Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

ALS PCS > PCP CORE DIRECTIVES > Flashcards

PCP CORE DIRECTIVES Flashcards

1
Q

supraglottic airway indications

A
  • need for ventilatory assistance or airway control,
    and
  • other airway management is ineffective
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

supraglottic airway conditions

A

absent gag reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

supraglottic airway contraindications

A
  • airway obstructed by a foreign object,
  • known esophageal disease (varices)
  • trauma to the oropharynx
  • caustic ingestion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

supraglottic airway treatment (insertion)

A

the max number of attempts is 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

supraglottic airway treatment (confirmation of placement)

A

primary: etco2 waveform capnography
secondary: etco2 non waveform, auscultation, chest rise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

SGA clinical considerations

A
  • An attempt at supraglottic airway insertion is defined as the insertion of the supraglottic airway into the mouth.
  • Confirmation of supraglottic airway should use ETCO2 (Waveform capnography). If waveform capnography is not available or is not working, then at least 2 secondary methods must be used.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

bronchoconstriction indications

A
  • respiratory distress and
  • suspected bronchoconstriction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

bronchoconstriction conditions salbutamol

A

n/a

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

bronchoconstriction conditions EPI

A

rr- bvm ventilation required
other- hx of asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

bronchoconstriction conditions dexamethasone

A

other: hx of asthma OR, COPD OR, 20 pack-year hx of asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

bronchoconstriction contraindications salbutamol

A

allergy/sensitivity to salbutamol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

bronchoconstriction contraindications EPI

A

allergy/ sensitivity to epi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

bronchoconstriction contraindications dexamethasone

A
  • allergy or sensitivity to steroids
  • currently on PO or parenteral steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

bronchoconstriction treatment salbutamol (weight <25kg)

A
  • MDI
    600 mcg
    5-15mins
    3 times
  • NEB
    2.5mg
    5-15 mins
    3 times
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

bronchoconstriction treatment salbutamol (weight >25kg)

A
  • MDI
    800 mcg
    5-15mins
    3 times
  • NEB
    5 mg
    5-15 mins
    3 times
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

bronchoconstriction epinephrine treatment

A
  • IM
    1mg/ml
    0.01mg/kg
    max 0.5mg
    1 time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

bronchoconstriction dexamethasone treatment

A

-PO/IM/IV
0.5mg/kg
max 8mg
1 time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

bronchoconstriction clinical considerations

A
  • epi should be the 1st medication administered if the patient is apneic. salbutamol may be administered subsequently using BVM MDI adapter
  • neb is contraindicated for pt with known or suspected fever or in setting of declared illness outbreak
  • MDI salbutamol administered every 4 breaths
  • spacer should be used when administering salbutamol MDI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

moderate to severe allergic reaction indications

A

exposure to probable allergen and signs and symptoms of a mod- severe allergic reaction incl anaphylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

moderate to severe allergic reaction conditions epinephrine

A
  • for anaphylaxis only
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

moderate to severe allergic reaction conditions diphenhydramine

A
  • > 25kg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

moderate to severe allergic reaction contraindications epinephrine

A

allergy or sensitivity to epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

moderate to severe allergic reaction contraindications diphenhydramine

A

allergy or sensitivity to diphenhydramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

