General Treatments

Question 1

What are the indications for obvious death in the field (w/o resuscitation)?

Answer 1

Pt is unresponsive, pulseless, apneic AND
Decapitation OR
Decomposition OR
Rigor mortis or dependent lividity w/ warm air temps OR
any advanced directives OR
Open cranium w/ exposed brain matter OR
Trauma incompatible w/ life OR
3rd-degree burns > 90% BSA OR
Mult-casualty situations where resources are needed for other pts

Question 2

What are the criteria for termination of resuscitation after reversible causes have been identified and treated?

Answer 2

ALS
Asystole OR
EtCO2 is < 10 after 20 min of ALS care and no ROSC
BLS
No ROSC despite “no shock” on 3 sequential AED analysis
Trauma
No ROSC following appropriate interventions (BVM, needle decompression, fluids, etc)

Question 3

How should death in the field be documented?

Answer 3

Cessation of resuscitative efforts

Question 4

What is the BLS medication for nausea and what’s the dose?

Answer 4

Zofran (ondansetron)
Adult: 4 mg IV/IM/IO/ODT, MAX total dose 32 mg
Pediatric >40 kg: 4 mg ODT (preferred
medication), MAX total dose 16 mg
<40kg 0.1mg/kg MAX total dose 8mg

Question 5

What are the ALS medications for nausea/vomiting?

Answer 5

Reglan (metoclopramide)
Phenergan (promethazine)
Compazine (prochlorperazine)
Droperidol (inapsine)

Question 6

What should you look for/consider in nausea/vomiting patients?

Answer 6

Hypotension and dehydration

Question 7

How do you treat hypotension/dehydration?

Answer 7

Fluid therapy
Adult 20ml/kg bolus PRN
Pediatric 10/ml/kg bolus PRN

Question 8

What monitoring do patients that have received multiple doses of pain medication (or benzos for anxiety) require?

Answer 8

4-lead ECG, SpO2, EtCO2, BP

Question 9

What options do you have for pain management aside from medication?

Answer 9

Position of comfort, rest, hot/cold packs, splinting, elevation

Question 10

What are the BLS medications for pain management and their doses?

Answer 10

Tylenol (acetaminophen)
Adult 500-1000 mg PO q 6 hrs
Peds 15 mg/kg PO q 6 hrs max 1000 mg/dose

Advil/Motrin (ibuprofen)
Adult 400 mg PO q 6 hrs
Peds >6mo 10mg/kg PO q 6 hours, max 400mg/dose

Question 11

What are the ALS medications for pain management?

Answer 11

Toradol (ketorolac)
Fentanyl (sublimaze)
Morphine (MS contin)
Dilaudid (hydromorphone)
Ketamine

Question 12

What are the contraindications for an IO?

Answer 12

Fracture of the targeted bone
Previous orthopedic procedures near insertion site
IO w/in past 24-48 hours in targeted bone
Infection at insertion site
Inability to locate landmarks or excessive tissue over insertion site

Question 13

What are the adult IO insertion sites?

Answer 13

Humeral head, proximal tibia, distal femur, distal tibia

Question 14

What are the pediatric IO insertion sites?

Answer 14

Proximal tibia, distal femur, distal tibia