RSI Medications
75/150
(I would also accept 80/160 per handtevy if rounding up)
what are the three main indications for administration of blood?
what are the two contraindications for administration of blood?
signs of hypo-profusion/shock
suspected source of bleeding
cardiac arrest w/i 5 mins and suspected bleed
religious exemption/age less than 12
what are two views used to identify cardiac contractility on pocus?
parasternal long
subxiphoid
What part of the capnometric waveform indicates the beginning of the inspiratory phase?
see whiteboard (falling off the cliff)
25yo M Motorcycle crash highway speeds, unconscious, unresponsive, snoring respirations. massive facial trauma, trismus
BP 200/162 HR 100 SpO2 94% supplemental
considerations:
facial bleeding
hypotension
This the paralytic dose of Rocuronium for a 130lb patient
60mg
what is the HR and BP criteria for blood administration?
HR 110
BP > 90systolic
besides heart and lung, what are some other confirmation exams we can perform with pocus?
abd, retroperitoneal, OB, ORTHO, IV, ET Tube placement verification, mechanical capture during pacing, Aorta
and so much more!
what medication is a muscarinic competitive antagonist that we could use as a reversal agent for side effects of ketamine administration such as hypersalivation, hyperlacrimation, or hyperhydrosis?
atropine
21yo F found down in bedroom by roommate, unknown downtime, known to "be depressed" pink pills found near patient and copious amounts of empty alcohol bottles
BP 98/60 HR126 SpO2 96% ora
considerations:
suction
seizure precautions
My patient's BP has dropped to 62/44mm/hg after induction. what medications can I use and what dose?
Push Dose EPI 10/20/30 mcg/ml
what is the Rh properties of the whole blood and PRBCs that SMFR carry?
Whole blood O+
PRBCS O-
how many cases of psuedo PEA do you think SMFR has had?
wrong.
Describe the oxygen dissociation curve
X/Y axis chart indicating the relationship of the binding of oxygen to hemoglobin (spo2) over time
55yo male known diabetic found unconscious and unresponsive. vomitus in airway and rapid deep breathing. pt is hot to touch
BP 196/98 HR 96 SpO2 99% nc 1lpm worn at baseline
considerations:
DKA, rapid breathing may be Kussmaul and compensatory
DO NOT RSI
What is the mechanism of action of Ketamine
Ketamine primarily acts as a non-competitive NMDA receptor antagonist, disrupting glutamate neurotransmission and producing dissociative anesthesia
Ketamine receptors inhibits muscarinic receptor (M,) which may explain some of its anticholinergic effects
what is the purpose of calcium in the setting of blood administration and what is the correct dose?
Calcium helps balance the calcium depleting preservative in the unit of blood
1gm
what does eFAST stand for?
ENHANCED FOCUSED ASSESSMENT with SONOGRAPHY in TRAUMA
Detection of an increase in pCO2 through ____ receptors in the ____(part of the bain) leads to an _____(increase/decrease) in ventilation. More CO2 is _____ (inhaled/exhaled) the pCO2 decreases and returns to normal
CHEMO
MEDULLA OBLONGATA
INCREASE
EXHALED
46yo M traumatic amputation of LLE after a crocodile that he was keeping as a pet attacked him. semi conscious, pale/diaphoretic/cool, bleeding controlled by a TQ placed PTA
CONSIDERATIONS:
where is the croc?
blood administration
PDE?
What is the mechanism of action of Rocuronium?
Rocuronium produces muscle relaxation by competitively blocking nicotinic acetylcholine receptors at the neuromuscular junction, preventing depolarization and subsequent muscle contraction.
(sodium and calcium blockade)
How does TXA work?
anti-fibrinolytic agent that works by blocking the binding site on plasminogen, preventing its conversion to plasmin. Plasmin is the enzyme that breaks down fibrin clots, so by inhibiting plasminogen activation, txa helps preserve clot integrity and reduces bleeding
COME DO A STUDY
yay
how does RhoGAM work?
RhoGAM contains anti-D antibodies that bind to any fetal Rh-positive red blood cells in the mother’s bloodstream. This prevents her immune system from recognizing them as foreign and forming her own antibodies
4yo female patient swallowed a light bulb and is now having abd pain, hematemesis x2 and bright red hematachezia x4, pale/cool/diaphoretic, pt is lethargic
BP UTO HR 156 SpO2 100
considerations?
call in to base?