Cardiac
Epinephrine Dose and Ratio
1mg
1:10,000
How soon must antibiotics be started?
1 hour
What is the window time for a stoke alert?
What if they are a TNK candidate?
24 hours
4 hours
3 types of distributive shock?
anaphylactic, sepsis, neurogenic
Where do DME forms go and what is the process?
Scanned into the patients chart and into the DME folder.
Prints with patients DC instructions and pt signs a copy and gets scanned into the patients' chart.
You are late drawing your 1-hour troponin, what should you do?
Discuss with the doctor and consider moving to the 3-hour pathway.
Where do we chart strokes?
What is the non-negotiable charting?
Stroke flowsheet
Neuro checks, VS, NIHSS, Swallow
You have a patient in septic shock, and they are not responding to fluids. What is the next treatment and why?
Pressors
Pipe/tank/pump?
Why don't we use succinylcholine in our patient population typically?
Hyperkalemia--increased levels of K in the blood during cardiac events, releases K into the bloodstream
If patient has an inferior wall MI, what is special about their EKG?
What medication don't we give?
II, III, aVF
Nitro
Fluid resuscitation mg/kg?
What population are bolus contraindicated in?
30 mh/kg
HF, dialysis
BP parameters before TNK?
BP parameters after TNk?
<185/110
<180/105
Your patient had blunt chest trauma. Noted to be developing SOB and tracheal deviation. What type of trauma is this?
Treatment?
Obstructive Shock
Needle decompression/chest tube
What is the length of stay flow goal?
226
Tell us the importance of lactates and timing.
2 hours re-draw
What are the components of a BEFAST note?
LWK, MD notification, balance, eyes, face, speech, time, BG
Treatment for anaphylactic shock?
Epi, benadryl, solu-medrol, pepcid
How often do you chart during a sedation?
Mod-Q2 and Q5
Deep-Q2
ETCO2, MRS, BP, HR, RR, SPO2, pain
Name the 5 H&Ts?
Tension pneumo, tamponade (cadiac), toxins, thrombosis (pulm), thrombosis (coronary)
Name SIRS criteria
SIRS Criteria (96.8>temp>100.9, HR>90, RR>20, SpO2<90%, AMS, Glucose>120, 4000> WBC> 12000, Lactic> 2
Worst headache ever, AMS, N/V, light sensitivity, nuchal rigidity, focal deficits, are all s/s of what type of hemorrhage?
SAH
What is neurogenic shock?
What are the s/s?
Treatments?
Loss of sympathetic nervous system.
Priapism, bradycardia
Vasopressors; fluids don't typically help.
Components of the fall checklist?
Notify charge, post fall assessment flowsheet, notify MD/PCS, STARS, SBAR
Fall debrief form, MRN & screenshot of department to Maggie