Acronyms & General Mnemonics Flashcards

Question

What does RAAS stand for, with respect to blood pressure regulation?

Answer 1

**RAAS** ## Footnote Renin-Angiotensin-Aldosterone System **R - R**enin **A - A**ngiotensin **A - A**ldosterone **S - S**ystem

Answer 2

**DOAC** ## Footnote **D - D**irect **O - O**ral **A - A**nti **C - C**oagulant *https://en.wikipedia.org/wiki/Atrial\_fibrillation*

Answer 3

**NOAC** ## Footnote **N - N**ovel **O - Oral** **A - Anti** **C - C**oagulant *https://www.pharmacytimes.com/contributor/sean-kane-pharmd/2016/09/noac-doac-or-tsoac-what-should-we-call-novel-oral-anticoagulants*

Answer 4

1. Warfarin (Coumadin); 2. Heparin (and other drugs ending with the suffix -parin); 3. Apixaban; 4. Rivaroxaban; 5. Edoxaban; 6. Dabigatran; Memory Aid for #s 4-6: A _pixy_ flies by a _river_ on the planet _Endor_, when suddenly _da big train_ whooshes by. *https://en.wikipedia.org/wiki/Atrial\_fibrillation*

Answer 5

**BAAM** ## Footnote **B - B**eck **A - A**irflow **A - A**irway **M - M**onitor *https://epmonthly.com/article/nasal-intubation/*

Answer 6

**RRC** ## Footnote **R - R**ecovery **R - R**esponse **C - C**enter *Pierce Co. EMS Procedures and PCPs, January 2017*

Answer 7

**UV SCAN** ## Footnote **U - U**nknown Origin Hypotension; **V - V**asogenic Shock; **S - S**eptic Shock; **C - C**ardiogenic Shock; **A - A**naphylactic Shock; **N - N**eurogenic Shock;

Answer 8

1. **H**ypotension, 2. **A**cutely altered mental status, 3. **S**igns of shock, 4. **I**schemic chest discomfort, 5. **A**cute heart failure Memory Aid: ??? *AHA ECC Handbook, 2015 Ed., p. 27-28*

Answer 9

**STONED** ## Footnote **S - S**troke (activate "Code Neuro") **T - T**rauma (activate Trauma System) **O - O**xygen Deficiency (open airway, provide oxygen, etc.) **N - N**arcotics (narcan) **E - E**pilepsy (postictal period) **D - D**iabetes (note hypo- versus hyperglycemia) *Berdancronym*

Answer 10

No **DIMES** ## Footnote A non-patient has no: **D - D**esire for care; **I - I**njury or **I**llness (obvious); **M - M**echanism of Injury (significant); **E - E**valuation (medical); **S - S**ymptoms; _Note: "Non-patients are symptomatic persons without a significant mechanism of injury, no obvious injury or illness, without a desire for care, and are not medically evaluated."_ *Pierce County EMS Procedures and PCPs, Administrative Policy, p. 7, June 2019*

Answer 11

**NANO ENIGMA** ## Footnote _Underline Indicates EMT May "Assist With" A Patient's Own Prescribed Medications_ **N - N**arcan (IM/IN; \*Contact Base Station for doses exceeding 10 mg total); **A -** \***A**cetaminophen (PO); **N - N**erve Agent Antidote Kit (IM; Includes both Atropine and Pralidoxime Chloride); **O - O**xygen (INH); **E - E**pinephrine 1:1,000 (IM; For anaphylaxis only; May use syringe or Epinephrine Auto-Injector; \*Contact Base Station for repeated doses); **N -** _**N**itroglycerine_ (SL); **I -** \***I**buprofen (PO); **G - G**lucose, Oral (PO or BUC); **M -** _**M**etered Dose Inhaler_ (INH; \*Contact Base Station after fifth dose); **A - A**spirin (PO); *Pierce County EMS Procedures and PCPs, Administrative Policy, p. 2, June 2019*

Answer 12

**DR. CHAD** ## Footnote **D - D**rug Overdose; **R - R**efractory Shockable Rhythm; **C - C**ircumstances require that the patient be transported; **H - H**ypothermia; **A - A**ge \<= 30 years old; **D - D**rowning; *Pierce County EMS Procedures and PCPs, Administrative Policy, p. 4, June 2019*

Answer 13

**PHAT ST.** ## Footnote **P - P**ericardiocentesis; **H - H**emorrhage control; **A - A**irway (aggressive management); **T - T**horacostomy (bilateral); **S - S**odium Chloride, 0.9% (fluid resuscitation); **T - T**ransport (if patient shows signs of improvement); *Pierce County EMS Procedures and PCPs, Administrative Policy, p. 4, June 2019*

Answer 14

**PAW** ## Footnote **P - P**luseless; **A - A**pneic; **W - W**ithout signs of life (witnessed by EMS responder on arrival); *Pierce County EMS Procedures and PCPs, Administrative Policy, p. 4, June 2019*

Answer 15

**PAW** ## Footnote **P - P**luseless; **A - A**pneic; **W - W**ithout signs of life (witnessed by EMS responder on arrival); _Note - PAW specifically refers to blunt force traumatic arrest, but is also applicable to penetrating trauma arrest. The PCPs specifically state, "In penetrating trauma, resuscitation efforts may be withheld if there are no signs of life (e.g. no pupillary reflexes, GCS 3, and no organized cardiac rhythm on ECG \> 40 bpm)."_ *Pierce County EMS Procedures and PCPs, Administrative Policy, p. 4, June 2019*

