Medications
Indications for Glucose
If blood glucose is known or suspected to be below 60 mg/dL and patient can self administer and swallow on command:
▪ Give one unit dose (15-30 grams) of oral glucose, or available sugar source (such as maple syrup, fruit juice or non-diet soda)
▪ If the patient is unable to swallow on command, do not administer oral glucose and begin transport
This type of shock is caused by loss of blood volume
Hypovolemic shock
Burns should be covered with dry, sterile dressings. Moist sterile dressings may be used to augment pain management only if the burn is ???? BSA (body surface area)
less than 10%
Oxygen administration protocol
Oxygen therapy via non-rebreather mask 10-15 LPM, or nasal cannula 2-6 LPM, to maintain oxygen saturation if saturation is <92% or to effectively manage other signs of dyspnea
I should only be using a lapel if I am this
A clinical leader
Indications for Narcan
Suspected opioid overdose and respiratory insufficiency or respiratory arrest (respirations <10/min)
Normal BGL
HR: 155; BP: 88/60; RR: 24; skin; cool, pale, diaphoretic; A&O x 4
Compensated shock
Treating a patella dislocation (describe/demonstrate)
Gradually extend the knee while, at the same time, a second provider applies pressure on the patella towards the midline of the knee
1 breath every 5-6 seconds (adult)
1 breath every 3-5 seconds (pediatric)
CUEMS uniform (9)
- CUEMS polo
- Navy BDUs
- BLACK BELT
- DARK NON-ABSORBENT shoes/boots (black boots preferred)
- Flashlight, brighter than penlight
- Watch (with seconds)
- ID card/EMT cert/BLS cert
- 2 BLACK pens
- Sharpie
Indications for Albuterol
Patients with effective but increased work of breathing with wheezing not due to trauma or suspected pneumothorax
HR: 122; BP: 74/40; RR: 22 shallow; skin: cyanotic; AMS; lethargy
Decompensated shock
Treating an amputation
• Elevate and wrap the stump with moist sterile dressings and cover with dry bandage
• Provide or direct care for amputated part:
o Moisten sterile dressing with sterile saline solution and wrap amputated part
o Place the severed part in a water-tight container, such as a sealed plastic bag
o Place this container on ice or cold packs, using caution to avoid freezing the limb
Treatment of suspected CO exposure
Any patient with suspected carbon monoxide poisoning should receive high flow oxygen via non-rebreather mask
I should get these unit numbers from the vehicle
Fire and EMS (excludes EHS)
Indications for Nitroglycerin
Patient has a prescription, systolic BP > 120 mmHg
HR: 160; BP: 80/52; RR: 28 shallow; Temp: 104 F; AMS; Skin: hot; BGL: 102
Septic shock
UNSTABLE patients should have transport initiated to the appropriate hospital/landing zone within X minutes of disentanglement/extrication
10
Something you should NOT use in treatment of adult with TAH (total artificial heart)
An AED
Things I should do when RMAing a 17-year old (not married or emancipated minor)
- contact ????
- record ????
- witnesses ????
If the patient is <18 years of age:
- Contact parent and ask: Patient’s full name, DOB
- Record dems of parent (at least full name, phone #, address)
- 2 providers must witness full conversation (one from another agency)
- If refusal, patient signs with witness
- DOCUMENT
Indications for Epinephrine; three scenarios
No hx anaphylaxis: severe respiratory distress, facial or oral edema, and/or hypoperfusion
Hx anaphylaxis: a history of anaphylaxis and has an exposure to an allergen developing respiratory distress and/or hypoperfusion and/or rash
Difficulty breathing w/ wheezing: no relief with 3 doses albuterol, requires Med Control
HR: 40; BP: 76/48; RR: 10 irregular; skin: warm, dry
Neurogenic shock
SMR criteria (6)
• Altered mental status – associated with trauma – for any reason including possible intoxication from alcohol or drugs
• Complaint of neck and/or spine pain or tenderness
• Weakness, tingling or numbness of the trunk or extremities at any time since the injury
• Deformity of the spine not present prior to the incident
• Painful distracting injury or circumstances (i.e., anything producing an unreliable physical exam)
• High risk mechanism of injury associated with unstable spinal injuries include, but are not limited to: ▪ Axial load (diving injury, spear tackle)
▪ High speed motorized vehicle crashes or roll over
▪ Pedestrian or bicyclist struck/collision
▪ Falls >3 feet/ 5 steps or patient’s height
Cushing's triad: what is it and what does it indicate
Indicative of increase in ICP (intracranial pressure)
20 automatic RLS response (name 15)
-Allergic reaction
-Serious bleeding
-Cardiac arrest
-Chest pain/cardiac symptoms
-CVA (stroke)
-Diabetic emergencies
-(Near) drowning
-Electric Shock
-Heat stroke/exhaustion
-Hypothermia
-Overdose/poisoning
-Respiratory distress/arrest
-Seizures
-Serious trauma
-Serious burns
-Unconsciousness
-Syncope
-Impending delivery
-Airway obstruction
-Unknown MOI/NOI