Trinity SMO Flashcards
What is acceptable ways to confirm placement of airway device?
EtCO2 of 35-45
Pulse oximetry of >90%
What is the BVM ventilatory rate for an adult?
6-8 per minute
What medications and dose do you consider for post-intubation?
Ativan 1-2 mg IV/IO. Or
Versed 2-5 mg IV/IO. Or
Valium 5-10 mg Iv/IO
What are the 3 criteria for a failed airway prior to surgical cricothyrotomy?
1) . Two failed intubation attempts
2) . Spo2 <90%
3) . Facial trauma or swelling
Name size and color of the adult king airways.
Yellow #3. (4-5foot)
Red #4. (5-6 foot)
Purple #5. (6 ft and up)
What is the age limit for intubation pediatrics?
Pediatric age =>9
Name the medications and dose for pediatric post intubation
Ativan 0.05-0.1 mg IV/IO. Or
Versed. 0.1- 0.2 mg IV/IO. Or
Valium 0.1-0.3 mg IV/IO.
Name vent rates (BVM) for neonates, toddlers, school age, and adolescents.
Neonates. 30
Toddlers. 25
School age. 20
Adolescents. 12
What are color and side of pediatric king LD?
Green #2. (35-45 inches)
Orange. #2.5. (41-51 inches)
What is the pco2 you should maintain in a pediatric intubated patient?
PCO2 of 30-35
SPO2 of >90
At what reported level of pain do you consider medications for back pain?
Pain of >6-10 scale
Who should not get acetaminophen for a fever
Pt with hx of liver failure
What is the medication and dose for adult pain control?
Morphine. 2-10mg. Iv/io/im
Fentanyl. 25-100 mcg. Iv/io/im
Fentanyl. 50-100mcg IN
If need is immediate or no iv/io
How often do you reassess a patient you gave pain meds
Every 15 minutes
What are the Contraindications for narcotic pain meds?
Hypotension, head injury,respiratory distress, severe COPD
What med and dose do you give for pediatric pain control?
Trauma pain
Morphine 0.1-0.2 mg/kg. iv/io/im
Fentanyl 1-2 mcg/kg. iv/io/im
Fentanyl 2mcg/ kg IN. Max dose 100 mcg for immediate need
Spinal immobilization clearance steps 1-6o
1) neuro exam- any focal deficits?
2) age >65/<5 or SIGNIFICANT trauma mechanism?
3) alertness- any alteration
4) intoxication or language barrier
5) distracting injury elsewhere
6) spinal exam- point tenderness or pain with rom
Any yes and you need to immobilize.
What is the medication and dose for adult nausea and vomiting
Zofra 4mg iv
List treatment for mild allergic reaction ( adult). Rash only
Cardiac monitor, iv access, diphenhydramine 50 mg. IM
Or
Diphenhydramine 25-50mg IV
List treatment for allergic reaction with impending resp distress pr shock ( adult)
Epinephrine 1:1000 0.3-0.5mg IM
Cardiac monitor, IV, diphenhydramine 50mg Iv/IO, methylprednisolone 125 mg Iv/io
If condition worsens repeat epinephrine x1
When should you contact med control prior to giving epinephrine for allergic reaction?
When the patient is over 50 yrs and have a cardiac hx or heart rate over 150
What is the treatment for decreased mental status with blood sugar <60
Spinal immobilization if needed
Iv access, blood glucose… <60
Give oral glucose if awake
Glucagon 1mg IM if no iv
D50 iv/io for adults
D25 iv/io for peds
What is the treatment for altered mental status with blood sugar >60
Spinal immobilization if needed
Iv access, blood glucose >60
Narcan 0.4-2mg IM/IN if resp depression and no IV
Narcan 0.4-2mg. Iv/IO if resp depressed
12 lead ekg… Cardiac monitor
NSaline bolus x1 if BS >250 or signs of dehydration
When can a diabetic refuse transport after treatment?
If a adult is present with patient and BS >100 patient must eat and be complaint free.
What is normal blood glucose range?
60-120
What are the criteria for discontinuation or withholding resuscitation?
