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EMT > Company Protocol > Flashcards

Company Protocol Flashcards

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1
Q 
Assessment:
dyspnea a/o cyanosis
diaphoresis
erect posture
distended neck veins
bilateral rales
tachycardia
H of CHF
A

Suspect acute pulmonary edema

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2
Q 
Assessment:
dyspnea
bilateral wheezes
urticaria
gen. erythemia
H of sting or ingestion
A

Suspect anaphylactic shock

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3
Q 
Assessment:
tachy/brady dysrhythmia, acute MI, blunt chest trauma
distended neck veins
rales/rhonchi
peripheral edema
A

Suspect cardiogenic shock
Consider tension pneumothorax
Consider cardiac tamponade

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4
Q 
Assessment:
confusion
severe headaches
speech disturbances
visual disturbances
effected coordination
staggered gate
hemiparesis or hemiplegia
unconscious a/o UR
A

Suspect cerebrovascular accident

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5
Q 
Assessment:
altered CNS
tachycardia/thready pulse
kussmaul breathing
hypotension
dry mucous membranes
cool skin
fruity odor
abdominal pain
nausea
vomiting
polyuria
polydipsia
polyphagia
A

Suspect hyperglycemia

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6
Q 
Assessment:
headache
blurred vision
dizziness
weakness
elevated blood pressure
nose bleeds
dyspnea
peripheral edema
pulmonary edema
A

Suspect hypertensive crisis

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7
Q 
Assessment:
febrile
hot dry skin
hypotensive
H of exposure
H of exertion
A

Suspect hyperthermia

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8
Q 
Assessment:
confusion
agitation
headaches
comatose
normal or tachycardic
shallow, slow R
diaphoresis
cool skin
flaccid muscle tone
Grand mal seizure
incontinence
A

Suspect hypoglycemia

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9
Q 
Assessment:
altered LoC
bradycardia
hypotension
temp
A

Suspect hypothermia

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10
Q 
Assessment:
blood loss
dehydration
HR >120
BP
A

Suspect hypovolemic shock

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11
Q

Assessment:
spinal injury or overdose
S of hypovolemic shock w/o peripheral vasoconstriction

A

Suspect neurogenic shock

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12
Q

Assessment:
slight R rate increase
mild wheezes
good skin color

A

Suspect mild respiratory distress

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13
Q

Assessment:
marked R rate increase
noticeable wheezes
accessory muscle use

A

Suspect moderate respiratory distress

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14
Q

Assessment:
R rate >twice of normal
loud wheezes or no wheezes
Pt anxious, ashen skin

A

Suspect severe respiratory distress

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15
Q 
Assessment:
cool, clammy skin
febrile
tachycardia/hypotension
H of infection
A

Suspect septic shock

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16
Q 
Assessment:
substernal oppressive pain
nausea a/o vomiting
dyspnea
diaphoresis
palpitations
H of CAD
H of CHF
cardiac medication use
syncope
tachycardia
bradycardia
A

Suspect symptomatic/ asymptomatic chest pain

17
Q 
Assessment:
acute respiratory distress or cyanosis w/ MoI and increasing distress
cyanosis
decreased/absent breath sounds unilaterally
hyper-resonance of chest unilateral
distended neck veins
subcutaneous emphysema
hypotension/cardiac arrhytmia (late)
tracheal deviation (late)
A

Suspect tension pneumothorax

18
Q 
Assessment:
substernal oppressive pain
nausea a/o vomiting
dyspnea
diaphoresis
palpitations
H of CAD
H of CHF
cardiac medication use
syncope
tachycardia
bradycardia
A

Suspect STEMI

19
Q 
Assessment:
no pneumothorax
Pt alert, cooperative
patent airway
R rate >25 
Sys BP of 90 mmHg
accessory muscle use
A

Consider CPAP

20
Q

Treat acute pulmonary edema

A

POC, O2, Heart Mon + VS, IV + lock

  1. Nitro 0.4 mg SL PRN x 3 Q 5 minutes (hold if hypotensive)
  2. Lasix 40-80mg IV over 2-3 min (1mg/kg in severe)
  3. Morphine Sulfate up to 10 mg IV slow titrated to BP + R
  4. Consider intubation
  5. Dopamine titrate to pt BP if hypotensive
  6. Contact MedCon
21
Q

Treat anaphylactic shock

A
  1. O2 100% + consider airway support
  2. Epi. 1:1,000 0.3mg SQ
  3. IV LacRing L bore - monitor hypotension
  4. Benadryl 50mg IVP
  5. Decadron 4mg IVP
  6. Contact MedCon (consider Epi 1:10,000 IV in severe)
22
Q

Treat cardiogenic shock

A
  1. Semi-fowlers or POC
  2. O2 100% + consider airway support
  3. IV NACL L bore
  4. Fluid challenge 500mL if low BP
  5. Consider Dopamine 2-20 mcg/kg/min on infusion pump (or dial-a-flow if NA)
  6. Contact MedCon
23
Q

