NREMT part IV Flashcards
Adrenergic
Refers to the sympathetic nervous system
(epinephrine)
See ‘sympathomimetics’ card
Agonist
medications that stimulate and effect
Antagonist
Medications that inhibit an effect
Drug profile
Provides essential information about a drug
Cholinergic
Referes to parasympathetic nervous system
Pharmacokinetics
study of how drugs enter the body, how they are metabolized and eliminated
Pharmacodynamics
study of drugs effects on the body
Drug profile componants
- Trade name
- generic name
- drug class
- machanism of action
- indications
- contraindications
- route of administration
- side effects
- supply (dose)
- Special considerations
Sympathomimetics
Adrenergic drugs
- mimics effects of sympathetic nervous system
- exmpl: Epinephrine
Alpha 1,2
Beta 1,2
Actions
Alpha 1: Vasoconstriction, smooth muscle constriction
Alpha 2: regulates alpha 1
Beta 1: increase HR, heart force
Beta 2: smooth muscle dialation
Anticholinergic
Define
- antagonist medication
- Inhibits effects of parasympathetic nervous system
E.x. Atropine and naloxone
“relative” contraindications
Define
- Contraindications that allow for some descretion
E.x withholding a drug may be more harmful than administering it
Enteral administration
Define
- Drugs that enter the body through the digestive system
- oral (PO)
Parenteral
Define
- enter the body through all other avenues other than enteral
E.x sublingal, inhaled, intramuscular
onset
Define
How long it takes the medication to begin the desired effect
peak
Define
- How long until the medication reaches its peak effect
Duration
Define
- How long medication will maintain desired effect
Enteral components
- Slow onset
- Safe
- Unpredictable absorption
intramuscular components
- Parenternal route
- Rapid absorbtion
- Not as fast as IV or IO
MAD
Define
- Mucosal atomizer device
E.x. Noloxone
Sublingal components
- Under tongue
- Faster onset than oral
- Considered either enteral or parenteral
5 rights + one
Love NREMT
- Right patient
- Right drug
- Right route
- Right dose
- Right time
- Right documentation
analgesics
Define
- Intravenous or over the counter pain medication
Activated charcoal
Common names
- Actidose
- Charcoal Aid
- Liqui-Char
- Super-Char
Aspirin
Common names
- ASA
- Anacin
- Bayer
Epinephrine
Common names
- Epipen
- Auvi-Q
Atropine
Common names
- Rafa auto injector
Naloxone
Common names
- Narcan
- Evzio
MDI
Define
- Albuterol
- Proventil
- Ventolin
Oral Glucose
Common names
- Glutose
- Inst-glucose
Nitroglycerine
Common names
- Nitrostat
- Nirtolingual
- NitroMist
Acute coronary syndrome
conditions caused by acute reduction of blood flow to the heart
Angina
Transient chest pain due to lack of O2 to the heart muscle
* typically caused by plauque buildup in coronary arteries (atherosclerosis)
* Releived within 10 min of rest
Unstable angina
Angina pectoris
- unpredictable onset
- unreleived by rest
Myocardial ischemia
Define
Lack of oxygen to muscle
Myocardial infarction
Define
Death to heart muscle becuase of lack of oxygen
Silent MI
Patient populations that are more likely to have a silent MI
- elderly patients
- Women
- Diabetics
- Alcoholics
AICD
Define
Whats that do?
Automatic implantible cardioverter - difibrillator
like an AED this resets the heart
This is not a pacemaker
Pacemaker
Define
Helps regulate the patients cardiac rate
Pacemaker malfunctioning S/S
- Dizziness
- weakness
- Bradycardia
- Hypotension
VAD
define
Whats that do?
