Adult treatments
What is max dose of naloxone allowed to be given?
No max. May repeat every 5 mins as needed. Titrated to adequate respiratory status
What are the routes and doses for versed in a pediatric seizure
IM: 0.1 mg/kg max of 4mg
IN 0.2 mg/kg max of 6 mg
IV 0.1 mg/kg 1-2 mg increments
What does the speed of a vehicle need to be in order to meet mechanism of injury criteria in a car accident?
No speed needed.
What patients can you take to VA?
Veteran patients
Adult Patients >14 under CPR when VA is time closest facility
Adult Patients >14 with unstable airway when VA is time closest facility
When would you with hold narcan from an unconscious patient?
When an advanced airway is in place
What is sepsis criteria?
Hx from patient family or care home, S/S of UTI, respiratory infection, skin infection and older adults or immune compromised patients with unexplained ALOC and no signs to suggest stroke and any of the following 2 criteria
Temp of 100.4F> or <96.8F
RR >20
HR >90
Capnography <25
SBP <90mmHg
What are the doses and routes for suspected pediatric narcotic overdose?
Where do trauma patients that meet trauma triage criteria go when they have a VAD?
UCDMC
What services does Mercy General Provide?
Cath lab, Stroke center, L&D, orthopedics, VAD, ED
Can midwives assume primary care of delivering infant and managing postpartum hemorrhage?
Yes
Albuterol 2.5 mg/Atrovent 0.5mg
What age can you intubate a pediatric patient?
8 years of age or green on broselow tape
What are examples of a trauma patient who may need a trauma center but do not meet trauma criteria?
Patients on blood thinners with unclear LOC
A clear HX of LOC
Pregnancy >20 weeks
When can you contact Sutter Roseville for base medical control?
You may contact SRMC for trauma patients being transported to respective hospitals. You may not contact SRMC for medical (non-traumatic) patients.
What patients do we perform a 12-lead on?
Any adult patient with a complaint of CP
Patients over 40 with symptomatic bradycardia or symptomatic tachycardia.
Diabetic patients >30 years old with typical or atypical symptoms of ACS
Syncope
ROSC
Patients over 75 years of age of women >40 years of age with atypical signs and symptoms of ACS
For burns <30% TBSA and no inhalation injury, how do you stop the burning process?
Run the burned area under cool running water for a total cumulative bystander and responder time of 20 mins.
What is normal HR and BP for a 0-3 month old patient?
HR 110-170
SBP 55-75 DBP 35-45
What is the physiologic trauma criteria?
Unable to follow commands (motor GCS<6)
RR <10 or >29 or respiratory distress with need for respiratory support (anything other than supplemental 02
Sustained HR >120 bpm
Room air Spo2 <90
Age 0-9 SBP <70 + 2x age
age 10-64 SBP <90 or HR>SBP
65> SBP < 110 or HR>SBP
What hospitals of L&D?
All except KHN and VA
What are EMT's and Paramedics determination of death?
EMT: Decapitation, incineration of the torso and or head, decomposition, separation or destruction of brain and or heart from body, rigor mortis, livor mortis.
Paramedic: Traumatic injuries, 1) absences of all pulses and 2) systole by monitor in two leads or 3) PEA with rate <40 bpm
What times do we perform an APGAR score and what do we do with an infant with an APGAR score of 7?
1 and 5 minutes
APGAR of 7 or greater, place skin to skin with mother or if mother refuses wrap baby warmly and place cap on head and continue to assess mother.
What is the max amount of fluid you may give a patient weighing 50kg?
1L or 1000ML
What is anatomic criteria?
All penetrating injuries to head, neck, torso and extremities proximal to the elbow and knee's
Skull deformity, suspected skull FX
Suspected fail chest, wall instability, or deformity
Suspected FX of 2 or more proximal long bone
Crushed, de-gloved, mangled or pulseless extremity proximal to wrist or ankle or pulseless extremity.
Amputation proximal to wrist or ankle
Suspected pelvic FX
Suspected spinal injury with new motor or sensory loss
Active bleeding requiring TQ or wound packing with continuous pressure.
Other than UCDMC what hospital has the most capabilities?
MSJ
What pre-existing vascular access devices may paramedics access during cardiac arrest of pending cardiac arrest?
Arteriovenous shunts, peripherally inserted central catheters (PICC) and tunneled catheters.