Answer 16

**NeRF ED** ## Footnote **N - N**earest; **R - R**eceiving; **F - F**acility's; **E - E**mergency; **D - D**epartment; _Note: "A medical patient with an unstable airway will be transported to the nearest Receiving Facility's emergency department regardless of the emergency department's designated capabilities."_ *Pierce County EMS Procedures and PCPs, Transport Policy, p. 13, June 2019*

Answer 17

**'NAM** Receiving Facility ## Footnote The tent from MASH **N - N**earest; **A - A**ppropriate; **M - M**edical; Receiving Facility; _Note: "Medical patients should generally be transported to the nearest appropriate medical Receiving Facility."_ *Pierce County EMS Procedures and PCPs, Transport Policy, p. 13, June 2019*

Answer 18

**NeRF ED** ## Footnote **N - N**earest; **R - R**eceiving; **F - F**acility's; **E - E**mergency; **D - D**epartment; _Note: "The nearest Receiving Facility's emergency department regardless of the emergency department's designated capabilities."_ *Pierce County EMS Procedures and PCPs, Transport Policy, p. 14, June 2019*

Answer 19

**NATRHOAL** The "natural" destination for Step 3-4 trauma patients. **N - N**earest; **A - A**vailable; **T - T**rauma; **R - R**eceiving; **H - H**ospital; **O - O**f; **A - A**ny; **L - L**evel; _Note 1: "Step 3 and Step 4 trauma patients can be taken to the nearest available trauma receiving hospital of any level."_ _Note 2: The Prehospital Trauma Triage (Destination) Procedures for Step 3 trauma patients instruct the provider to "take patient to the nearest appropriate trauma center within 30 minutes transport time (Air or Ground), which, depending upon the defined trauma system, need not be the highest level trauma center." For Step 4 trauma patients the provider is instructed to "contact medical control or receiving facility, and consider transport to a trauma center or a specific resource hospital."_ *Pierce County EMS Procedures and PCPs, Transport Policy, p. 14, Appendix B-1, June 2019*

Answer 20

**RRC** ## Footnote **R - R**ecovery; **R - R**esponse; **C - C**enter; *Pierce County EMS Procedures and PCPs, Transport Policy, p. 13, June 2019*

Answer 21

**SMR** ## Footnote **S - S**pinal; **M - M**otion; **R - R**estriction; *Pierce County EMS Procedures and PCPs, General Principles / Routine Care, p. 20, June 2019*

Answer 22

**START** ## Footnote **S - S**imple; **T - T**riage; **A - A**nd; **R - R**apid; **T - T**reatment; *Pierce County EMS Procedures and PCPs, Table of Contents, p. d, June 2019*

Answer 23

**ATV** ## Footnote **A - A**utomatic; **T - T**ransport; **V - V**entilator; *Pierce County EMS Procedures and PCPs, Administrative Policy, p. 3, June 2019*

Answer 24

**RIDDLED PM** ## Footnote **i.e., A Bullet-Riddled Corpse Lies Bloody in the Moonlight** **R - R**igor Mortis; **I - I**ncineration; **D - D**ecapitation; **D - D**ecomposition; **L - L**ivor Mortis (Dependent **L**ividity); **E - E**visceration of the heart or brain matter; **D - D**NR (Including "compelling reasons"); **P - P**EA (Traumatic cardiac arrest without PEA \> 40 bpm); **M - M**ortal Peril (Responders at risk of serious injury or mortal peril); * Pierce County EMS Procedures and PCPs, Administrative Policy, p. 3-4, June 2019* * Berdancronym*

Answer 25

**TR** ## Footnote **T - T**raumatic; **R - R**habdomyolysis; *Pierce County EMS Procedures and PCPs, Traumatic Emergencies, p. 30, June 2019*

Answer 26

**CVC** ## Footnote **C - C**entral; **V - V**enous; **C - C**atheter; _Note - the *Pierce County EMS Procedures and PCPs, General Principles / Routine Care, p. 19, June 2019 state "central vascular catheter."*_ *https://en.wikipedia.org/wiki/Central\_venous\_catheter*

Answer 27

**AICD** ## Footnote **A - A**utomatic; **I - I**mplantable; **C - C**ardioverter; **D - D**efibrillator; *Pierce County EMS Procedures and PCPs, Cardiac Emergencies, p. 31, June 2019*

Answer 28

**OPERA** ## Footnote **O - O**ral medication indicated; **P - P**anic (cannot tolerate CPAP therapy); **E - E**mesis; **R - R**espiratory arrest; **A - A**irway maintenance failure; *Pierce County EMS Procedures and PCPs, General Principles / Routine Care, p. 18, June 2019*

Answer 29

**ERUPT** ## Footnote **E - E**mesis; **R - R**espirations \< 8/min; **U - U**pper GI bleeding; **P - P**neumothorax (and significant chest trauma excluding pulmonary contusion); **T - T**racheostomy; *Pierce County EMS Procedures and PCPs, General Principles / Routine Care, p. 17-18, June 2019*

Answer 30

**HIPAA** ## Footnote **H - H**ealth; **I - I**nsurance; **P - P**ortability; and **A - A**ccountability; **A - A**ct; *Pierce County EMS Procedures and PCPs, Administrative Policy, p. 10, June 2019*

Answer 31

**PHI** ## Footnote **P - P**rotected; **H - H**ealth; **I - I**nformation; *Pierce County EMS Procedures and PCPs, Administrative Policy, p. 10, June 2019*

