Week 11- Sharp Safety and Med Draws Flashcards
1
Q
What is the MOH Equipment Standards for various syringes?
A
- Every ambulance will have available to the Paramedic the following syringe sizes: (ml same as cc)
- 1ml or cc
- 3ml or cc
- 10ml or cc
2
Q
Additional Syringe Sizes
A
- 60ml
- used for supraglottic airway “cuff” inflation with air
- Also used by ACP’s for certain drugs
3
Q
What is the syringe equipped with?
A
- A syringe is equipped with a plunger allowing paramedics to draw up medication/ fluid prior to administration
4
Q
How do we read a syringe?
A
- Always use the plunger ring closest to the tip to read the volume contained in a syringe
5
Q
How do we write/ document medical amounts in a syringe?
A
- Always include a “0” in front of a decimal when needed
Ex. 0.3ml of epinephrine
6
Q
What is a sharp?
A
A sharp is any object that is able to cut the skin
7
Q
Conventional Sharps is EMS
A
- EMS Needlestick injuries:
involves a Paramedic accidentally sticking themselves with a needle - “Dirty” meaning just withdrawn from a patient’s skin- may contain blood & other pathogens (Hep B/ Hep C/ HIV)
- Can contain medication dangerous to medic- ie. epinephrine
- Or can be clean and in the process of being prepared for use
8
Q
Other Sharps
A
- Lancets, razors, scissors/open ampoule, metal & glass
9
Q
Non Conventional Sharps
A
- Has more to do with the hazardous/ harmful substance the item may contain:
- IV tubing/ IV cannula/ Syringe/ Bone fragments/ teeth/ etc
10
Q
When do needle stick injuries occur?
A
- When medic is actually using the needle/ during injection
- After use- before disposal
- Between steps in procedures
- During sharp disposal
11
Q
What are some prevention of sharp injuries?
A
- PPE- wear gloves/ eye wear “goggles”
- Attend training & known safety policies surrounding sharp safety
- Use equipment properly- i.e. blunt tip needle, engaging safety features on injection needles, sharp containers, etc
- Ensure personal health, such as immunization is current
i.e. Hep B vaccine - Post Exposure Management Knowledge:
- Know how to report an injury, how to seek out treatment
12
Q
What is the treatment plan and management of needle stick injury?
A
- bleed it
- wash it
- cover it
- report it
13
Q
MOH Standards for every ambulance, Syringe vs Needle
A
- 22g in 1/2 inch size/ & 25g in both 1” & 5/8th size
- Attached to syringe (slip on/ or leur lock)
- Used for injections- piercing the skin for the purpose of administering a medication/ fluid
- SQ/ IM/ IV
- Blunt tip- 18g
- For drawing up meds or fluid from a container (Ampoule/ Nebule/ Vial/ Intravenous bag
- NOT USED FOR INJECTING THE MEDICATION INTO THE SKIN
14
Q
Intramuscular (IM)
A
- Means you need a longer needle to hit the muscle & will enter at 90 degree angle
- i.e. adult pt. would need a 1” to 1.5” length. Infant might be 5/8 the length.
- Skin is pulled tight during injection
15
Q
Subcutaneous (SQ)
A
- Means in the subcutaneous level of the skin at a 45 degree angle
- The 5/8th needle is selected
- Skin is “pinched” as to not hit the muscle
16
Q
Needle Safety Features
A
- Always inject with “bevel up”
- Activate safety cover upon withdrawing from skin
- Most Paramedic services have chosen needles with “safe features to reduce needle stick injuries”
17
Q
How do we discard a needle?
A
After drug administration with a needle:
- Activated upon withdraw from pt
- To reduce “sharp” injury
- Newer “safety” covers can actually be activated immediately upon injection withdraw from pt
18
Q
What are the routes for drug administration?
A
- Parenteral (injected through skin)
- Enteral (injected through mouth)
- Topical (applied to body)
- Intranasal (injected through nose)
- Inhalation (injected through inhaling)
- Transdermal (patch on skin)
19
Q
Parenteral Route
A
- Drugs avoid the “gut”
- Drug is given outside or avoid GI tract
- Problem: once given cannot be taken back
20
Q
Enteral Route
A
- Drug administered via GI tract
- Via the mouth- easy to administer
- Often absorbed within GI tract
- Oral/ Buccal/ Sublingual/ Rectal/ Inhalation
21
Q
What does parenteral routes include?
A
- IV: intravenous
- IM: intramuscular
- SC or SQ: subcutaneous
- Other: ACP skill “IO”- introsseous (into the bone)
22
Q
Ampoule
A
- Cannot be reused, intended for single use, cannot be resealed. Often glass
- Possess a “neck” that needs to be cracked in order to access the medication
- Odd shape/ various sizes
23
Q
Vial
A
- Can be reused, often have a rubber stopper on top for multiple doses
- May or may not be sealed once proactive lid removed
- Flat top/ various sizes
24
Q
Plastic Nebules
A
- Often “light” sensitive
- Kept in “foil” packaging when not in use
- Medication is squeezed out into medication cup
- Syringe can be used when smaller doses required
25
Q
What other drug packaging for ACP’s?
A
- ACP’s also have “pre-loaded” syringes for intravenous administrations
26
Q
How to prevent drug errors in the prehospital setting?
A
- Medical error: any preventable event that may cause or lead to an inappropriate medication use or pt harm while the medication is in the control of the Health Care Professional
- Pt safety has to be a priority!!
27
Q
What are the 5 rights to drug administration?
A
- Right drug
- Right patient
- Right dose
- Right route
- Right time
28
Q
Right Drug
A
- what is your working diagnosis?
- Which medical directive will you initiate?
- Does the pt meet the indications for a particular medical directive?
- Show the drug to their partner & ask for their partner to state the “name”.
29
Q
Right Patient
A
- Is this pt right for this drug?
- Does the pt meet indications for this drug? - Is the drug contraindicated for this pt?
- Med. hx?/ allergies?/ vital signs?
30
Q
Right Dose
A
- What does the medical directive state?
- Have you selected the proper working diagnosis?
- Do you need to calculate pt’s age and or weight to figure out the proper dose?
- Are you using the proper drug weight? ml/ mcg/ mg/ g
- Is this to be titrated? Meaning you keep administering until the desired result has been obtained…
31
Q
Right Route
A
- What is the administration order as outlined within the medical directive?
- Have you selected the proper route for this particular drug?
- Are you administering the medication properly?
32
Q
Right Time
A
- According to the medical directive are you administering the drug at the proper time during the assessment?
33
Q
Checking the 5 rights
A
- A paramedic will ensure the 5 rights are confirmed with their partner
- This will assist in reducing medication errord
34
Q
What are the additional rights?
A
- Right to know
- Right to refuse
- Right documentation
35
Q
What are the PCP medication routes?
A
- SQ or (SC): Subcutaneous
- IM: intramuscular
- IN: intranasal
- Neb: nebulizer
- SL: sublingual
- MDI: metered dose inhaler
- Oral
36
Q
What medication do we give oral?
A
- ASA, Ibuprofen, Acetaminophen, Glucose tablets
37
Q
What medications do we inject?
A
- Epinephrine, Dimenhydrinate, Diphenhydramine, Naloxone, Ketorolac, Glucagon
38
Q
What medications do we give intranasal?
A
- Naloxone
39
Q
What medication is given nebulized?
A
- Salbutamol, Epinephrine
40
Q
Sublingual Medication
A
- Nitroglycerin
