Flashcards in Drug profile, Glasgow coma Scale, Burn Ratio Deck (67):
What is the inter cranial pressure?
heart rate goes down, respiratory rate goes down, bp up
What is the eye opening response in glasgow coma scale to do when potential head injury ?
eye opening with spontaneous eye opening means patient opens eyes without you having to do anything-4, if closed have them try to open with normal voice-3, use painful stimuli-2, if no response at all-1
if more than minor eye injuries don’t do.
What is the verbal response in glasgow coma scale to do when potential head injury ?
Verbal response 1-5- 5-oriented (AVPU), 4-confused (cannot answer previous questions but speaks in phrases and sentences), 3-inappropriate words (requirng physical stimulaton and curses), 2-incomprehensible sounds (mumbling, moaning or groaning), 1-no verbal response (to painful and vocal sounds)
What is the motor response in glasgow coma scale to do when potential head injury ?
motor response 1-6
6-(obeys commands and instructions), 5-localized pain (attempt to remove hand from firm pressure to nails), 4-withdraws after painful stimulatoin (elbow flexes moves slowly appearance of stiffness), 3-posturing after painful stimulation (legs and arms extend and stiffness), 2-no motor response.
What are the dosages of activated charcoal?
premixed in water in plastic bottle 12.5 grams give 1g/kg body weight usually 25-50 g avoid powder
What are the names of activated charcoal?
generic: activated charcoal
trade: sper,char, instachar, actidose, actidose, liqui-char, and others
What are the indications of activated charcoal?
poisoning by mouth
How do you administer activated charcoal?
shake thoroughly. persuade to drink cover and use straw, shake or stir, record name, dose, route, time and administration of medication
What is the mechanism of actions of activated charcoal?
1) activated charcoal absorbs (binds) certain poisons and prevents them from being absorbed into body
2) not all brands of activated charcoal are same. some absorb much more than others so consult medical. direction about brand to use
What are the side effects of activated charcoal?
black stools; may vomit, ingested poisons and are nauseous if vomit repeat dose once
What are the contraindications of activated charcoal?
altered mental status, ingestion of acids or alkalis, inability to swallow
Do you need standing order of medical direction for activated charcoal?
on-line medical direction
What are the dosages of naloxone?
What are the names of naloxone?
What are the indications of naloxone?
suspected narcotic overdose or coma of unknown cause
How do you administer naloxone?
1) inspect patient's nose that there is no obstructions to see if can use this route such as significant damage
2) consider restraining if may be combative
3) attach atomizer to syrgine
4) push atomizer gently but firmly into nostril opening
5) push plunger firmly until desired amount of liquid expelled limit to 0.5 per nostril
6) repeat with other nostril and do slowly so don't have patient who wakes up combative
7) record name, dose, route, and time of administration of medication
What is the mechanism of actions of naloxone?
reverses effects of narcotics, including depressed level of consciousness and respiratory depression
What are the side effects of naloxone?
may precipitate withdrawal in patients dependent on narcotic
What are the contraindications of naloxone?
patient breathing adequately and bale to maintain own airway
Do you need standing order of medical direction for naloxone?
off-line medical directions
What are the dosages of epinephrine ?
adult: .3 mg
infant and child .15 mg if less than 25 kg
What are the names of naloxone?
delivery system: epicene or jr. twinject or Auvi=Q
What are the indications of epinephrine ?
1) patient exhibits signs of a severe allergic reaction, including either respiratory distress or shock (hypo perfusion)
2) medication is prescribed for this patient by a physician or is carried on the ambulance
3) medical direction authorizes use for this patient
How do you administer epinephrine?
1) obtain patient's auto=injector prescription is written for someone experiencing allergic reaction check medication is not discolored and has not expired
2) remove safety cap from auto-injector
3) grasp center of auto=injector (avoid accidentally injecting yourself)
4) place tip of auto-injector against patient's thigh-lateral portion of thigh midway between waist and knee
5) push injector firmly against thigh until injector activates
6) hold injector in place until medication is injection (10 seconds for epicene and 5 seconds for Auvi-Q)
7) record administration and time
8) disposable of a single-dose injector such as eliPen in biohazard container save two-dose injector such as twinject and transport it with patient in case second dose is later required
What is the mechanism of actions of epinephrine ?
1) dilates bronchioles
2) constrict blood vessels
3) makes capillaries less permeable (leaky)
What are the side effects of epinephrine?
increased heart rate, pallor, dizziness, chest pain, headache, nausea, vomiting, excitability and anxiety
What are the contraindications of epinephrine?
none when life-threatening
Do you need standing order of medical direction for epinephrine?
online if not prescribed
off-line if do not have prescription
if have prescription and want to get second must call
What are the dosages of nitroglycerin?
must be prescribed and then is for offline adults 0.4mg can take 1 tab every 5 minutes
medical direction if no prescription online or for
hardly ever give to children parents will have medications if so
What are the names of nitroglycerin?
trade: nitrostat, nitrolingual
What are the indications of nitroglycerin?
