General Information Flashcards

Question

PEDIATRIC VENTILATORY RATES

Answer 1

PATIENTS WITH A PULSE 1 BREATH EVERY 3 SECONDS PATIENTS WITHOUT A PULSE 1 BREATH EVERY 6 SECONDS. Coordinate compressions and ventilations to avoid simultaneous delivery. Patients with ICP and/or herniation: maintain ETCO2 between 30-35mm HG and SPO2 > 90% while continuously monitoring BP. The preferred method for ventilating pediatric patient is with a VVM in conjunction with an oral or nasal airway. Pediatric patients who cannot protect the airway or are unable to maintain oxygen saturation despite BVM ventilation, and/ or Cannot be effectively ventilated with a BVM, Should be upgraded to a Supraglottic airway (SGA) age specific followed by intubation if needed.

Answer 2

Cardiac arrest pre/post ROSC Bronchospasm (I.e, asthma, COPD) HIGH ETCO2, levels are acceptable and even desire in these patients

Answer 3

Priority 1: Patient in cardiac or respiratory arrest Priority 2: Unstable patients with immediate life-threatening conditions Priority 3: Stable patients with no immediate life-threatening conditions It’s expected that the lieutenant will be in patient care compartment during transport for all priority 1and 2 patients. The lieutenant may use discretion with priority three transports but shall be in patient care compartment for the majority of transports.

Answer 4

Priority one patient’s primary cardiac arrest: If transport time is <20 minutes: Transport to the closest STEMI facility If transport time is > 20mins: Transport to the closest ED Excluding freestanding ED Respiratory Arrest / SECONDARY ARREST: Transport to the closest ED excluding freestanding a ED

Answer 5

Shall be transported to the closest appropriate ED TRAUMA ALERT: Shall be transported to the closest trauma center if On bypass transport patients to the next closest trauma center. A minimum of one paramedic and one EMT must accompany a trauma alert patient in the back of the rescue provided it does not cause a significant delay in transport. On scene times for trauma alert patients should be <10 min. on scene times that are > 10 min shall have the reason for the delay documented in the EPCR report. If ground transport is > 25 min transport by air Trauma patients who arrest in the presence of FIRE RESCUE PERSONNEL shall be transported to the closest trauma center.

Answer 6

Pregnant patients meeting trauma alert criteria should be transported to ST . MARY’S TRAUMA CENTER BY AIR WHENEVER POSSIBLE. TRAUMA ARREST : if trauma hawk is not available and ground transport is greater than 40 mins it is acceptable to transport to the nearest ED

Answer 7

STEMI ALERTS: shall be transported to the closest STEMI facility, if ground transport is Longer than 40 minutes transport by air to the closest steamy facility with surgical back up Patient presentations that are indicative of myocardial ischemia That do not meet STEMI ALERT CRITERIA Should still be transported to a semi facility

Answer 8

all stroke alerts shall be transported to a comprehensive stroke center EXCEPTION : terminal illness or hospice care patients can still be treated as a stroke alert transport these patients to the closest stroke center primary or comprehensive. If ground transport is greater than 40 minutes transport by air to the closest comprehensive stroke center

Answer 9

All sepsis alerts should be transported to the closest ED excluding freestanding ED Saint Marys hyperbaric chamber Encode prior to transport to confirm availability. Decompression sickness Carbon monoxide exposure Hydrogen sulfide exposure Cyanide exposure

Answer 10

Should be both paralyzed and sedated by the sending facility if the sitting facility physician refuses to administer paralytics the EMS captain must be contacted follow the advanced airway protocol and accompany the patient to the receiving facility

Answer 11

Should be transported to the closest appropriate ED of their choice within 40 minutes the EMS captain may approve or deny transport request longer than 40 minutes Freestanding ED stable patient may be transported to a freestanding ED after being informed if they need to be admitted they will be transferred to another facility signing an emergency transport disclaimer

Answer 12

Obstacle OB patients are defined as gestation of 20 weeks or more Unstable OB patients should be transported to the OBED of their choice within 40 minutes

Answer 13

Stable baker act patient shall be transported to the closest appropriate facility for unstable baker act patients they shall be transported to the closest ED for stabilization

Answer 14

For the purpose of transport a pediatric patient is considered 18 and under PRIMARY PEDIATRIC EMERGENCY DEPARTMENT : These hospitals do not have an patient pediatric capabilities but are comfortable treating MINOR pediatric illnesses and injuries in the ED

Answer 15

These hospitals have pediatric admitting capabilities and surgery options they also provide a bridge to pediatric intensive care

