Respiratory Emergencies Flashcards
Nurse calls you for “SOB”, what do you want to know?
AS MUCH AS POSSIBLE
ECG + previous ECG, vitals, supplemental O2, “please start monitor,” order CXR stat, more history from chart
think ahead to when you might need help from senior/intubate
when to check for right sided EKG?
when you see ST elevations in inferior leads and/or patient is hypotensive
MI mgmt mnemonic
ONAB
o2, nitroglycerin, ASA, BBlocker
room air = ?? FiO2
21%
1 L increase in nasal cannula flow = ???% increase in Fi02
3-4% increase
what to use if patients o2 sats are in the 80s
oxygen rebreather masks with bag connected to wall
How many times can you give sublingual nitro?
can repeat 3 times
in emergency situation how can you order BBlockers?
5 mg metoprolol IV push if needed quickly
PO if pt can tolerate
cath fellow arrives, orders heparin…what else to worry about?
cath lab = contrast = PROTECT KIDNEYS (mucomyst, nacetylcysteine)
- treat hyperglycemia
- NPO
if high suspicion for PE what to do?
ANTICOAGULATE
unfractionated (can easily reverse) or lovenox (LMWH)
what to watch out for in lovenox
morbidly obese, impaired Cr clearance, high chance of bleeding
what can you try if patient with hx of afib complains of chest pain with ecg showing afib with rvr
metop 5 mg IV push and see what happens
or dilt/dig
Patient desatting from CHF, order chest xray then what?
LMNOP
lasix morphine nitrates O2 position/positive pressure