- Ventricular assist device
- Might not have a pulse
Replaces the function of the ventricles
ICD
Define
- Implantable cardioverter defibrillator
Rate of compressions
AHA guidlines for cardiovascular resuscitation
- Rate of compression 10-20/min
- Adult depth of compressions - 2-2.4 inches
- Children depth - 1/3rd the depth of the chest approximatly 2 inches
- Infants - depth 1.5 inches
Hypothermic cardiac arrest AED rules
AHA guidlines
- 1 shock then transport
indications for AED
- Pulseless adults and infants over 28 days old
Special situations for AED
- AED may not deliver shock while moving in the ambulance
- Adult pads can be used on peds
- pediatric pads can not be used on adults
cerebrovascular accident
Whats that?
Death of brain tissue due to interruption of blood flow
This is stroke
CPSS
Define
Cincinnati prehospital stroke scale
CPSS
Components
- Facial droop
- Arm drift
- Slurred speech
LPSS
Whats that?
Los angeles prehospital stroke screen
Headache
RED FLAGS… OH NO
- Worst headache they have head
- Sudden onset of severe headache
- AMS
- older than 50
- Immunocompromised
- Hypertension
- Fever
- Stiff neck
- vision changes
- Signs of stroke
- Recent trauma
Special patient populations
what age do organ start losing 1% of function every year
30
Congestive heart failure unique S/S
- Distended/spongy abd
- orthopnea
- paroxymal nocturnal dyspnea
- Upright position
- crackles/wheezes
- JVD
- peripheral edema
left sided heart failure
Pathophysiology and specific s/s
- left ventricle failure
- fluid in lungs
- left sided leads to right sided failure
-pulmonary edema
-dyspnea (exertion, at night, while supine)
-cough
Right sided heart failure
Pathophysiology and specific s/s
- left ventrical malfunction
- fluid backsup into venous system
-JVD
-Pedal edema
Compression to ventilation ratios
AHA guidelines
Single rescuer: 30:2
Adult: always 30:2
Children/infants(2 rescuers): 15:2
Meonates: 3:1
Special CPR consideration for pregnant pt
AHA guideline
continuous lateral uterine displacement
Special CPR consideration for Hypothermia
AHA guideline
Shock once then transport
When does AED reanalyze for shock
after 2 mins
Can AED deliver shock in moving ambulance
NO
Cerebrovascular accident
Stroke
Death to brain tissue due to interruption in the blood flow
Are ischemic or hemorrhagic strokes more likely?
Ischemic (87%)
CPSS
Cincinnati prehospital stroke scale
- Facial droop
- arm drift
- Slurred speech
LPSS
Los angeles prehospital stroke screen
- like CPSS but more in depth
- requires 9 assessments including GCS scale
12 lead placement
V1 = fourth intercostal space right of sternum
V2= fourth intercostal space left of sternum
V3= directly between leads V2+V4
V4= fith intercostal space at mid-clavucular line
V5= level with V4 at left anterior axillary line
V6= level with V5 at left mid-axillary line (midpoint under armpit)
AICD
what is and what do
Automatic implantable cardioverter-defibrillators
- Restarts pt heart
Pacemaker
what is and what do
- helps regulates pts cardiac rate by serving as artifical source of electrical impulses to stimulate heart
pacemaker malfunction s/s
- Dizzy
- Weakness
- bradycardia
- Hypotension
VAD
what is and what do
special considerations
- replaces function of ventricals
- pt may not have pulse
- innacurate Spo2 reading
- many vads have a ICD
ICD
what is
implantable cardioverter-defibrillator
GCS
min and max score
min = 3
max = 15
GCS
3 componants to measure and their total scores
- eye opening (4)
- verbal response (5)
- motor response (6)
GSC eye opening scores
Spontaneous = 4
to speech = 3
to pain = 2
none = 1
GCS verbal response scores
Alert and oriented = 5
confused = 4
inappropriate = 3
Incomprehensible = 2
none = 1
GCS motor response scores
obey commands = 6
localizes pain = 5
withdrawls from pain = 4
abnormal flexion = 3
abnormal extension = 2
non = 1
Tonic phase is
loss of consciousness
muscle rigidity
Clonic phase is
jerking movement
