ALS PCP core directives Flashcards
1
Q
conditions for a supraglottic airway
A
Age, LOA, HR, RR, SBP: N/A
other: absent gag reflex
2
Q
contraindications of a supraglottic airway
A
airway obstruction by foreign object, known esophageal disease (varices), trauma to oropharynx, caustic ingestion
3
Q
what is the maximum number of attempts of a supraglottic airway
A
2
4
Q
what is the first choice drug for Bronchoconstriction
A
salbutamol
5
Q
contraindications of salbutamol for Bronchoconstriction
A
allergy or sensitivity to Salbutamol
6
Q
what weight categories is Salbutamol for Bronchoconstriction split into
A
<25kg and >25kg
7
Q
what is the preferred route of administration of salbutamol for Bronchoconstriction
A
MDI (metered dose inhaler)
8
Q
what is the secondary route of administration available for salbutamol for Bronchoconstriction
A
NEB (nebulizer)
9
Q
what is the dose for MDI salbutamol for bronchoconstriction for a patient who is <25kg
A
600 mcg (6 puffs)
10
Q
what is the dose for MDI salbutamol for bronchoconstriction for a patient who is >25kg
A
800 mcg (8 puffs)
11
Q
what is the dose for NEB salbutamol for bronchoconstriction for a patient who is <25kg
A
2.5 mg
11
Q
what is the dose for NEB salbutamol for bronchoconstriction for a patient who is >25kg
A
5 mg
12
Q
what is the dosing intervals for salbutamol for bronchoconstriction
A
5-15 min PRN (as needed)
12
Q
what is the second choice of drug for bronchoconstriction
A
epinephrine
12
Q
what is the concentration of epinephrine
A
1mg/ml = 1:1000
13
Q
what is the max number of doses of salbutamol for bronchoconstriction
A
3
14
Q
what are the conditions of epinephrine for Bronchoconstriction
A
Age, weight, LOA, HR, SBP: N/A
RR- BVM ventilation required
Other- history of asthma
15
Q
what is the route of administration for epinephrine for bronchoconstriction
A
IM (intramuscular)
16
Q
contraindications of epinephrine for bronchconstriction
A
allergy or sensitivity to epinephrine
17
Q
what is the dose of epinephrine for bronchoconstriction
A
0.01 mg/km
18
Q
what is the max single dose of epinephrine for Bronchoconstriction
A
0.5 mg
19
Q
what is the dosing interval of epinephrine for Bronchoconstriction
A
N/A
20
Q
what is the maximum number of doses of epinephrine for bronchoconstriction
A
1
21
Q
what is the third choice drug for bronchoconstriction
A
dexamethasone
22
what are the conditions of dexamethasone for bronchoconstriction
Age, LOA, HR, RR, SBP: N/A
Other: history of asthma, COPD, 20 pack a year smoking history
23
contraindications of dexmethasone for bronchoconstriction
allergy or sensitivity to steroids, currently on PO/ parenteral steroids
24
what is the route of administration of dexamethasone for bronchoconstriction
PO, IM, IV
25
what is the dose of dexamethasone for bronchoconstriction
0.5 mg/kg
26
what is the maximum single dose of dexamethasone for bronchoconstriction
8 mg
27
what is the dosing interval of dexamethasone for bronchoconstriction
N/A
28
what is the maximum number of doses of dexamethasone for bronchoconstriction
1
29
what is the first choice drug for moderate/severe allergic reaction
epinephrine
29
what are the conditions of epinephrine for moderate/ severe allergic reaction
age, weight, LOA, HR, RR, SBP: N/A
other: only for anaphylaxis
30
what are the contraindications of epinephrine for moderate/ severe allergic reactions
allergy or sensitivity to epinephrine
31
what is the route of administration of epinephrine for moderate/ severe allergic reaction
IM
32
what is the dose of epinephrine for moderate/ severe allergic reactions
0.01 mg/kg
33
what is the max single dose of epinephrine for moderate/ severe allergic reactions
0.5 mg
34
