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RCEMS Protocols 9/24 > Cardiac - Adult > Flashcards

Cardiac - Adult Flashcards

1
Q

What is the scene time goal for cardiac chest pain?

A

<15 min

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2
Q

Should a cardiac chest pain patient’s EKG be transmitted to the receiving hospital?

A

Yes, if able

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3
Q

What is the criteria for a STEMI ALERT?

A

St elevation >1mm in two or more leads
OR
LBBB not known to be old in patient with typical symptoms

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4
Q

Should oxygen be placed on a patient with cardiac chest pain?

A

Only if the patient has respiratory distress

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5
Q

If a cardiac chest pain patient has respiratory distress, how should O2 be placed?

A

O2 at 2LPM via ETCO2 if SPO2 < 95% or in acute distress

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5
Q

What is the first medication given for cardiac chest pain?

A

ASA 324mg PO

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5
Q

What is the dose of Aspirin for a cardiac chest pain patient?

A

324mg PO

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6
Q

How is ASA given for cardiac chest pain

A

PO - chew, do not swallow

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6
Q

If cocaine usage is suspected in a cardiac chest pain patient, what medication can be given?

A

Versed 2mg IVP or 5mg IM/IN
Consult Medical Control for repeat dosages

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7
Q

If a cardiac chest pain patient has allergy to fentanyl, what medication can be administered for pain relief?

A

Versed 2mg IVP or 5mg IM/IN
Consult Medical Control for repeat dosages

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8
Q

What is the versed dosage for cardiac chest pain?

A

Versed 2mg IVP or 5mg IM/IN
Consult Medical Control for repeat dosages

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9
Q

Why is ASA given for cardiac chest pain?

A

ASA inhibits blood clots

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10
Q

What type of medication is ASA?

A

Nonsteroidal anti-inflammatory drug (NSAID

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11
Q

Is ASA a blood thinner?

A

No - though many patients may refer to it as one. It is important to ask if a patient is already taking ASA daily.

Aspirin is considered a platelet aggregator or a thromboxane A2 inhibitor.

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12
Q

When can Amiodarone be considered for PVCs?

A

If they present >6/min and/or have R on T phenomenon

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13
Q

What dose of Amiodarone can be given for R on T or PVCs >6/min?

A

150mg in 100ml D5W over 10mins

14
Q

Over how long should Amiodarone be administered?

A

10mins

15
Q

What medication should be administered after ASA for cardiac chest pain?

A

Nitroglycerin

16
Q

What vital sign should be considered when administering NTG?

A

Blood pressure - maintain SBP over 90mmHG

17
Q

What should be done if a patient is being given NTG for cardiac chest pain and becomes hypotensive?

A

NTG should immediately be stopped or titrated down. NS or Normosol IV bolus should be given.

18
Q

How can NTG be given for cardiac chest pain?

A

NTG pill: 0.4mg SL every 5 min (no max dose)
or
NTG Spray: SL 400mcg per spray
or
NTG paste: 1-1.5 inch applied to left chest. An additional dose of 0.5-1 inch can be applied to the opposite side of the chest
or
NTG infusion: 60mcg/min IV and titrate for comfort, max of 200mcg/min

19
Q

What is the cardiac chest pain dosage of NTG pills?

A

NTG pill: 0.4mg SL every 5 min (no max dose)

20
Q

What is the cardiac chest pain dosage of NTG spray?

A

NTG Spray: SL 400mcg per spray

21
Q

What is the cardiac chest pain dosage of NTG paste?

A

NTG paste: 1-1.5 inch applied to left chest. An additional dose of 0.5-1 inch can be applied to the opposite side of the chest

22
Q

What is the cardiac chest pain dosage of NTG infusion?

A

NTG infusion: 60mcg/min IV and titrate for comfort, max of 200mcg/min

23
Q

What is the max dose of cardiac chest pain NTG infusion?

A

200mcg/min

24
Q

What is the max dose of cardiac chest pain NTG pills?

A

There is no max dose for NTG pills.

25
Q

How often can NTG pills be given for cardiac chest pain?

A

Every 5mins as needed

26
Q

If pain persists for a cardiac chest pain patient despite front line treatments, what medications can be administered?

A

Fentanyl: 50-100mcg SLOW IV
or
Dilaudid: 0.5-1mg SLOW IV

27
Q

What is the cardiac chest pain dosage of Fentanyl?

A

Fentanyl: 50-100mcg SLOW IV

28
Q

What is the cardiac chest pain dosage of Dilaudid?

A

Dilaudid: 0.5-1mg SLOW IV

29
Q

How should fentanyl be pushed for cardiac chest pain?

A

Slowly via IV

30
Q

How should dilaudid be pushed for cardiac chest pain?

A

Slowly via IV

31
Q

If a cardiac chest pain patient becomes nauseous, what medication should be given?

A

Zofran: 4mg IV/PO

32
Q

What is the dosage for Zofran for a cardiac chest pain patient?

A

4mg IV/PO

33
Q

What patients should NOT be given NTG in any form?

A

If ED meds have been taken within past 24-72hrs, any patient taking Retavio for CHF/pulmonary hypertension, SBP less than 100mmHG or DBP less than 60mmHG

34
Q

What kind of drug is nitroglycerin?

A

Vasodilator

RCEMS Protocols 9/24 (17 decks)

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