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MIEMSS Protocol > Tactical Medicine > Flashcards

Tactical Medicine Flashcards

1
Q

Impaled ECW dart removal

A

-Dart to head, neck, hands, feet, or genitals must be stabilized and evaluated by physician.
-Barb extrication may be attempted once, as long as barb is not buried to the hub or in the above locations
-all patients receiving electrical intervention must be evaluated in ER

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2
Q

Pseudoephidrine (Sudafed)

A

OPERATIONAL
30 or 60 mg tablet
Decongestant
For nasal congestion/rhinorrhea
Contraindications: hypersensitivity, HTN
Side effect: insomnia
Dosage: 30-60 mg every 4-6 hours

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3
Q

Cetrizine (Zyrtec)

A

OPERATIONAL
10 mg tablet
Non-sedating antihistamine
For allergic symptoms
Contraindications: hypersensitivity
Precautions: HTN, liver/kidney disease
Side effects: dry mouth, urine retention
Dosage: 10 mg daily

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4
Q

Diphenhydramine (Benadryl)

A

NON-OPERATIONAL
25-50 mg tablets
Sedating antihistamine
For allergic symptoms
Contraindications: hypersensitivity
Precautions: HTN, liver/kidney disease
Side effects: dry mouth, urinary retention, somnolence
Dosage: 25-50 mg every 4-6 hours PER MD

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5
Q

Fexofenadine (Allegra)

A

OPERATIONAL
60 mg tablet
Non-sedating antihistamine
For allergic symptoms
Contraindications: hypersensitivity
Precautions: HTN
Side effects: dry mouth, urinary retention
Dosage: 60 mg once or twice daily

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6
Q

Oxymetazoline nasal spray (Afrin)

A

OPERATIONAL
Nasal spray 0.05%
Nasal vasoconstriction, decongestant
For rhinorrhea, sinus congestion, pain
Contraindications: hypersensitivity
Precautions: HTN
Side effects: minor nosebleed, often used to treat nosebleed
Dosage: 2x sprays per nare, 2-3 times a day

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7
Q

Antiacid (Mylanta or other)

A

OPERATIONAL
Liquid OTC
Antacid
For GI upset, GERD, PUD, gastritis, esophagitis
Contraindications: hypersensitivity
Precautions: some medications rely on acidic pH and should not be taken in combination
Interactions: Loose stool possible
Dosage: 15-45 mL every 4-8 hours

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8
Q

Cimetidine (Tagmet or other H2 blocker)

A

OPERATIONAL
200/300/400 mg tablet or 300 mg IV/IM
H2 blocker
For PUD, GERD, esophagitis, gastritis
Contraindications: hypersensitivity, other PPI use
Dosage: 300 mg IV/IM/PO every 6-8 hours, or 400 mg 2x daily

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9
Q

Loperamide (Imodium)

A

OPERATIONAL
2 mg tablet or 1 mg/5 mL suspension
Anti-diarrheal
For diarrhea
Contraindication: Known hypersensitivity, HTN, bloody diarrhea
Side effects: ENT Dryness
Dosage: 4 mg first dose, 2 mg each subsequent dose until stool formed, 16 mg max per day

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10
Q

5-HT3 Antagonist (Zofran)

A

OPERATIONAL
IV/IM injectable, tablets
Anti-emetic, anti-motion sickness
For nausea/vomiting
Contraindications: Hypersensitivity
Precautions: Long QT
Dosage: PER MD

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11
Q

Metoclopramide (Reglan)

A

NON-OPERATIONAL
10 mg IM/IV injectable
Anti-emetic, promotes GI motility
For nausea/vomiting
Contraindications: hypersensitivity
Precautions: Dystonic reaction risk (treat with diphenhydramine)
Side effects: sedation, dystonia
Dosage: 10-20 mg IV/IM/PO every 4 hours PER MD

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12
Q

Dimenhydrinate (Dramamine)

A

NON-OPERATIONAL
IM/IV injectable, 50 mg tablet
Anti-emetic, anti-motion sickness
For nausea/vomiting
Contraindications: hypersensitivity
Precautions/side effects: possible sedation
Dosage: 50-100 mg IM/IV/PO every 4 hours, PER MD

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13
Q

Meclizine (Antivert)

