ALLERGIC REACTION/ RESPIRATORY DISTRESS
At what lpm can you give oxygen to a patient using a nasal cannula?
1-6 LPM
You administered one dose of Narcan to the left nostril- how long after do you have to wait to administer the next dose, and which nostril should you use?
2-3min / right nostril
When you arrive at the scene of medical code for Chest pain what will you do first?
Assessment on patient
VS, pain assessment- score, manner of expression of pain (moaning/restless), nail bed/peripheral perfusion, skin temp, diaphoretic, heart rhythm intensity
Two-part question: You test your patient's blood sugar, and it is 65 mg/dl. Your patient is alert and able to swallow what are you options to give the patient and what is the policy for blood sugar recheck?
15- 15 rule administer 15 grams of carbs and recheck in 15 min.
3-4 glucose tablets or 1/2 c of juice
Where is the AED located in the Ebag?
What are the steps for a basic respiratory exam?
Observe- Rate rhythm depth and effort of respiration
Palpate- any areas of tenderness, expansion and contraction
Auscultate- posterior and anterior chest
What are s/s for opioid overdose?
pin point pupils
Respiratory and or central nervous system depression
bradycardia
hypotension
decreased level of consciousness
blue/gray lips, fingertips (cyanosis)
MUST GET AT LEAST 4 RIGHT FOR POINTS!
What are three things you can administer to a patient having chest pain?
oxygen 2/3l min via NC or 8-10l min via mask
Aspirin 325 mg
Nitro SL 0.4mg
What are the s/s of hypoglycemia?
blurry vision, rapid heart beat, sudden mood changes, anxiety, nervousness, fatigue, cold/clammy, headache, shakiness, confusion.
(MUST GET 3/5 FOR PTS!)
What is included in the diabetic equipment?
Lancets
glucometer
test strips
alcohol prep pads
cotton balls
glucagon injection
glucose tablets
oral glucose gel
You are administering a nebulizer treatment what are the instructions you are going to give the patient?
Instruct patient to place the mouthpiece in their mouth and secure their lips around it. Instruct the patient to breathe slowly through the mouthpiece in the medication is gone- generally 15-20min.
scenario: you are evaluating a 29 year old patient for AMS- during the interview you notice the pt is slurring their words, pale skin, trouble breathing. They report swallowing a bag of unknown drugs.
RR 14 bpm
pulse 60 lips bluish/ gray
What do you do?
Direct officers to call for EMS, obtain AED, crash cart and oxygen tank.
Check VS, administer oxygen, and narcan
What frequency and amount of times can you give Nitro?
Nitro 0.4mg SL may be administered two more times at 5 min intervals for a total of 3 tablets.
Your patient is a type 1 diabetic who is refusing glucose checks what is the plan of care?
Nurse interview patient to determine basis of refusal, notify medical provider, educate on medical consequences of refusing blood glucose testing and insulin administration, after 12 hours if continues to refuse place on suicide watch status for 15 min checks.
Inform shift sergeant and nursing supervisor
What is in included in the Changes in consciousness zipper pouch?
Narcan nasal spray
ammonia inhalants
1. administer benadryl 50Mg IM stat x1 dose
2. Start benadryl 25-50 mg po bid up to 7 days
3. Consult medical provider for further direction
Scenario continued- pt swallowed unknown baggie of drugs, difficulty breathing, RR14 pulse 60 lips blue/gray. You administered Narcan and begin non-rebreather
You now notice the patient has irregular breaths RR 6bpm, pulse of 40. They have lost consciousness. What is your next step?
Begin bag valve mask- oxygen set to at least 10 LPM and ventilating pt every 6 seconds.
What do you do if the patient is diagnosed with seizures and their medication verified taking in the community is not available?
Start the patient on Keppra BID 1000mg for 10 days and put in a referral to the next provider clinic.
You respond to a trauma of patient who has jumped from the second tier- what is the first thing that should be done.
"Scene size up" delegate someone to apply manual spinal immobilization and request EMS. While lead places C- collar.
What is included in the allergic reaction zipper pouch?
Benadryl vial
alcohol prep pads
band aids
epi pen
albuterol inhaler
3ml 25G x1
Your patient is having a moderate to severe reaction- generalized life threatening reaction what is the action taken?
1. Activate EMS and prepare for transfer of individual to Regions ED
2. Maintain open airway and perform basic life support as indicated (CPR)
3. May administer oxygen via mask at 8-10 LPM. (If history of COPD-administer oxygen at 2-3 L per nasal cannula)
4. Respiratory distress- for detainees > 55 pounds may administer Epinephrine 1:1000
0.3 mg STAT (Epi-Pen) SQ in the individual’s anterolateral aspect of the thigh.
May repeat one time in 5-15 minutes after initial dose if necessary.
5. Stay with individual, recheck vital signs every 5 minutes.
Scenario continued:
pt swallowed unknown drug- gave multiple doses of Narcan, pt lost consciousness you began BVM.
Now patient no longer has a pulse and is not breathing what do you do now? (be specific!)
Compressions 30: 2 Rescue breaths
Compresses 2 inches and allow complete recoil after each compressions
Continue compressions while AED is placed and then follow the prompts of the AED.
After what duration of a seizure would you administer versed and at what dose?
If the seizure duration is greater than 5 minutes and the patient is over 110lbs, a single dose of 10mg IM versed (midazolam) can be utilized. a. If the patient is under 110lbs, give a single dose of IM versed (midazolam) at 0.2mg/kg.
After placing C- collar on patient you begin your assessment what does this include?
LOC
ABCs
Chief complaint
VS
What is included in the Chest pain/ seizures zipper pouch?
Bottle of Nitro SL
Bottle low dose aspirin
versed 10mg
3 ml 23 G x1