Emergency Action Drills Flashcards
Difficult access in a critically ill patient
If no IV w/in 1 minute -> IO -> if no IO on first attempt -> crash femoral line
Hypotension: SBP 70 or less
Crack code cart, give 0.5 cc of cardiac epi
Precipitous delivery
Bed intact, support baby’s head, check for nuchal cord & reduce
Shoulder dystocia
McRoberts, suprapubic pressure
Postpartum hemorrhage
Bimanual uterine compression, pit -> methergine -> hemabate -> miso, MTP, TXA
Unannounced cardiac arrest
Start CPR, start bagging, IV access, place defib, give epi
Dropoff GSW to the chest
IV, O2, manual BP, CABs
STEMI loses pulses
Place defib & shock if VT/VF
Dropoff GSW to the chest loses pulses
Start CPR, start bagging, IV/IO, thoracotomy, MTP
GSW to the abdomen loses pulses
Start CPR, start bagging, MTP, thoracotomy
Unannounced blunt trauma arrest
Start CPR, start bagging, IV/IO, MTP, b/l chest tubes, pelvic binder, echo
Unannounced massive extremity hemorrhage
Put single finger on bleeder, place tourniquet
Floppy baby
Start bagging, IV, give 5 cc/kg D10, 20 cc/kg IVF bolus
IO if no IV w/in 1 minute
If no IO on first attempt -> UVC vs crash femoral line
Unannounced respiratory distress
Nasal cannula at flush rate, BVM w/ PEEP valve w/ good two-hand seal
i. Call for bipap if awake enough to tolerate
ii. If not, continue w/ above and plan for intubation
Unannounced unresponsive
Start bagging, IV/IO, place on monitor, check glucose, +/- Narcan
Severe agitation
No IV: ketamine 3 mg/kg IM
Yes IV: ketamine 2 mg/kg IV
Massive hemoptysis
Sit patient up, give patient suction, IV, MTP, TXA neb
Massive hematemesis
Sit patient up, give patient suction, IV, MTP, ketamine-assisted awake intubation
Crashing anaphylaxis
Crack code cart, give 0.5-1 cc cardiac epi, one attempt at intubation, then cric
i. RSI w/ paralytics as priority
Pregnant trauma patient loses pulses
Start CPR, start bagging, manually displace uterus to the left, MTP, prepare for perimortem C/S within 4 minutes
Cyanotic baby <10 days old
IV, O2, monitor, start PGE1 0.05 mcg/kg/min, prepare to intubate
Floppy newborn
Stimulate, open airway, suction, CPAP
Cardiac arrest in the hospital lobby
Start CPR, AED
Exsanguinating HD fistula
Place one finger on bleeder, tourniquet above and below fistula
Crashing bleeding trach
Place cuffed trach (if not already in place), hyperinflate balloon
Crashing hypoxic trach patient
100% O2 to patients face and stoma, pass suction or EtCO2 catheter to confirm trach patency
Unannounced adult seizure
Jaw thrust, 4 mg Ativan IV or 5 mg Versed IM
Pregnant seizure
O2, jaw thrust
If IV: mag 6 g IV, Ativan 4 g IV
If no IV: mag 10 mg IM in each butt cheek, Versed 5 mg IM
Unannounced pediatric seizure
Jaw thrust, 0.1 mg/kg Ativan IV or 0.2 mg/kg Versed IM/IN
Unannounced newborn seizure
Open airway, phenobarb 20 mg/kg IV or Versed 0.2 mg/kg IM
Fracture/dislocation without pulses
Ketamine 1-2 mg/kg IV, reduce, splint
New headache, AMS, or nausea/vomiting in a stroke patient who received thrombolytics
Stop lytics, ABCs, STAT CT head
Unstable tachycardia
Attach defibrillator, etomidate 0.1 mg/kg, synchronized cardioversion
Unstable bradycardia
Attach defibrillator, start transcutaneously pacing, crack code cart, give 0.5 cc
cardiac epi
