Medical Emergencies

Question 1

AEIOU TIPS acronym for AMS?

Answer 1

Alcohol
Epilepsy
Insulin
Overdose
Uremia

Trauma
Infection
Psych
Stroke/Shock

Question 2

BGL less than 60 mg/dl treatment?

Answer 2

Oral glucose if pt has intact gag reflex and following commands.
- D10: 250 ml IV then retest BGL. May repeat 1x if it remains below 60 mg/dl

Question 3

If unable to obtain IV access on a hypoglycemic pt?

Answer 3

• Insert IO
• 40 mg of Lidocaine over 1 min. Flush with NS flush after 1 min.
• D10: 250 ml IV then retest BGL. May repeat 1x if it remains below 60 mg/dl

Question 4

If BGL is over 300 mg/dl?

Answer 4

NS 1 Liter IV/IO may repeat 1 x.
Zofran 4mg IM or slow IV/IO over 30 seconds.

Question 5

Can IV Zofran be given sublingual?

Answer 5

Yes, if unable to get IV you can administer sublingual via needleless syringe.

Question 6

Dystonic reaction?

Answer 6

Pt taking antipsychotics, antiemetics, or antidepressants who present with spasms of face, neck or limbs

Question 7

Treatment for dystonic reactions?

Answer 7

Benadryl 50 mg IV/IM
- Rule out stroke

Question 8

Hyperkalemia treatment if presenting with arryhthmias?

Answer 8

• Calcium chloride 1 gm slowly over 2 min
• Albuterol 2.5 mg via neb
• Sodium Bicarb 50 meq over 2 min
  **DO NOT mix Bicarb and Calcium

Question 9

Hyperkalemia treatment if hypotensive?

Answer 9

NS 500 ml bolus may repeat 1x. Check lung sounds
- If needed Epi push dose pressor