Medic and Lt. Flashcards by Ricky Clarke

Indications for CPAP

1-2 word sentences,
O2 stat below 90%

CHF (10 cm), COPD (5cm)
severe asthma

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Indications for EPI, for an Asthma patient (dose)

AMS, accessory muscle use, cyanosis, hypoxia despite treatment

0.5 mg IM (under 5 y/o 0,.15mg)

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Steps for CHF Treatment (signs)

Sit up-right
Give NRB (to get o2 above 94%)
Give Nitro 0.4mg SL (up to 3)
Give CPAP (nitro paste 1 inch)

Signs: Swelling, BP High, Sweaty, JVD, PND, RR up, Hypoxia (below 94%) Rales or Wheezing

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Steps for COPD Treatment (and signs)

Give NRB
NEB Treatment Albuterol 2.5/Atrovent 500mcg
Dex 10mg

Epi if severe, Mags 1-2g over 10-20mins

Signs: SOB, tripoding, RR up, Dry

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Indications for Defribrillation

(What should you remember during pulse check)

Vfib, PVtach (immediately)
360j
REMEMBER to charge during pulse check

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Treatment for Croup (and signs)

Dex 0.5mg/kg PO

Neb Epi (2.5mL of 1:1,000)

Signs: Barky cough, with stridor)

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Treatment for Gunshot Victim

Ensure airway (check pulse)
Start CPR/PADs if needed
NDT if tension pneumo
Control Bleeding - tourniquet if needed
LR if hypotensive
Consider TXA 1g

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Treatment for Fall Patient, Jumped from Building

Ensure airway
Check pulse, Start CPR/PADs if needed
NDT if tension pneumo
Spinal Restriction
Control Bleeding - tourniquet if needed
Stabilize Fractures
LR if hypotensive
Consider TXA 1g

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Indication and Steps for Pediatric Code

Check for Pulse
High Quality CPR 100-120 compressions per minute
2 breaths per 30 compressions (one rescuer)
2: 15 (2 rescuer)

PADs
Advanced Airway (once every 3 seconds)
EPI (0.01mg/kg)
Defib 2, 4, 6, 8, 10

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Signs of CHF vs COPD

CHF - High BP, RALES, crackles, EDEMA, , jvd, wet (capno normal 35-40, rounded)

COPD - wheezing, tripoding, mottled, dry (capno above 45, shark-fin)

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Signs and Treatment for Anaphylaxis

Signs: (2 or more signs) hives, swelling wheezing, poss N/V or hypotension (shock), resp compromise, GI symptoms

EPI 0.5mg IM repeat every 5mins up to 3

Albuterol for wheezing

Diphen 50mg

Dex 10mg

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Signs of Opioid Overdose

Slow breathing
AMS
Constricted pupils
Cyanosis

Opioids - Fentanyl, Morphine, Hydrocodone, Heroin, Codine OD

Give narcan, assess airway

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List the H’s and T’s

Hypovolemia - low bp
Hypoxia - low ventilation
Hydrogen Ions (acidosis) - vent problem
Hypo/Hyper Kalemia - potassium imbalance
Hypoglycemia - check glucose
Hypothermia - warm

Toxins - antidotes if available
Tamponade, cardiac - pericardiocentesis if needed
Tension Pneumo - NDT if needed
Thrombus - pulm or coronary thrombosis
Trauma - Treat injuries

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Sodium Blocker OD, Signs and Treatment

AMS
Widening QRS
Dilated pupils, flushed skin

Give Sodium Bicarbonate 1mEq/kg IV

Sodium blockers - Lidocane, procainamide, Quinidine

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Calcium Channel Blocker OD, Signs and Treatment

Signs: sever hypotension, brady, poss AMS

Treatment - Give Calcium Chloride 1g slow IV push

Cal Ch OD - Diltiazem, Amlodipine, Verapamil

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Beta Blocker OD, Signs and Treatment

Treatment - Glucagon

Signs - brady, AMS, poss hypoglycemia

Beta - Metorpolol, Atenolol (lol)

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Mild,
Moderate,
Severe Allergic Reaction Signs

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Synchronized Cardioversion
When and How?

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Steps for Working Code (pVtach, Vfib)

CPR immediately for 2mins - BVM, Pads (front and back start) + Lucas

2 mins pulse chk - Defib 360j 1.

