final exam- ALS Flashcards

1
Q

bronchoconstriction indications

A

respiratory distress and suspected bronchoconstriction

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2
Q

salbutamol conditions- bronchoconstriction

A

N/A

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3
Q

EPI conditions- bronchoconstriction

A

BVM ventilations, Hx of asthma

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4
Q

dexmethasone conditions- bronchoconstrictions

A

HX of asthma, COPD, or 20 pack a year smoking history

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5
Q

contraindications of salbutamol- bronchoconstriction

A

allergy or sensitivity to salbutamol

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6
Q

contraindications of epi- bronchoconstriction

A

allergy or sensitivity to epinephrine

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7
Q

contraindications of dexmethasone- bronchoconstriction

A

allergy or sensitivity to steroids, currently on PO or parenteral steroids

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8
Q

treatment of salbutamol <25 kg- bronchoconstriction

A

MDI- dose 600mcg, dosing interval 5-15 min, max # of doses 3
NEB- dose 2.5mg, dosing interval 5-15 min, max # of doses 3

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9
Q

treatment of salbutamol >25 kg- bronchoconstriction

A

MDI- dose 800 mcg, dosing interval 5-15 min, max # of doses 3
NEB- dose 5 mg, dosing interval 5-15 min, max # of doses 3

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10
Q

treatment of epi- bronchoconstriction

A

route IM, dose 0.01mg/kg, max single dose 0.5 mg, max # of doses 1

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11
Q

treatment of dexmethasone- bronchoconstriction

A

route PO/IM/IV, dose 0.5mg/kg, max single dose 8mg, max # of doses 1

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12
Q

allergic reaction indications

A

exposure to probable allergens and signs and symptoms of moderate to severe allergic reaction

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13
Q

conditions of epi- allergic reaction

A

for anaphylaxis only

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14
Q

diphenhydramine conditions- allergic reaction

A

weight >25kg

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15
Q

contraindications of epi- allergic reaction

A

allergy or sensitivity to epi

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16
Q

contraindications of diphenhydramine- allergic reaction

A

allergy or sensitivity to diphenhydramine

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17
Q

treatment of epi- allergic reaction

A

route IM, dose 0.01mg/kg, max single dose 0.5mg, dosing interval min 5 min, max # of doses 2

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18
Q

treatment of diphenhydramine- allergic reaction

A

> 25kg- <50kg: route IV/IM, dose 25mg, max # of doses 1

> 50kg: route IV/IM, dose 50mg, max # of doses 3

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19
Q

croup indications

A

current history of URTI and braking cough/recent history of a barking cough

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20
Q

epi conditions- croup

A

age >6 months to <8 years, stridor at rest

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21
Q

dexmethasone conditions- croup

A

age >6 months to <8 years, LOA unaltered, for mild/moderate/severe croup

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22
Q

contraindications of epi- croup

A

allergy or sensitivity to epi

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23
Q

contraindications of dexmethasone- croup

A

allergy or sensitivity to steroids, steroids recieved within last 48 hours, unable to tolerate oral medications

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24
Q

epi treatment- croup

A

<10kg: route NEB, dose 2.5mg, max # of doses 1

> 10kg: route NEB, dose 5mg, max # of doses 1

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25
Q

dexmethasone treatment- croup

A

route PO, dose 0.5mg/kg, max single dose 8mg, max # of doses 1

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26
Q

medical cardiac arrest indications

A

non-traumatic cardiac arrest

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27
Q

CPR conditions- medical cardiac arrest

A

LOA altered, performed in 2 min intervals

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28
Q

manual defib conditions- medical cardiac arrest

A

age >24 hours, LOA altered, VF or pulseless VT

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29
Q

epi conditions- medical cardiac arrest

A

age >24 hours, LOA altered, anaphylaxis suspected as causative event

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30
Q

medical TOR conditions- medical cardiac arrest

A

age >16 years, LOA altered, arrest not witnessed by medic and no ROSC after 20min of resus and no defib delivered

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31
Q

contraindications of CPR- medical cardiac arrest

A

obviously dead per BLS standards, meet DNR BLS standards

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32
Q

contraindications of manual defib- medical cardiac arrest

A

rhythms other than VF or pulseless VT

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33
Q

contraindications of epi- medical cardiac arrest

A

allergy or sensitivity to epi

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34
Q

contraindications of medical TOR- medical cardiac arrest

A

known reversible cuase of arrest unable to be addressed, pregnancy >20 weeks, hypothermia, airway obstruction, non-opioid drug overdose