Answer 32

**SOLID** ## Footnote **S - S**ix hours expected to pass before recurrence; **O - O**bservation available for a reasonable amount of time by a competent person; **L - L**oss of life or limb unlikely; **I - I**nterventions of medical significance unrendered; **D - D**ecision making capacity demonstrated by patient or caregiver; _"1. No substantial medical intervention has been rendered._ _2. There is no potential risk for loss of life or limb._ _3. It is reasonable not to expect a recurrence of the condition within the next 6 hours._ _4. There is an individual with adequate decision-making capacity who can observe the patient for a reasonable amount of time._ _5. The adult patient or his/her caregiver meet all elements of the Pierce County Decision-Making Capacity Checklist and agrees to sign an ROR form."_ *Pierce County EMS Procedures and PCPs, Administrative Policy, p. 7-8, June 2019*

Answer 33

**EMR** ## Footnote **E - E**mergency; **M - M**edical; **R - R**esponder; *Pierce County EMS Procedures and PCPs, Administrative Policy, p. 1, June 2019*

Answer 34

**NICU** ## Footnote **N - N**eonatal; **I - I**ntensive; **C - C**are; **U - U**nit; *Pierce County EMS Procedures and PCPs, Transport Policy, p. 13, June 2019*

Answer 35

**SUID** ## Footnote **S - S**udden; **U - U**nexplained; **I - I**nfant; **D - D**eath; * Pierce County EMS Procedures and PCPs, Administrative Policy, p. 6, June 2019* * Berdancronym*

Answer 36

1. Rigor Mortis; 2. Incineration; 3. Decapitation; 4. Decomposition; 5. Livor Mortis (Dependent Lividity); 6. Evisceration of the heart or brain matter; _Note: These are components of the Berdancronym "**RIDDLED PM**," a memory aid for the situations which preclude rescuscitative efforts._ *Pierce County EMS Procedures and PCPs, Administrative Policy, p. 3-4, June 2019*

Answer 37

**DMCC** ## Footnote **D - D**isaster; **M - M**edical; **C - C**ontrol; **C - C**enter; *Pierce County EMS Procedures and PCPs, Communication Policy, p. 11, June 2019*

Answer 38

**BEFAST** ## Footnote **B - B**alance; **E - E**yes; **F - F**acial droop; **A - A**rm drift; **S - S**peech changes; **T - T**ime since LKW; *Pierce County EMS Procedures and PCPs, Appendix D - Prehospital Stroke Triage Procedure, p. D-2, June 2019*

Answer 39

**ExDs** ## Footnote **Ex - Ex**cited; **D - D**elirium; **s - S**yndrome; *Pierce County EMS Procedures and PCPs, Behavioral Emergencies, p. 48, June 2019*

Answer 40

1. Any patient with a psychiatric or behavioral health presentation who is ≥ 18 years old, or emancipated; _Memory Aid: **PB-HP**: **P**sychiatric or **B**ehavioral **H**ealth **P**resentation. Anyone crazy enough to eat a **PB-HP** sandwich (peanutbutter and HP sauce) qualifies for the RRC!_ *Pierce County EMS Procedures and PCPs, Behavioral Emergencies, p. 48, June 2019*

Answer 41

**DMHP** ## Footnote **D - D**esignated; **M - M**ental; **H - H**ealth; **P - P**rofessional; *Pierce County EMS Procedures and PCPs, Behavioral Emergencies, p. 49, June 2019*

Answer 42

**LWK** ## Footnote **L - L**ast; **K - K**nown; **W - W**ell; *Pierce County EMS Procedures and PCPs, Pierce County Prehospital Stroke Triage (Destination) Procedures, Appendix D-2, June 2019*

Answer 43

The **BARD** ## Footnote Shakespear can do as he pleases! **B - B**ase Station advised; **A - A**lternative to treatment / transport offered; **R - R**isks of refusal, benefits of treatment / transport, and condition explained; **D - D**ecision-making capacity demonstrated by patient; _Note:_ _"1. The patient meets all elements of the Pierce County Decision-Making Capacity Checklist (including being \>= 18 years old or an emancipated minor)._ _2. The patient has been told of his or her condition, the risks of refusing and the benefits of seeking medical treatment / transport._ _3. The patient has been offered a reasonable alternative._ _4. The Base Station has been consulted (a physician should speak to the patient whenever possible)."_ * Pierce County EMS Procedures and PCPs, Administrative Policy, p. 8, June 2019* * Berdancronym*

Answer 44

**CBD FOAM** ## Footnote **C - C**alcium Chloride 10% (hyperkalemia); **B -** Sodium **B**icarbonate 8.4% (hyperkalemia); **D - D**extrose (hypoglycemia); **F - F**entanyl (analgesia; consider substitutes); **O - O**xygen (PCPs: 15 LPM INH via NRB); **A - A**lbuterol (hyperkalemia); **M - M**idazolam (anxiolysis; only variant mentioned in PCPs); *-Berdancronym*

Answer 45

**PHAT ST** ## Footnote (Phat St.) **P - P**ericardiocentesis; **H - H**emorrhage control; **A - A**irway (aggressive management); **T - T**horacostomies (bilateral); **S - S**odium Chloride 0.9% (fluid resuscitation) **T - T**ransport (if patient shows signs of improvement); *-Berdancronym*

