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Procedures Protocol > Procedures > Flashcards

Procedures Flashcards

1
Q

Location and depth of compressions in adults?

A

Hand of heel between nipples

2 inches

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2
Q

If advanced airway is in place in adults you should give?

A

Unsynchronized ventilations
1 every 6 seconds
1 every 10 compressions

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3
Q

Where do you place hand for compressions on child?

A

Mid sternum

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4
Q

How do you place your hands for compressions in 1 rescuer CPR for infants?

A

Two fingers on the sternum

One finger below the nipple line

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5
Q

How deep do you go for infant compressions?

A

Half depth of chest for 1 rescuer CPR

1 and 1/2 inches for 2 rescuer CPR

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6
Q

How do you place you hands for 2 rescuer infant CPR?

A

Two thumbs side by side at the center of the breast bone just below the nipple line

Squeeze the infants posterior chest with encircled fingers

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7
Q

When doing a jaw thrust maneuver where do you grasp?

A

Angles of the patients mandible and lift upward

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8
Q

Adult rescue breathing?

A

10 to 12 a minute

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9
Q

Pediatric rescue breathing?

A

12 to 20 a minute

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10
Q

Advanced airway placement or CPR being performed ventilation rate?

A

8 to 10 a minute

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11
Q

What does 1 rescuer do in 2 person CPR?

A

Squeeze bag for 1 second while watching for chest rise

Apply continuous cricoid pressure

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12
Q

When should you not use NPA?

A

When frontal head of midfacial trauma where criboform place may be fractured

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13
Q

What position should a patients head be in when placing a NPA?

A

Neutral

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14
Q

How do you open the patients airway when inserting an OPA?

A

Tongue jawlift maneuver

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15
Q

What should be monitored while suctioning?

A

HR
Oxygen saturation
Clinical appearance

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16
Q

What should you do in bradycardia occurs during suctioning?

A

Admin 02 until returns to normal

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17
Q

What position should a patient head be in prior to inserting a king tube?

A

Neutral

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18
Q

What maneuver should be used by 1 hand while passing king tube through the other?

A

Tongue/Jaw lift

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19
Q

What degree should you insert a king tube at?

A

45 to 90

Rotate it midline as it passes the tounge

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20
Q

How far should you advance a king tube?

A

Advanced it until the base of the connector gastric access lumen is aligned with the patients teeth or gums

Do not use excessive force

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21
Q

When placing a king tube after inflating pharyngeal cuff with the recommended volume of air you should?

A

Ventilate with BVM

Withdrawal tube until air is readily passing and good compliance is felt

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22
Q

Where should tape be applied to when securing a king tube with tape?

A

Maxillary region of patients face

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23
Q

What position should patients head be in when attempting Orotracheal intubation?

A

Hyperextension

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24
Q

How quickly must you perform laryngoscopy in?

A

Less than 30 seconds

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25
Q

How far should you advance a Orotracheal tube?

A

Through the glottic opening until the proximal end of the cuff disappears past the vocal cords

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26
Q

If a patient is having difficulty tolerating intubation you can?

A

Sedate with Versed 0.02 mg/kg IV

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27
Q

How should you place the patient neck for pediatric needle cricothyroidotomy?

A

Hyperextend the neck

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28
Q

How can you locate the cricothyroid membrane?

A

Palpate the depression caudal(toward the feet) to the midline Adam’s apple

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29
Q

What equipment is necessary for needle cricothyroidotomy for pediatrics?

A

14 gauge over the needle catheter
10 cc syringe
15 mm adaptor from 3 or 3.5 ET tube

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30
Q

At what angle direct your 14 gauge over the needle catheter when inserting through skin and cricothyroid membrane?

A

45 degree angle caudally(toward the feet)

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31
Q

If a patient is less than what age should you refer to needle cricotyroidotomy procedure?

A

12

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32
Q

When using a scalpel what direction incision do you make through the cricothyroid membrane?

A

Vertical

Horizontal is second incision

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33
Q

Once the scalpel has passed through the cricothyroid membrane you should?

A

Insert the handle into the opening and twist the handle to open the space between the cricoid and thyroid cartilages

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34
Q

Why must you not aim the knife cephalad when opening the space between the thyroid and cricoid cartilages?

A

Injury to the vocal cords may occur

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35
Q

Which size tube should be inserted through the incision for cricothyroidotomy?

A

6 ET or tracheostomy

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36
Q

Signs of an autistic patient?

A

No babble or cooing by age of 1
Has not gestured, pointed, waived by 1
Hasn’t spoken a word by 16 months
Hasn’t spoken 2 word phrases by 2

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37
Q

Signs and symptoms of tension Pneumothorax ?

A

Absent of decreased breath sounds on affected side
Poor ventilation despite open airway
Tracheal deviation away from side of injury
Neck vein distention
Tympany to percussion on affected side
Shock
Decreased Sp02/end tidal CO2

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38
Q

Why may neck vein distention not occur in tension pneumothorax?

A

Severe hemorrhage

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39
Q

What is the location for chest decompression?

