PCP Treatment Protocol

Question 1

AEIOU TIPS (Causes of ↓LOC)

Answer 1

Alcohol / Acidosis
Epilepsy / Endocrine
Insulin
Overdose
Underdose/Uremia
Trauma / Toxins / Tamponade
Infection / Infarct
Psychiatric / Poison / Pneumonia
Stroke / Shock / Seizures

Question 2

Glyburide - Purpose

Answer 2

Stimulates insulin secretion

Question 3

Metformin - Purpose

Answer 3

Insulin sensitizer (decreases insulin resistance)

Question 4

Dimenhydrinate - Dosage/Routes

Answer 4

1 mg/kg (25-50mg)
Given - 25mg / Minute
• IM : Undiluted
• IV : Dilute with N/S

Question 5

Dimenhydrinate - Cautions

Answer 5

Age (anticholinergic effects)
Breathing (asthma/COPD)
Cardiovascular Disease
Eyes (glaucoma, increased intraocular pressure)
Prostatic hyperplasia and urinary obstruction
Pregnancy

Question 6

Dimenhydrinate - Contraindications

Answer 6

Hypersensitivity

Question 7

Dimenhydrinate - Indications

Answer 7

Nausea, vomiting and vertigo (prevention or control of)

Question 8

Diphenhydramine - Onset

Answer 8

IM - 20-30 min

IV - Immediate

Question 9

Epinephrine - Cautions

Answer 9

Pregnancy (↓ placental blood flow, induce labour)

Pre-existing tachycardia

Question 10

Epinephrine - Doses / Routes

Answer 10

0.01mg/kg IM 1:1000 (max 0.5 mg)

Question 11

Epinephrine - Onset

Answer 11

IM - 5 to 10 minutes

Question 12

Epinephrine - Indications

Answer 12

Signs of Anaphylaxis
Ongoing broncospasm (deteriorating patient)

Question 13

Epinephrine - Contracindications

Answer 13

Hypersensitivity

Question 14

Diphenhydramine - Contracindications

Answer 14

Hypersensitivity

< 2 years old

Question 15

Diphenhydramine - Indications

Answer 15

Relief of allergy symptoms / early anaphylaxis

Question 16

Diphenhydramine - Cautions

Answer 16

Age (anticholinergic effects)
Breathing (asthma/COPD)
Cardiovascular Disease
Hyperthyroidism
Eyes (glaucoma, increased intraocular pressure)

Question 17

Diphenhydramine - Doses / Routes

Answer 17

> 12 y/o - 50 mg
6-12 y/o - 25 mg
2-5 y/o - 12.5 mg

Given - 25mg / Minute
• IM : Undiluted
• IV : Dilute with N/S

Question 18

Diphenhydramine - Onset

Answer 18

PO - 1 to 7 hours
IM - 20-30 minutes
IV - Immediate

Question 19

Glucagon - Indications

Answer 19

Hypoglycemia - when IV is unattainable

Question 20

Glucagon - Contraindications

Answer 20

Know hypersensitivity

Question 21

Glucagon - Cautions

Answer 21

Nausea

Vomiting

Question 22

Glucagon - Doses / Routes

Answer 22

Weight ≥ 20 kg: 1 mg IM

Weight < 20 kg: 0.5 mg IM

Question 23

Glucagon - Onset

Answer 23

IM: 8 – 15 minutes
PO: 10 – 30 minutes

Question 24

Tranexamic Acid - Indications

Answer 24

Major trauma

Occult or ongoing bleeding

Question 25

Tranexamic Acid - Contraindications

Answer 25

Known hypersensitivity or allergy to TXA
• If time is greater than 3 hours after the injury
• Patient under 16 years of age

Question 26

Tranexamic Acid - Onset

Answer 26

Immediate

Question 27

Tranexamic Acid - Dose / Route

Answer 27

1g in a 50mL N/S; 60 gtts/minute (piggyback)
||
1 gram in 10 mL N/S; 1 mL/minute (IV push)

Question 28

FAST VAN

Answer 28

Face - Droop
Arms - Weakness
Speech - Slurred
Time < 6 Hours

Vision - Gaze
Aphasia - Language Difficulties
Neglect - One Side

Question 29

Narcan - Dose / Route

Answer 29

0.8mg IM; 0.4mg IV

Max 2.0mg

Question 30

Narcan - Onset

Answer 30

IM: 5-10 minutes
IV: < 2 minutes

Question 31

Sepsis Criteria

Answer 31

2 or More:
HR >90
RR > 20
Temperature <36 || ≥38
Altered LOC

AND Indication (recent surgery, illness, > 65 y/o)

Question 32

TXA - Mechanism of Action

Answer 32

Reduces conversion of plasminogen to plasmin

preventing fibrin degradation