what is the dosing interval of epinephrine for moderate/ severe allergic reactions
minimum 5 minutes
35
what is the max number of doses of epinephrine for moderate/ severe allergic reactions
2
36
what is the first choice of drug for croup
epinephrine
37
what are the conditions of epinephrine for croup
age: >6 months- <8 years
LOA, RR, SBP: N/A
HR: <200 bpm
other: stridor at rest
38
contraindications of epinephrine for croup
allergy or sensitivity to epinephrine
39
what weight categories is epinephrine for croup split into
<10 kg and >10 kg
40
what is the route of administration for epinephrine for croup
NEB
41
what is the dose of epinephrine for croup for a patient who is <10 kg
2.5 mg
42
what is the dose of epinephrine for croup for a patient who is >10 kg
5 mg
43
what is the maximum dose of epinephrine for croup for a patient who is <10 kg
2.5 mg
44
what is the maximum dose of epinephrine for croup for a patient who is >10 kg
5 mg
45
what is the dosing interval for epinephrine for croup
N/A
46
what is the maximum number of doses of epinephrine for croup
1
47
what is the second best medication for croup
dexamethasone
48
what are the conditions of dexamethasone for croup
Age: >6 months- <8 years
LOA: unaltered
HR, RR, SBP: N/A
other: mild/ moderate/ severe croup
49
contraindications of dexamethasone for croup
allergy or sensitivity to steroids, steroids received within the last 48 hours, unable to tolerate oral medications
50
what is the route of administration of dexamethasone for croup
PO
51
what is the max single dose of dexamethasone for croup
8 mg
52
what is the dose of dexamethasone for croup
0.5 mg
53
what is the dosing interval of dexmethasone for croup
N/A
54
what is the max number of doses of dexamethasone for croup
1
55
56
what is the first choice drug for medical cardiac arrest (fourth best option)
epinephrine
57
what are the conditions for epinephrine for medical cardiac arrest
age: >24 hours
LOA: altered
HR, RR, SBP: N/A
other: anaphylaxis suspected as causative event
58
what are the contraindications of epinephrine for medical cardiac arrest
allergy or sensitivity to epinephrine
59
what is the route of administration of epinephrine for medical cardiac arrest
IM
60
what is the dose of epinephrine for medical cardiac arrest
0.01mg/kg
61
what is the maximum single dose of epinephrine for medical cardiac arrest
0.5 mg
62
what is the dosing interval for epinephrine for medical cardiac arrest
N/A
63
what is the maximum number of doses of epinephrine for medical cardiac arrest
1
64
what is the first choice drug for a ROSC
0.9% fluid bolus
65
conditions of a 0.9% NaCl fluid bolus for a ROSC
age: >2 years
LOA, HR, RR: N/A
SBP: hypotension
other: chest auscultation is clear
66
contraindications of a 0.9% NaCl fluid bolus for a ROSC
fluid overload
67
what age category are for the 0.9% NaCl fluid bolus split into for a ROSC
>2 years to <12 years and >12 years
68
what is the route of administration for a 0.9% NaCl fluid bolus for a ROSC
IV
69
what is the infusion rate for a patient who is >2 years old and <12 years for a 0.9% NaCl fluid bolus for a ROSC
10 ml/kg
70
what is the infusion rate for a patient who is >12 years old for a 0.9% NaCl fluid bolus for a ROSC
10 ml/kg
71
what is the transfusion interval for a patient who is >2 years old and <12 years for a 0.9% NaCl fluid bolus for a ROSC
immediate
72
what is the transfusion interval for a patient who is >12 years old for a 0.9% NaCl fluid bolus for a ROSC
immediate
73
what is the maximum volume of a 0.9% NaCl fluid bolus for a ROSC
1000 ml
74
when do you reassess a patients 0.9% NaCl fluid bolus who is >2 years old and <12 years old for a ROSC
every 100ml
75
when do you reassess a patients 0.9% NaCl fluid bolus who is >12 years old for a ROSC
