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FI > Procedures > Flashcards

Procedures Flashcards

1
Q

what is a required diagnostic to be used when you intubate a patient?

A

ETCO2

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2
Q

what are the 2 “relative contraindications” of intubations? IT can lead to worse outcomes…

A

pediatric pts and head injury pts

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3
Q

If a ET tube becomes dislodged, what does DOPE stand for?

A

Dislodge
Obstruction
Pneumothorax
Equipment Failure

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4
Q

how many attempts at ET tube can you try before you need to move onto a BLS airway?

A

2

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5
Q

What are the the 4 contra indications to not nasal intubate a pt?

A
  • Apnea
  • Severe Mid-face trauma
  • BLOOD THINNERS
  • JAUNDICE
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6
Q

how old does a pt need to be for a nasal intubation?

A

12 yo and up

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7
Q

how soon do you need to notify EMS division about a cricothyrotomy?

A

24 hours

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8
Q

when should you consider doing a cricothyrotomy?

A

when there is an away issue and an airway is needed, ALL other means of ventilation have been exhausted.

  • CAN NOT INTUBATE CAN NOT VENTILATE

Ex:

  • anaphylaxis
  • burn
  • choking (consider right main stem first)
  • major facial trauma
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9
Q

what are the contraindications for a cricothyrotomy?

A

less than 12 yo

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10
Q

what are the major contraindications of using CPAP?

A
  • BP <90
  • pneumothorax
  • Lack of airway protective reflexes
  • Significant altered level of consciousness (unable to follow verbal commands)
  • Trauma
  • Resp or cardiac arrest
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11
Q

When is ETCO2 mediatory to use?

A

Any ET tube placement.

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12
Q

What does low CO2 values represent (<25)?

A

Low perfusion:

  • Sepsis
  • PE
  • hyperventilation (hyperglycemia, acidosis, or anxiety)
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13
Q

when you see the ETCO2 level dropping during CPR what is one thing you can do to see if you can make it go back up?

A

Switch the person doing compressions

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14
Q

At what level of CO2 after 20 min of CPR likely represents low CO2 and poor outcome to justifying stopping CPR efforts?

A

10 mmHg

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15
Q

A sudden spike in CO2 during CPR can indicate what?

A

ROSC

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16
Q

ALL 3 have to be present to indicate needle thoracotomy for a tension pneumothorax?

A
  • severe respiratory distress
  • hypotension and signs of shock
  • unilateral absent or decreased breath sounds
17
Q

When should you consider bilateral needle decompression?

A

Chest blunt trauma and there is traumatic pulseless arrest

18
Q

how many joules do you cardio vert an adult?

A

200J

19
Q

how many joules do you cardiovert a child?

A

0.5-1j/kg

20
Q

does the tachycardia cause the hypotension?

what blood pressure can you give a benzodiazepine to?

A

most like the hypotension is from the rapid heart rate.
88-90 systolic = benzo
<88 systolic = straight to cardiovert

21
Q

A-flutter or A-fib, should you cardio vert them right away?

A

NO, try to fix the cause with O2 and fluids. cardiovert in a-fib you can risk a stroke.

22
Q

What do you need to do if you have to pace a child under the age of 12yo?

A

contact base, it is rare that they need pacing.

23
Q

what are the starting values of pacing?

A

80 mAmps

80 beats per minute

24
Q

how much do you increase the mAmps if you have not gotten capture?

A

10 mAmps every 10-15 secs.

check the femoral pulse once you have electrical capture.

25
Q

what are the three indications that you can consider IO? When do you need to contact base?

A
  • Cardiac arrest
  • Severe hypotension with poor perfusion
  • Hypoglycemic (unresponsive) and no IV access

Contact base for any other circumstances

26
Q

Can you remove IOs in the field?

A

no

27
Q

how many attempts can you make an IO attempt in a single site?

A

1

28
Q

What are the contraindications for IO placement?

A
  • fracture
  • compartment syndrome
  • prosthetic
  • infection
29
Q

Can EMTs do humoral head IO placements?

A

NO

30
Q

What age can you do a proximal tibia or a distal femur IO?

A

Age 1-12

31
Q

what age do you do a manual insertion of IO?

A

<1 yo

32
Q

After placing a tourniquet what is one thing you need to do?

A

mark the skin or the tourniquet with time and date of placement.

33
Q

What is the number one indication of the use of physical restraints?

A

if the pt is posing danger to themselves or providers

34
Q

What are the 4 indications for the use of physical restraints?

A
  • significantly impaired (intoxication, medical illness, injury, psychiatric condition) and lacks decision making capacity.
  • pt who exhibits violent, combative, or uncooperative behavior and does not respond to verbal de-escalation
  • pt who is suicidal and concern of harming themselves
  • mental health hold and concern of elopement
35
Q

can law enforcement tell Ems to use restraints?

A

NO, must be under the clinical judgment of the provider

36
Q

are handcuffs an appropriate restraint tool?

A

no

37
Q

What are the major points to document when there was the use of restraints?

A
  • description of the scene and the pt
  • efforts to de-escalate the pt
  • type of restraint used
  • condition of the pt when restraints were placed, and reevaluations of pt
  • condition of the pt when transferred to hospital
  • any injury of pt or of EMS staff

NEVER use AxO4 for the pt mental status when use of chemical restraints

38
Q

Where can you NOT remove the probes of a taser?

A
  • eye
  • genitals
  • close to major neuromuscular structures

go to ER for removal

39
Q

What drug do you consider for a person who is hypotensive and needs pain management?

A

Ketamine

FI (5 decks)

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