SMOs- Medical Emergencies Flashcards
Acute asthma/COPD with wheezing (39)
Initial medical care
Transport immediately; all Tx enroute
O…DC > EM(s)
1. O2
-N.C or mask to maintain SPO2 >94%
2. Duo neb
-over 15 min
-may repeat one time
3. CPAP
Impending Res Failure:
4. Epi auto injector or Epi 1:1,000 .3mg IM
-may repeat x1 in 5 minutes
for Asthma, mag sulfate in severe cases or first line medication is not responding
Mag sulfate: 2g in 100-250mL bag over 10 minutes
Allergic RXN / Anaphylaxis (40)
Allergic RXN:
OB Solu-medrol will work, then monitor
1. 100% oxygen
2. Benadryl 50 mg IV/IM
3. Solu-medrol
4. Monitor
Anaphylaxis:
OE BC (DF M)
1. 100% oxygen
2. Epi auto injector or Epi 1:1,000
-.3mg IM
3. Benadryl
-50mg IV over 2-3min
-50mg IM if no IV
4. Cardiac monitor via pulse ox and capno
5. Duo neb if wheezing
6. Fluid if hypotensive
-200ml increments, up to 1L (lung check)
-Until SBP >90
7. Solu-medrol 125mg IV
Diabetic/Glucose Emergencies (41)
Hx of last med taken and eaten
O2 if needed
Check blood glucose
<60
1. Oral glucose or D50 (@50ml)
-Hard IV= Glucagon 1mg IM/IN
> 180
1. Fluid 200ml bolus
-may repeat up to 1L
*Can refuse transport if: Repeat BGL and >80, Pt takes insulin, Normal LOC, Eats a carb meal, Reliable person with patient
Drug OD, Alcohol related, Poisoning (42)
Check blood glucose
12-lead
ALOC or BGL <60
- Diabetic emergency protocol
Narcotic OD with RR <12
1. Narcan
-2mg IN/IV/IO/IM
-q5, up to 6mg
Coma of UNK origin (No Trauma) (43)
Check BGL
BGL <60
-Diabetic emergency protocol
RR<12
-consider narcan 2mg
Seizures / Status Epilepticus (44)
O…B.D.V (Bring the Damn Versed)
1. O2 as needed
Check BGL
BGL <60
-Diabetic emergency protocol
Active Seizure
1. Versed 10mg IM/IN
- 5mg IV
-may repeat x1 in 5 min
Heat Emergencies (45)
Heat Cramps
1. Oral intake of water/electrolytes
Heat Exhaustion or Syncope (104)
1. Move to cool environment
2. Supine with legs elevated
3. Active cooling
-remove clothes
-Ice packs
4. Oral drink if not vomiting
5. IV fluids if vomiting
Heat Stroke (104+)
IS OR
1. IV w/fluids
-IF <90: Fluid bolus 200ml increments until >90
2. Seizure protocol
3. 100% oxygen
-When indicated, intubate and ventilate
4. Rapid cooling
-Remove clothing
-Cool packs and wet sheet
Cold Emergencies (46)
Frostbite:
1. Move patient to warm environment
2. Handle skin like burn
-light sterile dressing
3. Cover patient and transport
Systemic Hypothermia
1. O2 12-15LPM
2. IV TKO
3. Rewarm with heat pack
4. Transport
Severe Hypothermia (no shivering)
1. Transport
2. O2 100%
3. IV TKO
Suspected Stroke (47)
PIB i12
1. Perform stoke scale
2. Identify last known normal, Hx of anticoagulants and TRANSPORT
3. Check BGL
4. IV TKO (en route)
5. 12-lead (en route)
HAZMAT Materials General (48)
PIT BO
1. Protect yourself first
2. Try to identify substance
3. Isolate
4. Brush off substance, remove clothes, and decontaminate
5. 100% oxygen NRB
HAZMAT Eye (49)
C both EyEs
1. Check for eye contacts/remove
2. Evaluate eye for ruptured globe
-if globe still intact, Tetracaine HCL .5% (1-2 drops; can repeat)
3. Eye irrigation 1L per eye
HAZMAT Pesticide / Nerve Agent (50)
CALL MEDICAL CONTROL ASAP
1. Atropine 2mg IV/IO q 5min
-until secretions significantly diminish
2. If seizing: 5mg Versed
TRANSPORT
HAZMAT Radiation (51)
- Isolate area and contact Hazmat team
- Tx pts per symptoms
HAZMAT Toxic / Smoke Inhalation / Cyanide Poisoning (52)
A CAB 12 pass cyno
1. Maintain patent airway and assess CABs
2. 12 lead and pulse ox
3. Assess for:
-ALOC
-Headache/confusion
-Dyspnea/N/V
-Pupil dilation/Seizure
No= Oxygen NRB and transport
Yes= 4. second IV 5. Cyano Kit 5g IVPB over 10 minutes and transport
Suspected Sepsis (53)
I PAC E BF! FIB PACE
1. IV
2. Pulse ox
3. Airway/vent support
-w/ O2
4. Cardiac monitor
5. ETCO2 monitor
6. BGL
7. FLUIDS
-maintain SBP >90
-Sepsis criteria remains, may repeat bolus
-up to 1L