250 ml
76
what is the first drug of choice for cardiac schema
ASA
77
conditions of ASA for cardiac ischemia
Age: >18 years
LOA: unaltered
HR, RR, SBP: N/A
Other: able to chew and swallow
78
contraindications of ASA for cardiac ischemia
allergy or sensitivity to NSAIDS, if asthmatic no prior use of ASA, current active bleeding, CVA/TBI in the previous 24 hours
79
what is the route of administration of ASA for cardiac ischemia
PO
80
what is the dose of ASA for cardiac ischemia
160-162 mg
81
what is the maximum single dose of ASA for cardiac ischemia
162 mg
82
what is the dosing interval of ASA for cardiac ischemia
N/A
83
what is the maximum number of doses of ASA for cardiac ischemia
1
84
what is the second best drug for cardiac ischemia
nitroglycerin
85
conditions of nitroglycerin for cardiac ischemia
Age: >18 years
LOA: unaltered
HR: 60-159 bpm
RR: N/A
SBP: normotension
Other: history of nitro use or Iv access obtained
86
contraindications of nitroglycerin for cardiac ischemia
allergy or sensitivity to nitrates, phosphodiesterase inhibitor use within previous 48 hours, SBP drops by 1/3 or more of initial value after administration, 12 lead ECG compatible with right ventricle MI
87
what value should the SBP be if a STEMI is present for nitroglycerin for cardiac ischemia
>100 mmHg
88
what value should the SBP be if a STEMI is not present for nitroglycerin for cardiac ischemia
>100 mmHg
89
what is the route of administration of nitroglycerine for cardiac ischemia
SL
90
what is the dose of nitroglycerin for a patient who has a STEMI in cardiac ischemia
0.3mg or 0.4 mg
91
what is the dose of nitroglycerin for a patient who doesn't have a STEMI in cardiac ischemia
0.3 or 0.4 mg
92
what is the maximum single dose of nitroglycerine for cardiac ischemia if a STEMI is present
0.4 mg
93
what is the maximum single dose of nitroglycerine for cardiac ischemia if a STEMI is not present
0.4
94
what is the dosing interval of nitroglycerine for cardiac ischemia if a STEMI is/ is not present
5 minutes
95
what is the maximum number of doses of nitroglycerin for cardiac ischemia if a STEMI is present
3
96
what drug is used for acute pulmonary edema
Nitroglycerin
97
conditions of nitroglycerin for acute pulmonary oedema
Age: >18 years
LOA, RR, other: N/A
HR: 60-159 bpm
SBP: normotension
98
contraindications of nitroglycerin for acute pulmonary oedema
allergy or sensitivity to nitrates, phosphodiesterase inhibitor use within previous 24 hours, SBP drops by 1/3 or more of initial value after nitro is administered
99
what are the categories of SBP for nitro for acute pulmonary edema
>100 mmHg to <140 mmHg and 140 mmHg
100
what Is the route of administration of nitroglycerin for acute pulmonary edema
SL
101
what is the dose of nitro for a patient whose SBP is >100 mmHg to <140 mmHg with a history of nitro/ IV for acute pulmonary edema
0.3 or 0.4 mg
102
what is the max single dose of nitro for a patient whose SBP is >100 mmHg and <140 mmHg for acute pulmonary edema
0.4 mg
103
what is the dose of nitro for a patient whose SBP is >1140 mmHg without a history of nitro/ IV for acute pulmonary edema
0.3 mg or 0.4 mg
104
what is the dose of nitro for a patient whose SBP is >140 mmHg with a history of nitro/ IV for acute pulmonary edema
0.6 or 0.8 mg
105
what is the max single dose of nitro for a patient whose SBP is >140 mmHg without a history of nitro/IV for acute pulmonary edema
0.4 mg
106
what is the max single dose of nitro for a patient whose SBP is >140 mmHg with a history of nitro/IV for acute pulmonary edema
0.8
107
what is the dosing interval of nitro for acute pulmonary edema
5 min
108