moderate to severe allergic reaction treatment epinephrine

A
  • IM
    1mg/ml
    0.01mg/kg
    max 0.5mg
    minimum 5 mins
    2 times
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
moderate to severe allergic reaction treatment diphenhydramine >25kg - <50kg
- IV/IM 25mg max 25mg 1 time
26
moderate to severe allergic reaction treatment diphenhydramine >50kg
- IV/IM 50mg max 50mg 1 time
27
moderate to severe allergic reaction clinical considerations
- epi takes priority over IV access - iv administration of diphenhydramine applies only to PCP authorized for PCP autonomous IV
28
croup indications
- current hx of a URTI - and barking cough or recent hx of a barking cough
29
croup conditions epinephrine
>6mons - 8years <200bpm stridor at rest
30
croup conditions dexamethasone
>6mons - 8years unaltered for moderate, mild or severe croup
31
croup contraindications epinephrine
allergy or sensitivity to epinephrine
32
croup contraindications dexamethasone
- allergy or sensitivity to steroids - steroids received within the last 48 hours - unable to tolerate oral medications
33
croup treatment epinephrine <10kg
-NEB 2.5 mg max 2.5 mg 1 time
34
croup treatment epinephrine >10kg
-NEB 5mg max 5 mg 1 time
35
croup treatment dexamethasone
>6mons - 8 years - PO 0.5mg/kg max 8mg 1 time
36
trache suctioning and reinsertion indications
- pt with and endotracheal or trache tube - AND airway obstruction or increased secretions
37
trache suctioning and reinsertion conditions suctioning
n/a
38
trache suctioning and reinsertion conditions trache reinsertion
- pt with existing trache where the inner and/or outer cannulas have been removed from the airway AND - respiratory distress AND - inability to adequately ventilate AND paramedics are presented with a tracheostomy cannula for the identified patient
39
trache suctioning and reinsertion contraindications suctioning
n/a
40
trache suctioning and reinsertion contraindications trache reinsertion
inability to landmark or visualize
41
trache suctioning and reinsertion suction settings
- <1 year: 60-100mmHg - > 1 year- <12 years: 100-120mmHg - >12 years: 100-150mmHg
42
trache suctioning and reinsertion treatment trache reinsertion
max attempts at reinsertion is 2
43
medical cardiac arrest indications
non traumatic cardiac arrest
44
medical cardiac arrest primary clinical considerations
- pregnancy >20 weeks gestation - hypothermia - airway obstruction - non opioid drug overdose/ toxicology - other known reversible cause of arrest for patients in refractory VF or pulseless VT, transport should begin after the third consecutive shock
45
medical cardiac arrest conditions CPR
altered performed in 2 min intervals
46
medical cardiac arrest conditions manual defibrillation
- > 24 hrs altered VF or pulseless VT
47
medical cardiac arrest conditions AED or SAED
- >24 hrs altered defibrillation indicated if not using manual defibrillation
48
medical cardiac arrest contraindications CPR
- obviously dead as per BLS PCS - meet conditions of the BLS PCS DNR standard
48
medical cardiac arrest contraindications epinephrine
allergy or sensitivity to epinephrine
48
medical cardiac arrest conditions medical TOR
- >16 years altered arrest not witnessed by EMS AND no ROSC after 20 mins of resuscitation AND no defibrillation delivered
49
medical cardiac arrest conditions epinephrine
- >24 hrs altered anaphylaxis suspected as causative event
50
medical cardiac arrest contraindications manual defibrillation
rhythms other than VF or pulseless VT
51
medical cardiac arrest contraindications AED or SAED
non shockable rhythm
52
medical cardiac arrest contraindications medical TOR
- known reversible cause of the arrest unable to be addressed - pregnancy presumed to be > 20 weeks - hypothermia - airway obstruction - non opioid drug OD/ toxicology
53
medical cardiac arrest treatment manual defibrillation >24 hrs - <8 years
initial dose 2J/kg subsequent dose 4J/kg every 2 mins
53
trauma cardiac arrest indications
cardiac arrest secondary to severe blunt or penetrating trauma
53
medical cardiac arrest treatment manual defibrillation >8 years
every 2 mins as normal
54
medical cardiac arrest treatment epinephrine
- IM 1mg/ml 0.01mg/ml max 0.5 mg 1 time
55
trauma cardiac arrest conditions CPR
altered performed in 2 min intervals
56
trauma cardiac arrest conditions manual defibrillation
>24 hrs altered VF or pulseless VT
57
trauma cardiac arrest conditions AED or SAED
>24 hrs altered defibrillation indicated
58
trauma cardiac arrest conditions trauma TOR
