PCP Directives

Question 1

What are the indications for an SGA?

Answer 1

1. Need for ventilatory assistance or airway control
2. Other airway management ineffective

Question 2

What are the conditions for an SGA?

Answer 2

1. absent gag reflex

Question 3

Contraindications for SGA

Answer 3

1. airway obstructed by FBAO
2. known esophageal disease
3. trauma to oropharynx
4. caustic ingestion

Question 4

Number of attempts for SGA

Answer 4

2

Question 5

Conditions for salbutamol
(bronchoconstriction directive)

Answer 5

none

Question 6

Conditions for epinephrine
(bronchoconstriction directive)

Answer 6

1. BVM ventilation required
2. Hx of asthma

Question 7

Conditions for dexamethasone
(bronchoconstriction directive)

Answer 7

1. Hx of asthma
   OR
2. COPD
   OR
3. 20 pack year hx smoking

Question 8

Contraindications for dexamethasone
(bronchoconstriction directive)

Answer 8

1. allergy or sensitivity to steriods
2. currently on PO or parenteral steroids (systemic only)

Question 9

Contraindications for salbutamol
(bronchoconstriction directive)

Answer 9

1. allergy or sensitivity to salbutamol

Question 10

Contraindications for epinephrine
(bronchoconstriction directive)

Answer 10

1. allergy or sensitivity to epinephrine

Question 11

Dose for dexamethasone
(bronchoconstriction directive)

Answer 11

PO, IM, IV
0.5mg/kg (max 8mg)
SINGLE DOSE ONLY

Question 12

Dose for epinephrine
(bronchoconstriction directive)

Answer 12

IM only
1:1,000
0.01mg/kg (max 0.5mg)
SINGLE DOSE ONLY

Question 13

Dose for epinephrine
(allergic reaction directive)

Answer 13

IM only
1:1,000
0.01mg/kg (max 0.5mg)
2 doses, q 5 minutes

Question 14

Indications for croup directive

Answer 14

1. Current hx of URTI
   AND
2. barking cough or recent hx of barking cough

Question 15

Conditions for epinephrine
(croup directive)

Answer 15

1. at least 6 months to <8 years
2. HR <200bpm
3. stridor at rest

Question 16

Conditions for dexamethasone
(croup directive)

Answer 16

1. at least 6 months to <8 years
2. unaltered

Question 17

Contraindications for dexamethasone
(croup directive)

Answer 17

1. Allergy or sensitivity to steroids
2. Steroids received in last 48 hours
3. unable to tolerate PO medications

Question 18

Contraindications for epinephrine
(croup directive)

Answer 18

1. allergy or sensitivity to epi

Question 19

Dosing, route and concentration for epinephrine
(croup directive)

Answer 19

NEB only, 1:1,000 only
<10kg gets 2.5mg
over 10kg gets 5mg

Question 20

Dosing, max single dose and route for dexamethasone
(croup directive)

Answer 20

PO only
0.5mg/kg (max 8mg)
SINGLE DOSE ONLY

Question 21

Indications for CPAP

Answer 21

1. severe respiratory distress
   AND
2. suspected ACPE or COPD

Question 22

conditions for CPAP

Answer 22

1. at least 18 years old
2. tachypnea
3. Normotension
4. SpO2 < 90% or accessory muscle use

Question 23

Contraindications for CPAP

Answer 23

1. asthma exacerbation
2. suspected pneumothorax
3. unstable or unprotected airway
4. major trauma or burnts to hear or torso
5. tracheostomy
6. inability to sit upright
7. Unable to cooperate

Question 24

CPAP settings

Answer 24

5cm initial
increase by 2.5cm q 5 mins
max 15cm

Question 25

Suction settings for patient less than 1 year

Answer 25

60-100mmHg

Question 26

Suction settings for patient 1 - <12 years

Answer 26

100-120mmHg

Question 27

Suction settings for patient older than 12 years

Answer 27

100-150mmHg

Question 28

Conditions for ASA
(cardiac ischemia)

Answer 28

1. pt is at least 18 years old
2. unaltered
3. able to chew and swallow

Question 29

Conditions for nitroglycerin
(cardiac ischemia)

Answer 29

1. at least 18 years old
2. unaltered
3. HR 60-159bpm
4. Normotensive
5. Prior hx of nitro OR IV access

Question 30

Contraindications for ASA
(cardiac ischemia)

Answer 30

1. Allergy or sensitivity to ASA
   2.if asthmatic, no prior use of ASA
2. current active bleeding
3. CVA or TBI in the previous 24 hours

Question 31

Contraindications for nitroglycerin
(cardiac ischemia)

Answer 31

1. Allergy or sensitivity to nitrates
2. Phosphodiesterase inhibitor use within the previous 48 hours
3. SBP drops 1/3 after initial dose
4. RV STEMI

Question 32

Dose of ASA
(cardiac ischemia)

Answer 32

160-162mg

Question 33

Dose for nitro for non-STEMI
(cardiac ischemia)

Answer 33

0.4mg
q 5 minutes
6 doses

Question 34

Dose for nitro for STEMI
(cardiac ischemia)

Answer 34

0.4mg
q 5 minutes
3 doses