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WPBfire EMS Protocol > ALS Emergencies > Flashcards

ALS Emergencies Flashcards

1
Q

Allergic Reaction Mild

A

Mild- Generalized Urticaria
Benadryl: 50mg IM
50mg Diluted 9ml Of Saline IV/IO

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2
Q

Allergic Reaction Moderate

A

Moderate- Airway Swelling/ Respiratory Distress/ Bronchospasm/ Tongue, Face Swelling
* Epinephrine 1:1000
0.3mg(0.3ml) IM lateral thigh x2 5min between
* Benadryl: 50mg IM
50mg diluted IV/IO
* Albuterol: 2.5mg Via nebulizer repeat as needed

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3
Q

Allergic Reaction Severe

A

Severe- Loss Of Radial Pulse
Push Dose Pressor Epinephrine
Maintain 100SBP
May repeat x2 max of 300mcg(30ml)

1 Liter Normal Saline May Repeat x1

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4
Q

Allergic Reaction Pediatric

A
  • Benadryl: 1mg/kg IM Dilute with 9ml of Saline IV/IO
    Contraindications: Neonates
  • EPI 1:1000- 0.01mg/kg IM Max Of .3
    Precautions: Do Not Administer Within 5 Min Of Epi Pen
  • Albuterol- 2.5mg Via Nebulizer
    Age Appropriate Hypotension
  • Epi Push Pressor
  • Saline 20ml/kg May Repeat x2
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5
Q

Hypoglycemia Symptoms

A

AMS
Slurred Speech
Dilated Pupils
Seizures
Coma
Irritability

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6
Q

Hyperglycemia Symptoms With DKA

A

Nausea/Vomiting
Abdominal Pain
General Weakness
Kussmaul Respirations
AMS
Hypotension
Tachycardia
Acetone smell

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7
Q

Hypoglycemia Treatment

A

Less than 60mg/dl
Oral Glucose 15g may repeat x1
Contraindications Not Conscious to swallow
D10 100ml IV/IO Repeat x1
Retest Glucose

Hypoglycemia In Cardiac Arrest 250ml IV/IO Rapid Infusion

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8
Q

Hyperglycemia Treatment

A

BGL 300 mg/dl With Signs Of DKA
Normal Saline 1 Liter May Repeat x1
Precaution coronary heart Disease CHF renal failure

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9
Q

Hypoglycemia In Pediatrics

A

BGL Less Than 60
Oral Glucose 15g
Contraindications: Not Able to Swallow/ Under 2 Years

D10: 5ml/kg IV/IO
May Repeat x1

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10
Q

Hyperglycemia Treatment Pediatrics

A

BGL greater than 300 signs of DKA
Normal saline 20ml/kg IV/ IO
May repeat x2 If BGL is above 300

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11
Q

Dystonic Reaction Characterized As

A

Spasmodic or sustained involuntary contractions
face, neck, trunk, pelvis, extremities, larynx
can happen hours or days

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12
Q

What Meds Cause Dystonic Reactions

A

Antipsychotic (Haldol, Risperdal)
Antiemetic (Compazine, Reglan, Phenergan)
Antidepressants (Prozac, Paxil)

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13
Q

Dystonic Reaction

A

Benadryl: 50mg IV/IO with 9mL NS
Pediatric Diluted Benadryl 1mg/kg IV/IO
Max Of 50mg Contraindications - Neonates

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14
Q

Fluid Resuscitation/ Dehydration Treatment

A

Indications: Hypotension, Fatigue, Dark Urine, Dry Mouth, Headache, Prolonged Vomiting, Non-Traumatic Bleeding, Rhabdomyolysis, Paramedic Discretion
Treatment: 1 Liter
May Repeat x1
Pediatric: 20ml/kg Repeat x2 Per age hypotension

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15
Q

Hyperglycemic Medications

A

Glyburide, Glimepiride, Glipizide

If taken by the pt, must be transported if treated.

