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Advanced Care Paramedic > BCEHS ACP Content > Flashcards

BCEHS ACP Content Flashcards

1
Q

Ipratropium Bromide Indications (1)

A

Severe bronchospasm

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2
Q

Ipratropium Bromide Adult Dose (Bronchospasm) (1)

A

8x20mcg MDI (160mcg total)

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3
Q

Ipratropium Bromide Contraindications (1)

A

Hypersensitivity/allergy

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4
Q

Salbutamol Indications (2)

A
  • Bronchospasm

- Hyperkalemia

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5
Q

Salbutamol Adult Dose (Hyperkalemia) (1)

A

10-20mg Nebulized, (MDI 4x100mcg to effect during COVID)

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6
Q

Magnesium Sulfate Indications (3)

A
  • VF/VT refractory to appropriate first line antiarrythmics
  • Bronchospasm refractory to bronchodilaton in asthma
  • Seizure control in suspected eclampsia
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7
Q

Magnesium Sulfate Adult Dose (VF/VT refractory to appropriate first line antiarrythmics) (2)

A
  • Perfusing: 2g over 15 mins (ex torsades or after amiodorone in monomorphic) (mandatory clinicall)
  • Non-perfusing: 4g IVP
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8
Q

Magnesium Sulfate Dose Adult (Bronchospasm refractory to bronchodilaton) (1)

A

2g over 20 mins

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9
Q

Magnesium Sulfate Dose Adult (Seizure control in suspected eclampsia) (2)

A
  • 5g IV over 20 mins (if seizure refractory up to 4g over 5 mins indicated)
  • 5g IM bilateral buttocks (not preferred)
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10
Q

Magnesium Sulfate Dose Pediatric (Cardiac arrest) (1)

A

50mg/kg IVP max 2g

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11
Q

Magnesium Sulfate Dose Pediatric (All non cardiac arrest indications) (1)

A

50mg/kg IV over 15 mins max 2g

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12
Q

Ipatropium Bromide Pediatric Dose (Bronchospasm) (1)

A

Call clinicall for dose

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13
Q

Magnesium Sulfate Contraindications (2)

A
  • 2nd/3rd degree heart block

- Hypersensitivity/allergy

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14
Q

Atropine Indications (2)

A
  • Symptomatic bradycardia

- Organophosphate poisoning

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15
Q

Atropine Adult Dose (Symptomatic bradycardia) (1)

A

0.6mg q5 mins, max 0.04mg/kg (3mg in most patients)

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16
Q

Atropine Adult Dose (Organophosphate poisoning) (1)

A

1-2mg IV/IM q5-60 mins PRN (Mandatory clinicall)

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17
Q

Atropine Pediatric Dose (Symptomatic bradycardia) (1)

A

0.02mg/kg RIVP, minimum 0.1mg, maximum 0.6mg; max total dose 0.04mg/kg

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18
Q

Atropine Pediatric Dose (Organophosphate poisoning) (1)

A

0.02-0.05mg/kg IV q10-20 mins PRN (Mandatory clinicall)

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19
Q

Atropine Contraindications (5)

A
  • Hypersensitivity/allergy
  • Glaucoma
  • Prostate hypertrophy
  • Myasthenia gravis
  • Severe hyperthyroidism (or other tachycardias)
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20
Q

Epinephrine Indications (6)

A
  • Severe bronchospasm
  • Anaphylaxis
  • Croup
  • Cardiac arrest
  • Significant bradycardia
  • Push pressor
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21
Q

Epinephrine Adult Dose (Cardiac arrest) (1)

A

1mg IV q3-5mins, max 4 doses

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22
Q

Epinephrine Pediatric Dose (Cardiac arrest) (1)

A

0.01mg//kg IV max 1mg q3-5 mins, max 4 doses

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23
Q

Epinephrine Adult Dose (Significant bradycardia) (1)

A

2-10mcg/minute IV infusion, increase to effect q2-3 mins

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24
Q

Epinephrine Pediatric Dose (Significant bradycardia) (1)

A

0.01mg/kg IVP q3-5 mins PRN, max 0.5mg/dose

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25
Q

Epinephrine Adult Dose (Push pressor) (1)

A

10mcg 1:100’000 SIVP PRN (may opt to do larger doses such as 20-30 if refractory) q2-3 mins

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26
Q

Epinephrine Pediatric Dose (Push pressor) (1)

A

1mcg/kg SIVP q2-3 mins

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27
Q

Transcutaneous Pacing Indications (2)

A
  • Unstable bradycardia

- Bradycardia refractory to atropine/epinephrine infusion

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28
Q

Transcutaneous Pacing for Pediatrics (1)

A

Mandatory clinicall

29
Q

Adenosine Indications (1)

A

Termination of SVT

30
Q

Adenosine Adult Dose (1)

A

6mg RIVP followed by a large flush, if refractory follow up with 12mg RIVP followed by a large flush

31
Q

Adenosine Pediatric Dose (1)

A

0.1mg (max 6mg) RIVP followed by large flush, if refractory follow up with 0.2mg/kg (max 12mg) RIVP followed by large flush

32
Q

Adenosine Contraindications (3)

A
  • Hypersensitivity/allergy
  • 2nd/3rd degree heart block or its with SSS
  • Drug/poisoning induced SVT
33
Q

Recommended Initial Energy Levels for Adult in Unstable SVT or AFL

34
Q

Recommended Initial Energy Levels for Adult Unstable Perfusing Monomorphic VT?

35
Q

Recommended Initial Energy Levels for Adult Unstable AFib?

