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Tinas Class > ALS > Flashcards

ALS Flashcards

1
Q

Bronco construction medical directive drugs

A

Salbutamol, epinephrine, dexamethasone

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2
Q

Bronco construction medical directive conditions

A

Salbutamol: N/A
Epinephrine: BVM ventilation and History of asthma
Dexamethasone: history of asthma, or COPD, or 20 pack a year smoking history

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3
Q

Bronco construction medical directive, contraindications

A

Salbutamol: allergy or sensitivity
Epinephrine: allergy or sensitivity
Dexamethasone: allergy or sensitivity and currently on PO or parenteral steroids

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4
Q

Bronchoconstriction treatment

A

Salbutamol (MDI,NEB): < 25kg MDI 600mcg Every 5-15mins MAX 3 doses. NEB 2.5mg 5-15mins MAX 3 doses
>25kg MDI 800mcg Every 5-15mins MAX 3 doses. NEB 5mg 5-15mins MAX 3 doses
EPI (IM) : 0.01mg per/kg. MAX 0.5mg only one dose
DEX(PO,IM,IV): 0.5mg per/kg MAX 8mg only one dose

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5
Q

Allergic reaction medical directive conditions

A

Epinephrine: anaphylaxis only
Diphenhydramine: >25 kg

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6
Q

allergic reaction medical directive Contraindications

A

Epinephrine: allergy or sensitivity
Diphenhydramine: allergy sensitivity

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7
Q

allergic reaction medical directive treatment

A

Epinephrine(IM): 0.01mg per/kg MAX 0.5mg. 2 doses wait 5 mins
Diphenhydramine(IV,IM,): >25kg <50kg = 25mg >50kg= 50mg

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8
Q

Croup medical directive conditions

A

Epinephrine: >6 months < 8years HR < 200bpm and Strider rest
Dexamethasone: >6 months < 8years, LOA unaltered

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9
Q

Croup medical directive conditions

A

Epinephrine: >6 months < 8years HR < 200bpm and Strider rest
Dexamethasone: >6 months < 8years, LOA unaltered

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10
Q

Croup medical directive, contraindications

A

Epinephrine: allergy or sensitivity
Dexamethasone: allergy or sensitivity, steroids received within the last 48 hours, unable to tolerate oral medication.

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11
Q

Croup medical directive treatment

A

Epinephrine(NEB): <10kg 2.5mg >10kg 5mg (one dose)
Dexamethasone(PO): 0.5mg per/kg max dose 8mg (one dose)

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12
Q

ROSC medical directive treatment

A

Fluid bolus(IV) > 2 years - 12 years. 12+
Infusion 10ml/kg. 10ml/kg
Reassess every: 100ml. 250ml
Max. Volume: 1000 ml. 1000ml

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13
Q

ROSC medical directive conditions

A

Fluid bolus: >2 years, hypertensive, clear chest auscillation.

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14
Q

Cardiac ischaemia medical directive conditions

A

ASA: >18 years, unaltered LOA, Able to chew and swallow
Nitroglycerine: > 18 years old, LOA unaltered, HR 60-159bpm, normotension, prior of nitro or able to get IV access.

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15
Q

Cardiac ischaemia medical directive contraindications

A

ASA: 1.allergy or sensitivity to NSAIDs,
2.asthmatic with no prior use of ASA,
3.current active bleeding,
4.CVA or TBI in the previous 24 hours.

Nitroglycerine: 1. allergy sensitivity to nitrates,
2.phosphodiesterase inhibitor use within the previous 48 hours,
3.systolic blood pressure drops 1/3 after use.
4.Right ventricular MI

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16
Q

Cardiac ischemia medical directive (treatment)

A

ASA(PO): 160-162mg (2 tablets)
Nitroglycerine(SL): (BP has to be >100mmhg)
NO STEMI. STEMI
Dose: 0.3 - 0.4mg Dose: 0.3 - 0.4mg
Time: 5 mins Time: 5 mins
Max doses: 6. Max dose: 3

17
Q

Pulmonary edema medical directive conditions

A

Nitroglycerine: >18 years, HR 60-159, normotension,

18
Q

Pulmonary edema medical directive contraindications

A

Nitroglycerine: 1. Allergy or sensitivity to nitrates
2. Phosphodiesterase inhibitor use within the last 48 hours.
3. Systolic blood pressure drops 1/3 after use.

