Other Adult Emergencies Flashcards
ALS level 1 for mild allergic reaction
Benadryl - 50 mg IM or SLOW IV
ALS level 1 for moderate allergic reaction
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)
ALS level 1 for severe allergic reaction
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)
ALS level 2 for severe allergic reaction
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
ALS level 1 for Hypoglycemia/Hyperglycemia
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
ALS level 1 for Sickle Cell Anemia
Fluid challenge - 500 mL NS (repeat to max 1000mL)
Morphine - 5 mg (repeat x1) (titrate to BP of 90)
Sepsis Alert =
SIRS + Documented/suspected infection
Severe sepsis =
Sepsis + Sepsis-induced organ dysfunction or tissue hypoperfusion
Organ dysfuction or tissue hypo perfusion is defined as
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
Formula to calculate modified shock index (MSI)
MSI = HR/MAP
SIRS stands for
Systemic Inflammatory Response Syndrome
SIRS criteria
Temp above 100.4F or less than 96.8F
RR above 20/min
HR above 90/min
Documented infections include
Pneumonia
UTI
Wounds
Skin/Decubitus ulcers
Suspected infection due to high risk criteria
a. Nursing home resident
b. Recent surgery
c. Immunosuppression
d. Indwelling device
ALS level 1 for Severe Sepsis Only
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)