what is the maximum number of doses of nitro for acute pulmonary edema
6
109
what is the first choice drug for hypoglycemia
dextrose
110
what are the conditions of dextrose
Age: > 2 years
LOA: altered
HR, RR, SBP: N/A
other: hypoglycemia
111
contraindications of dextrose for hypoglycemia
allergy or sensitivity to dextrose
112
what are the categories of concentrations of dextrose for hypoglycemia
10% and 50%
113
what is the route of administration of dextrose for hypoglycemia
IV
114
what is the dose of dextrose given if it is 10% dextrose for hypoglycemia
0.2 g/kg (2 ml/kg)
115
what is the maximum single dose of dextrose that is 10% dextrose for hypoglycemia
25 g (250 ml)
116
what is the dose of dextrose given if it is 50% dextrose for hypoglycemia
0.5 g/kg (1 ml/kg)
117
what is the maximum single dose of dextrose that is 50% dextrose for hypoglycemia
25 g (250 ml)
118
what is the dosing interval of dextrose for hypoglycemia
10 min
119
what is the maximum number of doses of dextrose for hypoglycemia
2
120
what is the second choice drug for hypoglycemia
glucagon
121
what are the conditions of glucagon for hypoglycemia
Age, HR, RR, SBP: N/A
LOA: altered
Other: hypoglycemia
122
contraindications of glucagon for hypoglycemia
allergy or sensitivity to glucagon, pheochromocytoma
123
what is the route of administration of glucagon for hypoglycemia
IM
124
what are the weight categories of dextrose for hypoglycemia split into
<25kg and >25kg
125
what is the dose of glucagon for a patient who is <25 kg for hypoglycemia
0.5 mg
126
what is the maximum single dose of glucagon for a patient who is <25kg for hypoglycemia
0.5 mg
127
what is the dose of glucagon for a patient who is >25 kg for hypoglycemia
1 mg
128
what is the maximum single dose of glucagon for a patient who is >25kg for hypoglycemia
1 mg
129
what is the dosing interval of glucagon for hypoglycemia
20 min
130
what is the maximum number of doses of glucagon for hypoglycemia
2
131
what is the first choice drug for opioid toxicity and withdrawal
naloxone
132
conditions of naloxone for opioid toxicity and withdrawal
Age: >24 hours
LOA: altered
HR, SBP: N/A
RR: <10 breaths per min
Other: inability to adequately ventilate or persistent need to assist ventilations
133
contraindications of naloxone for opioid toxicity and withdrawal
allergy or sensitivity to naloxone
134
what are the routes of administration for naloxone for opioid toxicity and withdrawal (in order of preferred route)
IV, IM, IN, SC
135
what is the dose of naloxone for the IV route of administration for opioid toxicity and withdrawal
up to 0.4 mg
136
what is the max dose of naloxone for the IV route of administration for opioid toxicity and withdrawal
0.4 mg
137
what is the dose of naloxone for the IM route of administration for opioid toxicity and withdrawal
0.4 mg
138
what is the max dose of naloxone for the IM route of administration for opioid toxicity and withdrawal
0.4 mg
139
what is the dose of naloxone for the IN route of administration for opioid toxicity and withdrawal
2-4 mg
140
what is the max dose of naloxone for the IN route of administration for opioid toxicity and withdrawal
2-4 mg
141
what is the dose of naloxone for the SC route of administration for opioid toxicity and withdrawal
0.8 mg
142
what is the max dose of naloxone for the SC route of administration for opioid toxicity and withdrawal
0.8 mg
143
what is the dosing interval of naloxone for opioid toxicity and withdrawal
5 min
144
what is the max number of doses of naloxone for opioid toxicity and withdrawal
3
145
conditions of buprenorphine/ naloxone for opioid toxicity and withdrawal
Age: >16 years
LOA: unaltered
HR, RR, SBP: N/A
