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Trinity SMO > Trinity SMO > Flashcards

Trinity SMO Flashcards

1
Q

What is acceptable ways to confirm placement of airway device?

A

EtCO2 of 35-45

Pulse oximetry of >90%

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2
Q

What is the BVM ventilatory rate for an adult?

A

6-8 per minute

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3
Q

What medications and dose do you consider for post-intubation?

A

Ativan 1-2 mg IV/IO. Or
Versed 2-5 mg IV/IO. Or
Valium 5-10 mg Iv/IO

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4
Q

What are the 3 criteria for a failed airway prior to surgical cricothyrotomy?

A

1) . Two failed intubation attempts
2) . Spo2 <90%
3) . Facial trauma or swelling

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5
Q

Name size and color of the adult king airways.

A

Yellow #3. (4-5foot)
Red #4. (5-6 foot)
Purple #5. (6 ft and up)

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6
Q

What is the age limit for intubation pediatrics?

A

Pediatric age =>9

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7
Q

Name the medications and dose for pediatric post intubation

A

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.

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8
Q

Name vent rates (BVM) for neonates, toddlers, school age, and adolescents.

A

Neonates. 30
Toddlers. 25
School age. 20
Adolescents. 12

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9
Q

What are color and side of pediatric king LD?

A

Green #2. (35-45 inches)

Orange. #2.5. (41-51 inches)

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10
Q

What is the pco2 you should maintain in a pediatric intubated patient?

A

PCO2 of 30-35

SPO2 of >90

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11
Q

At what reported level of pain do you consider medications for back pain?

A

Pain of >6-10 scale

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12
Q

Who should not get acetaminophen for a fever

A

Pt with hx of liver failure

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13
Q

What is the medication and dose for adult pain control?

A

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

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14
Q

How often do you reassess a patient you gave pain meds

A

Every 15 minutes

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15
Q

What are the Contraindications for narcotic pain meds?

A

Hypotension, head injury,respiratory distress, severe COPD

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16
Q

What med and dose do you give for pediatric pain control?

A

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

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17
Q

Spinal immobilization clearance steps 1-6o

A

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.

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18
Q

What is the medication and dose for adult nausea and vomiting

A

Zofra 4mg iv

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19
Q

List treatment for mild allergic reaction ( adult). Rash only

A

Cardiac monitor, iv access, diphenhydramine 50 mg. IM
Or
Diphenhydramine 25-50mg IV

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20
Q

List treatment for allergic reaction with impending resp distress pr shock ( adult)

A

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

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21
Q

When should you contact med control prior to giving epinephrine for allergic reaction?

A

When the patient is over 50 yrs and have a cardiac hx or heart rate over 150

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22
Q

What is the treatment for decreased mental status with blood sugar <60

A

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

23
Q

What is the treatment for altered mental status with blood sugar >60

A

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

24
Q

When can a diabetic refuse transport after treatment?

A

If a adult is present with patient and BS >100 patient must eat and be complaint free.

25
Q

What is normal blood glucose range?

A

60-120

26
Q

What are the criteria for discontinuation or withholding resuscitation?

A 
Valid DNR
Rigor mortis or dependent lavidity
Decapitation
Incineration
(Med control must be called to confirm discontinuation)
27
Q

Were should you put a tooth for transport?

A

In milk or normal saline

28
Q

How do you treat epistaxis?

A

Compress nostrils
Ice packs
Tilt head forward
Check BP and give iv fluid if <100

29
Q

What are the first treatments considerations given for a over dose?

A

Universal patient care ( vitals)
Cardic monitor, possible 12 lead EKG if disrhythmia ,
IV

30
Q

What medication and dose do you consider for a dialysis patient who has taken a over dose?

A

calcium Chloride 1Amp (10ml) or 1 gram IV/IO

Peds 20mg/kg/iv/io slow

31
Q

What medication and dose do you give for a overdose of tricyclic ingestion with tachycardia/ QRS widening?

A 
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

32
Q

What do you give for a over dose with respiratory depression?

A

Narcan. 0.4-2mg. IV/IO/IM/IN

33
Q

What do you give for organophosphates over dose?

A

DuoDote or
Atropine 1-2 mg IM/IV/IO
Per medical control
Large dose may be require (>10mg)

Ped: 0.02mg/kg

34
Q

How do you treat over dose pt with hypotension, seizures, ventricular dysrhythmias, or mental status change.

A

Fluids, meds,cardiac care, BS check… Ect

Per protocol for each symptom

35
Q

What are the symptoms of a tricyclic overdose?

A

Seizures, dysrhythmias, hypotension, decreased mental status or coma. Rapid progress from alert to dead.

36
Q

What are the symptoms of a Acetaminophen over dose?

A

Nausea/vomiting

Can cause irreversible liver failure

37
Q

What are the symptoms of a Aspirin over dose?

A

Abdominal pain / vomiting. Tachpnea and altered mental status later.
Late renal dysfunction, liver failure, cerebral edema possible.

38
Q

What are the symptoms of a Depressant over dose?

A

Decreased HR, decreased BP, Decreased temp, decreased respirations, non-specific pupils

39
Q

What are the symptoms of a Stimulant over dose?

A

Increased HR, increased BP, increased temp. , dilated pupils, seizures.

40
Q

What are the symptoms of a Anticholinergic over dose?

Atropine,atrovent,wellbutrin,dextromethorphan, benadryl

A

Increased HR, increased temp, dilated pupils, mental status change.

41
Q

What are the symptoms of cardiac medication over dose?

A

Dysrhythmias, and mental status change

42
Q

What are the symptoms of a solvent over dose?

A

Nausea,coughing, vomiting, mental status change.

43
Q

What are the symptoms of a insecticidal over dose?

A

Increased or decreased HR, increased secretions, nausea, vomiting, diarrhea, pinpoint pupils

44
Q

Who should you use the nerve agent antidote kit on?

A

MABAS- kits are for the responders only

45
Q

What history do you need on a possible over dose?

A

What was taken? Time? Route? Reason? (Suicide, accident, crimminal). Past medical hx and home meds

Who, what, when, how and why?

46
Q

What are the symptoms of Pulmonary Edema?

A

Respiratory distress, bilateral rales, Apprehension, orthopnea, JVD, pink frothy sputum, peripheral edema, diaphoresis, hypotension, shock, chest pain

47
Q

What history should you get from a pt with pulmonary edema?

A

CHF, Past hx, medications (digoxine, lasix), use of viagra, levitra, cialis, cardiac history myocardial infarct.

48
Q

List treatment for pulmonary edema.

A

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

49
Q

Who should nor be given Nitro

A

Anyone who has taken Viagra or Levitra in last 24 hours. Or cialis in past 36 hours.

50
Q

If a patient with pulmonary edema and chest pain has taken their own nitro without relief what would you consider could be a problem.

A

Old drug or potency

51
Q

What are the contraindications for narcotic pain meds?

A

Severe COPD, respiratory distress.

52
Q

Im what patients with pulmonary edema should you consider myocardial infarct?

A

Diabetics,and geriatrics.

53
Q

What should you monitor on patients you have given ASA, O2, nitro, and pain meds such as morphine for pulmonary edema?

A

Level of consciousness, BP, respitory

54
Q

test / add from computer

A

test

Trinity SMO (2 decks)

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