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Flashcards in Discomfort/Pain of suspected cardiac origin Deck (19):
0

Nitro tab dose

0.4mg

1

Nitro SBP minimum

> 90 mmHG

2

Nitro may be repeated every ____minutes

5

3

Titrate subsequent NTG to pain relieve as long as SBP > ______

90

4

Can you give nitro without an IV?

Yes....absence of an IV shall not preclude use of NTG as long as other criteria are met

5

NTG shall not be given to pt who have taken _____ inhibitors ex ____ within the last ____ hours. If they have taken these start with ______

PDE-5
Viagra, Avenfil, Tadafil (cialis), Vardenafil
48 hours
Morphine

6

ASA dose

320-325mg

7

Nitroglycerine (NTG) _______tablet or equivalent spray sublingual if Systolic Blood Pressure >_____. May repeat every ______min. Titrate subsequent NTG to ________ as long as the SBP >_______ mmHG while simultaneously establishing IV access. Absence of an IV shall not preclude use of NTG as long as all other criteria are met.

0.4
90
5
pain relief
90

8

Nitro *Caution*

NTG shall _____ be given to patients who have taken ______ inhibitors (Name 3_____,_____,____) or equivalent within the last ______hours, start treatment with _________ in these patients

not
PDE-5
Viagra, Cialis, Levitra
48hours
morphine

9

Administer _____mg-_____mg _______ Aspirin (ASA) orally, except in cases of ________ or _______ to ASA. Concurrent _________ therapy is not a contraindication for ASA admin.

320-325mg
chewable
intolerance or allergy
anticoagulation

10

The most appropriate facility for hemodynamically stable pt (SBP_____) who have a 12 lead ECG consistant with an acute myocardial infarction. is a facility providing interventional cardiac catheterization services. EX of 12 lead ECG computer interpretations reading "___________", "Acute _______ ________", "ST ______ _____ ___", or "________" are accepted as consistent with an acute myocardial infarction.

>90
Acute MI , Acute MI Suspected, ST elevation criteria met or STEMI

11

Hemodynamically unstable pt __________ shall be transported to the ____ _____ ____ providing ________ ____ _____ services

SBP <90
time closest facility
interventional cardiac catheterization services

12

pt should not have transport unduly delayed by attempts to obtain ______.
All cardiac monitor interpretations shall be relayed to the ________ facility prior to arrival.

12 lead ECG
receiving

13

IF NTG is ___________ or after the third (________ administered) NTG, the pt does not have relief of chest discomfort/pain the paramedic _____ elect to admin pain medication per _________ ________.

paramedic
may
pain management

14

Discomfort/pain of suspected cardiac origin - ALS (Just the rundown)

Pulse OX
ECG
Nitro
ASA
IV
12 lead
Tx to Cath Lab
May give morphine.

15

CP suspected Cardiac- Supplemental O2

Maintain SpO2 >94%
Use lowest concentration and flow rate

15

CP suspected Cardiac-How many ASA and what is the dose

4 -81 mg chewable tablets
= 324mg

15

CP suspected Cardiac- Administration of Narcotics
3- Indications

1)Severe Pain not relieved by O2 admin and 3 doses of NTG, or pt cannot take NTG because they are taking PDE-5.
2)SBP>90
3) RR>12
-not listed but allergic to NTG

16

CP suspected Cardiac- Fentanyl
Dose
Repeat
Max

1mcg/kg Slow IV/IO
Repeat every 5 minutes
Max dose 2mcg/kg/min