Other: received naloxone for current opioid toxicity episode and pt is exhibiting acute withdrawal with a COWS score >8
146
what is the second choice drug for opioid toxicity and withdrawal
buprenorphine/ naloxone
147
contraindications of buprenorphine/ naloxone for opioid toxicity and withdrawal
allergy or sensitivity to buprenorphine, taken methadone in the past 72 hours
148
what is the route of administration of buprenorphine/ naloxone for opioid toxicity and withdrawal
BUC/SL (under tongue and on cheeks)
149
what is the initial dose of buprenorphine/ naloxone for opioid toxicity and withdrawal
16 mg
150
what are the subsequent doses of buprenorphine/ naloxone for opioid toxicity and withdrawal
8 mg
151
what is the dosing interval of buprenorphine/ naloxone for opioid toxicity and withdrawal
10 min
152
what is the maximum cumulative dose of buprenorphine/ naloxone for opioid toxicity and withdrawal
24 mg
153
what is the drug used for a suspected adrenal crisis
hydrocortisone
154
conditions of hydrocortisone for a suspected adrenal crisis
Age, LOA, HR, RR, SBP: N/A
Other: medics presented with vial of hydrocortisone for identified pt AND age related hypoglycemia or GI symptoms or syncope or temp >38C/ suspected/history of fever or altered LOA or age related tachycardia or age related hypotension
155
contraindications of hydrocortisone for a suspected adrenal crisis
allergy or sensitivity to hydrocortisone
156
what is the route of administration of hydrocortisone for a suspected adrenal crisis
IM/IV
157
what is the dose of hydrocortisone for a suspected adrenal crisis
2 mg/kgw
158
what is the maximum single dose of hydrocortisone for a suspected adrenal crisis
100 mg
159
what is the dosing interval of hydrocortisone for a suspected adrenal crisis
N/A
160
what is the maximum number of doses of hydrocortisone for a suspected adrenal crisis
1
161
what is the first choice drug for analgesia
acetaminophen
162
what are the conditions of acetaminophen for analgesia
age: >12 years
LOA: unaltered
HR, RR, SBP, other: N/A
163
containdictions of acetaminophen for analgesia
acetaminophen use within previous 4 hours, allergy or sensitivity to acetaminophen, Hx of liver disease, active vomiting, unable to tolerate oral medication, suspected ischemic chest pain
164
what are the weight categories of acetaminophen for analgesia
>12 years to <18 years and >18 years
165
what is the route of administration of acetaminophen for analgesia
PO
166
what is the dose of acetaminophen for a pt who is >12 years and <18 years old for analgesia
500-650 mg
167
what is the max dose of acetaminophen for a pt who is >12 years and <18 years old for analgesia
650 mg
168
what is the dose of acetaminophen for a pt who is >18 years old for analgesia
960-1000 mg
169
what is the max dose of acetaminophen for a pt who is >18 years old for analgesia
1000 mg
170
what is the dosing interval of acetaminophen for analgesia
N/A
171
what is the maximum number of doses of acetaminophen for analgesia
1
172
what is the second choice drug for analgesia
ibuprofen
173
what are the conditions of ibuprofen for analgesia
Age: >12 years
LOA: unaltered
HR, RR, SBP, other: N/A
174
contraindications of ibuprofen for analgesia
NSAID use within previous 6 hours, allergy or sensitivity to ASA/ NSAIDS, pt on anticoagulation therapy, current active bleeding, Hx of peptic ulcer disease or GI bleed, pregnant, if asthmatic no prior use of ASA/ NSAIDS, CVA or TBI in previous 24 hours, renal impairment, active vomiting, unable to tolerate oral medication, suspected ischemic chest pain
175
what is the route of administration of ibuprofen for analgesia
PO
176
what is the dose of ibuprofen for analgesia
400 mg
177
what is the max single dose of ibuprofen for analgesia
