Respiratory
Suction
Clear airway, no more than 10 seconds at time. Measure from corner mouth to tip of ear
NSR
Normal sinus rhythm - normal heartbeat, regular 60-100 beats per minute
Types
Clot, Bleed -
Oxygen
Used if patient is symptomatic with shortness of breath, pulse oximetry less then 92%
CMS
Circulation, movement, sensation. Assessed all 4 extremities before and after splinting or movement.
Nasal Cannula
Used to provide oxygen at low levels (1-6 liters)
Bradycardia
Heart rate less than 60 beats per minute. Treatment includes oxygen, 12 lead ECG, IV access
Onset
Last known well, when did symptoms start, if woke with symptoms, were they present when patient went to bed
Epinephrine
Anaphylaxis, given IM. 1:1,000 concentration
0.3mg IM adult dose, repeat in 5 minutes if no improvement, draw up from vial (single use)
GCS
Glascow Coma Scale 15 lowest score 3
Eye opening (4)
Verbal Response (5)
Motor Response (6)
Non-Rebreather
Mask used for higher concentrations of oxygen, 10 - 15 liters per minute
Tachycardia
Heart rate faster than 100 beats per minute with symptoms. Treatment includes oxygen, 12 lead ECG, IV access, IV Fluid bolus if dehydration suspected
Altered Mental Status
Glucometer testing done to confirm not diabetic concern for altered mental status with stroke symptoms
Naloxone
Narcan - is opioid antagonist, given to reverse opioids.
Route given includes intranasal with nasal atomizer, IM or IV
dose is 0.4mg-2mg, need to maintain respiratory support
Field Clearance
Process for determining if need apply C-Collar
No distracting injuries, GCS 15, midline neck pain or tenderness with palpation or movement, no neurological deficits, provider discretion, loss of consciousness
King Airway
3 sizes, unresponsive patient who is not breathing Size 3 (4-5ft tall), size 4 (5-6ft tall), size 5 (over 6 ft tall), balloon filled after blind insertion
12 Lead ECG
detailed look at electrical activity of the heart, 10 monitor wires to look at 12 different views of heart. Landmarks (4 limbs, V1-V6 chest leads V1 4th intercostal space right sternal border, V2 4th intercostal space left sternal border, V3 between V2 and V4, V4 5th intercostal space midclavicular line, V5 between V4 and V6, V6 mid axillary line.
Vertigo
Dizziness with sudden onset. Room spinning, worse with movement. May have nausea, vomiting. Treatment includes blood glucose check, 12 lead ECG, stroke scale, oxygen, IV access
Ketorolac
Toradol - non-narcotic pain management, anti-inflammatory
given IM or IV
15-30 mg
Pelvic Binder
Suspected pelvic fracture, with blunt trauma. Remove clothing, find greater trochanter (outside upper edge of femur, where hip joint meets shaft of the bone). Place pelvic binder under patient with center of device at level of greater trochanter and tighten to maintain tension. For bleeding control and to stabilize pelvis
OPA
Oral Pharyngeal Airway - Need absent gag reflex, measured corner of mouth to bottom of earlobe. Placed in corner of mouth at 90 degree angle, advance and rotate to anatomical position while inserting
V-fib, V-tach
Shockable rhythms when using the defibrillator (AED mode prior to paramedic intercept arrival)
BE FAST
Balance - sudden loss of balance
Eyes - sudden blurred vision, double vision, loss of vision in one or both eyes
Face - is there facial droop on one side of face
Arm - does one arm drift downward when arms are raised
Speech - are the words slurred, can they get the words out
Time - time of symptom onset
IO access
Intra-osseous, used if patient is unresponsive, contraindicated if fracture proximal to insertion site, hold IO needle to 90 degree angle to bony surface, pressure to push needle through skin to bone. Use needle driver to push through bone until feel a pop., pull back to confirm placement. 15mm, 25mm, 45 mm needle sizes. Use pressure to infuse fluids.
Long Board
Used for patient movement, need maintain c-spine stabilization. Patient should be taken off the board once on the cot.