Epinephrine Push Dose Presser?

A

0.5-2ml every 2-5 minutes for SBP<90

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27
Q

According to the Chest Pain protocol if the Chest Pain is caused by Cocaine ingestion what treatment option should be considered?

A

Versed

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28
Q

According to the Chest Pain protocol by what route is Versed given in the Chest Pain pt caused by Cocaine ingestion?

A

IV/IO
IN
IM

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29
Q

According to the Chest Pain protocol what is the IV/IO adult dose of Versed given in the Chest Pain pt caused by Cocaine ingestion?

A

1-2.5mg
May repeat every 2-3 minutes
Max 3 doses

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30
Q

According to the Chest Pain protocol what is the IN adult dose of Versed given in the Chest Pain pt caused by Cocaine ingestion?

A

1-2.5mg
May repeat every 2-3 minutes
Max 3 doses

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31
Q

According to the Chest Pain protocol what is the IM adult dose of Versed given in the Chest Pain pt caused by Cocaine ingestion?

A

2.5mg
May repeat every 10-15 minutes
Max 2 doses

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32
Q

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol what should be obtained?

A 
IV access
12 Lead EKG
Capnography
Cardiac Monitoring
If STEMI notify accepting cardiac facility
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33
Q

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol how should the pt be placed?

A

In seated position

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34
Q

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol what treatment should be considered early?

A

CPAP

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35
Q

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol what treatment options should be considered?

A

Aspirin
Nitroglycerin or Nitrospray
Lasix

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36
Q

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol what is the goal blood pressure to reach by administering Nitroglycerin or Nitrospray?

A

SBP<140mmHg

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37
Q

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol what are the conditions for giving Lasix?

A

SBP<140

SBP>100

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38
Q

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol by what routes can Lasix be given?

A

IV

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39
Q

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol what is the IV adult dose of Lasix?

A

40-80mg

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40
Q

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol if SBP<90 what treatment option should first be considered?

A

NS Fluid bolus

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41
Q

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol what is the adult dose for a NS Fluid Bolus given for SBP<90?

A

250-500 mg

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42
Q

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol after treatment with a NS Fluid Bolus what is the next treatment option for SBP still <90?

A

Epinephrine Push Dose Presser

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43
Q

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol in Acute CHF pts what treatment has studies shown may lead to higher rates of intubation?

A

Neb treatments

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44
Q

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol can Neb treatments be used in the Acute CHF pt?

A

Yes but with caution

May lead to higher rate of intubation

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45
Q

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol in what pts should a Neb treatment be considered?

A

Pt with wheezing and a history of asthma or COPD

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46
Q

According to the Cardiogenic Shock protocol what should be obtained?

A 
IV
12 Lead EKG
Capnography
Cardiac Monitoring
If STEMI notify accepting cardiac facility
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47
Q

According to the Cardiogenic Shock protocol what 3 causes should be considered in the Cardiogenic Shock pt?

A
  1. Volume problem
  2. Rate problem
  3. Pump problem
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48
Q

According to the Cardiogenic Shock protocol if the problem is believed to be volume related what treatment should be considered first?

A

NS fluid bolus to maintain SBP>100

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49
Q

According to the Cardiogenic Shock protocol if the problem is believed to be rate what treatment should be considered first?

A

Tachycardia protocol
or
Bradycardia protocol

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50
Q

According to the Cardiogenic Shock protocol if the problem is believed to be with the pump what treatment option should be considered?

A

Epinephrine Push Dose Presser

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51
Q

According to the Atrial Fibrillation/ Atrial Flutter with Rapid Ventricular Response protocol what should be obtained?

A 
IV access
12 Lead EKG
Consider capnography
Cardiac monitoring
If STEMI notify accepting cardiac facility
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52
Q

According to the Atrial Fibrillation/ Atrial Flutter with Rapid Ventricular Response protocol if pt is unstable what is the first treatment option?

A

Cardioversion

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53
Q

According to the Atrial Fibrillation/ Atrial Flutter with Rapid Ventricular Response protocol if the pt is stable what should be verified?

A

Narrow Complex
Irregular Rhythm
Rate >110

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54
Q

According to the Atrial Fibrillation/ Atrial Flutter with Rapid Ventricular Response protocol if the pt is stable and the EKG reveals a Narrow Complex Irregular Rhythm with Rate >110 what is the treatment option?