400 mg
178
what is the dosing interval of ibuprofen for analgesia
N/A
179
what is the max number of doses of ibuprofen for analgesia
1
180
what is the third choice of drug for analgesia
Ketorolac
181
conditions of ketorolac for analgesia
Age: >12 years
LOA: unaltered
HR, RR, other: N/A
SBP: normotension
182
contraindications of ketorolac for analgesia
NSAID use within previous 6 hours, allergy or sensitivity to NSAIDS/ ASA, pt on coagulation therapy, current active bleeding, Hx of peptic ulcer disease/ GI bleed, pregnant, if asthmatic no prior use of ASA/ other NSAIDS, CVA/ TBI in previous 24 hours, known renal impairment, suspected ischemic chest pain
183
what is the route of administration of ketorolac for analgesia
IM/IV
184
what is the dose of ketorolac for analgesia
10-15 mg
185
what is the max single dose of ketorolac for analgesia
15 mg
186
what is the dosing interval of ketorolac for analgesia
N/A
187
what is the max number of doses of ketorolac for analgesia
1
188
188
189
190
191
what is the first choice drug for nausea/ vomiting
ondansetron
192
conditions of ondansetron for nausea/ vomiting
Age, HR, RR, SBP, other: N/A
weight: >25kg
LOA: unaltered
193
contraindications of ondansetron for nausea/vomiting
allergy to ondansetron, prolonged QT syndrome (known to pt), apomorphine use
194
what is the route of administration of ondansetron for nausea/ vomiting
PO
195
what is the dose of ondansetron for nausea/vomiting
4 mg
196
what is the max single dose of ondansetron for nausea/vomiting
4 mg
197
what is the dosing interval of ondansetron for nausea/ vomiting
N/A
198
what is the max number of doses of ondansetron for nausea/ vomiting
1
199
what is the second choice drug for nausea/ vomiting
dimenhydrinate
200
conditions of dimenhydrinate for nausea/ vomiting
Age: <65 years
weight: >25 kg
LOA: unaltered
HR, RR, SBP, other: N/A
201
contraindications of dimenhydrinate for nausea/ vomiting
allergy or sensitivity to dimenhydrinate or other antihistamines, overdose on antihistamines or anticholingerics or tricyclic antidepressants, co-administration of diphenhydramine
202
what are the weight categories of dimenhydrinate for nausea/ vomiting
>25 kg to <50 kg and >50 kg
203
what is the route of administration for dimenhydrinate for nausea/ vomiting
IV/IM
204
what is the dose of dimenhydrinate for a pt who is >25 kg and <50 kg for nausea/ vomiting
25 mg
205
what is the max single dose of dimenhydrinate for a pt who is >25 kg and <50 kg for nausea/ vomiting
25 mg
206
what is the dosing interval of dimenhydrinate for nausea/ vomiting
N/A
207
what is the max number of doses of dimenhydrinate for nausea/ vomiting
1
208
what is the dose of dimenhydrinate for a pt who is >50 kg for nausea/ vomiting
50 mg
209
what is the max single dose of dimenhydrinate for a pt who is >50 kg for nausea/ vomiting
50 mg
210
what is the drug used in emergency childbirth (fourth option)
oxytocin
211
conditions of oxytocin for emergency childbirth
Age: childbearing years
LOA, HR, RR: N/A
SBP: <160 mmHg
other: postpartum delivery and/ or placental delivery
212
contraindications of oxytocin for emergency childbirth
allergy or sensitivity to oxytocin, undelivered fetus, suspected or known pre-eclampsia with current pregnancy, eclampsia (seizures) with current pregnancy, >4 hours post placenta delivery
213
what is the route of administration of oxytocin for emergency childbirth
IM
214
what is the dose of oxytocin for emergency childbirth
10 units
215
what is the maximum dose of oxytocin for emergency childbirth
10 units
216
what is the dosing interval of oxytocin for emergency child birth
N/A
217
what is the maximum number of doses of oxytocin for emergency childbirth
1
