Cardiac Protocols Flashcards
True or false: you should interrupt compressions to place an advanced airway.
False
If airway is initially maintainable w/ a BVM then you should delay rescue airway attempt until after
initial defib
When should you defibrillate a patient with an auto pulse and why?
when the band is compressed to minimize impedance
What are the consequences of hyperventilation?
decreased preload, cardiac output, coronary perfusion, and cerebral perfusion
In chest pain patients aspirin should only be withheld in what three circumstances?
1) allergy 2) GI bleed 3) Dispatch advised aspirin administration immediately prior to EMS arrival
When should you perform a right sided 12 lead?
If elevation is noted in leads II, III, avF, and V1, right sided involvement will be noted in lead V4R.
When there is a right sided MI what should your immediate action be?
Establish IV of normal saline at KVO. If time permits establish a second line with NS lock.
In patient with ST elevation and right sided involvement what should your NS actions be?
250ml Bolus as needed to maintain systolic BP greater than 90 mmHg. Max should be 20ml/kg and use caution in patients with CHF.
What can you consider if hypotension in the right sided STEMI patient persists?
Consider initiation of Levophed (Norepinephrine)
What can you give for pain in STEMI patients?
Fentanyl 1 to 3 mcg per kg for pain if systolic BP is over 90 mmHg.
What should your actions be after aspirin for the non rightsided STEMI patient?
Make sure patient has not taken any ED drugs (Viagra, Cialis, Levitra in the past 24 hours. If systolic BP is over 90mmHg, administer Nitro 0.4 mg SL every 5 minutes for a max of 3 doses.
What are the generic names for Cialis, Viagra, and Levitra?
Cialis is Tadalafil, Viagra is Sildenafil, Levitra is Vardenafil
What can you give the chest pain patient for nausea/vomiting and what dose?
Zofran 0.1mg/kg slow over 2-5 minutes max of 4.0mg per dose.
Which hospitals are recognized PCI centers in the Richmond area?
Chippenham, Henrico Doctors Hospital, Memorial Regional Medical Center, Southside Regional Medical Center, St. Francis, St. Mary’s, McGuire’s, and VCU
In rightsided MIs the fluid bolus helps with
Preload
If 12 lead does not indicate AMI and you have reason to believe chest pain is due to cocaine use what can you do?
Administer Versed 2.5 to 5 mg slow IVP
Which leads will have elevation and reciprocal depression in a septal MI?
Leads V1 and V2. No reciprocal depression.
Which leads will have elevation and reciprocal depression in an anterior MI?
Lead V3 and V4. No reciprocal depression
Which leads will have elevation and reciprocal depression in an antero-septal MI?
Leads V1, V2, V3, V4. No reciprocal depression.
Which leads will have elevation and reciprocal depression in a lateral MI?
Leads I, avL, V5, V6. Reciprocal in II, III, avF
Which leads will have elevation and reciprocal depression in an anterolateral MI?
Leads I, avL, V3, V4, V5, V6. Reciprocal in II, III, avF
Which leads will have elevation and reciprocal depression in a inferior MI?
Leads II, III, avF. Reciprocal in I, avF
Which leads will have elevation and reciprocal depression in an infero-lateral MI?
Leads II, III, avF, V5, V6. Reciprocal in I, avL, V1, V2
Which leads will have elevation and reciprocal depression in a posterior MI?
No elevation. Reciprocal in V1, V2, V3, V4