A

Cardizem

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55
Q

According to the Atrial Fibrillation/ Atrial Flutter with Rapid Ventricular Response protocol by what route is Cardizem given for the stable pt with an EKG revealing a Narrow Complex Irregular Rhythm with a Rate >110?

A

IV

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56
Q

According to the Atrial Fibrillation/ Atrial Flutter with Rapid Ventricular Response protocol what is the IV adult dose for Cadizem given for the stable pt with an EKG revealing a Narrow Complex Irregular Rhythm with a Rate >110?

A

10-20mg
SLOW
May repeat dose if rate >110 after 5 minutes

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57
Q

According to the Adult Bradycardia protocol what is the definition of Adult Bradycardia?

A

HR <50

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58
Q

According to the Adult Bradycardia protocol what should be considered prior to any treatment?

A

Treatable Causes

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59
Q

According to the Adult Bradycardia protocol what should your first course of action be?

A 
Support ABC's
Give Oxygen
Attach monitor/defibrillator
Consider Capnography
Obtain 12 lead
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60
Q

According to the Adult Bradycardia protocol what question should you ask yourself about the pts Bradycardia prior to any further treatments?

A

Is the Bradycardia causing Cardiorespiratory Compromise?

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61
Q

According to the Adult Bradycardia protocol what is meant by Cardiorespiratory Compromise?

A 
Hypotension
AMS
Shock
Ischemia
CHF
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62
Q

According to the Adult Bradycardia protocol if the Bradycardia is NOT causing Cardiorespiratory Compromise what is the course of action?

A

Continue to support ABC’s
Given Oxygen as needed
Observe cardiac activity
Transport

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63
Q

According to the Adult Bradycardia protocol if the Bradycardia IS causing Cardiorespiratory Compromise what is the first treatment option?

A

Atropine

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64
Q

According to the Adult Bradycardia protocol what by what route is Atropine given for the Bradycardia pt with Cardiorespiratory Compromise?

A

IV/IO/ET

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65
Q

According to the Adult Bradycardia protocol what is the IV/IO/ET adult dose of Atropine given for the Bradycardia pt with Cardiorespiratory Compromise?

A

0.5-1mg
May repeat every 3-5 minutes
Max 3mg

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66
Q

According to the Adult Bradycardia protocol what should be considered concerning the EKG and the use of Atropine?

A

Some blocks may be resistant to Atropine especially if Wide Complex

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67
Q

According to the Adult Bradycardia protocol if the Bradycardia appears to be resistant to Atropine and the pt continues to experience Cardiorespiratory Compromise what should the next treatment be?

A

Transcutaneous Pacing

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68
Q

According to the Adult Bradycardia protocol what treatment options should be considered if after treatment pt blood pressure remains <90?

A

Epinephrine Push Dose Presser

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69
Q

According to the Adult Bradycardia protocol if the pt improves what should the next course of action be?

A

Continue to support and transport

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70
Q

According to the Adult Bradycardia protocol if the pt develops pulseless cardiac arrest what should the next course of action be?

A

Adult Cardiac Arrest Protocol

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71
Q

According to the Adult Tachycardia protocol what is the definition of Adult Tachycardia?

A

HR >150

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72
Q

According to the Adult Tachycardia protocol prior to treatment what should you consider?

A

Treatable Causes

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73
Q

According to the Adult Tachycardia protocol what should your first course of action be?

A 
Support ABC's
Give oxygen
Attach monitor/defibrillator
Consider capnography
Obtain 12 Lead EKG
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74
Q

According to the Adult Tachycardia protocol what should you ask yourself about the Tachycardia?

A

Is tachycardia causing Cardiorespiratory Compromise?

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75
Q

According to the Adult Tachycardia protocol what is meant by Cardiorespiratory Compromise?

A

Hypotension
AMS
Ischemia with sever chest pain
SOB

76
Q

According to the Adult Tachycardia protocol if the Tachycardia IS causing Cardiorespiratory Compromise what should your next course of action be?

A

Synchronized Cardioversion

77
Q

According to the Adult Tachycardia protocol if you are going to Synch Cardiovert the pt due to Cardiorespiratory Compromise what should you first consider as a treatment?

A

Sedation

78
Q

According to the Adult Tachycardia protocol what is your treatment option to sedate a pt you are about to Synch Cardiovert due to Cardiorespiratory Compromise?

