Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2nd Year PCP > ALS PCS > Flashcards

ALS PCS Flashcards

1
Q

ROSC- Indications

A

Patient with ROSC after the resuscitation was initiated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

ROSC- 0.9% NaCl Fluid Bolus Conditions

A

Age: ≥ 2 years
SBP: Hypotensive
Other: Chest auscultation is clear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

ROSC- 0.9% NaCl Fluid Bolus Contraindications

A

Fluid Overload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ROSC Treamtent- Consider optimizing ventilation and oxygenation

A

Titrate oxygen 94-98%
Avoid hyperventilation and target ETCO2 to 30-40mmHg with continuous waveform capnography (if available)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ROSC- 0.9% NaCl Fluid Bolus Treatment

A

Age: ≥ 2 years to < 12 years
Route: IV
Infusion: 10ml/kg
Infusion interval: immediate
Reassess every: 100 ml
Max volume: 1000ml

Age: ≥ 12 years
Route: IV
Infusion: 10ml/kg
Infusion interval: immediate
Reassess every: 250 ml
Max volume: 1000ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ROSC- Clinical Considerations

A

Consider initiating transport in parallel with the above treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cardiac Ischemia- Indications

A

Suspected cardiac ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cardiac Ischemia- Conditions ASA

A

Age: ≥ 18 years
LOA: unaltered
Other: Able to chew and swallow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cardiac Ischemia- Conditions Nitroglycerin

A

Age: ≥ 18 years
LOA: unaltered
HR: 60-159 bpm
SBP: normotensive
Other: prior history of nitro use or IV access obtained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cardiac Ischemia- Contraindications ASA

A

Allery or sensitivity to NSAIDs
If asthmatic, no prior use of ASA
Current active bleeding
CVA or TBI in the previous 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cardiac Ischemia- Contraindications Niroglycerin

A

Allergy or sensitivity to nitrates
Phosphodiesterase inhibitor use within the previous 48 hours
SBP drops by one-third or more of its initial value after nitroglycerin is administered
12-lead ECG compatible with Right Ventricular MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cardiac Ischemia- Treatment ASA

A

Route: PO
Dose: 160-162 mg
Max single dose: 162 mg
Max # of doses: 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cardiac Ischemia- Treatment Nitroglycerin

A

NON STEMI
Route: SL
Dose: 0.3-0.4 mg
Max single dose: 0.4mg
Dosing interval: 5 min
Max # of doses: 6

STEMI POSITIVE
Route: SL
Dose: 0.3-0.4 mg
Max single dose: 0.4mg
Dosing interval: 5 min
Max # of doses: 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cardiac Ischemia- Clinical Considerations

A

Suspect a RV MI in all inferior STEMI’s and perform V4R to confirm (≥1mm of elevation in V4R)
Do not administer nitro to RV MI
Apply defib pads with a STEMI is identified
Get a 12-lead in < 10 mins of patient contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ACPE- Indications

A

Moderate to severe resp. distress
AND
Suspected ACPE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ACPE- Conditions Nitroglycerin

A

Age: ≥ 18 years
HR: 60-159bpm
SBP: normotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ACPE- Contraindications Nitroglycerin

A

Allergy or sensitivity to nitrates
Phosphodiesterase inhibitor use within previous 48 hours
SBP drops by one-third of its initial value after nitroglycerin is administered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

ACPE- Treatment Nitroglycerin

A

SBP: ≥100 mmHg to <140 mmHg
IV or Hx: yes
Route: SL
Dose: 0.3-0.4 mg
Max single dose: 0.4mg
Dosing interval: 5 min
Max # of doses: 6

SBP: ≥140 mmHg
IV or Hx: no
Route: SL
Dose: 0.3-0.4 mg
Max single dose: 0.4mg
Dosing interval: 5 min
Max # of doses: 6

SBP: ≥140 mmHg
IV or Hx: yes
Route: SL
Dose: 0.6-0.8 mg
Max single dose: 0.8mg
Dosing interval: 5 min
Max # of doses: 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Hypoglycemia- Indications