>16 years - no palpable pulses AND - no defibrillation delivered AND - rhythm asystole AND - no SOL at any time since fully extricated OR - SOL when fully extricated with the closest ED >30 min transport time away OR - rhythm PEA with the closest ED > 30 min transport time away
59
trauma cardiac arrest contraindications CPR
obviously dead as per the BLS PCS meet conditions of the BLS PCS DNR standard
60
trauma cardiac arrest contraindications manual defibrillation
rhythms other than VF or pulseless VT
61
trauma cardiac arrest contraindications AED or SAED
non shockable rhythm
62
trauma cardiac arrest contraindications trauma TOR
<16 years - defibrillation delivered - SOL at any time since fully extricated - rhythm PEA and closest ED <30 min transport time away - PT with penetrating trauma to the torso or head/neck and lead trauma hospital <30 mins away
63
trauma cardiac arrest treatment defibrilation >24 hrs - <8 years
initial dose 2J/kg 1 time
64
trauma cardiac arrest treatment defibrilation > 8 years
1 defibrillation as normal
65
trauma cardiac arrest clinical considerations
- If no obvious external signs of significant blunt trauma, consider medical cardiac arrest and treat according to the appropriate medical cardiac arrest directive. - Signs of life: specifically any spontaneous movement, respiratory efforts, organized electrical activity on ECG, and reactive pupils. - An intravenous fluid bolus may be considered, where it does not delay transport and should not be prioritized over management of other reversible pathology.
66
newborn resuscitation conditions CPR
<24 hrs <60 bpm after 30 seconds of PPV with room air
67
newborn resuscitation conditions PPV
<24 hrs <100bpm
67
newborn resuscitation indications
newborn patient
68
newborn resuscitation contraindications PPV
- obviously dead as per the BLS PCS - presumed gestation age less than 20 weeks
69
newborn resuscitation contraindications CPR
- obviously dead as per the BLS PCS - presumed gestation age less than 20 weeks
70
newborn resuscitation clinical considerations
- If newborn resuscitation is required, initiate cardiac monitoring and right-hand pulse oximetry monitoring. - Infants born between 20-25 weeks gestation may be stillborn or die quickly. Initiate resuscitation and transport as soon as feasible. - If gestational age cannot be confirmed, initiate resuscitation and rapid transport. - If newborn is less than 20 weeks gestation, resuscitation is futile. Provide the newborn with warmth and consider patching to BHP for further direction.
71
ROSC indications
pt with ROSC after the resuscitation was initiated
72
ROSC conditions 0.9% NaCl fluid bolus
> 2 yrs hypotension chest auscultation is clear
73
ROSC contraindications 0.9% NaCl fluid bolus
fluid overload
74
ROSC treatment: consider optimizing ventilation and oxygenation
- titrate oxygenation 94-98% - avoid hyperventilation and target ETCO2 to 30-40 mmHg with continuous waveform capnography
75
ROSC treatment 0.9% NaCl fluid bolus >2yrs- <12 yrs
IV 10ml/kg immediate reassess every 100ml max 1000 ml
76
ROSC treatment 0.9% NaCl fluid bolus >12 yrs
IV 10ml/kg immediate reassess every 250ml max 1000 ml
77
ROSC clinical considerations
- Consider initiating transport in parallel with the above treatment. - IV fluid bolus applies only to PCPs authorized for PCP Autonomous IV.
78
cardiac ischemia indications
suspected cardiac ischemia
79
cardiac ischemia conditions ASA
>18 years unaltered able to chew and swallow
80
cardiac ischemia conditions nitroglycerin
>18 years unaltered 60-159 normotension prior history of nitroglycerin use OR iv access obtained
81
cardiac ischemia contraindications ASA
- allergy or sensitivity to NSAIDS - if asthmatic no prior use of ASA - current active bleeding -CVA or TBI in the previous 24 hrs
82
cardiac ischemia contraindications nitroglycerin
- Allergy or sensitivity to nitrates - Phosphodiesterase inhibitor use within the previous 48 hours - SBP drops by one-third or more of its initial value after nitroglycerin is administered - 12-lead ECG compatible with Right Ventricular MI
83
cardiac ischemia treatment ASA
- PO 160-162 mg max 162mg 1 time
84
cardiac ischemia treatment nitroglycerin >100mmHg no STEMI
-SL 0.3 OR 0.4 mg max 0.4 mg 5 mins 6 times
85
cardiac ischemia treatment nitroglycerin >100mmHg yes STEMI
-SL 0.3 OR 0.4 mg max 0.4 mg 5 mins 3 times
86
cardiac ischemia clinical considerations