A

200J (Mandatory clinicall if onset is believed to be greater than 48h from EMS arrival)

36
Q

Adult Procedural Sedation Drug and Dose

A

0.5mg/kg Ketamine, repeat 0.25mg/kg q1min PRN until sedation level desired

37
Q

Pediatric Procedural Sedation

A

Call Clinicall for Dose

38
Q

Amiodorone Indications (3)

A
  • Refractory VF/VT (cardiac arrest)
  • Unstable VT following cardioversion
  • Stable monomorphic WCT (clinicall mandatory)
39
Q

Amiodarone Adult Dose (Refractory VF/VT in cardiac arrest) (1)

A

300mg IVP, repeat 150mg IVP after 10 minutes if refractory

40
Q

Amiodarone Adult Dose (Unstable VT Following Cardioversion) (1)

A

150mg IV over 10 mins

41
Q

Amiodarone Adult Dose (Stable Monomorphic WCT) (1)

A

150mg IV over 10 mins

42
Q

Amiodarone Peds Dosage (All Indications)(1)

A

5mg/kg IV max 300/150 mg, call clinicall mandatory to discuss dose

43
Q

Amiodorone Contraindications (3)

A
  • Cardiogenic shock
  • Hypersensitivity/allergy
  • 2nd/3rd degree heart block
44
Q

Adult Defib Doses

A

200, 300, 360 J

45
Q

Peds Defib Dose

A

2J/kg, 4J/kg

46
Q

Pediatric Cardioversion Dose

A

0.5-1J/kgthen 2J/kg if refractory

47
Q

Nitroglycerine Adult Dose (APE)

A

0.4mg SL q3-5 mins. 0.8mg is arterial dilation dose, consider this in extreme hypertension/increased LV afterload?

48
Q

Preferred Landmark Sites (In Order) For Needle Thoracentesis? (2)

A
  • Mid axillary 5th intercostal space (#1)

- Mid clavicular 2nd intercostal space (#2)

49
Q

Calcium Chloride Indications (2)

A
  • Known or suspected hyperkalemia (ie renal failure, DKA, ECG changes)
  • CCB OD with hemodynamic instability
50
Q

Calcium Chloride Adult Dose (All Indications)

A

1g over 3 minutes, repeat once q5-10 mins if still indicated

51
Q

Calcium Chloride Pediatric Dose (Cardiac Arrest Hyperkalemia)

A

20mg/kg max of 1g over 3 mins, repeat once q10 mins if still indicated

52
Q

Calcium Chloride Pediatric Dose (Non-Cardiac Arrest Hyperkalemia/CCB OD)

A

10mg/kg over 15mins max dose 1g, repeat once q10 mins if still indicated

53
Q

Caclium Chloride Contraindications (2)

A
  • Hypersensitivity/Allergy

- Hypercalcemia

54
Q

Sodium Bicarbonate Indications (4)

A
  • Known or suspected hyperkalemia (if patient has metabolic acidosis only for the purpose of a K+ shift) (clinicall mandatory)
  • TCA or salicylate OD
  • Known or suspected metabolic acidosis
  • Pre-treatment prior to weight release in crush injury (clinicall mandatory)
55
Q

Sodium Bicarbonate Contraindications (2)

A
  • Excessive vomiting (which causes excessive Cl- loss)

- Suspected metabolic alkalosis

56
Q

Sodium Bicarbonate Adult Dose (All Indications)

A

1mEq/kg SIVP, repeat 1/2 doses q10-15 mins PRN

57
Q

Sodium Bicarbonate Infant Dose (All Indications)

A

1-2mEq/kg very slow IVP, repeat 1/2 doses q10-15 mins PRN. Use 4.2% solution for infant

58
Q

Sodium Bicarbonate Child Dose (All Indications)

A

1-3mEq/kg SIVP, repeat 1/2 doses q10-15 mins

59
Q

S1 Q3 T3 Indicative of? Depicted as?

A

Indicative of R-sided heart strain. Seen as a deep s-wave in lead 1, a deep q-wave in lead 3, and an inverted t-wave in lead 3.

60
Q

QSOFA?

A

Indicative of severe sepsis, 2 of the following:

  • ALOC
  • Tachypnea
  • Hypoperfusion
61
Q

Brugada Syndrome (Definiton)

A

A genetic syndrome that causes arrhythmias and sudden death.

62
Q

Brugada Syndrome (12 Lead Features)

A

Pseudo RBBB and ST elevation in V1-V2

63
Q

R vs L BBB?

A

V1, if the J-point is upwards deflection, then right, if down, then left.

Also look at V1 and V6, if it is M shaped in V1 and W shaped in V6, then RBBB (MaRRoW). If W shaped in V1, and W shaped in V6, then LBBB (WiLLiaM)

64
Q

Wellens Syndrome (Definition)

A

Pre-infarction stage of CAD suggesting 80-90% LCA occlusion. Risk of progressing to full STEMI.

65
Q

Wellens Syndrome (12 Lead Features) (Type A, Type B)

A

Type A: Biphasic T wave V2-3 (goes down then up like a sine wave). 25% of the time.

Type B: Deeply inverted T-wave in V1-V4. 75% of the time.

66
Q

DeWinter’s T-waves (Definition)

A

Early signs of evolving STEMI

67
Q

DeWinter’s T-waves (12 Lead Features) (2)

A
  • Tall prominent T waves in precordial leads

- J-point depression (1mm+) with upsloping ST segments

68
Q

Sgarbossa Criteria (Definition)

A

Used to identify AMI in LBBB rhythm

69
Q

Sgarbossa Criteria (12 lead Features) (2)

A

-ST-elevation 1mm+ when positive QRS complex
OR
-ST depression 1mm+ in V1, V2, or V3 with a negative QRS complex

Advanced Care Paramedic (2 decks)

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