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WPBfire EMS Protocol > ALS Emergencies > Flashcards

ALS Emergencies Flashcards

1
Q

Allergic Reaction Mild

A

Mild- Generalized Urticaria
Benadryl: 50mg IM
50mg Diluted 9ml Of Saline IV/IO

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2
Q

Allergic Reaction Moderate

A

Moderate- Airway Swelling/ Respiratory Distress/ Bronchospasm/ Tongue, Face Swelling
* Epinephrine 1:1000
0.3mg(0.3ml) IM lateral thigh x2 5min between
* Benadryl: 50mg IM
50mg diluted IV/IO
* Albuterol: 2.5mg Via nebulizer repeat as needed

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3
Q

Allergic Reaction Severe

A

Severe- Loss Of Radial Pulse
Push Dose Pressor Epinephrine
Maintain 100SBP
May repeat x2 max of 300mcg(30ml)

1 Liter Normal Saline May Repeat x1

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4
Q

Allergic Reaction Pediatric

A
  • Benadryl: 1mg/kg IM Dilute with 9ml of Saline IV/IO
    Contraindications: Neonates
  • EPI 1:1000- 0.01mg/kg IM Max Of .3
    Precautions: Do Not Administer Within 5 Min Of Epi Pen
  • Albuterol- 2.5mg Via Nebulizer
    Age Appropriate Hypotension
  • Epi Push Pressor
  • Saline 20ml/kg May Repeat x2
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5
Q

Hypoglycemia Symptoms

A

AMS
Slurred Speech
Dilated Pupils
Seizures
Coma
Irritability

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6
Q

Hyperglycemia Symptoms With DKA

A

Nausea/Vomiting
Abdominal Pain
General Weakness
Kussmaul Respirations
AMS
Hypotension
Tachycardia
Acetone smell

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7
Q

Hypoglycemia Treatment

A

Less than 60mg/dl
Oral Glucose 15g may repeat x1
Contraindications Not Conscious to swallow
D10 100ml IV/IO Repeat x1
Retest Glucose

Hypoglycemia In Cardiac Arrest 250ml IV/IO Rapid Infusion

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8
Q

Hyperglycemia Treatment

A

BGL 300 mg/dl With Signs Of DKA
Normal Saline 1 Liter May Repeat x1
Precaution coronary heart Disease CHF renal failure

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9
Q

Hypoglycemia In Pediatrics

A

BGL Less Than 60
Oral Glucose 15g
Contraindications: Not Able to Swallow/ Under 2 Years

D10: 5ml/kg IV/IO
May Repeat x1

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10
Q

Hyperglycemia Treatment Pediatrics

A

BGL greater than 300 signs of DKA
Normal saline 20ml/kg IV/ IO
May repeat x2 If BGL is above 300

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11
Q

Dystonic Reaction Characterized As

A

Spasmodic or sustained involuntary contractions
face, neck, trunk, pelvis, extremities, larynx
can happen hours or days

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12
Q

What Meds Cause Dystonic Reactions

A

Antipsychotic (Haldol, Risperdal)
Antiemetic (Compazine, Reglan, Phenergan)
Antidepressants (Prozac, Paxil)

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13
Q

Dystonic Reaction

A

Benadryl: 50mg IV/IO with 9mL NS
Pediatric Diluted Benadryl 1mg/kg IV/IO
Max Of 50mg Contraindications - Neonates

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14
Q

Fluid Resuscitation/ Dehydration Treatment

A

Indications: Hypotension, Fatigue, Dark Urine, Dry Mouth, Headache, Prolonged Vomiting, Non-Traumatic Bleeding, Rhabdomyolysis, Paramedic Discretion
Treatment: 1 Liter
May Repeat x1
Pediatric: 20ml/kg Repeat x2 Per age hypotension

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15
Q

Hyperglycemic Medications

A

Glyburide, Glimepiride, Glipizide

If taken by the pt, must be transported if treated.