A

NON-OPERATIONAL
25-50 mg tablet
Anti-emetic, anti-motion sickness
For nausea/vomiting
Contraindications: Hypersensitivity
Precautions/side effects: possible sedation
25-50 mg PO every 4 hours PER MD

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14
Q

Scopolamine Transdermal

A

OPERATIONAL (if previously tolerated)
1 mg patch
anti-emetic, anti motion sickness
For nausea, vomiting, motion sickness prevention
Contraindications: hypersensitivity, angle closure glaucoma, hypersensitivity to belladonna alkaloids, seizures, urinary retention
Precautions: may cause sedation, disorientation underwater
Side effect: sedation
Interactions: use caution when taking potentially sedative drugs and anticholinergics
Dosage: 1 mg patch every 3 days, PER MD

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15
Q

Proparacaine or Tetracaine (Alcaine)

A

OPERATIONAL
Ocular anesthetic solution
Topical anesthetic
To facilitate eye exam, relieve eye pain
Contraindications: hypersensitivity
Precautions: Ensure eye protection from foreign objects after exam
Dosage: 1-2 drops per eye PER MD

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16
Q

Fluorescein Stain (with blue light)

A

OPERATIONAL
Single application strips
Dye to facilitate eye exam
For suspected eye injury
Contraindications: hypersensitivity
Dosage: one drop per eye

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17
Q

Eye irrigation solution

A

OPERATIONAL
100 mL, 200 mL bottles
To irrigate contaminants from the eye following exposure to foreign bodies or chemicals in the eye.
Contraindications: hypersensitivity
Dosage: Irrigate until pH of 7.4 is achieved.

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18
Q

Erythromycin ophthalmic ointment

A

OPERATIONAL
0.5% ointment
Macrolide antibiotic
For infectious exposure per MD
Contraindications: Hypersensitivity to penicillins
Topical only
Side effects: GI upset, nausea/vomiting, diarrhea
Dosage: PER MD

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19
Q

pH paper

A

OPERATIONAL
Rolls or pre-cut strips
Measures baseline pH during decon./irrigation
Following exposure to foreign body or chemical to eye or skin
Contraindications: hypersensitivity
Precautions: not for penetrating eye injury
Dosage: (1) 1-2 inch strip PER MD

20
Q

Ciprofloxacin

A

OPERATIONAL
150/500/750 mg tablets, 400 mg IVPB, 250 or 500/5 suspension
2nd gen quinolone antimicrobial agent
Indicated PER MD for infectious exposure
Contraindications: hypersensitivity
Side effects: GI upset, nausea/vomiting, diarrhea, yeast infection
Dosage: PER MD

21
Q

Triple antibiotic ointment (Bacitracin/Polymyxin/Neomycin)

A

OPERATIONAL
Topical ointment
Polypeptide antibiotic
Indicated PER MD for infectious exposures
Contraindications: hypersensitivity
Topical use only
Side effects: Local irritation, GI upset
Dosage: Apply to scrapes, burns, wounds prior to sterile dressing

22
Q

Amoxicillin/clavulanate (Augmentin)

A

OPERATIONAL
875 or 125 mg tablets
Beta-lactamase inhibitors
Indicated PER MD for infectious exposures
Contraindications: hypersensitivity
Side effects: GI upset, nausea/vomiting, diarrhea
Dosage: PER MD

23
Q

Cefazolin (Ancef)

A

NON-OPERATIONAL
0.5-2 grams IM/IV
1st gen Cephalosporin antimicrobial agent
indicated PER MD for trauma applications with delayed transport and infectious exposures
Contraindications: hypersensitivity to PCN or Cephalosporins
Side effects: GI upset, nausea/vomiting, diarrhea, yeast infection
Dosage: PER MD

24
Q

Clindamycin (Cleocin)

A

OPERATIONAL
150-300 mg tablets, reconstituted liquid 75 mg/5 mL
Antibiotic
For suspected pharyngitis or respiratory infection, cellulitis
Contraindications: hypersensitivity to clindamycin
Side effects: diarrhea
Dosage: Pediatric: 10 mg/kg every 8 hours
Adult: 300 mg every 8 hours

25
Q

Trimethoprim/Sulfadiazine (Bactrim)