Answer 46

**DD GAMES** ## Footnote (Double-D Games) **D - D**iphenhydramine; **D - D**opamine (BP \< 90/S); **G - G**lucagon (epi-refractory anaphylaxis 2° to beta-blockade); **A - A**lbuterol ("can be given continuously"); **M - M**ethylprednisolone; **E - E**pinephrine; **S - S**odium Chloride 0.9% (BP \< 90/S); * Pierce County EMS Procedures and PCPs, Environmental Emergencies, p. 44-45, June 2019* * Berdancronym*

Answer 47

**get SOME!** ## Footnote **S - S**odium Chloride 0.9% (Blow-By via SVN); **O - O**xygen (Blow-By); **M - M**ethylprednisolone (only dexamethasone [w/ ondansetron] mentioned in PCPs); **E - E**pinephrine (Blow-By via SVN); *Berdancronym*

Answer 48

**EKO** ## Footnote **E - E**pinephrine (IM); **K - K**etamine (anxiolysis; consider alternatives); **O - O**xygen (Blow-By); *-Berdancronym*

Answer 49

**A MOM'S CAKE** ## Footnote **A - A**lbuterol; **M - M**ethylprednisolone or dexamethasone (moderate-to-severe reactions); **O - O**xygen; **M - M**agnesium Sulfate (asthma); **S - S**odium Chloride 0.9% (fluid resuscitation; Adult patients: mentioned for all reaction severities; Pediatric patients: mentioned for severe reactions only); **C - C**PAP; **A - A**trovent; **K - K**etamine (CPAP anxiolysis; PCPs only recommend diazepam and midazolam); **E - E**pinephrine (status asthmaticus); *Berdancronym*

Answer 50

**OH Blood!** ## Footnote **O - O**xygen (carbon monoxide poisoning; high flow @ 100% FiO₂); **H - H**ydroxocobalamin (cyanide poisoning); **Blood** Samples (prior to use of hydroxocobalamin); *-Berdancronym*

Answer 51

**CLAM BEDS** ## Footnote **C - C**alcium Chloride 10% (suspected hyperkalemia 2° renal failure); **L - L**idocaine (arrest 2° VF / pVT; alternative to amiodarone); **A - A**miodarone (shock & vasopressor refractory VF or pVT); **M - M**agnesium Sulfate (TdP & VF refractory to all other therapies [hypomagnesemia]); **B -** Sodium **B**icarbonate 8.4 % (acidosis); **E - E**pinephrine; **D - D**efibrillation; **S - S**odium Chloride 0.9% (fluid resuscitation); *-Berdancronym*

Answer 52

**BEDS** ## Footnote **B -** Sodium **B**icarbonate 4.2% (following ROSC); **E - E**pinephrine; **D - D**extrose 10% (max 12.5%); **S - S**odium Chloride 0.9% (fluid resuscitation); *-Berdancronym*

Answer 53

**SEDATE** with **Ketamine** ## Footnote **S - S**odium Chloride 0.9% (fluid resuscitation); **E - E**pinephrine (PCP 4th choice for symptomatic bradycardia); **D - D**opamine (PCP 3rd choice for symptomatic bradycardia); **A - A**tropine (PCP/AHA 1st choice for symptomatic bradycardia); **T - T**ranscutaneous Pacing (PCP/AHA 2nd choice for symptomatic bradycardia); **E - E**xpert Consultation **K - Ketamine** (procedural sedation; only diazepam and midazolam mentioned in PCPs); *Berdancronym*

Answer 54

**SAD VEAL** ## Footnote **S - S**odium Chloride 0.9% (fluid resuscitation); **A - A**miodarone (polymorphic VT & wide complex of uncertain origin); **D - D**iltiazem (narrow QRS); **V - V**agal Maneuvers (narrow complex); **E - E**xpert Consultation; **A - A**denosine (for both regular narrow complex and wide IF monomorphic); **L - L**idocaine (stable VT); *-Berdancronym*

Answer 55

**MAD SEAS** ## Footnote **M - M**agnesium Sulfate (TdP) **A - A**denosine (regular, narrow complex) **D - D**efibrillation (TdP with a pulse) **S - S**odium Chloride 0.9% (fluid resuscitation) **E - E**tomidate (procedural sedation; consider other agents) **A - A**miodarone (hemodynamically-unstable VT when cardioversion ineffective) **S - S**ynchronized Cardioversion *-Berdancronym*

Answer 56

**MONA’S O** ## Footnote (The sexual nature of this acronym is a reminder to ask about erectile dysfunction medications prior NTG administration.) **M - M**orphine (pain not relieved by NTG & NTG-refractory pain); **O - O**xygen (SpO₂ \< 94%); **N - N**itroglycerine; **A - A**spirin; **S - S**odium Chloride 0.9% (fluid resuscitation); **O - O**ndansetron; *-Berdancronym*

Answer 57

**SED** ## Footnote (thirst) **S - S**odium Chloride 0.9% (fluid resuscitation); **E - E**pinephrine; **D - D**opamine; *-Berdancronym*

Answer 58

P-QRS-T Brady? **ABC!** ## Footnote **A - A**lbuterol; **B -** Sodium **b**icarbonate 8.4%; **C - C**alcium chloride 10% or **c**alcium gluconate 10%; * Pierce County EMS Procedures and PCPs, April 2020, p. 40* * Berdancronym*

Answer 59

Lobster **BiSK** ## Footnote **Bi -** Sodium **Bi**carbonate 8.4%; **S - S**odium Chloride 0.9% (cooled); **K - K**etamine; *-Berdancronym*