A

2nd or 3rd inter coastal space

Between the 3 and 4th or 4th and 5th ribs

Midcalvicular line

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40
Q

How do you make a one way valve prior to completing chest decompression?

A

Insert 14 gauge 3 to 3 1/2 inch IV catheter through the finger of a sterile glove that has been moistened with water

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41
Q

When performing chest decompression you should insert catheter through?

A

Parietal pleura until air escapes under pressure

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42
Q

What fingers can you place CO monitoring device Rad-57 on?

A

Any one but thumb or pinky

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43
Q

Where si the rad-57 calibrated to penetrate?

A

Mid nail, not cuticle

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44
Q

How long does it take for the RAd-57 to calibrate on patient?

A

5 to 8 seconds

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45
Q

What level SpCO should up on rad-57?

A

1-99%

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46
Q

CO level 0-4?

A

Minor headache

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47
Q

CO level 5-9?

A

Headache

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48
Q

CO level 10-19?

A

Dyspnea, headache

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49
Q

CO level 20-29?

A

Nausea, dizziness, headache

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50
Q

CO level 30-39?

A

Vomiting, altered LOC, Severe headache

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51
Q

CO level 40-49?

A

Confusion, syncope, Tachcyardia

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52
Q

CO level 50-59?

A

Seizures, shock, Apnea, coma

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53
Q

CO level 60 and up?

A

Coma, death

54
Q

What position should a patient be in prior to using CPAP?

A

High fowlers

55
Q

Prior to securing a CPAP mask to a patients face you should?

A

Hold it to their face

When patient is comfortable you may strap it to there face

56
Q

Is it ok to have air leaks from the CPAP mask?

A

Yes, unless it is from the eye area

57
Q

What is the starting dose for cyanokit?

A

5g

58
Q

The hydrooxycarbolomin is to be reconstituted with?

A

100 mL per vial of 0.9% sodium chloride injection

59
Q

How long should you rock or rotate the cyanokit vial to mix?

A

30 seconds

Do not shake

60
Q

How long should you infuse the 1st and 2nd vials of hydroxycarbolomin over?

A

75 minutes

61
Q

V1 placement?

A

4th intercoastal space

Right of sternum

62
Q

V2 placement?

A

4th intercoastal space

Left of sternum

63
Q

V3 placement

A

Between V4 and V5

64
Q

V4 placement?

A

5th intercoastal space

Midcalvicular line

65
Q

V5

A

5th intercoastal space

Anterior axillary line

66
Q

V6 placement?

A

5th intercoastal space

Midaxillary line

67
Q

What HR should you set external pacemaker to?

A

70-80

68
Q

How can you tell when electrical capture has been achieved in external pacing?

A

Pacer spike followed by wide QRS

69
Q

Where should you check for a pulse when pacing?

A

Right carotid
Right femoral
Either brachial pulse to to muscle twitching

70
Q

If electrical capture is present but not pulse is present you should?

A

Treat for asystole/PEA

71
Q

If no electrical capture is achieved in pacing you should?

A 
Increase pacer to max energy
Recheck all settings
Cables
Battery charge
Electrode placement
Patients own rhythm
72
Q

How can you ensure adequate rinsing behind eyelid?

A

Hold the lid with your thumb and index finger

73
Q

How should you flush the eye to avoid contamination of the other eye?

A

Away form the nose for minimum of 20 minutes

74
Q

When should you consider removing a football helmet?

A

Facemask cannot be removed after reasonable amount of time

Chin strap does not hold patients head securely

Prevents immobilization during transport

75
Q

Where should you position tip of EPipen auto injector?

A

Other thigh, midway between knee and waist

76
Q

What is the minimum amount of time you should hold a autoinjector in place?

A

10 seconds

Until medication is fully injected

77
Q

To inject site with Duodote pen you should?

A

Swing and firmly push the green tip against the outer thigh at 90 degree angle

78
Q

What size needle should be used for IM medication administration?

A

21-23

1-1.5 inches long

79
Q

Contraindications for IN medication adminsitration?

A

Facial trauma
Epistaxis
Nasal congestion
Any recognized nasal mucosal abnormality

80
Q

What position should patient be in prior to IN medication administration?

A

Recumbent or supine

81
Q

3 sites for IO adminisitration?

A

Proximal tibia
Proximal humerus
Distal tibia

82
Q

Proximal tibia IO site?

A

Approx 2 cm below patella

2 cm medial to the tibial tuberosity

83
Q

Proximal humerus IO site?

A

Directly on the most prominent aspect of the greater tubercle

84
Q

Distal tibia IO site?

A

Approx 3cm proximal to the most prominent aspect of the medial malleolus

85
Q

Proximal humerus EZ IO site is permitted in pediatrics when?

A

Landmarks are clearly identified

86
Q

How do you find the proximal humerus site?

A

Rest patients hand on their abdomen and elbow is adducted(close to the body)

Slide thumb up the anterior shaft of the humerus until you feel the great tubercle(surgical neck)

Approx 1 cm above the surgical neck is the insertion site

87
Q

What is the prefered IO site for patients who are responsive to pain?

