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ACP Precourse Study > Directives > Flashcards

Directives Flashcards

1
Q

Contraindications for adenosine

A

Allergy
Sinus tach, a fib, a flutter
Taking carbamazepine (Tegretol) or dipyridamole (persantine)
Broncho construction on exam

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2
Q

Amiodarone dose for tachydysthymia

A

150mg q10 mins
2 doses

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3
Q

Lidocaine dose for tachydysrhytmia

A

1.5mg/kg
Subsequent dose 0.75mg/kg
3 doses q10 mins

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4
Q

Dopamine contraindications for ROSC

A

Allergy
Pheochromocytoma
Tachydysrhythmia
Mechanical shock

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5
Q

Morphine dose for cardiac ischemia vs pain

A

2mg q5 minutes (5 doses)

Vs

0.05-0.1mg/kg (>1- <18), Max 5mg, q15, max 10mg

2-10mg (>18yo), q15, max 20mg

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6
Q

What age do you have to patch for dose verification in pain medication?

A

Less than 12 years old.

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7
Q

What are the indications for needle thoracostomy in traumatic arrest?

A

Age N/A
LOA N/A
HR N/A
RR N/A
SBP N/A
Other: suspected tension pneumothorax AND absent or severely diminished breath sounds on affected side.

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8
Q

What are the indications and conditions for needle thoracostomy in the tension pneumothorax medical directive?

A

Indications: pre-arrest or VSA AND absent or diminished breath sounds on affected side

Age N/A
LOA N/A
HR N/A
RR N/A
SBP: hypotension or VSA
Other N/A

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9
Q

What are the contraindications for dopamine in cardiogenic shock?

A

Allergy
Tachydysrhymias
Mechanical shock
Hypovolemia
Pheochcomocytoma

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10
Q

What are the contraindications for dopamine in cardiogenic shock?

A

Allergy
Tachydysrhymias
Mechanical shock
Hypovolemia
Pheochcomocytoma

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11
Q

What are the routes for fentanyl in procedural sedation directive?

A

IV, IO, CVAD, IN

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12
Q

What are the routes for fentanyl in procedural sedation directive?

A

IV, IO, CVAD, IN

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13
Q

What are the routes for Midazolam in procedural sedation?

A

IV, IO, CVAD, IN

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14
Q

Can you give fentanyl and midazolam for procedural sedation if hypotension was present but corrected?

A

Yes

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15
Q

What are the routes of administration for calcium gluconate?

A

IV, IO, CVAD

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16
Q

What is the ETT epi dose in neonate resus?

A

1:10,000
0.1mg/kg
Max dose 0.3mg (3ml)
Max # of doses 1

17
Q

What are the indications for tension pneumothorax directive?

A

Pre-arrest or VSA

AND

Absent or severely diminished breath sounds

18
Q

What are the routes for fentanyl for pain?

A

IV/IN

19
Q

What are the routes for morphine for the pain directive?

A

IV/SC

20
Q

What is the route for dopamine in ROSC medical directive?

A

IV

21
Q

What is the route if administration for midazolam in combative directive?

A

IV/IM/IN

22
Q

What is the route of administration for ketamine in combative patient directive?

A

IM

23
Q

What are the indications for pediatric/adult IO

A

Need for fluid/meds

AND

IV unobtainable

AND

Pre arrest or VSA

24
Q

What are the routes for midazolam in seizure activity?

A

IV, IO, IM, IN, Buccal

Double dose for IM, IN, Buccal

25
Q

What are the indications for cricothyrotomy?

A

Need to advanced airway management

AND

Intubation and supraglottic airway unsuccessful

AND

Unable to ventilate

26
Q

What are the indications for CVAD access

A

Actual or potential need for fluid/meds

And

IV unsuccessful

AND cardiac arrest or prearrest

27
Q

What are the contraindications for CVAD

A

Inability to confirm patency

Inability to flush or aspirate

Injury or fracture proximal

Swelling of involved limb

Bleeding at insertion site

28
Q

What is the route of admin for atropine?

A

IV

29
Q

What is the route of administration for dopamine in bradycardia?

A

IV

30
Q

What type of medication is atropine?

A

Antimuscarinic

31
Q

How does atropine work?

A

Works through the inhibition of post synaptic acetylcholine receptors. Blocks the parasympathetic response and allows sympathetic drive to take over.

32
Q

How does dopamine work?

A

Dopamine is a catecholamine that works on the alpha and beta receptors. 5mcg is beta dose increasing heart rate and contractility. Alpha dose causes vasoconstriction.

33
Q

What is the route of administration for amiodarone in cardiac arrest?

A

IV/IO/CVAD

34
Q

What is the route of administration of lidocaine in cardiac arrest?

A

IV/IO/CVAD/ETT

35
Q

What are the contraindications of intubation?

A

Age <50 AND asthma AND not in or near cardiac arrest

36
Q

What are the routes of administration of amiodarone in tachydysrhythmia directive?

A

IV

37
Q

What is the classification of adenosine? And how does it work?

A

Purine nucleoside

Across on purinergic adenosine receptors which are located in AV node.

Drives K+ outside of cells and inhibits Ca+ influx leading to HYPERpolarization.

38
Q

What is the classification and effect of amiodarone?

A

Class III antiarryhtmic

Works by inhibiting influx of Na+, as well as Ca+

Has alpha and beta ANTAGONIST effects

Blocks K+ during phase 3 of cardiac action potential (repolarization)

Prolongs refractory period of cardiac myocytes

39
Q

What is the classification of lidocaine and what is its effect?

A

Class 1B antiarrythmic

Binds to sodium channels and slows down influx of Na+ into cardiac myocytes.

ACP Precourse Study (11 decks)

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