35
Q

manual defib treatment- medical cardiac arrest

A

> 24 hours- 8 years: dose 1 defib, initial dose 2 J/kg, subsequent dose 4 J/kg, dosing interval 2 min

> 8 years: dose 1 defib, initial dose depends on monitor, subsequent dosde depends on monitor, dosing interval 2 min

36
Q

epi treatment- medical cardiac arrest

A

route IM, dose 0.01mg/kg, max single dose 0.5mg, max # of doses 1

37
Q

trauma cardiac arrest indications

A

cardiac arrest secondary to severe blunt or penetrating trauma

38
Q

CPR conditions- traumatic cardiac arrest

A

LOA altered, performed in 2 min intervals

39
Q

manual defib conditions- traumatic cardiac arrest

A

age >24 hours, LOA altered, VF or pulseless VT

40
Q

trauma TOR conditions- traumatic cardiac arrest

A

age >16 years, LOA altered, HR/RR 0, no palpable pulses and no defib delivered, and rhythm asystole, and no signs of life at any time since fully extricated, or signs of life when filly extricated with closest ED >30 min away, or rhythm PEA with closest ED >30min away

41
Q

CPR contraindications- traumatic cardiac arrest

A

obviously dead per BLS standard, meets conditions of DNR standard

42
Q

manual defib contraindications- traumatic cardiac arrest

A

rhythms other than VF or pulseless VT

43
Q

trauma TOR contraindications- traumatic cardiac arrest

A

age <16 years, defib delivered, signs of life at any time since extrication, rhythm PEA and closest Ed is <30min away, patients with penetrating trauma to torso/head/neck and lead trauma hopsital is <30min away

44
Q

manual defib treatment- traumatic cardiac arrest

A

> 24hours- <8 years: dose 1 defib, initial dose 2 J/kg, max # of doses 1

> 8 years: dose 1 defib, initial dose depends on monitor, max # of doses 1

45
Q

ROSC indications

A

patient with ROSC after resuscitation was initiated

46
Q

0.9% NaCl fluid bolus conditions- ROSC

A

age >2 years, SBP hypotension, chest auscultation is clear

47
Q

0.9% NaCl fluid bolus contraindications- ROSC

A

fluid overload

48
Q

0.9% NaCl fluid bolus treatment- ROSC

A

> 2 years to <12 years: infusion 10ml/kg, interval immediate, reassess every 100ml, max volume 1000ml

> 12 years: infusion 10 ml/kg, interval immediate, reassess every 250ml, max volume 1000ml

49
Q

cardiac ischemia indications

A

suspected cardiac ischemia

50
Q

ASA conditions- cardiac ischemia

A

age >18, LOA unaltered, able to chew and swallow

51
Q

Nitro conditions- cardiac ischemia

A

age >18 years, LOA unaltered, HR 59-160 bpm, SBP normotension, prior history of nitro use or IV access obtained

52
Q

ASA contraindications- cardiac ischemia

A

allergy or sensitivity to NSAIDS, is asthmatic no prior use of ASA, current active bleeding, CVA?TBI in previous 24 hours

53
Q

nitro contraindications- cardiac ischemia

A

allergy or sensitivity to nitrates, phosphodiesterase inhibitor use within 48 hours, SBP drops 1/3 of intial volume after admin, 12 LEAD compatible with RVI

54
Q

treatment of ASA- cardiac ischemia

A

route PO, dose 160-162mg, max single dose 162mg, max # of doses 1

55
Q

treatment of nitro- cardiac ischemia

A

No STEMI: SBP >100 mmHg, route SL, dose 0.4mg, dosing interval 5 min, max # of doses 6

STEMI: SBP .100 mmHg, route SL, dose 0.4mg, dosing interval 5 min, max # of doses 3

56
Q

ACPE indications

A

moderate to severe respiratory distress and suspected ACPE

57
Q

nitro conditions- ACPE

A

age >18 years, HR 60-159 bpm, SBP normotension

58
Q

nitro contraindications ACPE

A

allergy or sensitivity to nitrates, phosphodiesterase inhibitor use within 48 hours, SBP drops 1/3 value after admin

