Fundamentals Flashcards
What are the Breaths per min of an Asthma Pt while bagging?
6-8
What are the breaths per min for bagging a normal adult?
1 breath every 6 seconds (10 breaths per min)
Target Spo2 for COPD
92%
Lidocaine dose for IO
1 MG/KG
Max Lidocaine dose
50 MG
Ondasetron (Zofran) Dose
4MG slow IVP May repeat once in 10 min
Fentanyl Dose and MAX Dose
1 MCG/KG Max of 100 MCG May repeat in 5 min .
Fentanyl Max dose w/ OLMC
300 MCG
Elderly Fentanyl dose
0.5 MCG/KG
Max elderly single dose of Fentanyl
50 MCG
How Many Vital Signs should each transport have?
2
Ketamine PAIN Dose IN/IVP/IN
0.5 MG/KG slow IVP or 1 MG/KG IN/IM may rpt 1/2 after 10 min
A valid DNR must contain how many signatures
- Patient or guardian, Witness, And authorized practitioner
Log roll elderly pts?
no
Obese Pt’s
consider risk of apnea. elevate head of stretcher Higher risk of ET tube dislodgement
Listen over back for breath sounds
Humerous IO 15G needle
OBESE PT’s
request bariatric ambulance use right sized BP cuff
Airway obstruction
5 abd thrusts
chest thrusts if pregnant
DAI Drugs
Etomidate 0.5 MG/KG max of 40mg
or
ketamine 2 mg/kg slow ivp or 4mg/kg IM keep sedated with midazolam 2mg slow ivp up to 20 mg
benzocaine
1-2 second spray 30 seconds apart x2
DAI preoxygenate
for 3 min breathing at a RR of 8 or greater
AFTER intubating
confirm with etco2, ascultate over epigastrum, bi-lateral midaxillary lines, and anterior chest
IF etco2 not detected, confirm with direct laryngoscopy
Sedatives in pregnancies
caution…could be harmful to fetus
Diphenhydramine
1mg/kg (max of 50)
EPI 1:1000
0.3mg IM
to not delay transport while waiting for response
Albuterol for ANPHYLACTIC
2.5 MG
Ipratropium
0.5 MG
CRITICAL ANAPHYLAXIS
EPI 1;1000 0.5mg IM vastus laterous THIGH
GLUCAGON if not responding to epi
AFTER IV— epi 1;10,000 titrate in 0.1 mg ivp/io doses to a max dose of 2mg
If no iv may repeat 1/1000 .5 mg may repeat x1
Respiratory Distress- if wheezing without COPD/Asthma
consider aspiration, PE, HF/pulmonary edema
NEB Treatments in Asthma/copd
may repeat x1
albuteral 2.5mg
Ipratropium .5 mg
Mag sulfate 2gm in NS total volume of 20ML Slow ivp over 5 min MAX 1 GM/MIN
How should IV ondasetron be delivered
4mg slow ivp no less than 30 sec
Blood thinners
Plavix, Coumadin, Pradaxa, Xarelto
What should be done if an extremely obese Pt experiences respiratory arrest?
A. Insert an alternate airway rather then attempting a difficult intubation.
Extremely obese Pts will lave decreased range of motion in laying supine?
True
If an obese Pt has had recent weight reduction surgery, what should you ask?
What type/nature of procedure and compliance with follow up instructions.
If given the option to DAI, or intubate…
DO IT
Midazolam for POST intubation
2mg invriments up to 20mg
What are the 2 most common side effects of Etomidate
Myoclonus and pain at the injection site
What is the desired action of Ketaine in DAI
Dissociative Anesthetic
Why choose ketamine for an asthmatic Pt
It causes bronchodilation
Side effect of Ketamine
Emergence reaction
WHen advancing ET over the bougie
the intubator should let the assistant pass th ET tube in the trachea
Where should lubricant be applied to the king
distal tip of the and posterior surface, avoiding ventilatory openings
when inserting a king airway, where should the blue orientation line be touching?
middle of the lower lip
