Medications
This medication can only be administered if prescribed to patient and (BP ≥ 100 systolic)
What is Nitroglycerin
This Protocol is the minimum standard of care expected for every patient, regardless of the level of care of the provider.
What is Universal Patient Care
Moderate: +2 Body Systems
Severe: +2 Body Systems + Hypotension OR Isolate Hypotension
S/S includes itching / hives, coughing, wheezing, or respiratory distress, chest or throat constriction, difficulty swallowing, hypotension or shock, edema
What is allergic reaction / anaphylaxis
Control hemorrhage with direct pressure
Apply Topical Hemostatic Agent/dressing QUICKCLOT
Apply tourniquet if no change
Clean amputation, wrap part in sterile dressing soaked in NS, and place in air tight container.
What is Extremity Trauma
This is a two-part immobilization method used to stabilize and support upper extremity sprains & deformities, preventing further injury.
It involves cradling the forearm to alleviate weight off the joint, while a wider band wraps around the torso to prevent the arm from swinging outward.
What is sling and swathe
This med is administered for fever/pain control.
Contraindicated in pt's age < 6 months, hypersensitivity to NSAID's, and known/suspected GI bleeding disorders or peptic ulcers.
What is Ibuprofen
Access respiratory Rate, Effort, Etc02 monitoring,
Goal Oxygenation ≥ 92%
Basic Maneuvers First:
open airway (chin life/jaw thrust)
nasal an/or oral airways
Supplemental oxygen
BVM +/- Peep
What is Airway Protocol
This medication is indicated for:
Symptomatic Hypoglycemia BGL ≤ 69 mg/dL
Known or suspected Beta-Blocker or Calcium Channel Blocker overdose
What are the routes and doses for each indication?
What is Glucagon (Glucagen):
1-2 mg [IM]
2-4 mg [IV/IO/IM]
Obtain GCS & BGL
Titrate target spo2 100% monitor HR, BP, and 02 every 3-5 min
Maintain etCO2 @ 35-45 mmHg
A single episode of hypoxia, hypotension, and hyperventilation increases mortality!
DO NOT place in Trendelenburg position, as it may increase ICP
What is Head Trauma
This device is used to suction infant mouth and nose if born through meconium staining and is NOT vigorous.
What is a bulb suction
Contraindications include:
Inability to follow commands or hold mouthpiece; severe head or facial injury with impaired consciousness, pneumothorax, air embolism, emphysema, chronic bronchitis, or other respiratory impairment
Severe abdominal pain, distention, injury, or bowl obstruction
1st Trimester pregnancy with a Viable Fetus
What is Nitrous [ProNox]
These criteria must be ruled out before a patient can __?__:
-ETOH
-Altered mental status
-GCS 15 with BGL ≥ 69 mg/dL
Understand the risks -vs- the benefits of transport
What is a Refusal
DAILY DOUBLE!!!
An upper airway constriction, involving swelling of the larynx and trachea, causing a distinct bark-like cough, hoarseness, and even high-pitched breathing. Usually found in pediatric pts between 6 months - 3 years.
Name the diagnosis and treatment:
What is Stridor/Croup
Albuterol Neb 1.25 - 2.5 mg
Epinephrine Neb 1 mg (1:1,000) in 2 ml NS
Hypotension (SBP<90), clinical signs of shock, and at least 1 of the following:
-JVD
-Tracheal deviation
-Absent or decreased breath sounds on the affected side
-Increased resistance when ventilating
What skill & appropriate anatomical location(s)?
What is chest decompression:
2nd intercostal space of the mid-clavicular line
-OR-
Laterally at the fourth intercostal space of the mid-axillary line.
The contraindications of this device includes:
Decreased mental status
Facial deformities that prevent adequate mask seal
Suspected simple or tension pnuemothorax
Excessive respiratory secretions.
Must maintain a systolic BP of ≥ 100mmHg.
What is NIPPV or CPAP
This medication can cause these potential adverse effects:
Hypertension / Bronchospasm / Chest Pain / Tremors Palpitations / Tachycardia / Excitement / Nervousness
What is Albuterol Sulfate
Obtain VS prior to transport, including BGL
Assess GCS / Pupil exam / LSN
Perform Prehospital ___ Screening
Maintain Spo2 ≥ 92%
Document deficits noted/ resolve time
What is Suspected Stroke
Mild: Normal HR, Elevated or normal BP
Nitro 0.3/0.4 mg SL, 1 inch of Nitro paste
Moderate /Severe: Elevated HR, Elevated BP
CPAP, Nitro, Furosemide 40 mg IV
Cardiogenic Shock: Tachycardia followed by bradycardia, Hypertension followed by hypotension
What is CHF/Pulmonary edema
For this treatment:
Consider Midazolam for anxiety relief.
If <2 hrs, Infuse 1L of NSS per hr via IV/IO for adult, or 30-60 ml/kg for peds
If >2 hrs, Decrease to 500 ml of NSS, or 10-20 ml/kg for peds
If ekg changes, consider Calcium chloride, Albuterol nebulizer, and /or sodium bicarbonate
What is Crush Syndrome Trauma
Attach 4 lead monitor.
Apply defib/pacing pads to chest & back.
Press the green pacer button.
Adjust heart rate to 70 BPM for an adult and 100 BPM for a child.
Start. Note pacer spikes on EKG screen.
Slowly increase output until capture of electrical rhythm on the monitor.
What is External Pacing
This medication is prescribed for cardiac irregular supraventricular tachydysrhythmias. What amount would you administer for an 80kg patient for the initial dose and follow up dose, if needed?
What is Cardizem: 20 mg @ 0.25 mg/kg
and 28 mg @0.35 mg/kg
Clinical indications:
Inability to ventilate with a BVM or longer EMS transport distance requires a more advanced airway.
An unconscious patient without a gag reflex who is apneic or demonstrating inadequate respiratory effort.
A component of Drug Assisted Intubation.
What is Intubation Orotracheal
Name the acronym used to treat ACS / Chest Pain / Acute MI / STEMI:
-Aspirin
-Nitro
-Oxygen
-Narcotics
What is MONA / FONA
This formula is called ? and used for ?
4ml x % BSA x weight (kg) = volume (ml)
1/2 to be given over the first 8 hrs
next 1/2 given over the next 16 hours
What is Parkland Formula, for fluid resuscitation for major burn victims to prevent shock
DOUBLE JEOPARDY!!
What color triage would this patient be and why???
A patient found inside of a smoking vehicle, breathing 32 breaths per minute, cap refill of 1 second, and crying but unable to follow basic commands.
Green / Yellow / Red / Black