2017 EMT skill Sheets Flashcards Preview

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Flashcards in 2017 EMT skill Sheets Deck (22):
1

What are the 3 things you need to do to prepare patient for CPAP administration? (1)

PPE
Systolic BP over 100
Position patient in a position that will optimize ease of ventilation

2

What are the indications for a CPAP? (2)

Asthma
CHF
Pulmonary edema
COPD

3

What are the contraindications for CPAP? (3)

-unconscious, unresponsive
-over 16 y/o
-inability to sit up
-respiratory arrest/ agonal respirations
-nausea/vomiting
-systolic BP under 100
-suspect pneumothorax
-cardiogenic shock
-penetrating chest trauma
-facial abnormalities, trauma, burns
-closed head injury
-active upper GI bleed or recent surgery

4

What is the goal of CPAP administration?

10 cm h20, coach patient to breath normally

5

What are the steps in reassessing patient for desired CPAP effects?

-decreased ventilatory distress
-spo2 greater than 92%
-decreased adventitious lung sounds
-absence of reactions I.e. Barotrauma or pnemo
-record settings, readings and document appro.

6

What are the first 3 initial steps of IN medication administration? (1)

-assure pt. Is being ventilated adequately
-ask patient for known allergies
-clearly explain procedure to patient

7

What is the equipment needed for IN medication administration? (2)

-medication
-syringe, needle, MAD device
-sharps container
-alcohol swabs
-sterile gauze

8

When administering medication IN, what are the 6 rights of medication administration? (3)

-right patient
-right medication
-right dosage/concentration
-right time
-right route
-right documentation

9

What do you also need to check the medication for before administration of IN? (4)

-clarity, expiration date
-assemble syringe/needle while staying steril
-cleanse stopper, draw med., dispel air
-reaffirm medication
-dispose needle in sharps, attach MAD
-verbalized PPE
-stop ventilation of patient
-admin 1/2 medication in each nostril
-properly dispose of syringe and MAD
-resume ventilation of patient if necessary
-verbalized need to monitor patient for desired effect and side effects

10

What are the six rights of medication administration?

Right medication - correct medication given in standing orders, generic vs. non generic brands, check expiration

Right patient - confirm patient ID and allergies, contraindications for that patient

Right dose - check concentration, calculations, and that the correct dose has been drawn up

Right route - route is accessible and matches what standing orders and medication label list, confirm dose is correct for chosen route

Right time - medication is given over proper time duration per standing orders

Right documentation - document medication, dose, time of administration, duration of administration, route and patient response

11

When administering medication IN, what else do you need to check for?

-clarity
-expiration date
-maintain sterility during assembly
-reaffirm medication
-dispose of needle properly and attach MAD
-verbalized PPE
-stop ventilation of pt. to administer medication
-admin 1/2 medication up each nostril
-disposes/verbalized proper of MAD & syringe
-resume ventilation of patient
-observe pt. for desired effect and side effects

*generally takes 5 minutes, side effects can be nausea

12

What are the 6 rights for Aspirin administration?

-pt. over 25 y/o with cardiac chest pain/AMI

-Acetylsalicylic acid in blister pack tablets, check expiration date

- 81 mg tablets x4 (324 mg)

-chewed up

-dose can be repeated every 3-4 hours

-right documentation (324 mg ASA administered po and chewed @ time)

13

What are the six rights of administration for EPIPEN?

-pt. in anaphylaxis or allergic reaction

-Epi pen or Epi pen jr. autoinjector, check expiration date, should be about 18 months

-if adult is above or equal to 30 kg (66 pounds) give both adult (0.3 mg) and jr. (0.15 mg). For cardiac arrest, pt. will be given 1 mg Epi 1:10 IV or IO.

-anterolateral thigh, hold for 10 seconds

-for adults, may repeat every 10-15 minutes as needed

-right documentation

14

What are the six rights of administration for nitro?

-used in pt. over 25 y/o or with prescribed nitro, cardiac related chest pain, pulmonary edema with systolic BP over 100, crack/cocaine OD with chest pain.

-medication will be abbreviated as NTG, called Nitrostat. Check expiration date on bottle and proper storage.

-dose is 0.4 mg tablet given sublingually every 5 min for continued chest pain up to a total of 3 tablets.

-route is sublingually

-time is a tablet can be given every 5 min of continued chest pain up to 3 tablets

-right documentation

15

What are the six rights of medication administration for Mark 1 kits?

-to be used following atropine in organophosphate or nerve gas poisoning for civilians and EMS personnel

-medication is pralidoxime or 2-Pam, check for expiration date

-dose is 600 mg IM for both adult and pedi greater than 20 kg

-route is anterolateral aspect of thigh, hold for 10 seconds

-time is?

-right documentation

16

What are the steps for the AED station?

-perform initial assessment of pt. LOC

-begin CPR with 100% O2 while preparing defib at a rate of 30/2. 2 minutes if unwitnessed. 100 per minute with a depth of 1/3 chest depth.

-attach AED/ turn on AED

-place defib pads on patient

-stop CPR, allow AED to analyze

-clear and shock

Resume immediately and repeat shock after another 2 minutes of CPR

17

What are the first steps for acquiring a 12 lead that must be performed in the first two minutes?

-expose chest
-limb lead placement and placement options
-precordial lead placement with no deviation
-when to acquire according to optional standing orders

18

What do you do for the hospital with suspected MI in 12 lead acquisition?

-notify that you or machine suspect MI
-rapid transport
-transmit EKG

19

With 12 lead artifact, what could cause it and how do you correct it?

-skin prep/ make sure it is dry as possible

-electrode attachment/ make sure all electrodes are in correct place with firm adhesive

-patient movement/ tell patient to stay still and not talk while taking EKG

-cable movement/ stay still

-vehicle movement/ if possible acquire EKG before transport

-EMI/ ?

20

What are the indications for insertion of an LMA? (1)

-recommended as the primary pediatric airway except in extreme cases such as airway edema

-limited to patients who need an artificial airway that are apneic and pulse less

21

What are the correct LMA sizes? (2)

1-neonate, infant up to 11 lb/ 4 ml air
1.5-infants up to 22 lbs/ 7 ml of air
2-infants/children (44 lbs.)/ 10 ml of air
2.5-children (66 lbs.)/ 14 ml of air
3- children (110 lbs)/ 20 ml of air
4-adults (154 lbs)/ 30 ml of air
5-adults (220 lbs)/40 ml of air
6-adults (220 lbs)/50 ml of air

22

What are the rest of the steps for LMA placement? (3)

-check cuff by inserting air, then withdrawing

-deflate cuff so it forms a smooth "spoon" shape

-lubricate the posterior surface of the mask with a water soluble lubricant

-hold the LMA like a pen, placing index finger at the junction of the cuff and the tube

-non trauma patient: with head extended and neck flexed, carefully flatten LMA tip against the hard palate. Trauma patient: have second person maintain inline stabilization, carefully flatten LMA tip against the hard palate.

-use the index finger to push cranially, maintaining pressure on the tube with the finger

-advance the mask until definite resistance is felt at the base of the hypopharynx

-gently maintain cranial pressure with the non dominant hand while removing the index finger

-without holding the tube, inflate the cuff with just enough air to obtain a seal. Never over-inflate.

-ventilate and check for breath sounds

-confirm sufficient cuff inflation using end tidal co2. Medications can not be given via LMA