A

suspected hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Hypoglycemia- Conditions Dextrose

A

Age: ≥ 2 years
LOA: altered
Other: hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Hypoglycemia- Conditions Glucagon

A

LOA: altered
Other: hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Hypoglycemia- Contraindications Dextrose

A

Alltergy or sensitivity to dextrose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Hypoglycemia- Contraindicaitons Glucagon

A

Allergy or sensitivity to glucagon
Pheochromocytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hypoglycemia- Treatment Dextrose

A

Concentration: 10% dextrose
Route: IV
Dose: 0.2g/kg (2ml/kg)
Max single dose: 25g (250ml)
Dosing Interval: 10 mins
Max # of doses: 2

Concentration: 10% dextrose
Route: IV
Dose: 0.5g/kg (1ml/kg)
Max single dose: 25g (50ml)
Dosing Interval: 10 mins
Max # of doses: 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Hypoglycemia- Glucagon Treatment

A

Weight: <25kg
Route: IM
Dose: 0.5mg
Max single dose: 0.5mg
Dosing interval: 20 mins
Max # of doses: 2

Weight: ≥ 25kg
Route: IM
Dose: 1mg
Max single dose: 1mg
Dosing interval: 20 mins
Max # of doses: 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Hypoglycemia- Clinical Considerations

A

If the patient responds to dectrose or glucagon, they may recieve oral glucose or other simple carbohydrates
If only mild signs or symptoms are exhibited, the pt may recieve oral glucose or other simple carbohydrates instead of medications.
If a patient initiates an informed refusal os transport, a final set of vital signs including blood glucometry must be attempted and documented

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Bronchoconstriction- Indications

A

Resp. distress
AND
Suspected bronchoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Bronchoconstriction- Conditions Epinepherine

A

RR: BVM ventilation required
Other: Hx of asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Bronchoconstriction- Conditions Salbutamol

A

NONE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Bronchoconstriction- Conditions Dexamethasone

A

Hx of asthma
OR
COPD
OR
20-pack-year history of smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Bronchoconstriction- Contraindications Salbutamol

A

Allergy or sensitivity to salbutamol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Bronchoconstriction- Contraindications Epinepherine

A

Allergy or sensitivity to epinepherine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Bronchoconstriction- Contraindications Dexamethasone

A

Allergy or sensitivity to steroids
Currently on PO or parental steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Bronchoconstriction- Treatment Salbutamol

A

Weight: < 25 kg
Route: MDI
Dose: up to 600 mcg (6 puffs)
Max single dose: 600 mcg
Dosing interval 5-15 mins PRN
Max # of doses: 3

Weight: < 25 kg
Route: NEB
Dose: 2.5mg
Dosing interval: 5-15 min PRN
Max # of doses: 3

Weight: ≥ 25 kg
Route: MDI
Dose: Up to 800 mcg
Max single dose: 800 mcg
Dosing interval 5-15 mins PRN
Max # of doses: 3

Weight: ≥ 25 kg
Route: NEB
Dose: 5mg
Dosing interval: 5-15 min PRN
Max # of doses: 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Bronchoconstriction- Treatment Epinepherine

A

Route: IM
Concentration: 1mg/ml= 1:1000
Dose: 0.01mg/kg
Max single dose: 0.5mg
Max # of doses: 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Bronchoconstriction- Treatment Dexamethasone

A

Route: PO/IM/IV
Dose: 0.5mg/kg
Max singl dose: 8mg
Max # of doses: 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Bronchoconstriction- Clinical Considerations

A

Epi should be the first med administered if the pt is apneic. Salbutamol MDI may be administered subsequently using a BVM MDI adapter.
Nebulization is contraindicated in patients with a known or suspected fever or in the setting of a declared febrile respiratory illness outbreak by the local medical officer of health.
When administering salbutamol MDI, the rate of administration should be 100 mcg approx. every 4 breaths.
A spacer should be used when administering salbutamol MDI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Mod to Severe Allergic Rx.- Indications

