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Medical Emergencies Flashcards

(130 cards)

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1
Q

Diphenhydramine (Benadryl) Class

A

Antihistamine

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2
Q

Diphenhydramine (Benadryl) Actions

A

blocks histamine receptors

has some sedative effects

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3
Q

Diphenhydramine (Benadryl) Indications

A

Anaphylaxis / allergic reactions / dystonic reactions due to phenothiazines

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4
Q

Diphenhydramine (Benadryl) Contraindications

A

Asthma / nursing mothers

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5
Q

Diphenhydramine (Benadryl) Precautions / Side Effects

A

Prec: hypotension

SE: sedation / dries bronchial secretions / blurred vision / headache / palpitations

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6
Q

Diphenhydramine (Benadryl) Dose

A

Adult: 25-50mg/slow IV push or deep IM
Pedi: 2-5mg/kg

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7
Q

D50W Class

A

Carbohydrate

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8
Q

D50W Action

A

elevates blood glucose level rapidly

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9
Q

D50W Indications

A

hypoglcemia

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10
Q

D50W Contraindications

A

none in an emergency setting

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11
Q

D50W Precautions / Side Effects

A

Prec: blood sample should be drawn before administration

SE: local venous irritation

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12
Q

D50W Dose

A

Adult: 25g(50mL)/IV

Pedi: 0.5g/kg slow IV; dilute 1:1 with sterile water to form a 25% solution

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13
Q

Glucagon Class

A

Hormone (antihypoglycemic agent)

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14
Q

Glucagon Actions

A 
Causes breakdown of glycogen to glucose
inhibits glycogen synthesis
elevates blood glucose level
increases cardiac contractile force
increases heart rate
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15
Q

Glucagon Indications

A

Hypoglycemia

Beta-blocker OD

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16
Q

Glucagon Contraindications

A

hypersensitivity

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17
Q

Glucagon Precautions / Side Effects

A

Prec: effective only if there are sufficient stores of glycogen within the liver / use with caution in pts with cardiovascular or renal disease / draw blood for glucose test before administration

SE: few in emergency situation

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18
Q

Glucagon Dose

A

Adult: 0.25-0.5units/IV or 1.0mg/IM
Peds: 0.03mg/kg

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19
Q

Sodium Bicarbonate Class

A

Alkalinizing agent

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20
Q

Sodium Bicarbonate Actions

A

combines with excessive acids to form a weak volatile acid

increases pH

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21
Q

Sodium Bicarbonate Indications

A

TCA overdose

severe acidosis refractory to hyperventilation

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22
Q

Sodium Bicarbonate Contraindications

A

Alkalotic states

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23
Q

Sodium Bicarbonate Precautions / Side Effects

A

Prec: correct dose is essential to avoid overcompensation of pH / can deactivate catecholamines / can precipitate with calcium / delivers large sodium load

SE: Alkalosis

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24
Q

Sodium Bicarbonate Dose

A

Adult: 1mEq/kg initially followed by 0.5mEq/kg every 10 min as indicated by blood gas studies