- Suspect a Right Ventricular MI in all inferior STEMIs and perform at minimum V4R to confirm (ST-elevation ≥ 1mm in V4R). - Do not administer nitroglycerin to a patient with Right Ventricular STEMI. - IV condition applies only to PCPs authorized for PCP Autonomous IV. - Apply defibrillation pads when a STEMI is identified. - The goal for time to 12-lead ECG from first medical contact is < 10 minutes where possible.
87
Acute cariogenic pulmonary edema indications
moderate to severe respiratory distress; and suspected acute cariogenic pulmonary edema
88
Acute cariogenic pulmonary edema conditions nitroglycerin
>18 HR: 60-159 SBP normotensive
89
Acute cariogenic pulmonary edema contraindications nitroglycerin
- allergy or sensitivity to nitrates - phosphodiesterase inhibitor use within the previous 48 hours - SBP drops by one third or more of its initial value after administration
90
Acute cariogenic pulmonary edema treatment nitroglycerin SBP >100-<140 and yes iv or hx
SL -0.3-0.4 - 0.4 max -5 mins - 6 times
91
Acute cariogenic pulmonary edema treatment nitroglycerin SBP >140 and no iv or hx
SL -0.3-0.4 - 0.4 max -5 mins - 6 times
92
Acute cariogenic pulmonary edema treatment nitroglycerin SBP >140 and yes iv or hx
SL -0.6-0.8 - 0.8 max -5 mins - 6 times
92
hypoglycemia indications
suspected hypoglycemia
93
hypoglycemia conditions dextrose
>2 years altered hypoglycemia
94
hypoglycemia conditions glucagon
altered >4y/o for IN hypoglycemia
95
hypoglycemia contraindications dextrose
allergy or sensitivity to dextrose
96
hypoglycemia contraindications glucagon
allergy or sensitivity to glucagon pheochromocytoma
96
hypoglycemia treatment 10% dextrose
-IV - 0.2 g/kg (2 ml/kg) - 25g max (250ml) - 10 mins - 2 times
97
hypoglycemia treatment 50% dextrose
-IV - 0.5 g/kg (1 ml/kg) - 25g max (50ml) - 10 mins - 2 times
98
hypoglycemia treatment glucagon <25kg
- IM -0.5 mg - max 0.5 - 20mins - 2 times
99
hypoglycemia treatment glucagon >25kg
- IM -1 mg - max 1 - 20mins - 2 times
100
hypoglycemia treatment glucagon IN
- IN -3mg - max 3mg - 20 mins -2 times
101
Opioid toxicity indications
suspected opioid toxicity
102
opioid toxicity naloxone conditions
>24 hrs altered <10 breaths per min inability to adequately ventilate or persistent need to assist ventilations
103
opioid toxicity buprenorphine conditions
>16 unaltered received naloxone for current opioid tox event and patient is exhibiting acute withdrawal with a COWS score of >8
104
opioid toxicity naloxone contraindications
allergy or sensitivity to naloxone
105
opioid toxicity buprenorphine contraindications
- allergy or sensitivity to buprenorphine - taken methadone in the past 72 hrs
106
opioid toxicity treatment naloxone IV
0.4mg max 0.4 5 mins 3 times
107
opioid toxicity treatment naloxone IM
0.4mg max 0.4 5 mins 3 times
108
opioid toxicity treatment naloxone IN
2-4 mg max 2-4 5 mins 3 times
109
opioid toxicity treatment naloxone SQ
0.8mg max 0.8 5 mins 3 times
110
opioid toxicity treatment buprenorphine
buc/SL 16mg initial 8mg subsequent 10 mins 24mg max
111
adrenal crisis indications
a patient with primary adrenal failure who is experiencing clinical signs of an adrenal crisis
112
adrenal crisis conditions
paramedics are presented with a vial of hydrocortisone for the pt AND - age related hypoglycemia OR - GI symptoms OR - syncope OR - temp >38c OR - altered LOA OR - age related tachycardia OR - age related hypotension
113
adrenal crisis contraindication
allergy or sensitivity to hydrocortisone
114
adrenal crisis treatment hydrocortisone
IV/IM - 2mg/kg - max 100mg 1 time
115
analgesia indications
pain
116
analgesia conditions acetaminophen
>12 unaltered
117
analgesia conditions ibuprofen
>12 unaltered
118
analgesia conditions ketorolac
>12 unaltered normotension
118
analgesia contraindications acetaminophen
- use within 4 hrs - allergy or sensitivity to acetaminophen - hx liver disease - active vomiting - unable to tolerate oral - suspected ischemic chest pain
119
analgesia contraindications ibuprofen
- NSAID use within 6 hrs - allergy or sensitivity to ASA or NSAIDS -anticoagulation therapy - current active bleeding - HX peptic ulcer disease or GI bleed - pregnant - if asthmatic, no prior use of ASA or NSAIDS - CVA or TBI in the previous 24 hrs - known renal impairment - active vomiting - unable to tolerate oral - suspected ischemic chest pain
120
analgesia contraindications acetaminophen
- NSAID use within 6 hrs - allergy or sensitivity to ASA or NSAIDS -anticoagulation therapy - current active bleeding - HX peptic ulcer disease or GI bleed - pregnant - if asthmatic, no prior use of ASA or NSAIDS - CVA or TBI in the previous 24 hrs - known renal impairment - suspected ischemic chest pain