Answer 60

**SEDATE** with **Ketamine** in a **GluM CaB** ## Footnote **S - S**odium chloride 0.9% (fluid resuscitation); **E - E**pinephrine (PCPs' 4th choice treatment for symptomatic bradycardia); **D - D**opamine (PCPs' 3rd choice treatment for symptomatic bradycardia); **A - A**tropine (AHA's and PCPs' 1st choice treatment for symptomatic bradycardia); **T - T**ranscutaneous pacing (AHA's and PCPs' 2nd choice treatment for symptomatic bradycardia); **E - E**xpert consultation; **K - K**etamine (TCP sedation; PCPs only mention diazepam); **Glu - Glu**cagon; **M - M**agnesium sulfate (TdP caused by sotalol-induced long QTI); **Ca - Ca**lcium chloride 10% or **ca**lcium gluconate 10%; **B -** Sodium **b**icarbonate (wide QRS caused by propanolol-induced sodium channel blockade); *Berdancronym*

Answer 61

**FREAKS** ## Footnote **F - F**entanyl (post-sedation anesthesia adjunct) **R - R**ocuronium (pre- and post-intubation paralysis) **E - E**tomidate (pre-sedation) **A - A**pneic Oxygenation **K - K**etamine (pre- and post-intubation sedation) **S - S**uccinylcholine (pre-intubation paralysis) *-Berdancronym*

Answer 62

**BEAM** ## Footnote **B - B**urns **E - E**xtremity Injury (Isolated) **A - A**bdominal Pain **M - M**yocardial Infarction * Pierce County EMS Protocols & PCPs, June 2019, p. O-42* * Berdancronym*

Answer 63

**A DAME** ## Footnote **A - A**lbuterol (wheezing); **D - D**iphenhydramine (antihistamine); **A - A**trovent (wheezing); **M - M**ethylprednisolone (anti-inflammatory, indicated for moderate-to-severe reactions); **E - E**pinephrine (anti-anaphylactic, indicated for airway involvement); * Pierce County EMS Procedures and PCPs, Environmental Emergencies, p. 44, Medication / IV Guide, p. O-39, June 2019* * Berdancronym*

Answer 64

**SOLID** ## Footnote **S - S**ix hours expected to pass before recurrence; **O - O**bservation available for a reasonable amount of time by a person of adequate decision-making capacity; **L - L**oss of life or limb reasonably unexpected; **I - I**ntervention of medical significance unrendered; **D - D**ecision-making capacity demonstrated by patient or caregiver; _"1. No substantial medical intervention has been rendered._ _2. There is no potential risk for loss of life or limb._ _3. It is reasonable not to expect a recurrence of the condition within the next 6 hours._ _4. There is an individual with adequate decision-making capacity who can observe the patient for a reasonable amount of time._ _5. The adult patient or his/her caregiver meet all elements of the Pierce County Decision-Making Capacity Checklist and agrees to sign an ROR form."_ * Pierce County EMS Procedures and PCPs, Administrative Policy, p. 7-8, June 2019* * Berdancronym*

Answer 65

**MP RIDDLED** ## Footnote A Military Policeman Stands Over a Bullet-Riddled Corpse **M - M**ortal peril (responders at risk of serious injury or mortal peril); **P - P**EA (traumatic cardiac arrest without PEA \> 40 bpm); **R - R**igor Mortis; **I - I**ncineration; **D - D**ecapitation; **D - D**ecomposition; **L - L**ivor mortis (dependent lividity); **E - E**visceration of the heart or brain matter; **D - D**NR orders (as well as POLSTs, Advance Directives and "compelling reasons") * Pierce County EMS Procedures and PCPs, Administrative Policy, p. 3-4, June 2019* * Berdancronym*

Answer 66

1. Good Samaritan Hospital; 2. Madigan Army Medical Center; 3. St. Anthony Hospital; 4. St. Joseph Medical Center; 5. Tacoma General Hospital; _Note: There are five Level I Cardiac Centers in Pierce County, the same as the number of fingers on one hand. Picture Levine's Sign as a memory aid, a five-fingered hand clutching the chest._ *Pierce County EMS Procedures and PCPs, Transport Policy, p. 12, June 2019*

Answer 67

1. Decompensation; 2. Medical; 3. EMS; _Memory Aid: **MD**/**PI** - **M**ental **D**isorder / **P**sychiatric **I**llness. A mental patient loony enough to dress up as an MD/PI (Medical Doctor / Private Investigator) needs to be cared for by EMS. "A patient who has a mental disorder with any decompensation of their psyciatric illness is a medical patient and is the responsibility of EMS."_ *Pierce County EMS Procedures and PCPs, Transport Policy, p. 14, June 2019*

Answer 68

1. Good Samaritan Hospital; 2. Madigan Army Medical Center; 3. St. Joseph Medical Center; 4. Tacoma General Hospital; _Note: These are also the only four receiving facilities in Pierce County which feature NICUs._ _Memory Aid: There are four letters in the acronym NICU, just as there are only four receiving facilities in Pierce County which feature NICUs._ *Pierce County EMS Procedures and PCPs, Transport Policy, p. 12, June 2019*

Answer 69

1. Good Samaritan Hospital - Level 2 NICU; 2. Madigan Army Medical Center - Level 3 NICU; 3. St. Joseph Medical Center - Level 2 NICU; 4. Tacoma General Hospital - Level 3 NICU; _Note: These are also the only four receiving facilities in Pierce County that provide obstetrical care._ _Memory Aid: Just as there are four letters in the acronym "NICU", there are four hospitals in Pierce County with NICUs._ *Pierce County EMS Procedures and PCPs, Transport Policy, p. 12, June 2019*

