STEMI
What Specific EKG changes indicate a STEMI?
ST-segment elevation in at least 2 contiguous leads
what is BEFAST stand for?
Balance, Eyes, Face,Arms, speech, time to call 911
What are the key differences in assessing a pediatric patient compared to an adult in an emergency situation?
Airway Management
what is sepsis?
sepsis is a life-threatening condition caused by body dysregulation response to an infection, leading to organ dysfunction.
What are the key signs and symptoms you would assess to differentiate between obstructive and restrictive causes of shortness of breath?
Obstructive lung diseases (e.g., asthma, chronic obstructive pulmonary disease [COPD]) are characterized by difficulty exhaling air from the lungs due to airway narrowing or obstruction.
Restrictive lung diseases (e.g., pulmonary fibrosis, interstitial lung disease, obesity, or neuromuscular diseases) are characterized by difficulty expanding the lungs due to a loss of lung compliance or mechanical restriction.
how long is "door to balloon time"?
90 minutes.
what is the "door to needle" time goal for administering tenecteplase?
60 minutes or less
How would you handle a pediatric patient who is unable to verbalize their symptoms (e.g., an infant or non-verbal child)?
Smaller Airways, Higher Respiratory Rates,
what are the key components of the sepsis 1-hour bundle?
measure lactate, obtain blood cultures, administer broad-spectrum antibiotics, rapid fluid resuscitation, and vasopressors if indicated.
What interventions would you initiate first for a patient presenting with acute shortness of breath and a low oxygen saturation level?
Assess the ABCs (Airway, Breathing, Circulation)
Administer Oxygen
Position the Patient
Assess for Life-Threatening Causes
Establish IV Access
administer Medications as Indicated
Consider Advanced Airway Management (if needed)
what is the significance of "door to balloon time" and why is it important?
door to balloon time refers to a patient with a STEMI arriving at the hospital ER the moment a balloon catheter is inflated in the blocked coronary artery to restore blood flow. it is important because a shorter time frame is linked to better pt outcome and reduce heart tissue damage.
what are the contraindications for administering TNK?
recent surgery, hemmorhagic stroke, active bleeding, stroke within the past 3 months, symptoms greater than 4.5 hours.
Can you describe the Pediatric Assessment Triangle (PAT) and how it helps in evaluating a child in an emergency?
three key areas: appearance, work of breathing, and circulation to the skin.
Appearance (A)
what are the common causes for sepsis?
pneumonia, Urinary tract infections, skin and soft tissue infections, abdominal infections, and bacteremia.
How do you prioritize your interventions when a patient presents with shortness of breath in the ER?
Assess the ABCs (Airway, Breathing, Circulation)
what is a STEMI, and how does it differ from other types of myocardial infarctions?
A STEMI is a type of heart attack that is characterized by a complete blockage of a major coronary artery, leading to a distinctive pattern of ST-segment elevation on EKG making it the most serious type compared to other types that may involve partial blockages and less pronounced EKG changes.
if a patient is not a TNK candidate, what other interventions might be considered?
mechanical thrombectomy
What are the primary considerations when administering medications to pediatric patients in an emergency setting?
Age and Weight-Based Dosing
Verification: Always verify the child’s current weight
Family/Caregiver Communication and Education
what type of fluids are preferred for resuscitation in sepsis?
crystalloid
How would you approach managing a patient who is experiencing sudden onset shortness of breath versus gradual onset?
The sudden onset of shortness of breath may indicate an acute, potentially life-threatening condition. Immediate attention and prioritization of interventions are necessary. (PE, Pneumothorax, asthma exacerbation, anaphylaxis, MI)
Gradual onset of SOB may point to a chronic or progressive condition, which could still be serious but may not require immediate life-saving interventions.( COPD, CHF, fibrosis, Pneumonia)
what are the immediate nursing interventions for a patient with a suspected STEMI?
make sure patients have bilateral Ivs, placed on oxygen, administered aspirin, pain medication, nitro if indicated.
what are your priorities when a stroke patient arrives in the ER?
rapid assessment, blood glucose POC, neuro evaluation, urgent CT head, vital signs monitor, accurate weight.
What are the signs of dehydration in a pediatric patient, and how would you assess and manage this condition in an emergency situation?
signs and symptoms of sepsis
hypothermia, fever, shortness of breath, tachypnea, tachycardia, altered mental status.
What would be your immediate course of action if you encounter a patient with shortness of breath and signs of anaphylaxis?
Assess Airway, Breathing, and Circulation (ABCs)
Epinephrine is the first-line treatment for anaphylaxis, and it should be given IM (intramuscularly) in the mid-outer thigh as soon as anaphylaxis is suspected
Administer supplemental oxygen to maintain an oxygen saturation level of at least 94-98%
Inhaled bronchodilators (e.g., albuterol)
Corticosteroids (e.g., methylprednisolone)