A

Etomidate

79
Q

According to the Adult Tachycardia protocol by what route is Etomidate given to sedate a pt who is about to be Sync Cardioverted due to Cardiorespiratory Compromise?

A

IV/IO

80
Q

According to the Adult Tachycardia protocol what is the IV/IO adult dose for Etomidate given to sedate a pt who is about to be Synch Cardioverted due to Cardiorespiratory Compromise?

A

0.1mg/kg

81
Q

According to the Adult Tachycardia protocol what should you assess about the pt EKG when choosing your dosage for Synchronize Cardioversion?

A

QRS duration

82
Q

According to the Adult Tachycardia protocol what is the adult dose for Synchronized Cardioversion when the QRS is found to be Narrow and Regular?

A

50-100J

83
Q

According to the Adult Tachycardia protocol what is the adult dose for Synchronized Cardioversion when the QRS is found to be Narrow and Irregular?

A

120-200J Biphasic

84
Q

According to the Adult Tachycardia protocol what is the adult dose for Synchronized Cardioversion when the QRS is found to be Wide Regular?

A

100J

85
Q

According to the Adult Tachycardia protocol what is the adult dose for Synchronized Cardioversion when the QRS is found to be Wide Irregular?

A

Defibrillate (Not Synchronized)

86
Q

According to the Adult Tachycardia protocol if the tachycardia is NOT causing Cardiorespiratory Compromise what should you next assess?

A

The QRS duration

87
Q

According to the Adult Tachycardia protocol what is considered a Wide QRS?

A

> = 0.12 seconds

88
Q

According to the Adult Tachycardia protocol if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Wide what is your first treatment option?

A

Amiodarone

89
Q

According to the Adult Tachycardia protocol by what route is Amiodarone given if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Wide?

A

IV/IO

90
Q

According to the Adult Tachycardia protocol what is the IV/IO adult dose of Amiodarone if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Wide

A

150mg
Over 10 minutes
May mix in 100ml NS over 10 minutes

91
Q

According to the Adult Tachycardia protocol if the pt converts with Amiodarone what is your next course of action?

A

Observe and Transport

Contact ER to notify to have Amiodarone drip prepared

92
Q

According to the Adult Tachycardia protocol if the pt returns to initial tachycardic rhythm after having converted with first dose of Amiodarone what is your next course of action?

A

May repeat Amiodarone dose

93
Q

According to the Adult Tachycardia protocol if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Wide and it is resistant to Amiodarone what is your next treatment option?

A

Adenosine

94
Q

According to the Adult Tachycardia protocol by what route is Adenosine given if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Wide and it is resistant to Amiodarone?

A

IV

95
Q

According to the Adult Tachycardia protocol what is the IV adult dose of Adenosine if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Wide and it is resistant to Amiodarone?

A

6mg with 20cc NS bolus
RAPID
May repeat with 12 mg with 20cc NS bolus
RAPID

96
Q

According to the Adult Tachycardia protocol if the rhythm converts with Adenosine what is your next course of action?

A

Observe and Transport

97
Q

According to the Adult Tachycardia protocol if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Narrow what is your first course of action?

A

Consider Vagal Maneuvers

98
Q

According to the Adult Tachycardia protocol if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Narrow after Vagal Maneuvers what is your next treatment option?

A

Adenosine

99
Q

According to the Adult Tachycardia protocol by what route is Adenosine given if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Narrow?

A

IV

100
Q

According to the Adult Tachycardia protocol by what is the IV adult dose of Adenosine given if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Narrow?

A

6mg with 20cc NS bolus
RAPID
May repeat with 12 mg with 20cc NS bolus
RAPID

101
Q

According to the Adult Tachycardia protocol if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Narrow but resistant and at any time appears irregular what is your treatment option?

A

Cardizem

102
Q

According to the Adult Tachycardia protocol by what route is Cardizem given if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Narrow but resistant and appears at any time irregular?

A

IV

103
Q

According to the Adult Tachycardia protocol what is the IV adult dose of Cardizem if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Narrow but resistant and at any time appears irregular?

A

10-20mg

SLOW

104
Q

According to the Adult Tachycardia protocol if the pt develops pulseless arrest what is your next course of action?

A

Adult Cardiac Arrest Protocol

105
Q

According to the Adult Cardiac Arrest protocol what is your first course of action when presented to an adult pt in cardiac arrest?