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16
Q

Hyperkalemia Indications

A

History Of Renal Failure/ Dialysis or Pre-Dialysis
Weakness
Cardiac Arrhythmias and ECG Abnormalities:
Peaked T-waves (early sign)
Sine Wave
Wide Complex QRS
Regular Really Wide Complex Tachycardia
Severe Bradycardia
High Degree AV Block

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17
Q

Hyperkalemia Treatment

A
  • Calcium Chloride 1g IV/IO Over 2 minutes
  • Albuterol 2.5mg Via Nebulizer
  • Sodium Bicarbonate: 100 mEq IV/IO Over 2 minutes

Hypotensive:
Normal Saline 500ml IV/IO Repeat x1

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18
Q

Hyperkalemia Treatment Pediatric

A
  • Calcium Chloride
    20mg/kg IV/IO Over 2 Minutes
  • Albuterol 2.5mg Via Nebulizer
  • Sodium Bicarbonate 1mEq/kg Over 2 minutes
    Max Single Dose is 50mEq
    May Repeat x1 In 5 Minutes Max Total Of 100mEq
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19
Q

Nausea/ Vomiting Treatment Adult

A
  • NS 1Liter IV/IO Repeat x1
  • Zofran 4mg IV/IO/IM/PO
    Over 2 Minutes for IV/IO Repeat x1
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20
Q

Nausea/ Vomiting Treatment Pediatric

A
  • NS 20ml/kg IV/IO Repeat x2 For Age-Appropriate
  • Zofran
    0.1mg/kg IV/IO/IM/PO
    Over 2 minutes For IV/IO
    Max Dose Of 4mg
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21
Q

COPD & Asthma Information

A
  • Pts have prolonged exhalation secondary to bronchospasm, Causing air to be trapped resulting in hypercapnia High Co2
  • SpO2 greater than 90 is most important
22
Q

Auto Peep Definition

A

When air is forced into the lungs by BVM before the PT has fully exhaled risking a pneumothorax

23
Q

COPD Pts with bad bag compliance or hypotension treatment

A

Discontinue to allow pt to fully exhale before continuing ventilation
Adults: 20-40 Seconds
Pediatrics: 10-20 Seconds

