(C) APO CPG (A0406) Flashcards Preview

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Flashcards in (C) APO CPG (A0406) Deck (8)
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1
Q

APO.

Care Objectives

A

> Nitrates - symptomatic (C)APO

> CPAP - if unresponsive to nitrates / significant resp. failure

2
Q

APO.

w/ chest pain?

A

Mx as per ACS CPG (A0401)

3
Q

APO.

CPAP CI’s

A
  • GCS < 13
  • facial trauma
  • secure airway needed
  • active vomiting
  • hypoventilation
  • pneumothorax
  • life-threatening arrhythmias
4
Q

APO.

Mx

A

? SOB & crackles
> GTN 300 mcg S/L (SBP > 110)
Repeat @ 5/60 - titrate to pain / side effects
> GTN patch 50 mg (0.4 mg / hr) to upper torso / arms
Remove patch if SBP < 90

? no improvement / full-field APO
> CPAP
> suction & assisted ventilation as req’d

** MICA **
> ETT intubation
> Furosemide administration

5
Q

COPD.

Suspected in…

A

Pts > 40 who have:

  • smoking hx
  • fam hx COPD
  • dyspnoea worse w/ exercise
  • chronic cough
  • chronic sputum production
6
Q

COPD.

Exacerbation definitions

A

Increased:

  • dyspnoea
  • cough
  • sputum production
7
Q

COPD.

Indications and CI’s

A
  • Indication:
    Sp02 < 90% RA / Sp02 < 95% on O2 **
    **
    Why 95%? Shouldn’t COPD Pts have O2 titrated to 88-92% SpO2??
* CI's
Ineffective:
- cardiac / resp. arrest
- Pt agitation / mask intolerance
- nil improvement after 1/24 Rx
VS:
- HR < 50, SBP < 90
- LOC / GCS < 13
- decreasing SpO2
Active Pt risk
- loss of airway control
- copious secretions
- active vomiting
- paramedic judgement of clinical deterioration
8
Q

COPD.

Mx

A

All exac. COPD:
> Salbutamol 10 mg + Ipratropium 500 mcg NEB
> Dexamethasone 8 mg IV/PO

Adequate:
> titrate O2 to target 88-92%

Inadequate after 10/60:
** MICA **
> CPAP

Pt deteriorates:
> ventilate with 100% O2
** MICA **
> consider ETT intubation