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AH EMS > Protocol > Flashcards

Protocol Flashcards

1
Q

GCS

Glasgow coma scale

A

Eye:4-1
Spontaneous- sound- pain- none

Verbal: 5-1
Oriented-confused-inappropriate- incomprehensible-none

Motor: 6-1
Obeys- localized pain- withdrawal pain- flexion- extension- none

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2
Q

BURN CHART

A
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3
Q

Universal formula

A

(Desired/have) x volume= dose

DRIP RATE

Vol(ml)/minutes x drop factor= flow rate ( gtt/min)

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4
Q

OCYGEN CYLINDER LIFE

A

TIME REMAINING= (tank conversion factor X remaining tank pressure) / continuous flow rate

CONVERSION FACTOR
D= 0.16
E=0.28
H/K= 3.14
M= 1.56

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5
Q

CHEST TUBE MANAGEMENT

A

*never clamp a chest tube!
* if tube becomes dislodged apply a three sided dressing
* if patient deteriorates prepare for a finger or needle thoracostomy

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6
Q

Defibrillation

A

INDICATIONS: vfib, pulseless vtach, and torsades

VFIB= 360 joules
PULSELESS VTACH= 150-200 j biphasic; 360j monophasic
TORSADES= 200j

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7
Q

ETCO2

A

Normal range=35-45

Effective CPR=10-20
Ineffective CPR= <10
Probable ROSC= >20

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8
Q

EXTERNAL VENTRICULAR DRAIN
‘EVD’

A

INDICATIONS= ICP MONITORING

*HOB must be @30•
*drainage back must have less than 400 ml prior to transport or empty bag.
*secure transducer to the level of tragus
ZERO TRANSDUCER: turn stopcock on the transducer off to drain, remove sterile cap. Zero on LP15. Leave stopcock of to the drain and place new sterile cap.
* dampened wave form= kink or clot
TRANSDUCE: leaving stopcock off to drain, continuously transduce ICP.

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9
Q

INTRA-AORTIC BALLOON PUMP

A

INDICATIONS: left ventricular failure/ acute heart failure/ cardiogenic shock

*assess position of catheter at insertion site before and after all movements. As well as periph. pulses
*during transport document ecg and ISBP q10 minutes

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10
Q

OXYGEN THERAPY

A

NASAL CANNULA: 28-48% oxygen @1-6LPM

NRB: 40-90% oxygen @10-15LPM

BVM: 100% oxygen @15 LPM

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11
Q

TRANSCUTANEOUS PACING

A

ELECTRICAL CAPTURE: a wide QRS following every pacer spike

MECHANICAL CAPTURE: palpating a pulse that corresponds to electrical spike capture
* set rate between 60-80 BPM
*rapidly increase to 40mA and increase until capture

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12
Q

TRANSVENOUS PACING

A

*Set rate based on pt need and physician order (70-90 BPM)
*start at 2-5 mV

** a lack of pacer output due to not sensing electrical activity turn sensitivity DOWN. If pacer is sensing beats not present then sensitivity UP.

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13
Q

VENTILATOR

A

TO CORRECT HYPOXIA:
Titrate fiO2 and PEEP

TO CORRECT pCO2:
Rate and tidal volume

Inspiratory pressure: MAX 30mmHg

TIDAL VOLUME: based on ideal body weight 4-8 ml/kg

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14
Q

IDEAL BODY WEIGHT

A

MALE: 50+ 2.3(height-60)

FEMALE: 45.5 + 2.3(height-60)

Pediatrics: broslowe tape

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15
Q

CPAP/BIPAP

A

CONTRAINDICATIONS: ams, hypotension, facial trauma, chest trauma, n/v, pneumothorax w/o chest tube.

Bi-pap: NIV-ST
settings are additive.
Hospital 15/5= Pinsp10 PEEP5

C-pap : NIV
Set Psupport=0 and PEEP < 10

*MAX transport time 75 minutes

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16
Q

ABUSE HOTLINE

A

1-800-96-ABUSE

17
Q

Trauma alert :blue

A

Trauma blue: any (2) of the following
RR>30, HR>120, soft tissue loss, GSW to the extremities, long bone fracture, 55+ year old, ejection from vehicle, deformed steering wheel

18
Q

TRAUMA ALERT: Red

A

Any (1) of the following :
Active airway assistance, lack of radial pulse with sustained HR >120, hypotension, GCS <12, paralysis, spinal cord injury, loss of sensation, TBSA>15, amputation wrist/ankle, penetrating injury to head/neck/torso, 2+long bone fractures

19
Q

Pedi trauma GREEN

A

Follow local protocol:
Anything greater than 12 kg
Normal airway- supplemental 02
Awake/alert
Good circulation
No suspected fx
No vis injury- contusion/abrasion

20
Q

Pedi trauma BLUE

A

Any (2) of the following:
Weight <11kg, length <33 in on length based tape.
Amnesia or +LOC
Lack of peripheral pulse.
Hypotension
Single closed long bone fx

21
Q

Pedi trauma RED

A

Any (1) of the following
Assisted ventilation/ intubation
AMS, cons, paralysis, spinal cord injury, loss of sensation.
Faint/non palpable carotid/femoral pulse.
Hypotension.
Open long bone fx
Multiple fractures
Multiple dislocations
Major soft tissue disruption
TBSA >10%
Amputation proximal to wrist/ ankle
Any penetrating injury to head/neck/torso.

22
Q

MCI triage

A

IMMEDIATE(red): pt @risk for early death. Priority treatment

DELAYED(yellow): not expected to deteriorate significantly over hours.

MINOR(green): walking wounded.

23
Q

MCI: immediate(red)

A

Breathing (including with airway maneuver)

Resp rate greater than 30

Absent/weak/irregular pulse

Not following simple commands

24
Q

MCI: delayed (yellow)

A

Not following simple commands

25
Q

State poison control

A

800-222-1222

AH EMS (3 decks)

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