A

Perform CPR for 2 minutes

106
Q

According to the Adult Cardiac Arrest protocol what are the expectation concerning compression when performing CPR

A

Rate = 100-120 compressions/minute
Hard and Fast
Allow for full recoil

107
Q

According to the Adult Cardiac Arrest protocol other than compressions what other things should occur during the first 600 compressions?

A

Ventilate via BVM with oxygen
Attach monitor/defibrillator
Establish IV/IO

108
Q

According to the Adult Cardiac Arrest protocol when should an advanced airway be established?

A

After 600 compressions

109
Q

According to the Adult Cardiac Arrest protocol is there a benefit to IV fluids during cardiac arrest?

A

There are no trials showing a clear benefit of IV fluids during cardiac arrest unless hypovolemia is suspected

110
Q

According to the Adult Cardiac Arrest protocol if hypovolemia is suspect during Cardiac Arrest what is the treatment option during CPR?

A

1-2L NS

111
Q

According to the Adult Cardiac Arrest protocol what should you consider during CPR concerning why the pt is in Cardiac Arrest?

A

Treatable Causes

112
Q

According to the Adult Cardiac Arrest protocol if it is an unwitnessed arrest, prolonged downtime, dialysis pt, or persistent PEA what treatment option should you first consider during your CPR?

A

Sodium Bicarbonate

113
Q

According to the Adult Cardiac Arrest protocol by what routes is Sodium Bicarbonate given during CPR?

A

IV/IO

114
Q

According to the Adult Cardiac Arrest protocol what is the IV/IO adult dose of Sodium Bicarbonate given during CPR?

A

1meq/kg

115
Q

According to the Adult Cardiac Arrest protocol during CPR what should you ask yourself concerning the pts rhythm when assessing the EKG?

A

Is the rhythm Shockable?

116
Q

According to the Adult Cardiac Arrest protocol what are considered Shockable Rhythms?

A

Ventricular Fibrillation

Pulseless Ventricular Tachycardia

117
Q

According to the Adult Cardiac Arrest protocol if the pt IS in what is considered a Shockable rhythm what is your first course of action after your 2 minutes of CPR?

A

Give 1 Shock

118
Q

According to the Adult Cardiac Arrest protocol what is the adult dose of defibrillation for a pt with a shockable rhythm?

A

200-360J Biphasic or AED

119
Q

According to the Adult Cardiac Arrest protocol when choosing your dosage for defibrillation what should you consider?

A

The highest defibrillation amount available

120
Q

According to the Adult Cardiac Arrest protocol immediately following your first shock during CPR what should you do?

A

Resume CPR

121
Q

According to the Adult Cardiac Arrest protocol when resuming CPR throughout the course of a cardiac arrest how long should it be performed?

A

5 cycles/ 2 minutes

122
Q

According to the Adult Cardiac Arrest protocol after each 5 cycles/ 2 minutes of CPR what should occur?

A

Rhythm Check

123
Q

According to the Adult Cardiac Arrest protocol during each rhythm check what are you asking yourself concerning the rhythm?

A

Is the Rhythm Shockable or NOT shockable

124
Q

According to the Adult Cardiac Arrest protocol what are your treatment options during your 3rd round (minutes 4-6) of CPR?

A

Epinephrine 1:10,000

Vasopressin

125
Q

According to the Adult Cardiac Arrest protocol by what routes can Epinephrine 1:10,000 be given?

A

IV/IO

ET

126
Q

According to the Adult Cardiac Arrest protocol what is the IV/IO adult dose of Epinephrine 1:10,000?

A

1mg

Repeat every 3-5 minutes

127
Q

According to the Adult Cardiac Arrest protocol what is the ET adult dose of Epinephrine 1:10,000?

A

2x IV/IO dose

Repeat every 3-5 minutes

128
Q

According to the Adult Cardiac Arrest protocol by what routes can Vasopressin be given?

A

IV/IO/ET

129
Q

According to the Adult Cardiac Arrest protocol what is the IV/IO/ET adult dose of Vasopressin?

A

40 Unites

Can replace 1st or 2nd dose of Epinephrine 1:10,000 the continue with Epinephrine after 5 minutes

130
Q

According to the Adult Cardiac Arrest protocol if you replace your first or 2nd dose of Epinephrine 1:10,000 with Vasopressin with what medication will you follow it with and after how long?

A

Epinephrine 1:10,000

After 5 minutes

131
Q

According to the Adult Cardiac Arrest protocol other than Defibrillation and Epinephrine 1:10,000/ Vasopressin what other treatment options should you consider for the pt in a shockable rhythm?

