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Paramedic Coach F.C Flashcards

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1
Q

What is the dose of Epi for cardiac arrest?

Adult and Peds

A

Adult: 1mg of 1:10,000 w/ 10cc flush
Peds: .01mg/kg

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2
Q

What is the dose of Amiodarone for cardiac arrest?

Adult and Peds

A

Adult: 300mg
Peds: 5mg/kg

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3
Q

What are the H’s and T’s?

A
  1. Hypovolemia
  2. Hypoxia
  3. H+ (acidosis)
  4. Hypo/hyperkalemia
  5. Hypothermia
  6. Tension pneumothorax
  7. Tamponade (cardiac)
  8. Toxins
  9. Thrombosis, pulmonary
  10. Thrombosis, coronary
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4
Q

H’s and T’s: How to treat hypovolemia?

A

IV fluids

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5
Q

H’s and T’s: How to treat Hyperkalemia?

A

Sodium Bicarbonate

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6
Q

H’s and T’s: How to treat Toxins?

A

Narcan

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7
Q

H’s and T’s: How to treat hypoxia?

A

O2

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8
Q

H’s and T’s: How to treat cardiac tamponade?

A

We cant do, but hospitals will perform a pericardiocentesis

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9
Q

H’s and T’s: How to treat Tension pneumothorax?

A

Needle D

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10
Q

H’s and T’s: How to treat H+?

A

Sodium Bicarbonate

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11
Q

How to treat hypotension (<90) after ROSC?

A
  1. IV/IO fluid bolus
  2. Vasopressor infusion
  3. Consider treatable causes
  4. Assess 12-lead ECG
    * Remember BLEACHO*
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12
Q

After ROSC, if the patient is not awake, what should you consider?

A

Consider induced hypothermia

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13
Q

PALS: What are the main problems that cause peds to have heart problems?

A
  1. Respiratory

2. Volume

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14
Q

PALS: What is the difference between respiratory distress and respiratory failure?

A 
Respiratory Distress
1. IC muscle usage
2. Increased RR
Respiratory Failure
1. Starts tanking
2. Decrease respiratory rate
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15
Q

What does big and/or wide Q waves indicate?

A

Old MI occured

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16
Q

What does the T wave represent?

A

Ventricular repolarization

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17
Q

Cardioversion: Why is synchronizing important?

A

So shock isnt hitting on T wave causing R on T phenomenon (V-Tach)

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18
Q

Who can have sinus bradycardia naturally?

A

Athletes

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19
Q

When do you treat sinus bradycardia?

A

When the patient has symptoms

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20
Q

What are the symptoms to determine stable vs unstable?

A
  1. Hypotension
  2. Ischemic chest discomfort
  3. Signs of shock
  4. ALOC
  5. Acute heart failure
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21
Q

What is the base rate for junctional rhythm?

What is special about junction rhythms?

A

40-60

Impulse starts in the junction (AV node and bundle of his) meaning either retrograde, hidden, or after QRS P-wave

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22
Q

What is the base rate for idioventricular rhythm?

What is special about idioventicular rhythms?

A

20-40

Wide rhythm with no P wave

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23
Q

How do you treat a first degree heart block?

A

Dont really treat it. make not and routine EMS

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24
Q

What type of heart conditions does atropine work on?

A
  • Sinus Brady

- 2nd degree type 1

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25
Q

What are the qualifications for first degree heart block?

A

PRI >.2 seconds

26
Q

What are the qualifications for second degree type 1?

A

PRI gets longer and longer then drops and restarts the process

27
Q

What are the qualifications for second degree type 2?

A

PRI constant til beat is dropped

28
Q

What are the qualifications for third degree?

A

P waves and QRS complex have no relationship

29
Q

Dealing with physical final, what should you have with EKGs?

A

Each patient gets 2 12-leads to compare trends

30
Q

12-lead: What does elevation everywhere indicate?

A

Pericarditis

31
Q

12-lead: What should you do if you see an inferior MI?