19
Q

Pulmonary edema medical directive treatment

A

Nitro(SL) >100 <140 SBP. >140mmhg. >140mmhg
IV or Hx: YES. NO Yes
Dose: 0.3-0.4mg 0.3-0.4mg 0.3 - 0.4mg
Dosing time: 5mins 5mins 5mins
MAX#: 6 6 6

20
Q

Hypoglycaemia medical directive conditions

A

Dextrose: > 2 years, altered LOA, hypoglycaemia
Glucagon: altered LOA, hypoglycaemia

21
Q

Hypoglycaemia medical directive contraindications

A

Dextrose: allergy or sensitivity
Glucagon: allergy or sensitivity, pheochromocytoma (tumour above the adrenal glands)

22
Q

Hypoglycaemia medical directive treatment

A

Dextrose(IV) 10% 50%
Dose. 2ml/kg 1ml/kg
Max dose 250ml 50ml
Dosing interval 10mins 10mins
Max# dose: 2 2

Glucagon(IM): <25kg >25kg
Dose: 0.5mg 1mg
Dosing interval: 20min 20min
Max # dose 2 2

23
Q

Opioid toxicity medical directive Conditions and contraindications

A

Naloxone: >24 hours old, altered LOA, <10 breaths/min, inability to ventilate or persistent need to assist ventilations

Naloxone contraindications: allergy or sensitivity

24
Q

Opioid toxicity medical directive treatment

A

Naloxone:
Route: IV. IM. IN. SC
Dose: Up to 0.4mg. 0.4mg. 4mg. 0.8mg
Dosing interval: 5mins. 5min. 5min. 5min
Max# doses: 3. 3. 3. 3.

25
Q

Analgesia medical directive Conditions

A

Acetaminophen: > 12 years old, LOA unaltered.
Ibuprofen: > 12 years old, LOA unaltered
Ketorolac: >12 years old, LOA unaltered, Normotension

26
Q

Analgesia medical directive contraindications for acetaminophen

A
  1. acetaminophen use within the previous four hours.
  2. Allergy or sensitivity
  3. History of liver disease.
  4. Active vomiting.
  5. Unable to tolerate oral medication.
  6. Suspected ischaemic chest pain.

“All Adults Hate Active Upset Stomachs”

27
Q

Analgesia, medical directive counter indications for ibuprofen

A
  1. NSAID use within previous six hours.
  2. Allergy or sensitivity to ASA or NSAID
  3. Patient on anticoagulation therapy
  4. Current active bleeding.
  5. History of peptic ulcer disease or G.I. bleed
  6. Pregnant
  7. If asthmatic no prior use of ASA or other NSAID
  8. CVA or TBI in the previous 24 hours
  9. Known renal impairment.
  10. Active vomiting.
  11. Unable to tolerate oral medication.
  12. Suspected ischemic chest pain
28
Q

Analgesia medical directive contraindications for Ketorolac

A
  1. NSAID use within previous six hours.
  2. Allergy or sensitivity to ASA or NSAID
  3. Patient on anticoagulation therapy
  4. Current active bleeding.
  5. History of peptic ulcer disease or G.I. bleed
  6. Pregnant
  7. If asthmatic no prior use of ASA or other NSAID
  8. CVA or TBI in the previous 24 hours
  9. Known renal impairment.
  10. Suspected ischemic chest pain
29
Q

Analgesia medical directive treatment

A

Acetaminophen(PO):
Age: >12 - <18 18+
Dose: 500-650mg 960-1000mg
Max # doses 1 1

Ibuprofen(PO): >12 years old
Dose: 400mg give only once

Ketorolac(IM/IV):
Age: >12 years old
Dose: 10-15 mg
Max # doses: 1

30
Q

Nausea/vomiting medical directive conditions

A

Ondansetron: >25kg, LOA unaltered
Dimenhydrinate: <65 years, >25kg, LOA unaltered.

31
Q

Nausea/vomiting medical directive Contraindications

A

Ondansetron: 1. allergy
2.Prolonged QT syndrome (known to pt)
3. Apomorphine use

Dimenhydrinate: 1.allergy or sensitivity to Dimenhydrinate or other antihistamines
2. Overdose on antihistamines or anticholinergics or tricyclic antidepressants
3. Co-administration of diphenhydramine

32
Q

Nausea/vomiting medical directive treatment

A

Ondansetron: >25kg
Dose: 4mg
Max# dose: 1

Dimenhydrinate(IV/IM):
Weight: >25kg <50kg >50kg
25mg 50mg

33
Q

Suspected adrenal crisis medical directive conditions

A

Hydrocortisone
Other: 1.paramedics are presented with a vile of hydrocortisone for the identified patient
2. Age related hypoglycemia. OR
G.I. symptoms.(vomiting, diarrhoea abdominal pain.) OR syncope OR temperature >38c or suspected fever OR altered LOA OR age related tachycardia OR age related hypotension

34
Q

Suspected adrenal crisis medical directive contraindications

A

Hydrocortisone: allergy or sensitivity

35
Q

Suspected adrenal crisis medical directive treatment

A

Hydrocortisone(IM/IV):
Dose: 2mg/kg
Max single dose: 100mg
Max# doses: 1

36
Q

EMRG child birth oxytocin conditions

A
  1. Childbearing years
  2. SBP <160 mmhg
  3. Postpartum delivery and/or placental delivery
37
Q

EMRG child birth oxytocin contraindications

A
  1. Allergy or sensitivity
  2. Undelivered fetus
  3. Suspected or known pre-eclampsia with current pregnancy
  4. Eclampsia (seizures) with current pregnancy
  5. > 4 hours post placenta delivery
38
Q

EMRG child birth oxytocin treatment

A

10 units only given once

Tinas Class (11 decks)

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