A

Amiodarone

132
Q

According to the Adult Cardiac Arrest protocol by what routes can Amiodarone be given for the shockable rhythm?

A

IV/IO

133
Q

According to the Adult Cardiac Arrest protocol what is the IV/IO adult dose of Amiodarone for the shockable rhythm?

A

300mg

May repeat with 150mg ONCE

134
Q

According to the Adult Cardiac Arrest protocol if the pt is in a shockable rhythm and the rhythm is interpreted as Torsades de Pointes what is the treatment option?

A

Magnesium

135
Q

According to the Adult Cardiac Arrest protocol by what routes can Magnesium be given for the pt in a shockable rhythm interpreted as Torsades de Pointes?

A

IV/IO

136
Q

According to the Adult Cardiac Arrest protocol what is the IV/IO adult dose of Magnesium given for the pt in a shockable rhythm interpreted as Torsades de Pointes?

A

2 grams

137
Q

According to the Adult Cardiac Arrest protocol if the pt is in a shockable rhythm but hypothermic how does this affect your treatment options?

A

Withhold Amiodarone until pt is warmed above 92 degrees F

138
Q

According to the Adult Cardiac Arrest protocol if the pt converts with Amiodarone what is your next course of action?

A

Observe and Transport

Contact ER and notify to have Amiodarone drip prepared

139
Q

According to the Adult Cardiac Arrest protocol if the pt has a Return of Spontaneous Circulation (ROSC) what is your course of action?

A

Continue supportive care

Refer to Hypothermic Protocol after ROSC

140
Q

According to the Adult Cardiac Arrest protocol what is your treatment option for a pt with ROSC but BP <90?

A

Epinephrine Push Dose Presser

141
Q

According to the Adult Cardiac Arrest protocol what Unshockable Rhythms?

A

Asystole

PEA

142
Q

According to the Adult Cardiac Arrest protocol when does a rhythm check take place?

A

After 5 cycles/2 minutes of CPR

143
Q

According to the Adult Cardiac Arrest protocol what is the cycle of treatments for a Shockable Rhythm?

A

Epinephrine/Vasopressin, Amiodarone, Shock, CPR

144
Q

According to the Adult Cardiac Arrest protocol what is the cycle of treatments for an Unshockable Rhythm?

A

Epinephrine/Vasopressin, CPR

145
Q

According to the Adult Cardiac Arrest protocol what are the capnography goals?

A

35-45mmHg ideally

146
Q

According to the Adult Cardiac Arrest protocol what does a capnography <10mmHg indicate?

A

Inadequate CPR/Ventilation

Poor Outcome

147
Q

According to the ROC Research Guidelines what is the pt age requirement?

A

18 years and older

148
Q

According to the ROC Research Guidelines what kind of cardiac arrest qualifies?

A

Non-traumatic

149
Q

According to the ROC Research Guidelines when may an automatic CPR device be used?

A

After 10 minutes of manual CPR

150
Q

According to the ROC Research Guidelines when should pads be placed on the pt?

A

Within the first minue

151
Q

According to the ROC Research Guidelines what lead should the monitor be in?

A

Paddle mode

152
Q

According to the ROC Research Guidelines when should the first dose of Epinephrine/ Vasopressin be given?

A

Within 10 minutes

153
Q

According to the ROC Research Guidelines when can an advanced airway (King airway/ ET tube) be established?

A

After 600 compressions (6 minutes of CPR)

154
Q

According to the ROC Research Guidelines what should you avoid during advanced airway placement?

A

Stopping CPR

155
Q

According to the ROC Research Guidelines what should occur every 2 minutes?

A

Switch compression provider

156
Q

According to the ROC Research Guidelines what should not happen for the first 10 minutes?

A

Moving the pt

157
Q

According to the ROC Research Guidelines what rate should compressions be performed at?

A

100-120 compressions per minute (use metronome)

158
Q

According to the ROC Research Guidelines at what rate should ventilation be performed?

A

8-10 respirations per minute

159
Q

According to the ROC Research Guidelines how should compressions be given?

A

Continuously

160
Q

According to the ROC Research Guidelines at what % of pt contact should compressions occur?

A

75%

161
Q

According to the ROC Research Guidelines how long should the pre-shock pause last?

A

<5 seconds

162
Q

According to the ROC Research Guidelines how long should the post-shock pause last?