A

OPERATIONAL
DS Tablet
Sulfonamide antibiotic
Indicated PER MD for infectious exposures
Contraindications: hypersensitivity
Precautions: Liver/kidney disease, anemia, thrombocytopenia
Side effects: GI upset, nausea/vomiting, diarrhea
Dosage: PER MD

26
Q

Azithromycin (Zithromax)

A

OPERATIONAL
250 mg tablet
Macrolide antibiotic
Indicated PER MD for infectious exposures
Contraindications: hypersensitivity to penicillin
Precautions: liver/kidney disease
Side effects: GI upset, nausea/vomiting, diarrhea
Dosage: PER MD

27
Q

Doxycycline

A

OPERATIONAL
100 mg tablet
Tetracycline antibiotic
Indicated PER MD for infectious exposures
Contraindications: Known hypersensitivity to tetracyclines, PREGNANCY
Precautions: liver/kidney disease, photoreactivity rash
Side effects: GI upset, nausea/vomiting, diarrhea
Dosage: PER MD

28
Q

Mupirocin topical ointment (Bactroban)

A

OPERATIONAL
2% topical ointment
Other antibiotic
Indicated PER MD for infectious exposures
Contraindications: hypersensitivity
Precautions: avoid eyes, limit prolonged use
Side effects: Local irritation, GI discomfort
Dosage: PER MD

29
Q

Emtricitabine and tenofovir (Truvada)

A

OPERATIONAL
Tablet containing tenofovir DF 300 mg, emtricitabine 200 mg
Anti-retroviral
Indicated PER MD for infectious exposures
Contraindications: hypersensitivity
Precautions: liver/kidney disease
Side effects: GI upset, nausea/vomiting, diarrhea
Dosage: PER MD

30
Q

Prednisone (PO)

A

OPERATIONAL
PO, (1/5/10/20/50 mg) tablets
Corticosteroid, anti-inflammatory
For allergic reaction, auto immune condition, PER MD
Contraindications: hypersensitivity
Precautions: PUD/GERD/GI bleed Hx.
Side effects: GI upset, nausea
Dosage: 40 mg to 60 mg once daily PER MD

31
Q

Dexamethasone (Decadron)

A

OPERATIONAL
PO or IV/IM, tablets
Corticosteroid, anti-inflammatory
For allergic reaction, auto-immune condition, PER MD
Contraindications: hypersensitivity
Precautions: PUD/GERD/GI bleed Hx.
Side effects: GI upset, nausea
Dosage: 10 mg once daily, PER MD

32
Q

Acetaminophen (PO)

A

OPERATIONAL
Tablet: 325 and 500 mg
Pain medication
For mild-moderate pain
Contraindications: hypersensitivity, liver disease, PUD/GERD/GI bleed Hx.
Side effects: GI upset
Dosage: 650-1000 mg/ 6 hours

33
Q

Ibuprofen (Motrin/Advil)

A

OPERATIONAL
200 mg tablet (OTC), 100 mg/5 mL suspension, 600 and 800 mg tablets
NSAID
For mild to moderate pain
Contraindications: hypersensitivity, renal insufficiency, PUD/GERD/GI bleed Hx
Precautions: do not use with other NSAIDs, caution steroid use
Side effects: GI upset, nausea, GI bleed risk
Dosage: 400-600 mg/4-6 hours
600-800 mg/6-8 hours

34
Q

Naproxen (Aleve/Naprosyn) PO

A

OPERATIONAL
Tablet: 220/375/500 mg
NSAID
For mild to moderate pain
Contraindications: hypersensitivity, renal insufficiency, PUD/GERD/GI bleed Hx
Precautions: do not use with other NSAIDs, caution steroid use
Side effects: GI upset, nausea, GI bleed risk
Dosage: 220-500 mg every 12 hours

35
Q

Tramadol (Ultram) PO

A

OPERATIONAL (with no side effects)
50 and 100 mg tablets
Pain medication
For moderate to moderately severe pain
Contraindications: hypersensitivity, seizure disorder, SSRI/TCA/MAOI use, renal/hepatic insufficiency (adjust dose)
Precautions: use care with opiate use
Side effects: dizziness/nausea
Interactions: antidepressants, antipsychotics, warfarin, digoxin, tegretol, quinidine
Dosage: 50-100 mg every 4-6 hours, 400 mg/day max

36
Q

Lidocaine (transdermal or IM/SQ)