1) patient complains of chest pain
2) patient has history of cardiac problems
3) patient's physical has prescribed nitroglycerin (NTG)
4) systolic blood pressure is greater than 90 systolic
How do you administer nitroglycerin?
1) perform focused assessment for cardiac patient
2) take patient's blood pressure systole must be above 120
3) contact medical direction if no standing orders
4) ensure right patient, time medication, dose and rout check expiration
5) make sure alert
6) ask about last dose taken and effects
7) ask to lift tongue place table or spray dose under tongue (while wearing gloves) or have patient place tablet or spray under tongue
8) have patients keep mouth closed with tablet under tongue without swallowing until dissolved and absorbed
9) recheck patients blood pressure within 2 minutes record administration route and time
What is the mechanism of actions of nitroglycerin?
relaxes blood vessels and decrease workload of heart
What are the side effects of nitroglycerin?
hypotension (lowers blood pressure), headache, pulse rate changes
What are the contraindications of nitroglycerin?
1) patient has hypotension or systolic blood pressure below 90
2) patient has a head injury
3) patient is an infant or child
4) already taken prescribed dose
5) recently taken viagra, challis, levity, or another drug for erectile dysfunction
Do you need standing order of medical direction for nitroglycerin?
if prescribed: standing order
if not prescribed online
What are the dosages of aspirin?
164-324 mg or 2-4 81 mg tablets of chewable baby aspirin
What are the names of aspirin?
trade: many available
What are the indications of aspirin?
patient complains of chest pain, not allergic to aspirin, no asthma, not taking medications to prevent clotting, no other contraindications to aspirin, able to swallow without endangering airway, medical direction authorizes administration of medication
How do you administer aspirin?
gather history and perform physical exam appropriate for cardiac patient, ensure right med, patient, time, dose, and route check expiration. ensure alert. ask if they can chew.
What is the mechanism of actions of aspirin?
presents blood from clotting as quickly leading to increased survival after myocardial infarction. aspirin not being used to relieve pain.
What are the side effects of aspirin?
nausea, vomiting, heartburn, patient allergic bronchospasm and wheezing with bleeding
What are the contraindications of aspirin?
patient is unable to swallow without endangering airway, allergic or sensitive to aspirin, has history of asthma, has gastrointestinal ulcer or recent bleeding, has known bleeding disorder, medical direction may decide if benefit of giving outweighs risk
Do you need standing order of medical direction for aspirin?
What are the dosages of inhalers?
number of inhalations based on prescription
What are the names of inhalers?
generic: albuterol, metaproterenol
trade: proventil, ventolin, alupent, and metaprel
What are the indications of inhalers?
patient exhibits signs and symptoms of respiratory emergency. patient has physical-prescribed handheld inhaler, medical direction gives specific authorization to use
How do you administer inhalers?
1) ensure right patient, time, medication, dose, route, and patient alert enough to use inhaler
2) check expiration date of inhaler
3)check patient already taken doses
4) ensure inhaler is at room temperature or warmer
5) ensure inhaler room temperature or warmer
6)shake inhaler vigorously
7)have patient exhale deeply
8) have patient put lips around opening
9)have patient depress handheld inhaler begins to inhale deeply
10)instruct patient hold breath for as long as feels comfortable to be absorbed
11)put oxygen back on
12)allow patient to breath few times before repeating dose use spacer design
What is the mechanism of actions of inhalers?
beta-agonist bronchodilator dilates bronchioles, reducing airway resistance
What are the side effects of inhalers?
increased else rate, tumors and nervousness
What are the contraindications of inhalers?
patient is unable to use device (not alert), inhaler is not prescribed for patient, no permission given by medical direction, patient has already taken maximum prescribed dose prior to EMT's arrival
Do you need standing order of medical direction for inhalers?
if prescribed from doctor can assist if not medical control
What are the dosages of oxygen?
nonrebreather: 12-15 L/minute
nasal cannula: 1-6 L/min
What are the indications of oxygen?
spO2 less than 94%
How do you administer oxygen?
via different masks
What is the mechanism of actions of oxygen?
supplies patients respiratory system with higher concentration
What are the side effects of oxygen?
What are the contraindications of oxygen?
emphysema patients in late stages
Do you need standing order of medical direction for oxygen?
What are the dosages of oral glucose?
What are the names of oral glucose?
generic: glucose, oral
Trade; gluotose, insta-glutose
What are the indications of oral glucose?
patients with altered mental status and known history of diabetes mellitus
How do you administer oral glucose?
ensure signs and symptoms of altered mental status with known history of diabetes, ensure patient conscious, administer glucose, place on tongue depressor between cheek and gum or have patient self-administer between cheek and gum
What is the mechanism of actions of oral glucose?
increases blood pressure
What are the side effects of oral glucose?
none when given priorly may be aspirated
What are the contraindications of oral glucose?
unconsciousness, known diabetic who has not taken insulin for days, unable to swallow