A

<5 seconds

163
Q

According to the ROC Research Guidelines what is the overall goal concerning compressions?

A

Never be off the chest >10 seconds unless moving the pt

164
Q

According to the ROC Research Guidelines what should occur with ROSC?

A

Start hypothermia

165
Q

According to the ROC Research Guidelines what should occur if EMS witnesses the arrest with pads on the pt?

A

Shock without delay

166
Q

According to the ROC Research Guidelines what is the overall goal?

A

Perform quality CPR for the first 6 minutes
Establish airway
Move pt after 10 minutes

167
Q

According to the Adult Cardiac Arrest protocol what should be done if the scene is deemed unsafe in anyway?

A

Do what is necessary to keep the crew and the pt safe

168
Q

According to the Adult Cardiac Arrest protocol what are the 5 H’s of Adult Treatable Causes?

A
  1. Hypovolemia
  2. Hypoxia or ventilation problems
  3. Hydrogen ion (acidosis)
  4. Hypo/Hyperkalemia
  5. Hypoglycemia
169
Q

According to the Adult Cardiac Arrest protocol what are the 5 T’s of Adult Treatable Causes?

A
  1. Toxins
  2. Tamponade (cardiac)
  3. Tension pneumothorax
  4. Thrombosis (coronary or pulmonary)
  5. Trauma (hypovolemia, increased ICP)
170
Q

According to the Hypothermic Protocol after ROSC what are the 4 indications for its use?

A
  1. Adult (age>18) medical cardiac arrest
  2. Persistent coma
  3. Less than 1 hour from collapse to ROSC
  4. Unable to follow simple commands (hold up one finger, wiggle toes, answer simple yes/no questions, etc.)
171
Q

According to the Hypothermic Protocol after ROSC what are the 6 contraindications for its use?

A
  1. Traumatic/ hemorrhagic related arrests
  2. Apparent pregnancy
  3. Refractory cardiogenic shock (SBP<90)
  4. Initial temperature 34 degrees C (93 degrees F)
  5. Refractory ventricular arrhythmias
  6. Underlying terminal illness
172
Q

According to the Hypothermic Protocol after ROSC what are the 3 procedures?

A
  1. Remove clothing (undergarments may remain for pt privacy)
  2. Place ice pack into axilla and groin direcly on skin for maximum cooling
  3. Rapidly infuse 30ml/kg IV/IO cold saline (33-39 degrees F) (Max 2 L) via pressure infuser
173
Q

According to the Hypothermic Protocol after ROSC if during hypothermia treatment pt begins to shiver what is your treatment option?

A

Versed

174
Q

According to the Hypothermic Protocol after ROSC by what route it Versed given if during hypothermia treatment pt begins to shiver?

A

IV/IO
IN
IM

175
Q

According to the Hypothermic Protocol after ROSC what is the IV/IO adult dose of Versed?

A

2.5-5mg
Every 2-3 minutes
Max 3 doses

176
Q

According to the Hypothermic Protocol after ROSC what is the IN adult dose of Versed?

A

2.5-5mg
Every 2-3 minutes
Max 3 doses

177
Q

According to the Hypothermic Protocol after ROSC what is the IM adult dose of Versed?

A

5mg
Every 10-15 minutes
Max 2 doses

178
Q

According to the Hypothermic Protocol after ROSC should transport be delayed for cooling?

A

NO

179
Q

According to the Hypothermic Protocol after ROSC what should you obtain if able?

A

Initial temperature

180
Q

According to the Hypothermic Protocol after ROSC if able to monitor pt temperature what is the goal?

A

90-93 degrees F

181
Q

According to the Hypothermic Protocol after ROSC if pt temperature drops below 90 degrees F what should occur?

A

Discontinue cooling

182
Q

According to the Hypothermic Protocol after ROSC what should you avoid when providing for respirations for the pt?

A

Hyperventilation

183
Q

According to the Hypothermic Protocol after ROSC what level should you keep your ETCO2 around during ventilation?

A

40mmHg

184
Q

According to the Hypothermic Protocol after ROSC which takes precedence Chilled Saline or ROSC drips?

A

Chilled Saline

185
Q

According to the Hypothermic Protocol after ROSC can both liters of chilled saline be given simultaneously?

A

YES

186
Q

According to the Hypothermic Protocol after ROSC where should the pt receiving hypothermic treatment be transported?

A

Facility able to continue hypothermic treatment

EMS Protocols 2015 (8 decks)

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