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16
Q

Hyperkalemia Indications

A

History Of Renal Failure/ Dialysis or Pre-Dialysis
Weakness
Cardiac Arrhythmias and ECG Abnormalities:
Peaked T-waves (early sign)
Sine Wave
Wide Complex QRS
Regular Really Wide Complex Tachycardia
Severe Bradycardia
High Degree AV Block

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17
Q

Hyperkalemia Treatment

A
  • Calcium Chloride 1g IV/IO Over 2 minutes
  • Albuterol 2.5mg Via Nebulizer
  • Sodium Bicarbonate: 100 mEq IV/IO Over 2 minutes

Hypotensive:
Normal Saline 500ml IV/IO Repeat x1

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18
Q

Hyperkalemia Treatment Pediatric

A
  • Calcium Chloride
    20mg/kg IV/IO Over 2 Minutes
  • Albuterol 2.5mg Via Nebulizer
  • Sodium Bicarbonate 1mEq/kg Over 2 minutes
    Max Single Dose is 50mEq
    May Repeat x1 In 5 Minutes Max Total Of 100mEq
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19
Q

Nausea/ Vomiting Treatment Adult

A
  • NS 1Liter IV/IO Repeat x1
  • Zofran 4mg IV/IO/IM/PO
    Over 2 Minutes for IV/IO Repeat x1
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20
Q

Nausea/ Vomiting Treatment Pediatric

A
  • NS 20ml/kg IV/IO Repeat x2 For Age-Appropriate
  • Zofran
    0.1mg/kg IV/IO/IM/PO
    Over 2 minutes For IV/IO
    Max Dose Of 4mg
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21
Q

COPD & Asthma Information

A
  • Pts have prolonged exhalation secondary to bronchospasm, Causing air to be trapped resulting in hypercapnia High Co2
  • SpO2 greater than 90 is most important
22
Q

Auto Peep Definition

A

When air is forced into the lungs by BVM before the PT has fully exhaled risking a pneumothorax

23
Q

COPD Pts with bad bag compliance or hypotension treatment

A

Discontinue to allow pt to fully exhale before continuing ventilation
Adults: 20-40 Seconds
Pediatrics: 10-20 Seconds

24
Q

Bronchospasm secondary to COPD & Asthma treatment

A
  • Albuterol:
    2.5mg VIA Nebulizer may be administered with CPAP
    Repeat as needed
25
Q

Severe Asthma Not Responding to Nebulizer Treatment Adult

A
  • Epi (1:1000) .3mg IM Repeat x2 5 Min Intervals
  • Magnesium Sulfate Dilute 2g in a 50ml bag D5W
    Administer over 10 minutes IV/IO 10 Drop Set 1 gtt/sec
26
Q

Moderate Or Severe COPD, Asthma, Pneumonia Treatment

A

CPAP 10 cm H20

27
Q

Pediatric Bronchospasm

A

Albuterol 2.5mg Via Nebulizer
May Repeat As Needed

28
Q

Pediatric Severe Asthma

A
  • Epinephrine 1:1000
    0.01mg x2 5 min Intervals
  • Mag Sulfate
    Dilute 40mg/kg in a 50ML Bag Of D5W
    Administer over 25 Min IV/IO Max Dose 2G
29
Q

Pediatric Croup, Epiglottitis

A
  • Epinephrine 1:1000
    3mg (3ml Total) Delivered Via Nebulizer
    Precaution do not stress the patient
    Do not Intubate, OPA, NPA Pt
    BVM as needed
30
Q

Croup Signs and symptoms

A
  • Less than 3 years old
  • Sick for couple days
  • Low grade fever
  • Not toxic appearing
  • Stridor / Barky cough
31
Q

Epiglottitis

A

Usually 3-6 Years Old
Sudden Onset
High Grade Fever
Poor General Impression
Drooling
Tripod Position
Stridor/ Barky Cough

32
Q

Seizure Causes

A

Meningitis Drugs
Fever Alcohol
Head Trauma Diabetic
Hemorrhagic Stroke Poisoning

33
Q

Adult Seizure Treatment

A

Versed 5mg IV/IO/IN/IM
x1 in 5 minutes
Contraindications Hypotensive
Precaution Monitor Respirations

