Final Flashcards
Common causes for a cardiac arrest in a pediatric pt.?
Respiratory problems like foreign body obstruction
How much millimeters of O2 can a BVM hold?
1000-1600 mL when tank at least has 500 psi
Nitroglycerin actions?
Vasodilator and decreases cardiac workload
Nitroglycerin contras?
Hypotension, head injury, max dose, ED drug, pt. is a child or infant
Bronchodilator do?
They relax the smooth muscles in the lower airway causing bronchodilation.
Bronchodilator generic names?
Albuterol, and Metaproterenol
Bronchodilator trade names?
Proventil, Ventolin, Alupent
Bronchodilator side effects?
Tachycardia and agitation
Epinephrine actions?
Bronchodilator, vasoconstriction, capillaries become less permeable
Epinephrine side effects?
Tachycardia, dizziness, chest pain, headache, NV, anxiety
Nitroglycerin methods of delivery?
Spray, sublingual, and a patch
Angina can be a result of?
Can result from a vasospasm, but usually a result of CAD
S/S of an AMI
Chest pain (pressure, squeezing, dull) Sudden onset of sweating N and V Pain may radiate to lower jaw, arms, neck Lightheaded SOB Dyspnea Anxiety Abnormal pulses
Difference between AMI and angina?
Angina comes on exertion and leaves w/ rest and an AMI comes on randomly and leaves w/ death
Aspirin indications?
Chest pains Not allergic No Hx of asthma Is not already taking medicines to prevent clotting Is able to swallow
Aspirin contras?
Unable to swallow w/o endangering airway, Hx of asthma, has GI ulcer or recent bleeding, pt. has known bleeding disorder, pregnant, recent surgery
Aspirin side effects?
N and V, heartburn, if allergic causes bronchospasm and wheezing, bleeding
S/S of CHF
Tachycardia SOB Diaphoresis Orthopnea JVD Anxiety Rhales from pulmonary edema Pink frothy Sputnik from pulmonary edema Pedal edema
Causes of pulmonary embolism?
- Venous stasis: trapping of blood due to compressions of veins
- Venous injury: sometimes from surgery
- Increased blood coagulability(dries, and hardens)
- Pregnancy
- Multiple trauma
S/S of pulmonary embolism?
SOB Acute pleuritic chest pain Hemoptysis (coughing up blood) Cyanosis Tachycardia Hypoxia Sudden death
Know what your artery of sudden death is?
LAD coronary artery due to AMI or Aorta due to blood loss, if both present choose aorta
S/S of hypoglycemia:
Pale, clammy skin Diaphoresis Dizziness, headache Rapid pounding pulse Aggressive, confused, lethargic, or unusual behavior Hunger Fainting, seizure, or coma
Hypoglycemia causes:
Too much insulin
Not eating
Vomiting food intake
Overexertion
Emergencies before delivery?
Maternal hypotension
Pre-Eclampsia and Eclampsia
S/S of maternal hypotension
Shock
Low BP
Pedal edema
Treatment of a maternal hypotension pt.?
Avoid supine position
Position in lateral or semi-fowlers position
Tilt board if c-spine necessary
S/S of pre-eclampsia and eclampsia:
Pregnancy induced hypertension Maternal weight gain Hands and feet swelling Proteinuria Headaches, seeing spots, anxiety N&V
Rx for pre-eclampsia and eclampsia
ABCs
Lateral position (left)
Transport
Assist with and monitor IV
Load and go or stay and deliver?
Due date? In labor already? Which labor stage? (Stage 2=stay and deliver) Determine past pregnancy history. Check for crowning? Keep track of contractions. Is tranportation available?
Delivery steps?
- BSI
- Call for Additional EMS
- Open OB kit
- Time contractions
- Reassure mother
- Position mother (knee-chest)
- Never reach into vagina unless breech or prolapsed cord
- Keep gentle control of baby’s head
- Check for nuchal cord
- Suction mouth & nose
- Assist delivery of shoulders- down then up
- Dry and warm the baby
- APGAR (at 1 and 5 min), time of delivery
- Cut the cord
Complicated deliveries?
Nuchal cord Amniotic sac not ruptured Meconium (baby has a bowel movement) Breech presentation Prolapsed cord Multiple Premature infants
After birth Rx for excessive bleeding >250-500 cc?
Save pads
Treat for shock
O2 via NRB
Massage Fundus
Rx for resuscitating a baby?
Stimulate breathing by rubbing Blow-by air over the baby Start with ventilation 40-60/min Recheck pulse after ventilating 30 sec If pulse is
Qs for seizure pt.?
What did it look like?
Where/how did it start?
Was it a fall then seize or a seize then fall?
Has the pt. been medication compliant?
Stroke terminology?
Hemiparesis: weakness on half of the body
Hemiplegia: paralysis on half of the body
Dysarthria: inability to speak clearly
Aphasia: inability to speak or understand (expressive or receptive)
Diplopia: double vision
Convulsions: muscle contractions
S/S of a Ischemic Stroke
Hemi-paresis/plegia Numbness on one side of the body Aphasia Confusion Diplopia Convulsions Headache and dizziness
S/S of a hemorrhagic stroke?
None, usually asymptomatic until attack
Hypotension pt. order of Rx?
Position(supine)
High flow O2
Prevent heat loss
Transport
S/S of heat stroke:
Initial: hot, flushed skin; may or may not sweat; rapid pulse; confusion, weakness, anxiety
Later: CNS-agitation, seizures, coma; vasodilation; digestive system failure
How should the amniotic sac look like?
- Clear
2. If dark or murky fluid indicates Meconium staining, which indicates fetus or neonate in destress.
PAT components: ped triangle?
- Appearance (mental/AVPU, body position, muscle tone
- Breathing (visible movement, effort, audible sounds)
- Circulation (skin color, temp, cap refill)
Two assessments: first- general impression “from the door”
Second- hands on confirms initial impression
S/S of dehydration in Peds?
Dry mucous membrane Inability to produce tears Sunken fontanelles Sleepy/irritable Fewer wet diapers Dry lips/gums
Rx for febrile seizures?
Cooling measures Transport Get history Begin BVM if not improved No alcohol or cold water to cool
S/S of head injury?
Deformity of the skull Unequal pupils Battle signs Ecchymosis Raccoon eyes Cushing's triad Projectile vomiting Loss of CSM Seizures
Rx of head injuries?
C-spine ABCs C-collar Administer high O2 Talk to pt. provide emotional support Manage secondary injuries and wounds Be prepared for vomiting Transport and monitor V/S
Initial response steps?
Triage
Rx
Communications
Transport
Best location to park ambulance on freeway?
In the downstream shadow w/ loading doors pointed towards the accident
Subcutaneous emphysema found w/…..
Primarily found w/ fractured larynx but may also be in a pneumothorax