Answer 70

1. Fistula; 2. Graft; 3. Catheter; _Memory Aid: Picture a patient's arm with a tightly clenched fist (fistula), a kidney grafted onto the forearm (graft) and an IV placed in the AC (catheter)._ *https://www.freseniuskidneycare.com/ckd-treatment/in-center-hemodialysis/hemodialysis-access-options*

Answer 71

**C**-**DOM** ## Footnote (Condom) **C - C**alcium chloride 10% / **C**alcium gluconate 10%; **D - D**iphenhydramine; **O - O**ndansetron; **M - M**orphine; * Pierce County EMS Procedures and PCPs, Medication / IV Guide, p. O-11, O-12, O-20, O-42, O-49, June 2019* * Berdancronym*

Answer 72

**ACED IV** ## Footnote **A - A**tropine; **C - C**alcium chloride 10% / **C**alcium gluconate 10%; **E - E**pinephrine; **D - D**opamine; **I - I**soproterenol; **V - V**ecuronium; * Pierce County EMS Procedures and PCPs, Medication / IV Guide, p. O-12, O-53, June 2019* * Berdancronym*

Answer 73

1. Legal surrogate; ## Footnote _Memory Aid: Think of the "**LS**" in PO**LS**T as an acronym for "**l**egal **s**urrogate"._ *Pierce County EMS Procedures and PCPs, Administrative Policy, p. 4, June 2019*

Answer 74

1. Should; ## Footnote _Memory Aid: Think of the "**s**" in living will**s** as an acronym for "**s**hould"._ *Pierce County EMS Procedures and PCPs, Administrative Policy, p. 5, June 2019*

Answer 75

1. Respiratory emergencies requiring CPAP therapy; 2. Crush Injury Syndrome (CIS); _Memory Aid: Treatment algorithms for each of these medical conditions require covering the mouth and nose with a mask, making intranasal midazolam delivery less convenient. When nose access is inconvenient, the PCPs mention only the IO / IV routes for midazolam._ *Pierce County EMS Procedures and PCPs, Respiratory Emergencies, p. 36, Traumatic Emergencies, p. 30, June 2019*

Answer 76

1. StatBand; 2. Prior to transport; 3. Tracking number; 4. Patient's destination; _Memory Aid I: "StatBand" and "JumpSTART," both terms associated with triage, are both compound words._ _Memory Aid II: Picture the StatBand as a criminal GPS tracking bracelet in order to recall that the tracking number must be recorded prior to transport._ *Pierce County EMS Procedures and PCPs, General Principles / Routine Care, p. 23, June 2019*

Answer 77

1. "One word sentences, diaphoretic, altered mental status (AMS)." Memory Aid: **OWS DAMS: O**ne **W**ord **S**entences, **D**iaphoretic, **A**ltered **M**ental **S**tatus (AMS). *Pierce County EMS Procedures and PCPs, Respiratory Emergencies, p. 35, June 2019*

Answer 78

1. Suspected hyperkalemia - renal failure and missed dialysis; 2. From 5 days post significant burn or crush injury until healed; 3. From 5 days post severe intra-abdominal infection until treated; 4. From 5 days - 6 months post spinal cord injury or severe stroke; 5. Neuromuscular diseases such as Multiple Sclerosis and Muscular Dystrophy; 6. Personal or family history of malignant hyperthermia; _Memory Aid: A man lounges in an threadbare dialysis treatment recliner, surrounded by obsolete equipment (**hyperkalemia**). A red-hot boulder sizzles on his abdomen (**significant burns**), squashing his internal organs (**crush injury**). The super-heated viscera boil and churn within his belly (**severe intra-abdominal infection**). The boulder is so heavy that it fractures the spine (**spinal cord injury**), sending a lightning bolt up the cord to short-circuit the brain (**severe stroke**). The man's hands tremble uncontrollably (**neuromuscular diseases**), and finally his entire body lights on fire (**malignant hyperthermia**)._ *Pierce County EMS Procedures and PCPs, Appendix F, June 2019*

Answer 79

1. ≤: * Transport partial and full-thickness burn injuries affecting \> 10% of total body surface area (TBSA) to HMC when patient is ≤ 8 y/o (as opposed to *all* patients when such burns affect \> 20% of TBSA); * CPAP contraindicated when ≤ 12 y/o; * Utilize JumpSTART Triage (as opposed to START Triage) when patient is ≤ 8 y/o; * Administer ibuprofen at pediatric doses (as opposed to adult) when ≤ 10 y/o; * No *age-related* EMS Sepsis Score awarded when patient is ≤ 54 y/o; * Consider transporting a medical patient with CPR in progress when patient is ≤ 30 years old; * Ondansetron prescribed at pediatric doses (as opposed to adult) when ≤ 11 y/o (4 - 11 y/o administered L via ODT 4 mg or IO / IV 0.15 mg/kg); * Administer glucagon at 0.5 mg IM (as opposed to 1 mg) when patient is ≤ 20 kg ; * Administer sodium bicarbonate 4.2% (as opposed to 8.4%) when patient is ≤ 5 kg (or neonate); * Administer midazolam IM for seizures at 5 mg (as opposed to 10 mg) when patient is ≤ 40 kg (13 - 40 kg); _Memory Aid (for differentiation of care based on age or weight being_ ≤ a specified figure)_: A yound boy jumps (**JumpStart Triage**) over a burning **CPAP** (**burns \> 10% TBSA**) in order to catch a flying tablet of **ibuprofen** in his mouth. An "OG" (**ondansetron** / **glucagon**) lies next to the fire supine, head resting on a Sepsis Scorecard (**no age score if**_ **≤ 54**)_, with CPR compressions being performed on his chest (**transport if**_ **≤ 30 y/o**)_. The gangster's pants lie low on his thighs, showing evidence of a BM (**sodium bicarbonate 8.4% / midazolam**)._ *Pierce County EMS Procedures and PCPs, Administrative Policy, p. 4, Appendix DD, Traumatic Emergencies, p. 29, Appendix M-2, Medication / IV Guide, p. O-28, O-30, O-40, O-53, June 2019*