A

Proximal humerus

88
Q

How do you find the distal tibia IO site?

A

Place one finger directly over the medial malleolus

Move 3cm proximal and palpate the anterior and posterior borders

Assure your insertion site is on the flat center aspect of the bone

89
Q

What weight do you use the pink IO needle for?

A

3 - 39 kg

90
Q

What weight do you use the blue IO needle for?

A

Over 40 kg

91
Q

At what point do you apply steady downward pressure with the IO?

A

When it touches the bone

92
Q

When do you release trigger on IO gun?

A

Where there is a give or a pop

When the needle reaches the desired depth of 5mm

93
Q

What are the preferred sites for venipuncture IV?

A

Hand
Forearm
Antercubital fossa

94
Q

What angle should you insert an IV catherter?

A

30-45 with bevel up

95
Q

When you feel the needle pop into the vein and observe flashback of blood into the chamber you should?

A

Advance needle 0.5 cm farther

96
Q

How long should a patient breath as camly, deeply, and evenly as possible when being administered medication via nebulizer?

A

Until no more mist is present

5 to 15 minutes

97
Q

How do you insert a morgans lens?

A

Have patient look down
Insert it into upper eye lid
Have patient look up
Retract lower lid to drop lens into place

98
Q

How do you prevent accidental lens removal of morgans lens?

A

Tap tubing to forehead

99
Q

What position does a patient need to be in to use broselow tape?

A

Supine

100
Q

When end of broselow tape should be placed at to of patients head?

A

Red

101
Q

What position should you place a patient in prior to restraining them?

A

Supine on a backboard

102
Q

What should you check for after physically restraining a patient?

A

Circulatory
Neurological
Respiratory compromise

103
Q

What should be documented when physically restraining a patient?

A

Justification
Time
Duration

104
Q

Pulse oximeters are used for detection of hypoxemia in?

A

Arterial oxyhemoglobin

105
Q

Where should a pulse oximeter be placed?

A

Finger or toe

106
Q

Normal oxygen saturation?

A

92-100

107
Q

Mild distress oxygen saturation?

A

90-92

108
Q

Moderate distress oxygen saturation?

A

80-89%

109
Q

Severe distress oxygen saturation?

A

Less than 80%

110
Q

What can cause false high oxygen saturation readings?

A

Carbon monoxide poisoning

Trauma

111
Q

What can give false low readings of oxygen saturation?

A

Deeply pigmented patients may diminish light transmission
Nail polish or fake nails
Patient movement
Low blood flow status

112
Q

Spinal immobilization decision assessment?

A 
Neurological deficit(focal deficit, tingling, reduced strength, numb in extremities)
Significant trauma mech and extreme ages
AMS
Intoxication or mental impairment
Distracting, painful injury
Point tenderness or pain range of motion
113
Q

Space of invasion of more than how many feet indicates significant trauma?

A

1 foot

114
Q

What position should you immobilize a patients head in?

A

Neutral, in line position

115
Q

contraindications for in line spinal immobilization?

A 
Neck spasm
Increased pain
Onset of neurological deficit
Compromised of airway or ventilation
Injuries so severe head represents misalighnment that no longer appears to extend from midline of shoulders
116
Q

How far above the patient should you position hat back board next to?

A

1-2 feet

117
Q

What direction should you not move a patient with possible spinal injuries?

A

Lateral

118
Q

Why should a patients arms be placed on their side during spinal immobilization?

A

To prevent should girdle movement

119
Q

How can you prevent side to side movement of the spinal immobilization patient?

A

Straps across iliac crest and mid to distal thigh

Or at the pelvis with groin loops

120
Q

How far above the patients head should the pediatric immobilizer be when placing them on it?

A

6 to 12 inches

121
Q

The KED should be positioned so the device fits securely under the patients?

A

Axilla

122
Q

What should be left loose on the KED until the patients head is immobilized?

A

Uppermost torso strap

123
Q

How can you prevent excessive movement of patient when fastening groin straps?

A

Adjust one side at a time

124
Q

Which head strap on the KED should be applied first?

A

Forehead strap

Then chin strap

125
Q

Which strap do you apply first when using the hare splint?

A

Angle strap

126
Q

Where do you place the ischial pad on the hare splint?

A

Illiac crest

127
Q

You should tighten the ratchet and release manual traction with the hare splint until?

A

Patient has relief of pain or muscle spasm

128
Q

What should be done prior to ice water vagal maneuver?

A

ECG
IV
Conscious and cooperative patients

129
Q

What are the contraindications for vagal maneuvers?

A

ACS
Hypertension
Heart transplant

130
Q

Stop vagal maneuvers if?

A

Patient becomes confused
HR drops below 100
Asystole occurs

131
Q

What are the 2 approved vagal maneuvers?

A

Ice water immersions

Valsalva

132
Q

How is the valsalva maneuver performed?

A 
Have patient inhale and hold breath
Bear down
Hold for 20 to 30 seconds
Try to turn face red
Blow forcefully through a straw or IV catheter for as long as possible

Procedures Protocol (1 decks)

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