A

Exposure to a probable allergen
AND
Signs and symptoms of a moderate to severe allergic reaction (including anaphylaxis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Mod to Severe Allergic Rx.- Conditions Epinepherine

A

FOR ANAPHYLAXIS ONLY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Mod to Severe Allergic RX.- Conditions Diphenhydramine

A

Weight: ≥ 25 kg

41
Q

Mod to Severe Allergic Rx.- Epinepherine Contraindications

A

Allergy or sensitivity to epinepherine

42
Q

Mod to Severe Allergic Rx.- Diphenhydramine Contraindications

A

Allergy or sensitivity to diphenhyramine

43
Q

Mod to Severe Allergic Rx.- Treatment Epinepherine

A

Route: IM
Concentration: 1mg/ml=1:1000
Dose: 0.01mg/kg
Max single dose: 0.5mg
Dosing interval: 5 min
Max # of doses: 2

44
Q

Mod to Severe Allergic Rx.- Treatment Diphenhydramine

A

Weight: ≥ 25 to < 50 kg
Route: IV/IM
Dose: 25 mg
Max single dose: 25 mg
Max # of doses: 1

Weight: ≥ 50 kg
Route: IV/IM
Dose: 50 mg
Max single dose: 50 mg
Max # of doses: 1

45
Q

Mod to Severe Allergic Rx.- Clinical Considerations

A

Epinepherine administration takes priority over IV access.

46
Q

Croup- Indications

A

Current history of URTI
AND
Barking cough or recent history of barking cough

47
Q

Croup- Conditions Epinepherine

A

Age: ≥ 6 months to < 8 years
HR: <200 bpm
Other: Stridor at rest

48
Q

Croup- Conditions Dexamethasone

A

Age: ≥ 6 months to < 8 years
LOA: unaltered
Other: mild, moderate to severe croup

49
Q

Croup- Contraindications Epinepherine

A

Allergy or sensitivity to epinepherine

50
Q

Croup- Contraindications Dexamethasone

A

Allergy or sensitivity to steroids
Steroids received within the last 48 hours
Unable to tolerate oral meds

51
Q

Croup- Treatment Epinepherine

A

Weight: <10 kg
Route: NEB
Concentration: 1mg/ml=1:1000
Dose: 2.5mg
Max single dose: 2.5mg
Max # of doses: 1

Weight: ≥ 10 kg
Route: NEB
Concentration: 1mg/ml=1:1000
Dose: 5 mg
Max single dose: 5 mg
Max # of doses: 1

52
Q

Croup- Treatment Dexamethasone

A

Route: PO
Dose: 0.5 mg/kg
Max single dose: 8 mg
Max # of doses: 1

53
Q

Supraglottic Airway- Indications

A

Need for ventilatory assistance or airway control
AND
Other airway management is ineffective

54
Q

Supraglottic Airway- Conditions

A

Other: Absent gag reflex

55
Q

Supraglottic Airway- Contraindications

A

Airway obstructed by a foreign object
Known esophageal disease (varices)
Trauma to the oropharynx
Caustic ingestion

56
Q

Supraglottic Airway- What is the maximum number of insertion attempts?

A

2

57
Q

Supraglottic Airways- Primary and Secondary methods of confirmation

A

Primary- ETCO2 (waveform capnography)
Secondary- ETCO2 (non waveform device), auscultation, chest rise

58
Q

Supraglottic Airways- Clinical Considerations

A

An attempt at supraglottic airway insertion is defined as the insertion of a supraglottic airway into the mouth. Confirmation of supraglottic airway should use ETCO2 (Waveform capnography). If waveform capnography is not available or is not working, then at least 2 secondary
methods must be used.

