Exam 2 flashcards
nitroglycerin (1/2 treatments of acute myocardial infarction) (how often to reassess, what a dose entails, indications and contraindications)
-REASSESS VITALS EVERY 2 MINUTES
-we can only ASSIST with nitroglycerin
- we can only administer 3 doses 5 mins apart (one spray or one tab)
when to use:
-patient’s systolic bp is greater than 120 mmHg
-patient has not had relief (cardiac chest pain)
contraindications:
-use of erectile dysfunction medications in past 72 hours (blood thinner)
-systolic blood pressure is less than 120 mmHg
aspirin dosage (2/2 treatment for acute myocardial infarction)
324 mg of Aspirin (4x 81mg tablets)
treatment for COPD and Emphysema (7 steps)
1) BSI scene safety always
2) check ABC
3) request ALS and monitor vitals
4) don’t allow patient to do physical activity (carry them)
5) ASSIST with a metered dose inhaler (MDI) if patient is alert and no contraindications
6) administer high conc oxygen (NRB 15LPM)
IF WHEEZING ADMINISTER ALBUTEROL
7) transport in position of comfort)
treatments for poisoning (substance identification)
1) attempt to identify the product or substance
2) estimate the amount of product or substance if possible
3) estimate duration or exposure
4) obtain info about product from the container’s label
5) if safe, bring product or substance in the container to the hospital
treatment for positions (swallowed poisons)
1) contact medical control for instructions (you may have to administer activated charcoal, milk, water, and/or syrup of ipecac to induce vomiting)
2) transport and keep patient warm
3) obtain patient vitals and reassess
4) record all patient care info, including patient medical history
treatment for poisons (inhaled) (5 steps)
1) ensure scene is safe (request other personnel if required)
2) remove patient to fresh air
3) perform initial assessment, check ABCs
4) administer high conc O2 and place patient in position of comfort
5) obtain patient vitals and repeat
scene size up (what always comes first?what acronym do we use after?
scene safety
-look for danger (smoke, fire, downed power lines and spills)
-consider direction wind is blowing
BSI
-ppe
MANS
m- mechanism of injury
*analyze forces, kinetic energy, spider web on windshield(skull hitting windshield), presence of seatbelts and airbag deployment and damage to the underneath if the steering wheel (patient went under wheel during collision)
a- additional resources
* is ALS needed?
* more BLS?
* other resources? (police, fire, rescue squad, hazmat)
n- number of patients
*number of patients hurt
*extent of injuries
*age groups
*find best access to scene
s-spinal precautions (admins)
* AMS - altered mental status
*Distracting injury
*Midline spinal tenderness
*Intoxicated
* Neuro deficits present- Think sensory response
significant moi (MANS)
falls
-adults 20 feet, children 2-3 times their height
collision
-12 inches intrusion into passenger compartment
motorcycle crash
- >20 mph or separation from motorcycle
vehicle vs passenger/bicycle
- above 5 mph
extrication
- >20 minutes
primary assessment flow chart
-BSI scene safety
-MANS
-GASP
-AVPU
A
B (ELPASSO)
C (VCRS)
D
E
-DCAP-BTLS
- Body parts and what to look for
GASP meaning (primary assessment)
G- Gender
A- Age
P- Position found in
S - Significant life threats
ELPASSO meaning (primary assessment)
GASP meaning (trauma primary assessment)
G - Gender
A- Age
S- Significant/obvious life threats
P- position patient is found
-Race
-Does patient look lifeless?
-Does patient look like they are dying?
A of ABCDE (primary assessment)
A - Airway
1) open mouth, try to visualize obstructions
2) sweep and suction (as needed)
3) open airway and insert OPA. If not tolerated use NPA, except for trauma
if patient is talking or crying, airway is patent
B of ABCDE/ ELPASSO meaning (trauma primary assessment)
B- Breathing
E- Expose as necessary
L- Look/Inspect for breathing inadequacies
•cyanosis, pursed lips, deviated trachea, accessory muscle usage, unilateral chest rise
P-Palpate for any injuries (start from clavicle)
•Flail chest, obtain a respiratory rate
A- Auscultate breath sounds
S- Seal
•seal sucking chest wounds, if breathing is increasingly difficult, make it a flutter valve
S- Stabilize impaled objects
O- Oxygenate accordingly
C of ABCDE/VCRS meaning (trauma primary assessment)
C - Circulation
V- Voids ( check for serious bleeds, bright red is an arterial bleed)
C- CTC of skin
R- Radial pulses bilaterally (check if present)
• if weak or absent, check carotid pulse
S- shock (treat if signs are presenr)
•Andious and agitated
•skin is pale, cool and diaphoretic
•do NOT do trendelemberg for trauma