Answer 80

1. ≥: * D₅₀W (as opposed to lower concentrations) permitted offline when ≥ 8 y/o; * Adult medical and "injured" patients (as opposed to pediatric) designated when ≥ 18 y/o; * Nitrous oxide permitted offline when ≥ 18 y/o; * Lidocaine permitted offline for IO anesthesia when ≥ 18 y/o; * Adult Step Trauma patients (as opposed to pediatric) designated when ≥ 15 y/o; * Epinephrine 1:1,000 IM for anaphylaxis prescribed at 0.3-0.5 mg (as opposed to 0.15 mg) when ≥ 66 lbs; * Epinephrine 1:1,000 INH via SVN (blow-by) for Croup prescribed at 3 mg (as opposed to 2 mg) when ≥ 6 y/o; * RSI medications prescribed at adult doses (as opposed to pediatric) when ≥ 10 y/o; * Midazolam IM for seizures permitted offline at 5 mg (as opposed to 10 mg for \> 40 kg) when 13-40 kg (i.e., ≥ 13 kg); * Nasal intubation permitted offline when ≥ 8 y/o; * Afrin permitted offline when ≥ 6 y/o; * Ibuprofen permitted offline when ≥ 6 m/o (6 m/o - 10 y/o administered at 10 mg/kg as opposed to 400-800 mg for \> 10 y/o); * Ondansetron permitted offline when ≥ 4 y/o (4 - 11 y/o administered L via ODT 4 mg or IO / IV 0.15 mg/kg as opposed to adult doses); * Pharmacologic treatment for angina permitted offline when ≥ 18 y/o (e.g., aspirin, nitroglycerin, morphine, fentanyl); * Glucagon permitted offline for all indications (as opposed to only hypoglycemia) when ≥ 18 y/o; _Memory Aid: A boy sits on top of a large pile of sugar (**D₅₀W)**. The boy's right ankle is in a brace (**"injured" / medical**) and an IO (**lidocaine**) has been placed in his proximal tibia. His foot is glued (**glucagon**) on top of a bottle of **nitrous oxide**. The boy's left foot has been amputated above the ankle (**Step Trauma**). An EpiPen protrudes from the boy's right shoulder (**epinephrine 1:1,000 for anaphylaxis**), an NRB delivers nebulized fog in front of the boy's face (**epinephrine 1:1,000 blow-by for croup**), and a syringe of Versed protrudes from his left shoulder (**midazolam IM for seizures / RSI medications**). An ET tube protrudes from the boy's right nostril (**nasal intubation**) while a bottle of **Afrin** juts from his left nostril. A caplet of **ibuprofen** and a tablet of **ondansetron** hang precariously from the tip of his tongue like a set of testicles. He wears a shirt with a large red heart over the center of his chest (**ACS medications**)._ *Pierce County EMS Procedures and PCPs, Communication Policy, p. 11, General Principles / Routine Care, p. 18, Appendix F, Medication / IV Guide, p. O-8, O-16, O-24, O-28, O-30, O-34-35, O-48, June 2019*

Answer 81

1. Magnesium sulfate: IO / IV (15 min) 2 g in 10 mL sodium chloride 0.9%; ## Footnote _Note: Consider mixing 2 g magnesium sulfate (0.5 g/mL end concentration, i.e., 4 mL) in 250 mL sodium chloride 0.9% and administering over 15 minutes with a 10-drop administration set (167 gtt/min)._ _Memory Aid (for the drip rate of magnesium sulfate when administered to adult patients for the treatment of asthma / COPD): Magnum PI (**magnesium sulfate**) drives his open-top convertible Ferrari through heavy smog on Hwy 167 (**167 gtt./min**), wheezing and coughing heartily (**asthma / COPD**)._ *Pierce County EMS Procedures and PCPs, Respiratory Emergencies, p. 36, June 2019*

Answer 82

**MAD BACH GEM** ## Footnote **M - M**idazolam (pediatric: 2 min); **A - A**denosine (1-3 sec "rapid IV push"); **D - D**iltiazem (2 min); **B -** Sodium **B**icarbonate 8.4% (Crush Injury Syndrome: 44 min); **A - A**miodarone (wide complex tachycardia: 10 min); **C - C**alcium chloride 10% / **C**alcium gluconate 10% (adult: 5 min); **H - H**ydroxocobalamin (15 min); **G - G**lucagon (beta-blocker or calcium channel blocker overdose: 3-5 min); **E - E**tomidate (induction: 30-60 sec); **M - M**agnesium sulfate (asthma / COPD / wheezing: 15 min, seizure: 5 min, Torsades de Pointes: 15 min); _Note: There are 11 medications in this group, just as there are 11 medications permitted for EMT utilization in Pierce County._ _Memory Aid: Picture the Mad Bach Gem swinging back and forth to the steady tick of a metronome._ *Pierce County EMS Procedures and PCPs, Medication / IV Guide, p. O-3, O-7, O-11, O-12, O-13, O-19, O-26, O-28, O-36, O-41, O-53, June 2019*