59
Q

N/V- Indications

A

Nausea or vomiting

60
Q

N/V- Conditions Ondansetron

A

Weight: ≥25 kg
LOA: unaltered

61
Q

N/V- Conditions Dimenhydrinate

A

Age: < 65 years
Weight: ≥25 kg
LOA: unaltered

62
Q

N/V- Contraindications Ondansetron

A

Allergy to ondansetron
Prolonged QT syndrome
Apomorphine use

63
Q

N/V- Contraindications Dimenhydrinate

A

Allergy or sensitivity to dimenhydrinate
Overdose on antihistamines or anticholinergics or tryclic antidepressant
Co-administration of diphenhydramine

64
Q

N/V- Treatment Ondansetron

A

Route: PO
Dose: 4mg
Max single dose: 4mg
Max # of doses: 1

65
Q

N/V- Treatment Dimenhydrinate

A

Weight: ≥25 kg to <50 kg
Route: IV/IM
Dose: 25mg
Max single dose: 25mg
Max # of doses: 1

Weight: ≥50 kg
Route: IV/IM
Dose: 50 mg
Max single dose: 50 mg
Max # of doses: 1

66
Q

N/V- Clinical Considerations

A

Prior to IV administration, dilute dimenhydrinate (concentration of 50mg/1ml) 1:9 with normal saline or D5W. If IM, do not dilute.
If a patient has received Ondansetron and has no relief of their nausea & vomiting symptoms after 30 mins, dimenhydrinate may be considered.

67
Q

Opioid Toxicity- Indications

A

Altered LOC
AND
Resp. depression
AND
Inability to adequately ventilate OR persistent need for ventilation
AND
Suspected overdose

68
Q

Opioid Toxicity- Conditions Naloxone

A

Age: ≥ 24 hours
LOA: altered
RR: < 10 breaths/min

69
Q

Opioid Toxicity- Contraindications Naloxone

A

Allergy or sensitivity to naloxone

70
Q

Opioid Toxicity- Treatment Naloxone

A

Route: IV
Dose: up to 0.4mg
Max single dose: 0.4mg
Dosing interval: 5 min
Max # of doses: 3

Route: IM
Dose: 0.4mg
Max single dose: 0.4mg
Dosing interval: 5 min
Max # of doses: 3

Route: IN
Dose: 2-4mg
Max single dose: 2-4mg
Dosing interval: 5 min
Max # of doses: 3

Route: SC
Dose: 0.8mg
Max single dose: 0.8mg
Dosing interval: 5 min
Max # of doses: 3

71
Q

Opioid Toxicity- Clinical Considerations

A

Upfront aggressive management of the airway is paramount and the initial priority.
If no response to initial treatment; consider patching for further doses.
If the pt does not respond to airway management and the administration of naloxone, glucometry should be considered.
Combative behaviour should be anticipated following naloxone administration and paramedics should protect themselves accordingly, thus the importance of gradual titrating (if given IV) to desired clinical effect; RR: ≥ 10, adequate airway and ventilation, not full alertness.

72
Q

Adrenal Crisis- Indications

A

A patient with primary adrenal failure who is experiencing clinical signs of adrenal crisis.

73
Q

Adrenal Crisis- Conditions Hydrocortisone

A

Paramedics are presented with a vial of hydrocortisone for the identified patient
AND
Age-related hypoglycemia OR
GI symptoms (vomiting, diarrhea, abdo pain) OR
Syncope
OR
Temp ≥ 38 degrees or suspected/history of fever OR
Altered LOA OR
Age-related tachycardia OR
Age-related hypotension

74
Q

Adrenal Crisis- Contraindications Hydrocortisone

A

Allergy or sensitivity to hydrocortisone

75
Q

Adrenal Crisis- Treatment Hydrocortisone

A

Route: IM/IV
Dose: 2mg/kg
Max single dose: 100mg
Max # of doses: 1

76
Q

Emergency Childbirth- Indications

A

Pregnant patient experiencing labour OR
Post-partum patient immediately following delivery and/or placenta

77
Q

Emergency Childbirth- Conditions Oxytocin

A

Age: Childbearing years
SBP: <160 mmHg
Other: Postpartum delivery
AND/OR
Placental delivery