59
Q

nitro treatment >100 mmHg to <140 mmHg- ACPE

A

IV/ Hx yes, route SL, dose 0.4mg, dosing interval 5 min, max # of doses 6

60
Q

nitro treatment >140 mmHg- ACPE

A

IV/Hx no: route SL, dose 0.4mg, dosing interval 5 min, max # of doses 6

IV/Hx yes: route SL, dose 0.8mg, dosing interval 5 min, max # of doses 6

61
Q

hypoglycemia indications

A

suspected hypoglycemia

62
Q

dextrose conditions- hypoglycemia

A

age >2 years, LOA altered, hypoglycemia

63
Q

glucagon conditions- hypoglycemia

A

LOA altered, hypoglycemia

64
Q

contraindications of dextrose- hypoglycemia

A

allergy or sensitivity to dextrose

65
Q

contraindications of glucagon-hypoglycemia

A

allergy or sensitivity to glucagon, pheochromocytoma

66
Q

treatment of dextrose- hypoglycemia

A

10%: dose 0.2 g/kg (2ml/kg), max single dose 25g (250ml), dosing interval 10 min, max # of doses 2

50%: dose 0.5 g/kg (1ml/kg), max single dose 25g (50ml), dosing interval 10min, max # of doses 2

67
Q

glucagon treatment- hypoglycemia

A

<25kg: route IM, dose 0.5mg, dosing interval 20 min, max # of doses 2

> 25kg: route IM, dose 1mg, dosing interval 20min, max # of doses 2

68
Q

adrenal crisis indications

A

patient with primary adrenal failure who is experiencing clinical signs of an adrenal crisis

69
Q

hydrocortisone conditions- adrenal crisis

A

medics are presented with vial of hydrocortisone for identified patient, and age related hypoglycemia, or GI symptoms, syncope, temp >38 C/hx of fevere, altered LOA, tachycardia, hypotension

70
Q

contraindications of hydrocortisone- adrenal crisis

A

allergy or sensitivity to hydrocortisone

71
Q

treatment of hydrocortisone- adrenal crisis

A

route IM/IV, dose 2ml/kg, max single dose 100mg, max # of doses 1

72
Q

analgesia indications

A

pain

73
Q

analgesia conditions

A

acetaminophen: age >12 years, LOA unaltered

Ibuprofen: age >12 years, LOA unaltered

ketorolac: age >12 years, LOA unaltered, SBP normotension

74
Q

acetaminophen contraindications- analgesia

A

acetaminophen use within 4 hours, allergy or sensitivity to acetaminophen, Hx of liver disease, active vomiting, unable to tolerate oral medications, suspected ischmeic chest pain

75
Q

ibuprofen contraindications- analgesia

A

NSAID use within pervious 6 hours, allergy or sensitivity to ASA/NSAIDS, pt on anticoagulation therapy, current active bleeding, Hx of peptic ulcer disease or GI bleed, pregnant, is asthmatic no prior use of ASA/NSAIDS, CVA/TBI in previous 24 hours, known renal impairment, active vomiting, unable to tolerate oral medication, suspected ischemic chest pain

76
Q

ketorolac contraindications- analgesia

A

NSAID use within previous 6 hours, allergy or sensitivity to NSAIDS, pt on anticoagulation therapy, current active bleed, Hx of peptic ulcer disease or GI bleed, pregnant, is asthmatic no prior use of ASA/NSAIDS, CVA/TBI in previous 24 hours, known renal impairment, suspected ischemic chest pain

77
Q

acetaminophen treatment- analgesia

A

> 12 years to <18 years: dose 600-650mg, max dose 650mg, max # of doses 1

> 18 years: dose 960-1000mg, max single dose 1000mg, max # of doses 1

78
Q

ibuprofen treament- analgesia

A

dose 400mg, max dose 400mg, max # of doses 1

79
Q

ketorolac treatment- analgesia

A

route IM/IV, dose 10-15mg, max single dose 15mg, max # of doses 1

80
Q

CPAP indications

A

severe respiratory distress, signs and symptoms of acute pulmonary edema or COPD

81
Q

CPAP conditions

A

age >18 years, RR tachypnea, SBO normotension, SPO2 <90% or accessory muscle use

82
Q

CPAP contraindications

A

asthma exacerbation, suspected pneumothorax, unprotected/unstable airway, major trauma/ burns to head or torso, tracheostomy, inability to sit upright, unable to cooperate

83
Q
A