Cardiac Arrest
For CPR what defined as an adult vs child
What are signs of puberty = adult
Pheochromocytoma
What is a contraindication for Glucagon
The identification of an opiate overdose
What are pinpoint pupils, respiratory depression, decreased LOC
most common complaint that goes untreated in pre-hospital setting
What is Pain
A catecholamine secreted by the adrenal medulla
Adrenaline
Fight or flight
What is Epinephrine
Patch point for Medical TOR if patient meets criteria
What is after 20 minutes of resuscitation without ROSC
May receive oral glucose or other simple carbohydrates
What is when the patient responds to dextrose or glucagon or if mild signs and symptoms of low blood sugar.
slurred speech, decreased LOA, weakness, decreased or irregular respiratory drive
What Opioid overdose, hypoglycemia and stroke have in common
Providing treatment of Analgesia downfalls
What can cause respiratory depression and hypotension
What may mask the progression of symptoms
What can complicate assessment after arrival in the receiving facility
The therapeutic classification of epinephrine
What is sympathomimetic, sympathetic nervous system, alpha and beta effects
3 shocks - vector change - 3 more shocks
What is refractory v-fib or v-tach
2 yr old BS 2.8 will receive what dose and route and how many times at what intervals.
5 yr old BS 3.2
What is 0.5 mg Glucagon IM total 2 doses 20 min interval
What is 1.0 mg Glucagon IM total 2 doses 20 min interval or 3 mg IN total 2 doses 20 min intervals
The Common Opioids
What is Heroin, morphine, oxycodone, percocet, percodan, hydromorphone, fentanyl, codeine, opium, demerol, pentazocine
The Conditions in order to administer
Acetaminophen, Ibuprofen and Ketorolac
What is >/= to 12 years old, LOA unaltered, HR, RR, SBP, other .... not applicable
Used for treatment of moderate allergic reactions and has also been used for over the counter sleep aids
What is Diphenhydramine
Pull over and run full 20 minute medical directive
What is your protocol if your patient goes VSA on route for the first time.
The word 'altered' refers to what in the ALS standards
What is a GCS that is less than normal for the patient
Routes of entry for overdoses
Injection, PO, Absorption(transdermal) Intranasal (snorting) Inhalation(smoking)
The contraindications to administering Ibuprofen
What are the following: NSAID use within previous 6 hours, allergy or sensitivity to ASA or NSAIDS, on anticoagulation therapy, current active bleeding, Hx. peptic ulcer disease or GI bleed, pregnant, if asthmatic no prior use of ASA or other NSAIDS, CVA or TBI in previous 24 hours, known renal impairment, active vomiting, unable to tolerate oral medication, suspected ischemic chest pain
Anaphylaxis Protocol Indications
What is exposure to a probable allergen
AND
Signs and/or symptoms of a moderated to severe allergic reaction (including anaphylaxis)
Special Considerations for VSA's consider leaving early after minimum one analysis
What is Pregnancy >20 weeks, Hypothermia, Airway obstruction, non-opiate drug OD, other known reversible cause
The patient is >/= 18 and < 65, dx of diabetes, explained by insulin administration, responded promptly to a single dose dextrose or glucagon and/or consumed oral glucose, blood glucose >/= 4.0 mmol/L.........
What are considerations for treat and discharge
Treatment for Male patient found unresponsive with evidence of needle tracks no witnesses
HR 56 RW, RR 4 RS, BP 92/58
Assist respirations via OPA or NPA and BVM with supplemental O2, if no response to airway management administer .4 mg naloxone IM may repeat to a max 3 doses 5 min intervals.
If pt does not respond post Naloxone glucometry should be considered
Treatment for 65 year old female fall down 2 stairs, obvious deformity right tib, fib - Pain scaled 10/10
HR - 102 RF, RR 28 RF, BP 154/96
Hx. High blood pressure, TIA 6 months ago
Meds: Viacoram, Plavix
no nausea or vomiting
couch breathing, provide O2 via NRB or NP, splint and immobilize #, Acetaminophen 960 - 1000 mg PO, Ibuprofen 400 mg PO
4 body systems involved when someone is possibly exposed to an allergen
What is Integumentary - hives, itching, flushing, swelling, angioedema
Cardio-Vascular - Increased HR, decreased BP, syncope, decrease LOC, hypoxemia
Respiratory - SOB, wheeze, cough, stridor
Gastro-Intestinal- cramping, nausea, vomiting, diarrhea