PCP AUXILLARY DIRECTIVES

Question 1

CPAP indications

Answer 1

• severe respiratory distress AND
• signs and or symptoms of acute pulmonary edema or COPD

Question 2

CPAP contraindications

Answer 2

• asthma exacerbation
• suspected pneumothorax
• unprotected or unstable airway
• major trauma or burns to the head or torso
• tracheostomy
• inability to sit upright
• unable to cooperate

Question 3

CPAP treatment

Answer 3

• initial 5cm
• titration 2.5cm
• interval 5 mins
• max 15cm

Question 4

cardiogenic shock indications

Answer 4

• STEMI positive 12 lead ECG AND
• cariogenic shock

Question 5

cariogenic shock conditions 0.9% NaCl FB

Answer 5

> 18
hypotension
chest auscultation is clear

Question 6

cariogenic shock contraindications 0.9% NaCl FB

Answer 6

• fluid overload
• SBP >90mmHg

Question 7

cariogenic shock conditions 0.9% NaCl FB

Answer 7

iv
- 10ml/kg
- reassess every 250 mls
- max 1000mls

Question 8

IV fluid therapy indications

Answer 8

actual or potential need for IV medication or fluid therapy

Question 9

Iv fluid therapy conditions for iv cannulation

Answer 9

> 2 years

Question 10

Iv fluid therapy conditions for NaCl FB

Answer 10

> 2 years
hypotensive

Question 11

Iv fluid therapy contraindications iv cannulation

Answer 11

Suspected fracture proximal to the access site

Question 12

Iv fluid therapy contraindication NaCl FB

Answer 12

fluid overload

Question 13

Iv fluid therapy treatment NaCl >2 years - <12 years maintenance infusion

Answer 13

IV
-15ml/hr

Question 14

Iv fluid therapy treatment NaCl >12 years maintenance infusion

Answer 14

IV
- 30-60 ml/hr

Question 15

Iv fluid therapy mandatory patch point

Answer 15

Patch to BHP for authorization to administer 0.9% NaCl fluid bolus to hypotensive patients ≥2 years to <12 years with suspected Diabetic Ketoacidosis (DKA)

Question 16

Iv fluid therapy treatment NaCl >2 years - <12 years FB

Answer 16

IV
20ml/kg
reassess every 100ml
max 2000ml

Question 17

Iv fluid therapy treatment NaCl >12 years FB

Answer 17

IV
20ml/kg
reassess every 250ml
max 2000ml

Question 17

seizure considerations for treat and discharge

Answer 17

• the patient is ≥18 AND <65 years old;
• patient must have a history of epilepsy;
• the patient is taking their anticonvulsant medication as prescribed;
• the patient must have only had a single seizure episode in the past 24 hours;
• the seizure pattern and duration must be similar to past seizures;
• the patient has returned to their normal level of consciousness;
• a complete set of vital signs including temperature are within expected normal
  ranges;
  AND
• the seizure must not be related to hypoglycemia, alcohol or substance abuse or withdrawal;
• the patient must not have received midazolam by paramedics;
• the patient did not injure themselves during seizure activity;
• the patient must not have a fever, preceding illness or recently started a new
  medication, and;
• the patient is not pregnant.

Question 18

seizure in addition requirements

Answer 18

• a responsible adult agrees to remain with the patient for the next 4 hours;
• all of the patient or substitute decision makers questions were answered
  and a care plan was developed;
• the patient or substitute decision maker has been advised to follow up with their primary health care team or provider;
• clear instructions to call 911 were provided should symptoms redevelop;
• patient or substitute decision maker has the ability to access 911
  should symptoms redevelop, and
• patient or substitute decision maker consents to the discharge.