Valid DNR Rigor mortis or dependent lavidity Decapitation Incineration (Med control must be called to confirm discontinuation)
Were should you put a tooth for transport?
In milk or normal saline
How do you treat epistaxis?
Compress nostrils
Ice packs
Tilt head forward
Check BP and give iv fluid if <100
What are the first treatments considerations given for a over dose?
Universal patient care ( vitals)
Cardic monitor, possible 12 lead EKG if disrhythmia ,
IV
What medication and dose do you consider for a dialysis patient who has taken a over dose?
calcium Chloride 1Amp (10ml) or 1 gram IV/IO
Peds 20mg/kg/iv/io slow
What medication and dose do you give for a overdose of tricyclic ingestion with tachycardia/ QRS widening?
Sodium bicarbonate 1 amp (50 meq) IV/IO May repeat every 5 minutes for maximum of 3 doses
Peds: 1meq/kg/iv/io
May repeat every 5 minutes for max of 3 doses
What do you give for a over dose with respiratory depression?
Narcan. 0.4-2mg. IV/IO/IM/IN
What do you give for organophosphates over dose?
DuoDote or
Atropine 1-2 mg IM/IV/IO
Per medical control
Large dose may be require (>10mg)
Ped: 0.02mg/kg
How do you treat over dose pt with hypotension, seizures, ventricular dysrhythmias, or mental status change.
Fluids, meds,cardiac care, BS check… Ect
Per protocol for each symptom
What are the symptoms of a tricyclic overdose?
Seizures, dysrhythmias, hypotension, decreased mental status or coma. Rapid progress from alert to dead.
What are the symptoms of a Acetaminophen over dose?
Nausea/vomiting
Can cause irreversible liver failure
What are the symptoms of a Aspirin over dose?
Abdominal pain / vomiting. Tachpnea and altered mental status later.
Late renal dysfunction, liver failure, cerebral edema possible.
What are the symptoms of a Depressant over dose?
Decreased HR, decreased BP, Decreased temp, decreased respirations, non-specific pupils
What are the symptoms of a Stimulant over dose?
Increased HR, increased BP, increased temp. , dilated pupils, seizures.
What are the symptoms of a Anticholinergic over dose?
Atropine,atrovent,wellbutrin,dextromethorphan, benadryl
Increased HR, increased temp, dilated pupils, mental status change.
What are the symptoms of cardiac medication over dose?
Dysrhythmias, and mental status change
What are the symptoms of a solvent over dose?
Nausea,coughing, vomiting, mental status change.
What are the symptoms of a insecticidal over dose?
Increased or decreased HR, increased secretions, nausea, vomiting, diarrhea, pinpoint pupils
Who should you use the nerve agent antidote kit on?
MABAS- kits are for the responders only
What history do you need on a possible over dose?
What was taken? Time? Route? Reason? (Suicide, accident, crimminal). Past medical hx and home meds
Who, what, when, how and why?
What are the symptoms of Pulmonary Edema?
Respiratory distress, bilateral rales, Apprehension, orthopnea, JVD, pink frothy sputum, peripheral edema, diaphoresis, hypotension, shock, chest pain
What history should you get from a pt with pulmonary edema?
CHF, Past hx, medications (digoxine, lasix), use of viagra, levitra, cialis, cardiac history myocardial infarct.
List treatment for pulmonary edema.
Vitals, pulse oximetry/ O2,
ASA 324 mg po if patient able to take,
IV, nitro 0.4 mg SL x2 doses if BP>100 systolic,
cardiac monitor,
morphine 2-4 mg, or Fentanyl 25-75mcg IV/IO for pain.
Consider CPap
Who should nor be given Nitro
Anyone who has taken Viagra or Levitra in last 24 hours. Or cialis in past 36 hours.
If a patient with pulmonary edema and chest pain has taken their own nitro without relief what would you consider could be a problem.
Old drug or potency
What are the contraindications for narcotic pain meds?
Severe COPD, respiratory distress.
Im what patients with pulmonary edema should you consider myocardial infarct?
Diabetics,and geriatrics.
What should you monitor on patients you have given ASA, O2, nitro, and pain meds such as morphine for pulmonary edema?
Level of consciousness, BP, respitory
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