A

Right sided ekg or RV4

32
Q

12-lead: What should you do if you see depression in V1 and V2?

A

It is a possible posterior MI. Do a 15 lead

33
Q

What are the qualifications for Sinus rhythm?

A 
PRI: .12-.2 (start at beginning of P to beginning of Q)
QRS: .08-.12sec
QT: .4-.46
*Wide QRS is >.12 sec
Rate: 60-100
34
Q

What is the elevated portion of a 12-lead called?

A

J point

35
Q

What does ST depression represent?

A

Ischemia

36
Q

What is the qualifications of a STEMI?

A

2 or more contiguous leads show ST elevation of at least 2mm (2 small boxes) or more

37
Q

What should you do dealing with posterior MIs?

A

Move V4, V5, and V6 to the back (ST elevation in V7, V8, and V9 confirms posterior

38
Q

What should you do during RV4 if you see elevation?

A

Inferior confirmed. DO NOT give Nitro

39
Q

Tx for BB OD?

A

5mg, IV Glucagon

40
Q

Tx for CCB OD?

A

1-2g calcium IV

41
Q

Tx for opiate/narcotic OD?

A

.4-2mg Narcan

Titrate to effect

42
Q

Tx for Organophosphate OD?

A

Atropine 2-6mg

Good indicator is farm environment

43
Q

Tx for TCA OD?

A

Sodium Bicarbonate 1mEq/Kg

44
Q

What are the options for psych chemical restraint?

A 
Versed: 5mg IM/IV
Valium: 5mg IM/IV
Ativan: 2mg IM/IV
Haldol: 5mg IV (10mg IM)
Ketamine: 4mg/kg IM (1-2mg/kg IV
45
Q

What are the major concerns dealing with burn injuries?

A
  • Hypothermia
  • Infection (dry and sterile. No wetness with severe burns)
  • Fluid (if over 20%)
46
Q

What is the fluid resuscitation for burn patients?

A

20cc/kg

47
Q

What is the treatment for asthma and COPD?

A
  1. Albuterol 2.5mg with .5mg atrovent (NEB)
  2. Solumedrol: 125mg IV (peds: 2mg/kg)
    If severe
  3. Epi: .3mg IM (.15mg for PEDS)
  4. mag: 2g
48
Q

What is the treatment for anaphylaxis?

A

look up

49
Q

What is the treatment for a MI?

A
  • O2
  • Aspirin (324mg)
  • Nitro .4mg q 5 minutes (but not for inferior)
  • Morphine .1mg/kg (usually about 2-4mg)
50
Q

What is the treatment for sepsis?

A

IV fluids to keep systolic BP to 90

Epi if fluids are not working and you need something stronger (2-10mcg/min)

51
Q

What are the signs for CHF?

A
  • Respiratory noises: Bilateral rales
  • Vitals: Increased BP (200/100)
  • Positive JVD
  • SOB
52
Q

What is the treatment for CHF?

A
  • 12-lead
  • CPAP: 10cm H20
  • Nitro .4 SL
53
Q

What is a major contraindication for pain medications?

A

Hypotension

54
Q

What is the treatment for hyperkalemia?

A
  1. Calcium Chloride (1g IV)
  2. Albuterol (maybe 5-10mg?)
  3. Sodium Bicarbonate (1mEq/kg)
55
Q

Treatment for hyperglycemia?

A
  • 12-lead

- NS 250-300 Bolus (to dilute them)

56
Q

Treatment for hypoglycemia?

A

Not altered: oral glucose
Altered: D50
-If you cant get a line (Glucagon 1mgIM)

57
Q

What is the normal level of pH in blood?

A

7.35-7.45

58
Q

What is the normal level of PaCO2?

A

“acid” 35-45

59
Q

What is the normal level of PaO2?

A

oxygen 80-100

60
Q

What is the normal level of HCO3?

A

“base” 22-26

Paramedic (34 decks)

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