121
analgesia acetaminophen treatment >12-<18yrs
-PO - 500-650mg -max 650mg 1 time
122
analgesia acetaminophen treatment >18
PO 960-1000mg max 1000mg 1 time
123
analgesia ibuprofen treatment
PO -400mg max 400mg 1 time
124
analgesia ketorolac treatment
IM/IV - 10-15mg max 15mg 1 time
125
nausea/vomiting indications
nausea or vomiting
126
nausea vomiting conditions ondansetron
>25kg unaltered
127
nausea vomiting conditions dimenhydrinate
<65y/o >25kg unaltered
128
nausea vomiting contraindicatons ondansetron
- allergy or sensitivity to ondansetron - prolonged QT known to pt - apomorphine use
129
nausea vomiting contraindications dimenhydrinate
-allergy or sensitivity to gravel or antihistamines - overdose on antihistamines, anticholinergics or tricyclic antidepressants - co-administration of diphenhydramine
130
nausea vomiting treatment ondansetron
PO 4mg max 4mg 1 time
131
nausea vomiting treatment dimenhydrinate >25kg-50kg
IV/IM 25mg max 25mg 1 time
132
home dialysis emergency disconnect indications
- pt receiving home dialysis and connected to dialysis machine and req. transport to closest receiving facility AND - pt is unable to disconnect AND - there is no family member or caregiver who is available and knowledgeable in dialysis disconnect
132
nausea vomiting treatment dimenhydrinate >50kg
IV/IM 50mg max 50mg 1 time
133
home dialysis disconnect conditions
N/A
134
home dialysis disconnect contraindications
N/A
134
emergency childbirth indications
- pregnant patient experiencing labour OR - post partum pt immediately following delivery and/ or the placenta
135
emergency childbirth conditions delivery
- child bearing years - second stage labour and/or - imminent birth and/or - shoulder dystocia and/or - breech delivery and/or - prolapsed cord
135
emergency childbirth conditions umbilical cord management
- child bearing years - cord complications OR - If neonatal or maternal resuscitation is required OR - due to transport considerations
136
emergency childbirth conditions external uterine massage
- childbearing years - post-placental delivery
136
emergency childbirth contraindications delivery
n/a
137
emergency childbirth conditions oxytocin
- child bearing years - <160mmhg SBP - post partum delivery and or placental delivery
137
emergency childbirth contraindications external uterine massage
placenta not delivered
138
emergency childbirth contraindications umbilical cord management
n/a
139
emergency childbirth contraindications oxytocin
- allergy or sensitivity to oxytocin - undelivered fetus - suspected or known pre-eclampsia with current pregnancy - eclampsia (seizures) with current pregnancy - >4 hrs post placental delivery
140
emergency childbirth treatment delivery
position the pt and deliver neonate
141
emergency childbirth treatment shoulder dystocia
perform ALARM twice on scene. if successful deliver neonate. if unsuccessful transport to closest appropriate facility
142
emergency childbirth treatment breech
-HANDS OFF BREECH. allow neonate to deliver to umbilicus; consider carefully releasing the legs and arms as they are delivered otherwise hands off - once hairline is visible and or 3 mins has passed since umbilicus was visualized, attempt the MSV maneuver - if successful deliver neonate. if unsuccessful transport to closest appropriate facility
143
emergency childbirth treatment cord prolapse
If a cord prolapse is present, the fetal part should be elevated to relieve pressure on the cord. Assist the patient into a knee-chest position or exaggerated Sims position, and insert gloved fingers/hand into the vagina to apply manual digital pressure to the presenting part which is maintained until transfer of care in hospital.
144
emergency childbirth treatment umbilical cord management
-If a nuchal cord is present and loose, slip cord over the neonate’s head. Only if a nuchal cord is tight and cannot be slipped over the neonate’s head, clamp and cut the cord, encourage rapid delivery. -Following delivery of the neonate, the cord should be clamped and cut immediately if neonatal or maternal resuscitation is required. Otherwise, after pulsations have ceased (approximately 2-3 minutes), clamp the cord in two places and cut the cord.
145
emergency childbirth treatment external uterine massage
post placental delivery
146
emergency childbirth treatment oxytocin
- IM 10 units max 10 units 1 time

ALS PCS (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions