General Patient Care/Monitoring & Vascular Access Flashcards
What is patient history?
OPQRST/SAMPLE
What do you bring to patient’s side?
Equipment, medication, and resources
What is skill level 1?
Treat all patients with respect; ensure scene/crew safety, BSI/PPE precautions, request ALS/additional resources as needed, consult OLMD as needed, bring equipment, medication, resources to patient’s side, establish LOC, manage Immediate Life Threats IAW appropriate protocols, complete initial assessment/patient hx/physical exam as indicated by patient presentation, treat illness/injury IAW applicable protocol or OLMD instruction, airway management, oxygen, patient monitoring, and medication administration.
What is respiratory distress/SOB?
Titrate SpO2 ≥94%
What is hypoxemia or cyanosis?
SpO2<90%
What vitals should you be monitoring?
HR, RR, BP, SpO2, and pain
What other places can you get an SpO2?
Ear, toe, and scalp
How to take temperature?
Oral tympanic, temperature as patient condition/protocol requires
BGL?
obtain as patient condition or protocol requires
Why do you monitor carbon monoxide?
If there is suspected CO exposure, fires/smoke inhalation
What is skill 2?
Transport to appropriate facility based on chief complaint AMA, EtCO2, cardiac monitoring, and a 12-lead EKG
When does EtCO2 (capnometry) used?
For all AMS/lethargy, hypotension, SOB, *trauma, or cardiac arre3st Tier 2 & 3 will document RR and EtCO2 only
When do we use a cardiac monitor?
For all AMS/lethargy, hypotension, CP/SOB, *trauma, or cardiac arrest Skill Level 2 & 3 will document rate ONLY, not complete interpretation
What is skill level 3?
Vascular access and temperature
What are the three types of vascular access?
IV access via single lumen (standard IV) when required (saline Lock or NS/LR TKO), IV access via double lumen (Twin-Cath IV) when required (limited access, multiple infusions), and IO access if the IV access is unobtainable and/or lie-threatening condition exists.
How do you give IO for alert/verbal patients?
2% Cardiac Lidocaine Bristojet, Inj - 40mg IO x 1 for analgesia before fluid administration
When do we use blood/fluid warmers?
For all *Trauma/Hypovolemia & Hypothermic patients
When may you utilize rectal monitoring?
Truma and hypo/hyperthermia
What is skill 4?
External jugular, medication infusions, tunneled catheters, PICC line, dialysis graft/shunt, temperature, EtCO2, and SpHb (Hemoglobin)
What do you use for external jugular?
Via single or double umen IV or saline lock
What are the two forms of medication infusions?
Vasopressors and infusion pumps
How should vasopressors be given?
Via IV placed in the AC, if able
What is the formula for infusion pumps?
mL/hr = gtts/min (using 60 gtt tubing)
What are the requirements for tunneled catheters, PICC line, dialysis graft/shunt?
IV/IO access must be unobtainable and must have OLMD approval prior o accessing and must be approved/trained by local EMS medical director with documentation in training record.
When do BLS calls not resume after evaluating for life threats?
Patient requires or there is a high clinical suspicion that the patient will require ALS interventions, an intervention was performed on the pt requires continuous monitoring that is beyond the EMT scope, patient has received or will require the administration of a medication that is beyond the scope of the EMT, or any patient requiring a hospital alert
What is a PCR?
Patient Care Report
When does a PCR need to be completed?
As soon as possible after the completion of the call, but no later than the end of the primary provider’s shift.
What should be uploaded with the PCR to the receiving facility?
Copies of rhythm strips, EKGs and waveform capnography
What temperature is hypothermia?
< 35°C or 95°F
What temperature is hyperthermia?
> 38° or 100.4°F
How often do you record vital signs?
q 5 min for critical pts and q 15 min for non-critical pts
When do you use Blood Tubing?
For massive blood loss or expected blood transfusion
What do you do if IV extravasation occurs?
Stop infusion, connect syringe to IV catheter and attempt to withdraw fluids, remove IV catheter, immobilize extremity, and elevate above the level of the heart, and apply heat packs to the area
What do you do if IV infiltration occurs?
Stop the infusion and remove the catheter
What do you do if IO extravasation/infiltration occurs?
Stop infusion, secure in place, and do not attempt to remove
