Ems 430 Flashcards
Foreign body airway obstruction
If foreign body cannot be removed attempt to bypass by pushing the obstruction into one bronchus with the ET tube and then intubating the other bronchus. Supraglotic airway is contra-indicated in this situation
Glucagon may not be effective in patients with
Liver disease
Diabetic
Hyperglycemia
BGL greater than 300,
If no IV access and GCS less than or equal to 8 establish I/O
Nose bleed
Placed patient in sitting position with their head leaning forward
Instruct patient to hold pressure for at least 20 minutes
Nose bleed
Neo-Synephrine contra indications
Nose bleed secondary to hypertension bp greater than or equal to 180/110
and nose bleeds secondary to head injury
and CSF drainage
Nausea/ Vomitting
Adult Zolfran dose
4 mg IV
may repeat once after 15 minutes if vomiting persist
Nausea/ Vomitting
Pediatric Zofran dose
0.15 mg/kg IV,
max total dose 4 mg,
no repeat dose
Active seizure treatment
Midazolam 2-5 mg Iv/io/im
If seizing persists may repeat up to 10 mg
Decompression sickness O2 Delivery
Provide 100% oxygen via NRB
Hyperthermia Pt Placement
Place patient in supine position
Insects and spiders
Remove stinger if present and clean it with peroxide
Carbon monoxide and cyanide exposure O2 Delivery
Administer 100% oxygen via NRB
Eclampsia and severe preeclampsia
Possible seizure, altered LOC, and blood pressure greater than 160/110
Breech delivery
Place the mother in the knee chest position.
If head does not deliver within three minutes use a glove hand to make an airway for the Neonate
Limb or brow presentation
Place the mother and the knee chest position
Prolapsed cord
Place the mother in the knee chest position or supine with hips elevated
Reassess newborn every blank seconds
30 seconds
The humerus is contra indicated in
Newborns and infants
The autopulse is contraindicated in patients less than….
18 years of age
neonate less than one month hypoglycemia with vascular access
D10w at 5ml/kg iv for BGL less than 45 mg/dL
Infant/child (1month to 12 years) hypoglycemia with vascular access
D25w at 2ml/kg iv for BGL less than 60mg/dL
Adolescent 13 to 18 years hypoglycemia with vascular access
D50w at 1ML/KG IV for BGL less than 60mg/dL
Max does 25 grams
Hypoglycemia without vascular access for pediatric
Less than 20kg, give glucagon 0.5 mg IM
20kg or greater, give glucagon 1mg IM
Hyperglycemia
BGL >300, administer 20ml/kg IV fluids, max 2L
Pediatric Seizures
If pt is febrile ( ) apply cooling measures
Greater than or equal to 104 degrees
Pediatric seizure Midazolam dosage.
0.1 mg/kg iv/io/im
Max single dose 5mg
May repeat initial dose in 5 minutes
If the pediatric patient has a temperature of greater than 102° and the parent has ibuprofen or acetaminophen
Administer ibuprofen 10 mg/kg PO (Not for children under six months).
Or acetaminophen 15 mg/kg PO
Extremity Trauma
Amputation
Place the amputated part in sterile gauze, moisten with intravenous fluids
Keep amputated part cool
Dress and splint partial amputation’s in alignment with the extremity, being careful to avoid torsion
Do not clamp
Burns
Toddlers and infant head percentage….
Leg percentage….
Heads are 18%
Legs are 13.5%
Eye Trauma
Direct trauma
Maintain patient in supine position to reduce leakage of fluid from the eye. If blood is noted in anterior chamber, place the patient in…..
Semi-Fowler’s
Tachycardia
Sync cardioversion
Narrow regular SVT
Shock @ 50j and repeat up to 100j
Tachycardia
Sync cardioversion
Narrow irregular QRS
Shock at 120j repeating up to 200j
Tachycardia
Wide regular QRS
Shock at 100j repeating up to 200j