Answer 16

Transport to comprehensive pediatric ED Pediatric patients who have regained a ROSC Pediatric respiratory arrest cases that have successful airway management Transport to closest approve pediatric ED primary for Pulseless pediatric patients Pediatric respiratory arrest patient you have an unstable air way

Answer 17

TRAUMA ALERT PATIENTS SAME AS ADULT Transported to the closest trauma center if I’m bypass transport patient to the next closest trauma center Minimum of one paramedic and one EMT must accompany a trauma alert patient in the back of the rescue provided it is not cause a significant delay in transport On seen times for trauma alert patients should be less than 10 minutes On seen times longer than 10 minutes shall have the reason for the delay documented in the EPCR report If ground transport is longer than 25 minutes transport by air Trauma patients who arrest in the presence of fire rescue personal shall be transported to the closest trauma center

Answer 18

If trauma hawk is not available and ground transport is greater than 40 min it is acceptable to transport to the nearest ED

Answer 19

All stroke alerts shall be transported to ST MARY If ground transport is longer than 40 min transport by air to st Mary

Answer 20

Should be transported to closest comprehensive pediatric ED

Answer 21

Decompression sickness same as adult If ground transport is longer than 40 minutes Transport by air to st Mary’s Carbon monoxide exposure Hydrogen sulfide exposure Cyanide exposure

Answer 22

Should be transported to the closest appropriate pediatric ED

Answer 23

Helicopter operational criteria for trauma patients is as follows pre-hospital ground transport to a trauma center >25 Pre-– Hospital scene extraction time >15 min Pre- Hospital ground response time to the scene is > 10 min Mass casualty incidents MCI involving multiple patients with traumatic injuries

Answer 24

HELICOPTER MAY BE USED for patients weighing 350lbs - 500lbs discretion should be used as to whether air transport is preferred method of transport The flight crew must be capable of loading and loading and treating the patient within the confines of the aircraft the flight crew has final authority to accept or reject the transport

Answer 25

Bariatric patient known or estimated to be five hundred pounds or greater Patient who is unable to lay supine when clinically indicated for transport Patient who is combative and cannot be physically and/or chemically restrained Hazmat contaminated patient

Answer 26

ALLERGIC REACTION : allergic reactions are characterized by generalized urticaria , Airway, tongue, or facial swelling, respiratory distress, bronchospasm, nausea, vomiting or diarrhea, loss of radical pulse or SBP of <90 mm hg Determine the source of the allergic reaction if patient presents with airway swelling/respiratory distress/bronchospasm/ tongue and or facial swelling/loss of radical pulse SBP OF <90 mm hg ASSIST PATIENT WITH PRESCRIBED EPI PEN

Answer 27

Try to identify source of the overdose/poisoning. Assist patient with Narcan if available/applicable Consider contacting the Florida poison control center 1800-222-1222

Answer 28

Consider the possible causes which can be meningitis, fever, head trauma, drugs, alcohol, diabetic, poisoning,hemorrhagic stroke, If patient is actively seizing protect from injury

Answer 29

Check and record BGLFPGL is less than 60 MG/DL and patient is able to protect their airway/swallow : ORAL GLUCOSE 15G If able to swallow and follow commands you may repeat 1x prn Contraindications : patients who are not conscious enough to swallow Patients <2 years old

Answer 30

EXPOSE : as a general rule only remove as much of the clothing as necessary to determine the presence or Absence of injury. Cover the patient as soon as possible to keep the patient warm

Answer 31

Spinal motion restriction Perform manual spinal motion restriction by providing manual cervical stabilization and apply an appropriately sized cervical collar As appropriate if the patient needs any of the following criteria Complaint or finding a focal neurologic deficit on motor or sensory exam Complaint or finding of paint the neck or back, presence of distracting injury, altered level of consciousness within MOI, intoxication with an MOI present The key objective is to move the patient in the safest most anatomically neutral position possible If the right size collar is not available or the collar compels the patient to move remove the collar and provide spinal motion restriction by Placing rule towels on the sides of the patient’s head and neck secure with tape The cervical collar should not cause a patient any discomfort search they are compelled to move, Place patient on the stretcher cushion supine if the patient is not able to tolerate this position place in position of comfort that also respects normal alignment

Answer 32

Helmets should removed from our patients athletic trainer should be consulted in the helmet/protective pad removal process spinal motion restriction should be manually performed during the removal process

Answer 33

Chemical exposures you must remove contact lens if present, Irrigate affected eyes with normal saline, be careful not to contaminate the unaffected eye with runoff PENETRATING EYE INJURIES by stabilizing any penetrating object, cover both eyes with gauze and an eye shield Keep patient calm as crying and screaming or coughing can force more of the tissue outward, DONOT attempt to replace or move the protruding tissue.

General Information Flashcards

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