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Primary Care paramedic > ema protocols > Flashcards

ema protocols Flashcards

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1
Q

Indications for initiating a N/S IV?

A

to replace fluids for hypovolemia(bleeding, diarrhea, vomiting) ((burns))
Administer Medication
suspected shock or TBI
DO NOT DELAY TRANSPORT OF UNSTABLE PATIENT TO START AN IV

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2
Q

Indications for hypovolemia protocol?

A

evidence of significant fluid loss (bleeding, diarrhea, vomit)
Systolic BP <90mmHg
anticipated shock or signs of shock
2nd and 3rd degree burns >20% TBSA

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3
Q

maintain rate for N/S?

A

75ml/hr X 10gtts/min / 60mins/hr = 12.5 gtts/min

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4
Q

what should be completed before initiating an IV of N/S?

A

Complete primary
load and transport
SAMPLE history
obtain baseline vitals
auscultate the lungs (looking for crackles=edema)
verify indications and contraindications
Six rights (check fluid -expiry, dose..etc)

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5
Q

Contraindications for N/S?

A

None

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6
Q

Rate for N/S with a SBP > 90?

A

75ml/hr = approx 1 drop every 5 sec

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7
Q

bolus amount for N/S?

A

500ml with a BP <90

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8
Q

cautions for hypovolemic protcol

A

shortness of breath

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9
Q

Max dose of N/S

A

2000ml Must auscultate and do vitals between each 500ml bolus

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10
Q

nausea and vomiting protocol indications

A

pt. experiencing N/V or vertigo

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11
Q

Contraindications for Dimenhydrinate

A

Known hypersensitivity or allergy to Gravol (dimenhyrinate)

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12
Q

Dimenhydrinate Cautions

A

Glaucoma (increased intraocular pressure)
Asthma/COPD
cardiovascular disease (htn, ischemic heart disease)
Prostatic hyperplasia/urinary obstruction
Elderly (frail)
Pregnancy

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13
Q

Dimenhydrinate Doses

A

1mg/kg to a max of 50mg
phone if patient is <25kg
12.5 mg in the frail and elderly

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14
Q

Routes of administration for dimenhydrinate?

A

IM 50mg/ml

IV slow push over 2 mins, 50mg/ml + 9ml N/S

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15
Q

TXA indications

A 
Trauma suggesting occult bleeding
>16 y/o 
SBP <90mmHG
Heart rate>110
within 3hrs from time of injury and on route to hospital
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16
Q

TXA contraindications

A

Known hypersensitivity to TXA

Doesn’t meet indications, ie, time is greater then 3 hrs after injury, Patient is under 16

17
Q

tranexamic acid TXA dose

A

1g/10ml TXA infused in 50ml N/S (piggy back) 60gtts/min = 1 gtts/sec
OR slow IV push 1g/10ml TXA over 10mins

18
Q

txa Cautions

A

hypotension if administered to quickly

19
Q

indications for Salbutamol

A

SOB with a Hx of asthma or COPD

Broncospasms and wheezing

20
Q

contraindications for Salbutamol

A

hemodynamically significant tachyarrhythmias

allergy to salbutamol

21
Q

Neb dose for salbutamol

A

> 15kg 5mg/5ml

<15kg 2.5ml/2.5mg

22
Q

Ventolin Drug class

A

Sympathomimetic

bronchodilator

23
Q

What is meant by a staged approach to SOB protocol

A

start with o2 in primary
include chest exam and auscultation after RBS
transport
obtain Hx and vitals
If patient meets criteria for treatment admin. Salbutamol
if not explore other causes and SOB consider CPAP?

24
Q

CPAP Indications

A 
>13 y/o in respiratory distress
maintain a patent airway
Exhibits ALL the following:
RR>24
SpO2 <94% on O2
Acessory Muscle use
25
Q

CPAP Contraindications

A 
Low LOC'S
RA
Vomiting
unable to fit the mask
<12y/o
Traumatic cause of SOB
Pneumothorax
and SBP <90mmHg
26
Q

Glucagon Indications

A

Hypoglycemia when IV access attempts have been unsuccessful

27
Q

Glucagon Dose

A

0.5-1mg IM (0.5mg <20kg)

28
Q

D10W maintaince rate

A

100ml/hr 16 gtts/min (1gtts/3sec)

29
Q

D10W indications

A

Diabetic Pt. with decreased LOC’s and Bgl <4mmol

30
Q

how many bolus’s of D10W can we administer without medical directions

A

2 bolus’s of 100ml, access vitals for improvement inbetween bolus’s

31
Q

ASA indications

A

Chest Pain or atypical symptoms assoiciated with cardiac ischemia/AMI

32
Q

ASA contraindications

A

Allergy to ASA

Asthma

33
Q

Cautions for ASA

A 
Recent internal bleeding (GI, peptic ulcers)
known bleeding diseases
anticoagulants
recent surgery
pregnancy
34
Q

EPI Dose

A

0.01mg/kg max dose 0.5mg

35
Q

Diphenhydramine DOSE

A

Pt >12 y/o 25-50mg
Pt 6-11 y/o 25mg
pt 2-5 y/o 12.5mg
NOT for neonates

36
Q

At what point in a call do you give EPI?

A

you must complete:
your primary survey and sencondary Hx by then you should have info to warrant Anaphalxis protocol.
Get a baseline set of vitals, go over 6 rights and contraindications.
give epi, give diphenhydramine
TRANSPORT

Primary Care paramedic (4 decks)

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