Mayo Protocols A Flashcards
What should you do if you need an AeroNeb set-up for continuous medication delivery?
Call dispatch.
They will also need to know if you want an adult, pediatric, or neonatal set-up.
What is dispatch’s phone number at St. Mary’s?
5-5969
Aeroneb Continuous delivery: What is the rate of delivery for all meds?
15 ml/hr
Can you use a BAN for Pentamidine?
No
If heart rate increases by ___ bpm, terminate the breathing treatment.
25
Do not fill the aerogen nebulizer more than ___ mL.
6 mL
Assess and treat protocol: 0-5 points Meds given how often? How often should you re-assess? What modality should be used?
Q2 PRN or home medication regimen
No re-assessment needed
No modality needed
Assess and treat protocol: 6-10 points Meds given how often? How often should you re-assess? What modality should be used?
Meds TID and Q2 PRN
Modality BID and PRN
Re-assess q72 hours with VC
Assess and treat protocol 11-15 points Meds given how often? How often should you re-assess? What modality should be used?
Medications QID and Q2PRN
Modality TID and PRN
Re-assess q72 hours
Assess and treat protocol 16-20 points Meds given how often? How often should you re-assess? What modality should be used?
Medications Q6 and Q2 PRN
Modality QID and PRN
Re-assess q72 hours with VC
Assess and treat protocol More than 20 points Meds given how often? How often should you re-assess? What modality should be used?
Medications q4 and q2PRN
Modality QID and PRN
Re-assess q24 hrs
Rib fracture protocol: What do you need to measure?
FVC and NIF
Bedside muscle strength protocol: What do you need to measure?
FVC, NIF, and MEP
Rib fracture protocol and bedside muscle strength protocol: How often should you collect data? When should you contact the provider?
Collect every 6 hours even if you have to wake the patient up.
Call provider if FVC is less than 50% of predicted.
What are initial vent settings?
SIMV 6-8 ml/kg 12-20 breaths PEEP 8 cm H2O (May go up to 12) O2sat to remain greater than 92% Press Support 5 cm H2O
When you start a patient on a ventilator, you must remember to do these two things (Not vent settings)
Keep HOB 30 degrees unless contraindicated
Get an ABG in 20 min
To begin weaning the patient from the vent, first check these 5 things (Hemodynamic Status)
Systolic BP >90 Heart rate within 30 BPM from post-operative baseline Urine output more than 0.5mL/kg/hr Temp greater than 35.5 degrees Cardiac index >2.2
When weaning a patient from anesthesia, check these three things:
Strong grip bilaterally and/or 5 sec head lift
Patient response to voice
Moves all extremities
When weaning a patient with post-operative bleeding or chest tubes, check these three things:
Subcutaneous emphysema
Air leak
Hemoglobin 8g/dL or greater
When beginning SBT, set pressure support to maintain a TV between ____ and _____ ml/kg.
Titrate FiO2 to maintain SpO2 __% or greater.
Between 4 and 10
SpO2 92% or greater
Extubation criteria for pH
7.32 and 7.5
Extubation criteria: PaCO2
Between 30 and 50
Extubation criteria: PaO2
Greater than 70 with FiO2 0.5 or less
Extubation criteria: Resp rate and TV
8-25
Spont TV greater than 4 mL/kg PBW