24
Q

Bronchospasm secondary to COPD & Asthma treatment

A
  • Albuterol:
    2.5mg VIA Nebulizer may be administered with CPAP
    Repeat as needed
25
Severe Asthma Not Responding to Nebulizer Treatment Adult
* Epi (1:1000) .3mg IM Repeat x2 5 Min Intervals * Magnesium Sulfate Dilute 2g in a 50ml bag D5W Administer over 10 minutes IV/IO 10 Drop Set 1 gtt/sec
26
Moderate Or Severe COPD, Asthma, Pneumonia Treatment
CPAP 10 cm H20
27
Pediatric Bronchospasm
Albuterol 2.5mg Via Nebulizer May Repeat As Needed
28
Pediatric Severe Asthma
* Epinephrine 1:1000 0.01mg x2 5 min Intervals * Mag Sulfate Dilute 40mg/kg in a 50ML Bag Of D5W Administer over 25 Min IV/IO Max Dose 2G
29
Pediatric Croup, Epiglottitis
* Epinephrine 1:1000 3mg (3ml Total) Delivered Via Nebulizer Precaution do not stress the patient Do not Intubate, OPA, NPA Pt BVM as needed
30
Croup Signs and symptoms
* Less than 3 years old * Sick for couple days * Low grade fever * Not toxic appearing * Stridor / Barky cough
31
Epiglottitis
Usually 3-6 Years Old Sudden Onset High Grade Fever Poor General Impression Drooling Tripod Position Stridor/ Barky Cough
32
Seizure Causes
Meningitis Drugs Fever Alcohol Head Trauma Diabetic Hemorrhagic Stroke Poisoning
33
Adult Seizure Treatment
Versed 5mg IV/IO/IN/IM x1 in 5 minutes Contraindications Hypotensive Precaution Monitor Respirations
34
Adult Patient Seizure Not Responding to Versed
* Ketamine Dilute 100mg into a 50ml bag of D5W IV/IO With 60gtt Set, Wide Open Precaution: Pregnant, Penetrating eye injury Non-Traumatic Chest Pain
35
Seizure with no Vascular Access
Ketamine 100mg IN/IM
36
Pediatric Seizures
Febrile Seizure, Active Cooling, Actively Seizure Versed 0.1mg/kg IV/IO Max of 5mg Versed 0.2mg/kg IN/IM Max of 5mg Contraindications: Hypotension Ketamine 1mg/kg IN/IM Repeat x1 In 5 Min
37
Sepsis Symptoms
* Temperature Greater than 100.4 or Less than 96.8 * UTI * Pneumonia * Wounds that look infected * PT on Antibiotics * Recent Surgery * AMS or Poor Oral Intake * Bed Sores * All Sepsis PTS are priority 2
38
Sepsis Criteria
Adult & Not Pregnant Suspected or Documents Infection H- Hypotension less than 100 A- Altered Mental status new onset T- Tachypnea respirations greater than 22 Or ETCO2 less than 25
39
Sepsis Precations
Keep Pt from becoming Hypotensive - Increases Morbidity Rates Pneumonia pts with rales still require fluids
40
Adult: Sepsis treatment
* Normal Saline 1L MUST repeat if time permits * Ceftriaxone(Rocephin) 2g mixed with 20ml of NS Into a 50ml Bag 10gtt set over 10 minutes 1gtt a sec Ancef, Ceclor, Cefdinir, KeflexArtificial Heart Valve Replacement * Gentamicin 80mg IM ONLY Paromycin, Tobramycin, Neomycin Artificial Heart Valve Replacement Hypotensive * Push dose Epi Contraindications: Allergy to Aminoglycoside Antibiotics
41
Pediatric Sepsis Treatment
* Normal Saline 20ml/kg IV/IO Regardless of Bp Repeat x2 * Push-Dose Epi 1ml
42
Stroke Assessment
Symptoms within 24 Hours Cincinnati Srtoke Assessment Race Score Greater Than 0 Witnessed (24hrs) Unwitnessed Unknown Time Stroke Alerts
43
Race Score
MAX of 11 0 Is Perfect 0-1-2 scoring Facial - Smile Arm Motor- Hold Arm Leg Motor- Hold Leg Cortical PLUS Encode Head and Eyes
44
Stroke Treatment Adult
BGL Position- 30 Degrees Head Elevation Oxygen 2lpm NC IV Access 18g Antecubital Unaffected Side Normal Saline 500 IV/IO Regardless Of BP
45
Stoke Treatment Pediatric
BGL Position- 30 Degrees Head Elevation Oxygen 2lpm NC IV 10ml/kg IV/IO max dose of 250ML
46
Sickle Cell Anemia Adult Treatment
* SpO2 95 or Greater * Normal Saline 500ml IV/IO Repeat x1 * Pain Management Protocol If Hypotension Occurs During Fentanyl limit saline to 500ml
47
Pediatric: Sickle Cell Anemia treatment
* SpO2 95 Or Greater * Normal Saline 20ml/kg x2 * Pain Management
48
Taser Protocol
Stabilize Probe if above the clavicles, genitalia, areola Transport for: Excited Delirium Drug Use Cardiac History Altered Mental Hyperthermia Any Chief Complaint Pregnancy Blood thinners
49
Aphasia
understands but difficulty expressing
50
Agnosia
Inability to recognize
51
CPAP Contraindications
* SBP< 90 * No Spontaneous Respirations * Decreased LOC * Patients < 30kg

WPBfire EMS Protocol (13 decks)

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