78
Q

Emergency Childbirth- Contraindications Oxytocin

A

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

79
Q

Emergency Childbirth- Treatment Oxytocin

A

Route: IM
Dose: 10 units
Max single dose: 10 units
Max # of doses: 1

80
Q

IV and Fluid Therapy- Indications

A

Actual or potential need for intravenous medication OR fluid therapy

81
Q

IV and Fluid Therapy- Conditions IV Cannulation

A

Age: ≥ 2 years

82
Q

IV and Fluid Therapy- Conditions 0.9% NaCl Fluid Bolus

A

Age: ≥ 2 years
SBP: hypotensive

83
Q

IV and Fluid Therapy- Contraindications IV Cannulation

A

Suspected fracture proximal to the access site

84
Q

IV and Fluid Therapy Contraindications 0.9% NaCl Fluid Bolus

A

Fluid Overload

85
Q

IV and Fluid Therapy- 0.9% NaCl Maintenance Infusion

A

Age: ≥ 2 years to < 12 years
Route: IV
Infusion 15 ml/hr

Age: ≥ 12 years
Route: IV
Infusion 30-60 ml/hr

86
Q

IV and Fluid Therapy- Mandatory Patch Point

A

Patch to BHP for authorization to administer 0.9% NaCl fluid bolus to hypotensive patients ≥ 2 years to < 12 years with suspected DKA

87
Q

IV and Fluid Therapy- Treatment 0.9% NaCl Fluid Bolus

A

Age: ≥ 2 years to < 12 years
Route: IV
Infusion: 20 ml/kg
Reassess every: 100 ml
Max volume: 2000 ml

Age: ≥ 12 years
Route: IV
Infusion: 20 ml/kg
Reassess every: 250 ml
Max volume: 2000 ml

88
Q

IV and Fluid Therapy- Clinical Considerations

A

Microdrips and/or volume control administration sets should be considered when IV access is indicated for patients < 12 years of age.
An IV fluid bolus may be considered for a patient who does not meet trauma TOR criteria, where it does not delay transport and should not be prioritized over management of other reversible causes.

89
Q

Cardiogenic Shock- Indications

A

STEMI positive 12 lead ECG
AND
Cardiogenic shock

90
Q

Cardiogenic Shock- Conditions 0.9% NaCl Fluid Bolus

A

Age: ≥ 18 years
SBP: hypotensive
Other: chest auscultation

91
Q

Cardiogenic Shock- Contraindications 0.9% NaCl Fluid Bolus

A

Fluid Overload
SBP ≥ 90 mmHg

92
Q

Cardiogenic Shock- Treatment 0.9% NaCl Fluid Bolus

A

Route: IV
Infusion: 10 ml/kg
Reassess every: 250 ml
Max Volume: 1000 ml

93
Q

CPAP- Indications

A

Severe resp. distress
AND
signs and/or symptoms of acute pulmonary edema or COPD

94
Q

CPAP- Conditions

A

Age: ≥ 18 years old
RR: tachypnea
SBP: normotension
Other: Spo2 < 90% or accessory muscle use

95
Q

CPAP- Contraindications

A

Asthma exacerbation
Suspected pneumothorax
Unprotected or unstable airway
Major trauma or burns to the head or torso
Tracheostomy
Inability to sit upright
Unable to cooperate

96
Q

CPAP- Treatment

A

Initial Setting: 5 cm H2O or equivalent flow rate of device as per RBHP direction
Titration increment: 2.5 cm H2O or equivalent…
Titration interval: 5 min
Max setting: 15 cm H2O or equvalent…

97
Q

CPAP- Consider increasing FiO2 (if available)

A

Initial FiO2: 50-100%
FiO2 increment (if available on device): Spo2 <92% despite treatment and/or 10 cm H2O pressure or equivalent flow rate of device as per RBHP direction
Max FiO2: 100%

98
Q
A

2nd Year PCP (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions