Other Adult Emergencies

Question 1

ALS level 1 for mild allergic reaction

Answer 1

Benadryl - 50 mg IM or SLOW IV

Question 2

ALS level 1 for moderate allergic reaction

Answer 2

EPI (1:1000) - 0.3 mg IM (x1)
Benadryl - 50 mg IM or SLOW IV
Albuterol - 2.5mg/2.5mL (x2)
Atrovent - 0.5mg/0.5mL (1st tx. only)

Question 3

ALS level 1 for severe allergic reaction

Answer 3

EPI (1:1000) - 0.3 mg IM (max 3 doses)
Benadryl - 50 mg IM or SLOW IV
Albuterol - 2.5mg/2.5mL (x2)
Atrovent - 0.5mg/0.5mL (1st tx. only)

Question 4

ALS level 2 for severe allergic reaction

Answer 4

EPI (1:100,000) - 10 mL IV over 5-10 mins (titrate to BP of 90) replace 9mL of EPI (1:10,000) w/ 9 mL NS

Question 5

ALS level 1 for Hypoglycemia/Hyperglycemia

Answer 5

Glucose less than 60:
pt. conscious - oral glucose 15g (1 tube)
D50 - 50 mL IV
Glucagon - 1 unit (repeat x1 after 20 mins if needed)

Glucose above 300:
NS 500 mL IV

Question 6

ALS level 1 for Sickle Cell Anemia

Answer 6

Fluid challenge - 500 mL NS (repeat to max 1000mL)

Morphine - 5 mg (repeat x1) (titrate to BP of 90)

Question 7

Sepsis Alert =

Answer 7

SIRS + Documented/suspected infection

Question 8

Severe sepsis =

Answer 8

Sepsis + Sepsis-induced organ dysfunction or tissue hypoperfusion

Question 9

Organ dysfuction or tissue hypo perfusion is defined as

Answer 9

a. Hypotension - Mean Arterial Pressure (MAP) less than 65
b. Lactate greater than 4 mg/dL
c. AMS
d. MSI : below 0.7 or above 1.3

Question 10

Formula to calculate modified shock index (MSI)

Answer 10

MSI = HR/MAP

Question 11

SIRS stands for

Answer 11

Systemic Inflammatory Response Syndrome

Question 12

SIRS criteria

Answer 12

Temp above 100.4F or less than 96.8F
RR above 20/min
HR above 90/min

Question 13

Documented infections include

Answer 13

Pneumonia
UTI
Wounds
Skin/Decubitus ulcers

Question 14

Suspected infection due to high risk criteria

Answer 14

a. Nursing home resident
b. Recent surgery
c. Immunosuppression
d. Indwelling device

Question 15

ALS level 1 for Severe Sepsis Only

Answer 15

NS 30mL/kg (repeat to max of 2L)(titrate to MAP of 70)
Consider pressors after 1L of saline (mx. 2L NS)
Dopamine - 5-20 mcg/kg/min (titrate to MAP of 70)

Question 16

Where is MAP located

Answer 16

on monitor (in BP section)

Question 17

Formula for MAP

Answer 17

MAP = [(2 x diastolic) + systolic] / 3

Question 18

What does DAN stand for

Answer 18

Divers Alert Network

Question 19

Where is DAN located

Answer 19

Duke University Medical Center

Question 20

What are the different categories of hypothermia

Answer 20

Mild = 94-97*F
Moderate = 86-94*F
Severe = below 86*F

Question 21

Most oral thermometers do not read below

Answer 21

96*F

Question 22

Tympanic thermometers read between

Answer 22

68-108*F

Question 23

What patients will present with shivering, lethargy, and stiff uncoordinated muscles

Answer 23

Mild to moderate hypothermic patients

Question 24

Severe hypothermia will produce what wave on the ECG

Answer 24

Osborn or J-wave

Question 25

Patients with temperature below 86*F (Tx)

Answer 25

CPR and transport

Question 26

Cases of Frostbite

Answer 26

Bandaged w/sterile dressing and transported without rewarming

Question 27

Heat stroke temperature

Answer 27

greater than 105*F

Question 28

Heat-related: Pts. should be cooled to

Answer 28

102*F

Question 29

ALS level 1 for Heat-related emergencies

Answer 29

Heat cramps/exhaustion/stroke: | NS 500 mL

Question 30

After taser deployment what should be determined

Answer 30

How many 5-second cycles of energy the individual was exposed to