Treat cerebrovascular accident

A

O2, consider intubation, heart mon + VS, IV + lock

  1. Check sugar, admin D50 + recheck
  2. Narcan 2mg IVP if narcotics suspect
  3. Keep head elevated
  4. Maintain body heat
  5. Anticipate seizures- treat w/ Valium up to 10mg IV Slow
  6. Doc stroke scale outcomes to det stroke status
  7. Contact MedCon
24
Q

Treat drug ingestion- pt CONSCIOUS, patent, and substance NOT acid/alkali/petroleum base

A
  1. Protect self from exposure/unruly pt
  2. O2
  3. IV + lock
  4. Narcan 2mg titrated to effect if narcotics suspected
  5. Valium IV slow up to 10mg if pt convulses

A. If conscious, patent, and NOT acid/alkali/petroleum:

  1. Insert NG tube + lavage 1000mL H2O
  2. Actidose 50g via NG tube
25
Q

Treat external chemical exposure

A
  1. Protect self from exposure
  2. ID subs + verify MSDS when possible
  3. Notify proper agencies of location of spill + truck #s
  4. Contact MedCon/PsnCon
  5. Protect self from exposure
  6. Remove pt from source + clothing
  7. Decontaminate as directed by MedCon/PsnCon
26
Q

Treat chemical exposure-inhalation

A
  1. Protect self from exposure
  2. ID subs + verify MSDS when possible
  3. Notify proper agencies of location of spill + truck #s
  4. Contact MedCon/PsnCon
  5. Protect self from exposure
  6. Remove pt from source (consider “C” haz mat suits + hood)
  7. O2 100%
  8. Treat SS as present
    Contact MedCon/PsnCon
27
Q

Treat drug ingestion- pt UNconscious, or substance IS acid/alkali/petroleum base

A
  1. Protect self from exposure/unruly pt
  2. O2
  3. IV + lock
  4. Narcan 2mg titrated to effect if narcotics suspected
  5. Valium IV slow up to 10mg if pt convulses

B. If unconscious or IS acid/alkali/petroleum base:

  1. ABC’s, IV + lock, heart mon
  2. Insert NG tube + lavage 1000 mL H2O
  3. Actidose 50g via NG tube
  4. Contact MedCon
28
Q

Treat hyperglycemia

A
  1. O2
  2. IV NACL KVO (consider fluid bolus if hypotensive)
  3. If sugar >250mg/dL, increase IV rate to 200 mL/hr and heart mon
  4. Contact MedCon
29
Q

Treat hypertensive crisis

A
  1. O2
  2. Elevate pt head
  3. Heart mon
  4. IV + lock
  5. Consider nitroglycerin 0.4 mg SL (do not rapidly drop BP)
  6. Contact MedCon
30
Q

Treat hyperthermia

A
  1. O2
  2. Remove clothing + cover w/ tepid H2O, esp forearms
  3. Expose circulating air
  4. Consider cold packs behind neck + under arms
  5. IV LacRing KVO + heart mon
  6. Consider fluid bolus if pt tachycardic or hypotensive
  7. Contact MedCon
31
Q

Treat hypoglycemia

A
  1. Monitor VS
  2. Heart mon if comatose
  3. O2
  4. IV + lock
  5. Check sugar
    If
32
Q

Treat hypothermia- unconscious + pulseless (evaluate one full minute)

A
  1. Handle gently- no triggering V-Fib
  2. Remove wet clothing; dry + cover
  3. Warm humidified O2

Unconscious + Pulseless

  1. CPR & O2, intubate as needed
  2. DO NOT CPR if bradycardic rhythm on monitor
  3. Contact MedCon
33
Q

Treat hypothermia- fibrillating + core temp

A
  1. Handle gently- no triggering V-Fib
  2. Remove wet clothing; dry + cover
  3. Warm humidified O2

Fibrillating +

34
Q

Treat hypothermia- fibrillating + core temp >85F

A
  1. Handle gently- no triggering V-Fib
  2. Remove wet clothing; dry + cover
  3. Warm humidified O2

Fibrillating + >85F

  1. V-Fib protocol
  2. Contact MedCon
35
Q

Treat hypothermia- transport time >15 min

A
  1. Handle gently- no triggering V-Fib
  2. Remove wet clothing; dry + cover
  3. Warm humidified O2

Transport time >15min

  1. Add heat via warm external objects to head, neck, chest, + groin
  2. Do not warm extremities
  3. Contact MedCon
36
Q

Treat hypovolemic shock

A
  1. O2
  2. Control bleeding
  3. Two large bore IV’s (blood set for one if possible)
  4. Heart mon + VS
  5. Keep warm + cover
  6. Contact MedCon

EMT (10 decks)

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