34
Q

Adult Patient Seizure Not Responding to Versed

A
  • Ketamine
    Dilute 100mg into a 50ml bag of D5W
    IV/IO With 60gtt Set, Wide Open
    Precaution: Pregnant, Penetrating eye injury
    Non-Traumatic Chest Pain
35
Q

Seizure with no Vascular Access

A

Ketamine 100mg IN/IM

36
Q

Pediatric Seizures

A

Febrile Seizure, Active Cooling, Actively Seizure
Versed 0.1mg/kg IV/IO Max of 5mg
Versed 0.2mg/kg IN/IM Max of 5mg
Contraindications: Hypotension
Ketamine 1mg/kg IN/IM
Repeat x1 In 5 Min

37
Q

Sepsis Symptoms

A
  • Temperature Greater than 100.4 or Less than 96.8
  • UTI
  • Pneumonia
  • Wounds that look infected
  • PT on Antibiotics
  • Recent Surgery
  • AMS or Poor Oral Intake
  • Bed Sores
  • All Sepsis PTS are priority 2
38
Q

Sepsis Criteria

A

Adult & Not Pregnant
Suspected or Documents Infection
H- Hypotension less than 100
A- Altered Mental status new onset
T- Tachypnea respirations greater than 22 Or ETCO2 less than 25

39
Q

Sepsis Precations

A

Keep Pt from becoming Hypotensive - Increases Morbidity Rates
Pneumonia pts with rales still require fluids

40
Q

Adult: Sepsis treatment

A
  • Normal Saline 1L MUST repeat if time permits
  • Ceftriaxone(Rocephin) 2g mixed with 20ml of NS
    Into a 50ml Bag 10gtt set over 10 minutes 1gtt a sec
    Ancef, Ceclor, Cefdinir, KeflexArtificial Heart Valve Replacement
  • Gentamicin 80mg IM ONLY
    Paromycin, Tobramycin, Neomycin Artificial Heart Valve Replacement
    Hypotensive
  • Push dose Epi

Contraindications: Allergy to Aminoglycoside Antibiotics

41
Q

Pediatric Sepsis Treatment

A
  • Normal Saline 20ml/kg IV/IO
    Regardless of Bp Repeat x2
  • Push-Dose Epi 1ml
42
Q

Stroke Assessment

A

Symptoms within 24 Hours
Cincinnati Srtoke Assessment
Race Score Greater Than 0
Witnessed (24hrs) Unwitnessed Unknown Time
Stroke Alerts

43
Q

Race Score

A

MAX of 11
0 Is Perfect
0-1-2 scoring
Facial - Smile
Arm Motor- Hold Arm
Leg Motor- Hold Leg
Cortical PLUS Encode
Head and Eyes

44
Q

Stroke Treatment Adult

A

BGL
Position- 30 Degrees Head Elevation
Oxygen 2lpm NC
IV Access 18g Antecubital Unaffected Side
Normal Saline 500 IV/IO Regardless Of BP

45
Q

Stoke Treatment Pediatric

A

BGL
Position- 30 Degrees Head Elevation
Oxygen 2lpm NC
IV
10ml/kg IV/IO max dose of 250ML

46
Q

Sickle Cell Anemia Adult Treatment

A
  • SpO2 95 or Greater
  • Normal Saline 500ml IV/IO Repeat x1
  • Pain Management Protocol
    If Hypotension Occurs During Fentanyl limit saline to 500ml
47
Q

Pediatric: Sickle Cell Anemia treatment

A
  • SpO2 95 Or Greater
  • Normal Saline 20ml/kg x2
  • Pain Management
48
Q

Taser Protocol

A

Stabilize Probe if above the clavicles, genitalia, areola
Transport for:
Excited Delirium
Drug Use
Cardiac History
Altered Mental
Hyperthermia
Any Chief Complaint
Pregnancy
Blood thinners

49
Q

Aphasia

A

understands but difficulty expressing

50
Q

Agnosia

A

Inability to recognize

51
Q

CPAP Contraindications

A
  • SBP< 90
  • No Spontaneous Respirations
  • Decreased LOC
  • Patients < 30kg

WPBfire EMS Protocol (13 decks)

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