      I/O, iGel

4 mins pulse chk - Defib 360j 2. (Decide Staying, 2nd monitor eta…)

     Amio 300 + Epi (no other epi after)

6 mins pulse chk - Defib 360j (next is vector/dual sequential change (after 3rd shock) Don’t move patient till this

   New pads

8 mins pulse chk - Defib 360j (or dual sequential)

  Amio 150 slow IV 2mins

10 mins pulse chk - Defib 360j (or dual sequential)

  Esmolol 3-5ml for avg pt 2mins

12 mins pulse chk - Defib 360j (or dual sequential)

Repeat until ROSC or TOR

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Sepsis Signs and Treatment

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GCS (M, V, E)

Trauma Tree (A, B, C, D)

During Code how often do you pulse check and
how often do you give Epi/Amio

Every 2 mins - pulse check

Steps for Pacing

What can you give for Stable Brady

What do you give for TCA OD

Signs - AMS, hypotension, Dysrhythmias, widen QRS, dialated pupils TCAs - Amitriptyline Treatment - Sodium BiCarb 1mEq/kg

Ped Dose for Benadryl

Ped Dose for Epi for Anaphylaxis

What is the compression rate for 2 person CPR for Ped Adult

Define Priority 1 vs Priority 2 Patients

Per 5-1 Priority 1 patients are those who need to be transported with visible and audible emergency warning devices to the nearest hospital or medical facility that can stabilize and treat them, unless a medical consultation directs otherwise Priority 2 patients, are transported without the use of emergency warning devices to the most appropriate area hospital, considering the best interest of a time-critical patient, which may sometimes involve the use of emergency warning devices at the EMS crew's discretion Per Maryland Protocol, 2-1 Priority 1 patients are critically unstable, requiring immediate life-saving interventions that cannot be provided in the field. They are triaged to the closest appropriate hospital-based emergency department, designated trauma, or designated specialty referral center Priority 2 patients are stable enough to be triaged according to Maryland Medical Protocols to the closest appropriate hospital-based emergency department, designated trauma, or designated specialty referral center unless otherwise directed by EMS system medical consultation. Stable Priority 2 patients may also be referred to a freestanding emergency medical facility

If a Doctor shows up and gives orders what must you do?

Per 5-13 Get ID Doctor must agree to go with Patient Lastly, you, as the EMS provider, need to talk directly with the medical control, over radio.

PED code steps (yes.. again)

Check pulse Start compressions Start ventilations (15:2) Attach AED Give EPI (0.01mg/kg) Pulse check every 2mins

Steps for pVtach, Vfib (Code)

Check pulse Start CPR PAD (confirm VF/VT) Defib immediately 200j Resume CPR for 2mins Defib 300j Give Amio 300mg, follow with EPI If Torsades give Mags If Hyperkalemia giver Cal Hloride and Sodium BiCarb Consider Consider Dual - Sequential Defib

TCA OD Med (and dose)

Signs - AMS, hypotension dysrhythmia widen QRS, dialated pulpils Treatment - Sodium Bicarb 1mEq

Beta Blocker OD Signs, Med (and Dose)

Signs - brady, hypotension, AMS Treatment - Glucagon (1mg)

When do you switch from CPAP to BVM

If patients spo falls below 90% and capno 45-50 or below 30 AMS

Esmolol - What’s it for, when do you give, Dose

Indications - esmolol - beta blocker for Vfib, pVtach 500mcg/kg (average 3.5mL)

Hyper K - signs (Med and Dose)

Signs - Peaked T waves, wide QRS, brady, dialysis Treatment Cal Chloride 1g Slow, Sodium Bicarb 50mEq over 5 mins

OD - Signs, Med and Dose

Signs - brady, hypo, AMS Treatment -

Step after ROSC

When do you Sync Cardiovert (Signs and Jules)

Trouble Breathing Treatment

Cardiac Hospitals

Stroke Hospitals

Cat A Trauma Indications

Droperidol Dose

Cardizem is for

Afib, aflutter

Calcium chloride is for Dose?

For hyper k, cal ch od 1g slow

Esmolol dose

Glucagon is for (2) and dose

Low bgl and beta blocker od And 1mg

Sodium bicarb is for Dose?

DKA, acidosis, renal failure, crush TCA OD 1mEq/IV

Mags is for

Eclampsia and