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Paramedic Coach F.C Flashcards

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
What are the qualifications for first degree heart block?
PRI >.2 seconds
26
What are the qualifications for second degree type 1?
PRI gets longer and longer then drops and restarts the process
27
What are the qualifications for second degree type 2?
PRI constant til beat is dropped
28
What are the qualifications for third degree?
P waves and QRS complex have no relationship
29
Dealing with physical final, what should you have with EKGs?
Each patient gets 2 12-leads to compare trends
30
12-lead: What does elevation everywhere indicate?
Pericarditis
31
12-lead: What should you do if you see an inferior MI?
Right sided ekg or RV4
32
12-lead: What should you do if you see depression in V1 and V2?
It is a possible posterior MI. Do a 15 lead
33
What are the qualifications for Sinus rhythm?
``` 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
What is the elevated portion of a 12-lead called?
J point
35
What does ST depression represent?
Ischemia
36
What is the qualifications of a STEMI?
2 or more contiguous leads show ST elevation of at least 2mm (2 small boxes) or more
37
What should you do dealing with posterior MIs?
Move V4, V5, and V6 to the back (ST elevation in V7, V8, and V9 confirms posterior
38
What should you do during RV4 if you see elevation?
Inferior confirmed. DO NOT give Nitro
39
Tx for BB OD?
5mg, IV Glucagon
40
Tx for CCB OD?
1-2g calcium IV
41
Tx for opiate/narcotic OD?
.4-2mg Narcan | Titrate to effect
42
Tx for Organophosphate OD?
Atropine 2-6mg | *Good indicator is farm environment*
43
Tx for TCA OD?
Sodium Bicarbonate 1mEq/Kg
44
What are the options for psych chemical restraint?
``` 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
What are the major concerns dealing with burn injuries?
- Hypothermia - Infection (dry and sterile. No wetness with severe burns) - Fluid (if over 20%)
46
What is the fluid resuscitation for burn patients?
20cc/kg
47
What is the treatment for asthma and COPD?
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
What is the treatment for anaphylaxis?
look up
49
What is the treatment for a MI?
- O2 - Aspirin (324mg) - Nitro .4mg q 5 minutes (but not for inferior) - Morphine .1mg/kg (usually about 2-4mg)
50
What is the treatment for sepsis?
IV fluids to keep systolic BP to 90 | Epi if fluids are not working and you need something stronger (2-10mcg/min)
51
What are the signs for CHF?
- Respiratory noises: Bilateral rales - Vitals: Increased BP (200/100) - Positive JVD - SOB
52
What is the treatment for CHF?
- 12-lead - CPAP: 10cm H20 - Nitro .4 SL
53
What is a major contraindication for pain medications?
Hypotension
54
What is the treatment for hyperkalemia?
1. Calcium Chloride (1g IV) 2. Albuterol (maybe 5-10mg?) 3. Sodium Bicarbonate (1mEq/kg)
55
Treatment for hyperglycemia?
- 12-lead | - NS 250-300 Bolus (to dilute them)
56
Treatment for hypoglycemia?
Not altered: oral glucose Altered: D50 -If you cant get a line (Glucagon 1mgIM)
57
What is the normal level of pH in blood?
7.35-7.45
58
What is the normal level of PaCO2?
"acid" 35-45
59
What is the normal level of PaO2?
oxygen 80-100
60
What is the normal level of HCO3?
"base" 22-26

Paramedic (34 decks)

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