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Old Officer study material > EMS chemical control > Flashcards

EMS chemical control Flashcards

0
Q

How shall restrained pt’s be positioned?

A

Supine, semi-fowlers, or lateral position.

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1
Q

Pt shall be restrained when?

A

only if its necessary to protect the pt or personnel from harm.

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2
Q

What is the dose for ketamine in excited delirium?

A

4mg/kg IV or IM to a max of 400mg

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3
Q

What types of adverse reactions are possible with ketamine?

A

hypersalivation and laryngospasm

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4
Q

How is hypersalivation treated with regards to ketamine?

A

Atropine 0.5mg IV IM IO.

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5
Q

How is laryngospasms treated with regards to Ketamine?

A

Hi Flow 02
BVM
RSI

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6
Q

After administration of ketamine what are the next treatments?

A

Upon arrival to ED Versed 2.5mg IV or IO
5.0mg IN
obtain IV access if not already done
Obtain temperature.

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7
Q

What is the treatment for temperatures greater than 103F with excited delirium? Adults

A

ice packs to groin and axilla
saline 30mg/kg wide open max of 2L
Sodium Bicarb 50meq IV IO

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8
Q

What is the treatment for cardiac arrest with regards to excited delirium?

A

treat as SECONDARY Arrest
sodium bicarb 100meq IV IO
saline 30mg/kg max 2L
ACLS protocols

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9
Q

What is the treatment for pediatrics, cardiac arrest in excited delirium?

A

There is none.

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10
Q

What is the treatment for Violent/ combative pt’s?

A

The same as Excited delirium. If there is no chance of Ketamine being administered during pt care then:

Versed 2.5mg IV IO
5.0mg IN IM

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11
Q

What are the contraindications with regards to fentanyl and pain mgt?

A

pregnant females greater than 32 weeks

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12
Q

To reverse fentanyl reactions what is the treament?

A

0.5mg narcan IV, IO, IM
or
2mg narcan IN

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13
Q

What are the side effects from fentanyl?

A

chest wall rigidity

respiratory depression

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14
Q

what is the dose of fentanyl in an adult for pain mgt?

A

50mcg IV, IM, IO max dose is 150mcg IV IO IM
or
100mcg IN max dose 200mcg IN

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15
Q

what is the pediatric dose of fentanyl in pain mgt?

A

1 mcg/kg IV, IM, IO max of 50mcg
or
1.5mcg/kg IN max of 150mcg

16
Q

What is the contraindication with fentanyl and pain mgt for the pediatric pt?

A

Must be greater than 6mo.

17
Q

What is the treatment to reverse fentanyl in pediatrics for pain mgt?

A

Narcan 0.5mg IV, IO, IM
or
1.0mg IN

18
Q

What is the dose for zofran in pediatrics with regards to pain mgt?

A

0.1mg/kg IM ONLY

19
Q

Who is responsible for ensuring an airway is obtained after paralytics are adminsitered?

A

District captain.

20
Q

IF there are multiple pts who should the district captain accompany?

A

the most critical.

21
Q

What are the indications for paralytics?

A
  1. Status epilepticus
  2. multi system trauma
  3. head injuries with GCS < 8
  4. trismus, lock jaw or clenched teeth
  5. burn injuries to the upper airway
  6. District captain disrection
22
Q

What are the contraindications for Succinylcholine?

A

Predicted difficult intubation- obesity, short neck, small mouth
thyromental distance of < 3 finger widths
Major facial or laryngeal trauma
Pt that cannot be BVM’d
Penetrating Eye injuries or glaucoma
organophosphate poisoning
renal failure- dialysis / hyperkalemia
hypersensitivity or malignant hyperthermia
pre-existing nu-euromuscular ds.
chronic paralysis

23
Q

in the advanced airway protocol what type and when should 02 be applied?

A

NC 15L/min after giving sedation or pre-sedation for paralytics

24
Q

What is the dose of ketamine in the advanced airway protocol for severe asthma?

A

2mg/kg IV IO IM may repeat 1x max 400mg

25
Q

What is the does of etomidate for adults and children in advanced airway?

A

20mg IV IO over 30-60sec. May repeat 1x.

0.3mg/kg IV IO max single dose 20mg may repeat 1x.

26
Q

What is the dose for Succinylcholine in adult and children?

A

adults 100mg IV IO
pedi < 2: 2mg/kg IV IO max 100mg
pedi >3: 1mg/kg IV IO max 100mg

27
Q

Once inutbated what are the doses of norcuron for adults and pedi?

A

adult: 0.1mg/kg max dose 10mg
pedi: 0.1mg/kg max dose 10mg

28
Q

Once intubated and if the pt is HYPOtensive what can be given and how much?

A

ketamine

adult : 2mg/kg IV IO IM max dose is 400mg
pedi: 1mg/kg IV IO IM max dose is 400mg

29
Q

The provisions for the advanced airway protocol for pediatrics applies to which age and is affected by what medications?

A

greater than 3mo and applies to Etomidate, ketamine, norcuron.

Old Officer study material (30 decks)

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