A

OPERATIONAL
1% (10 mg/mL) ampule/vial
Injectable anesthetic
For local pain/injury
Contraindications: hypersensitivity
Precautions: should not exceed 4 mg/kg or 300 mg
Side effects: seizure, lightheadedness, tinnitus
Dosage: topical application at site of dental pain

37
Q

Fentanyl Transmucosal (PO)

A

NON-OPERATIONAL
Lozenge/lollipop 800 mcg
Opioid analgesic
For severe pain/injury
Contraindications: hypersensitivity
Precautions: Controlled substance. Patient should not bite or chew lozenge, let it dissolve slowly
Side effects: Patient must be monitored for CNS depression
Dosage: Oral application for patient directed analgesia, patient should remove the lollipop once pain is controlled.

38
Q

Clove Oil (topical for dental analgesia)

A

OPERATIONAL
Topical liquid (OTC)
Topical dental anesthetic
For dental pain/injury
Contraindications: hypersensitivity
Precautions: Penetrating trauma, open intra-oral wounds
Dosage: topical application to the site of dental pain

39
Q

Ketorolac (Toradol)

A

OPERATIONAL
30 mg/mL IV/IM
NSAID
For mild/moderate pain
Contraindications: hypersensitivity, renal insufficiency, PUD/GERD/GI bleed Hx.
Precautions: Do not use with NSAIDs, caution with steroid use
Side effects: GI upset/nausea, GI bleed risk
Dosage: 15-30 mg IM/IV every 6-8 hours

40
Q

Caffeine (No-Doz)

A

OPERATIONAL
200 mg tablet
Enhances alertness
For caffeine withdrawal headache, to facilitate functioning with limited rest periods
Contraindications: hypersensitivity
Side effects: insomnia
Dosage: 200 mg every 3-4 hours as needed

41
Q

Zalepon (Sonata)

A

NON-OPERATIONAL (4x hours after administration)
10 mg capsule
Anxiolytic/hypnotic, shorted t-1/2 of agents available
For facilitating rest during non-operational periods in prolonged deployment/transportation, minimum of 4 hours required (6 hours preferred)
Contraindications: hypersensitivity, unsecure location, lack of assured 4-hour non-operational period
Precautions: may not drive/operate machinery/ use weapons for at least 4 hours
Side effects: sedation
Interactions: Alcohol/other sedatives potentiate effect
Dosage: 10-20 mg with assured 4 hour non-operational block, APPROVED BY MD

42
Q

Modafinil (Provigil)

A

OPERATIONAL
200 mg tablet
Enhances alertness/concentration
For facilitating functioning with limited rest periods
Contraindications: hypersensitivity
Side effects: Insomnia, mild BP elevation
Dosage: 200 mg once daily

43
Q

Cyanoacrylate adhesive (Dermabond)

A

OPERATIONAL
Single use ampule
Tissue adhesive
For minor trauma
Contraindication: hypersensitivity
Precautions: avoid near eyes
Side effect: transient local discomfort
Dosage: as required for wound closure, 2-4 layered applications

44
Q

Topical hemostatic dressing

A

NON-OPERATIONAL
Individual use packages
Promotes blood clotting
For hemorrhage
Contraindications: hypersensitivity
Precautions: standard universal precautions for wound care
Dosage: Single or multiple dressings applied to a bleeding wound

45
Q

Steri-strips

A

OPERATIONAL
Individual use packages
Facilitates closure of wounds
For superficial wounds
Contraindications: hypersensitivity to adhesive
Precautions: standard universal precautions for wound care
Dosage: single or multiple dressings applied for wound closure

46
Q

Staples

A

OPERATIONAL
Individual use staple dispensers
Facilitates closure of wounds
Contraindications: contaminated wounds, wounds with foreign material
Precautions: standard universal precautions for wound care
Dosage: single or multiple dressings applied for wound closure PER MD

47
Q

Albuterol MDI

A

NON-OPERATIONAL (without MD consult)
0.83 mcg MDI
Bronchodilator
For respiratory distress/bronchospasm
Contraindications: hypersensitivity
Precautions: standard universal precautions for respiratory patient
Dosage: (2) puffs, may be repeated 2 additional times. Additional doses PER MD

MIEMSS Protocol (6 decks)

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