General medical knowledge

Question 1

What are critical things to know about seizure patients?

Answer 1

What their seizure history is, if they are taking seizure meds, what their blood sugar is, what their temperature is, and if they are pregnant. Also if there’s been any recent trauma to the head.

Question 2

What is the new nausea medication? What is the dose?

Answer 2

Inapsine/Droperidol:

IV/IO .625 mg-1.25 mg every 5 to 10 minutes. Max dose of 5 mg.

IM: 2.5 mg repeat every 5 to 10 minutes. Max dose of 5 mg.

Hold for history of prolong QT syndrome, Torsades, or EPS.

Question 3

What is the dose for famotidine?

Answer 3

IV/IO ONLY: 20 mg every 12 hours, and should be administered in conjunction with diphenhydramine.
May dilute in 100 to 250 mL of normal saline and administered over 15 minutes.

Question 4

What is the dose for Dilaudid?

Answer 4

.5 mg over 2 to 3 minutes. They repeat every 10 minutes to a max dose of 2 mg.

Question 5

What is the cut off for active versus passive cooling in hyperthermic patients?

Answer 5

103°F. If they are cooler than this, use passive cooling techniques. If they are hotter than this, wet them down and actively cool them with ice bags.

Question 6

What are the cut offs for mild, moderate, and severe hypothermia?

Answer 6

Mild: 95°F – 93°F
Moderate: 93°F – 86°F
Severe: < 86°F

Question 7

What changes are made to cardiac arrest protocol in hypothermia?

Answer 7

Check for a pulse for at least 30 seconds before initiating CPR.

Shock ones, and then hold additional shocks until temperature increases above 86°F.

Treat as gently as possible while performing necessary procedures, and actively rewarm the patient.

Hold medication for body temperature is below 86°F.

For temperatures greater than 86°F, increase interval between medications.

Bradycardia may be physiologic in Hypothermia cases, so pharmaceutical and electrical treatments are not indicated.

Question 8

What are the 5 Hs and 4 Ts?

Answer 8

Hypoxia
Hypovolemia
Hypothermia
Hyper/hypokalemia
Hydrogen Ion (acidosis)

Toxins
Tamponade
Tension pneumothorax
Thrombosis

Question 9

What is the dose for haloperidol?

Answer 9

2-5 mg, Repeat PRN to a max of 10 mg.
Administer in conjunction with Benadryl.

Be cautious with this medication and cases of hyperthermia, Seizure risk, or hyperdynamic drug use.

Consider a mRASS assessment prior to and after patient restraint and medication.

Question 10

At a minimum, what should the combative patient be assessed for?

Answer 10

Pain, delirium, and anxiety.

Question 11

What is a possible side effect of glucagon?

Answer 11

Vomiting

Question 12

What are signs of hyperkalemia?

Answer 12

Peaked T waves, QRS of >.12 ms and a history suggestive of hyperkalemia