Answer 83

**TADA**! **C**ocaine! ## Footnote **TA - T**ricyclic **A**ntidepressants **D - D**iphenhydramine **A - A**spirin **C**ocaine! _Note: Diabetic Ketoacidosis is also identified as a bicarbonate-responsive acidosis._ * Pierce Co. EMS Procedures and PCPs, June 2019, Medication / IV Guide, p. O-53* * Berdancronym*

Answer 84

1. * Symptomatic hypoglycemia; * Altered mental status; _Note: These are components of "**SHAMS**", a Berdancronym for conditions which indicate the use of oral glucose._ **SHAMS** The indications for oral glucose are so general they should be considered a sham! **S - S**ymptomatic **H - H**ypoglycemia **A - A**ltered **M - M**ental **S - S**tatus * Pierce County EMS Procedures and PCPs, Medication / IV Guide, p. O-29, June 2019* * Berdancronym*

Answer 85

1. * Mixing / dilution of medications; * To keep vein open (AKA KVO or TKO); * Fluid resuscitation: * Childbirth (p. 51); * Vaginal bleeding (p. 53); * Asthma / COPD (p. 36); * Burns (thermal and electrical; p. 28-29); * Excited Delirium Syndrome (p. 48); * Shock * Due to status of pulse and blood pressure (i.e., Shock Index; p. 19); * Vasogenic shock (p. 41); * Anaphylactic shock (p. 44); * Neurogenic shock (p. 31); * Septic shock (Appendix DD); * Traumatic hypovolemic shock (p. 24); * Uncontrolled internal hemorrhage (p. 24); * TBI (p. 24); * Controlled hemorrhage with shock (p. 24); * Trauma (p. 24-26); * Traumatic cardiac arrest (p. 4); * CNS (p. 24-25); * Facial (p. 24-25); * Spinal (p. 25); * Neck (p. 26); * Chest (26); * Abdominal (p. 26); * Femur / hip / pelvic fractire (p. 27); * HoTn of unknown origin (p. 41); _Note: These are components of "BEST CVA", a Berdancronym for the general indications for fluid resuscitation with sodium chloride 0.9%._ **BEST CVA** **B - B**urns **E - E**xDs **S - S**hock **T - T**rauma **C - C**hildbirth **V - V**aginal bleeding **A - A**sthma / COPD *Pierce Co. EMS Procedures and PCPs, p. Administrative Policy, p. 4, General Principles / Routine Care, p. 19, Traumatic Emergencies, p. 24-28, Respiratory Emergencies, p. 36, Medical Emergencies, p. 41, Environmental Emergencies, p. 44, Behavioral Emergencies, p. 48, OB / GYN Emergencies, p. 51, 53, Appendix DD, Medication / IV Guide, p. O-42, April 2020*

Answer 86

**CA DANK** ## Footnote **C - C**PAP (moderate / severe distress) **A - A**lbuterol (wheezing [e.g., cardiac asthma]) **D - D**opamine (BP \< 90/S) **A - A**spirin (ACS) **N - N**itroglycerin (mild / moderate / severe distress with BP \> 100/S) **K - K**etamine (CPAP anxiolysis; PCPs only mention diazepam and midazolam); *Berdancronym*

Answer 87

**CBD FOAM** ## Footnote **C - C**alcium chloride (or carbonate) 10% (hyperkalemia); **B -** Sodium **b**icarbonate 8.4% (hyperkalemia); **D - D**extrose (hypoglycemia); **F - F**entanyl (analgesia [consider substitutes]); **O - O**xygen (INH via NRB 10-15 LPM); **A - A**lbuterol (hyperkalemia); **M - M**idazolam (anxiolysis [only variant specifically mentioned in the Traumatic Emergencies section {IO/IV route uniquely suggested}]); *Pierce County EMS Procedures and PCPs, Traumatic Emergencies, p. 30, Medication / IV Guide, p. O-16, June 2019*

Answer 88

**Mystery VAN** ## Footnote Scooby and Shaggy roast bowls in the Mystery Van **Mystery -** Hypotension of **unknown** etiology; **V - V**asogenic shock; **A - A**naphylactic shock; **N - N**eurogenic shock;

Answer 89

**UV SCAN** ## Footnote **U - U**nknown-origin hypotension; **V - V**asogenic Shock; **S - S**eptic Shock; **C - C**ardiogenic Shock; **A - A**naphylactic Shock; **N - N**eurogenic Shock; *Pierce Co. EMS Procedures and PCPs, June 2019, Medical Emergencies, p. 41, O-21*

Answer 90

**HEAVEN** ## Footnote **H - H**ypoxemia; **E - E**xtremes of size; **A - A**notomic challenge; **V - V**omit / Blood / Fluid; **E - E**xanguination / Anemia; **N - N**eck mobility;

Answer 91

**PICA** ## Footnote **P - P**eri-; **I - I**ntubation; **C - C**ardiac; **A - A**rrest; https://publications.aap.org/aapgrandrounds/article-abstract/44/5/59/88174/Peri-intubation-Cardiac-Arrest-in-the-Cardiac-ICU?redirectedFrom=fulltext

Acronyms & General Mnemonics Flashcards

(115 cards)