Peds: 1mEq/kg initially followed by 0.5mEq/kg every 10 min

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25
Methylprednisone (Solu-Medrol) Class
Steroid
26
Methylprednisone (Solu-Medrol) Actions
anti-inflammatory | suppresses immune response (especially in allergic reactions)
27
Methylprednisone (Solu-Medrol) Indications
severe anaphylaxis asthma COPD
28
Methylprednisone (Solu-Medrol) Contraindications
none in emergency setting
29
Methylprednisone (Solu-Medrol) Precautions / Side Effects
Prec: must be reconstituted and used promptly / onset of action may be 2-6hrs, thus should not be expected to be of use in the critical first hour following an anaphylactic reaction SE: gastrointestinal bleeding / prolonged wound healing / suppression of natural steroids
30
Methylprednisone (Solu-Medrol) Dose
Adult: 125-250mg/IV/IM Peds: 30mg/kg/IV/IM
31
Dexamethasone (Decadron, Hexadrol) Class
Steroid
32
Dexamethasone (Decadron, Hexadrol) Actions
possibly decreases cerebral edema anti-inflammatory suppresses immune response (especially in allergic reactions)
33
Dexamethasone (Decadron, Hexadrol) Indications
Anaphylaxis (after epinephrine and diphenhydramine) asthma COPD
34
Dexamethasone (Decadron, Hexadrol) Contraindications
none in emergency setting
35
Dexamethasone (Decadron, Hexadrol) Precautions / Side Effects
Prec: protect from heat / onset may be 2-6hrs thus should not be considered to be of use in the critical first hour following an anaphylactic reaction SE: gastrointestinal bleeding / prolonged wound healing
36
Dexamethasone (Decadron, Hexadrol) Dose
Adult: 4-24mg/IV/IM Peds: 0.2-0.5mg/kg/IV/IM
37
Midazolam (Versed) Class
tranquilizer (benzodiazepine)
38
Midazolam (Versed) Actions
hypnotic | sedative
39
Midazolam (Versed) Indications
premedication before cardioversion | acute anxiety states
40
Midazolam (Versed) Contraindications
hypersensitivity narrow angle glaucoma shock
41
Midazolam (Versed) Precautions / Side Effects
Prec: emergency resuscitative equipment must be available / flumazenil (Romazicon) should be available / dilute with normal saline of D5W prior to IV administration / respiratory depression more common with midazolam than other benzodiazepines SE: drowsiness / hypotension / amnesia / respiratory depression/apnea
42
Midazolam (Versed) Dose
Adult: 1.0-2.5mg/IV Peds: 0.03mg/kg Routes: IV, oral, intranasal
43
Diazepam (Valium) Class
Tranquilizer (benzodiazepine)
44
Diazepam (Valium) Actions
anticonvulsant skeletal muscle relaxant sedative
45
Diazepam (Valium) Indications
``` major motor seizures status epilepticus premedication before cardioversion skeletal muscle relaxant acute anxiety states ```
46
Diazepam (Valium) Contraindications
hypersensitivity
47
Diazepam (Valium) Precautions / Side Effects
Prec: local venous irritation / short duration of effect / do not mix with other medication because of possible precipitation problems / Flumazenil (Romazicon) should be available SE: drowsiness / hypotension / respiratory depression/apnea
48
Diazepam (Valium) Dose
Adult Status epilepticus: 5-10mg/IV Adult Acute Anxiety: 2-10mg/IM/IV Adult Premedication before cardioversion: 5-15mg/IV Peds Status Epilepticus: 0.1-0.2mg/kg Routes: IV care must be taken not to administer faster than 1mL/min / IM / rectal
49
Promethazine (Phenergan) Class
Phenothiazine antihistamine (H1 Antagonist)
50
Promethazine (Phenergan) Actions
mild anticholinergic activity antiemetic potentiates actions of analgesics
51
Promethazine (Phenergan) Indications
Nausea and vomiting motion sickness to potentiate the effects of analgesics sedation
52
Promethazine (Phenergan) Contraindications
comatose states | pts who have received a large amount of depressants (including alcohol)
53
Promethazine (Phenergan) Precautions / Side Effects
Prec: avoid accidental intraarterial injection / extravasation can cause tissue damage SE: may impair mental/physical ability / drowsiness
54
Promethazine (Phenergan) Dose
Adult: 25-75mcg/kg as needed Peds: 1mg/kg IV Route: IV/PO
55
Thiamine (Vitamin B1) Class
Vitamin
56
Thiamine (Vitamin B1) Action
allows normal breakdown of glucose
57
Thiamine (Vitamin B1) Indications
Coma of unknown origin Alcoholism Delirium tremens
58
Thiamine (Vitamin B1) Contraindications
none in emergency setting
59
Thiamine (Vitamin B1) Precautions / Side Effects
Prec: rare anaphylactic reactions have been reported / should not be used as part of a "coma cocktail" SE: rare, if any
60
Thiamine (Vitamin B1) Dose
Adult: 100mg/IV/IM Ped: rarely indicated
61
Succinylcholine (Anectine) Class
Depolarizing neuromuscular blocking agent (paralytic)
62
Succinylcholine (Anectine) Action
skeletal muscle relaxant / paralyzes skeletal muscles, including respiratory muscles
63
Succinylcholine (Anectine) Indications
to achieve paralysis to facilitate endotracheal intubation
64
Succinylcholine (Anectine) Contraindications
known hypersensitivity
65
Succinylcholine (Anectine) Precautions / Side Effects
Prec: do not administer unless person skilled in ET are present / ET equipment must be available / O and resuscitative meds must be available / paralysis occurs within 1min and lasts for approx. 8min SE: prolonged paralysis / hypotension / bradycardia
66
Succinylcholine (Anectine) Dose
Adult: 1-1.5mg/kg/IV (40-100mg) Ped: 1mg/kg/IV
67
Rocuronium Class
Nondepolarizing neuromuscular blocker (paralytic)
68
Rocuronium Action
Prevents neuromuscular transmission by blocking the effect of acetylcholine / skeletal muscle paralysis
69
Rocuronium Indication
Induction of skeletal muscle paralysis
70
Rocuronium Contraindication
hypersensitivity
71
Rocuronium Precautions / Side Effects
Prec: underlying cardiovascular disease / dehydration/electrolyte abnormalities SE: bronchospasm
72
Rocuronium Dose
Adult: Initial RSI induction 600mcg/kg Maintenance dose 100-200mcg/kg continuous infusion IV/IV drip Ped: Initial RSI induction 600mcg/kg Maintenance dose 75-125mcg/kg continuous IV infusion
73
Vecuronium (Norcuron) Class
Non depolarizing neuromuscular blocking agent
74
Vecuronium (Norcuron) Action
Skeletal muscle relaxant | paralyzes skeletal muscles including respiratory muscles
75
Vecuronium (Norcuron) Indications
to achieve paralysis to facilitate endotracheal intubation
76
Vecuronium (Norcuron) Contraindications
known hypersensitivity
77
Vecuronium (Norcuron) Precautions / Side Effects
Prec: ETI will be required after administration paralysis occurs within 1min and lasts for approx 30min SE: prolonged paralysis / hypotension / bradycardia
78
Vecuronium (Norcuron) dose
Adult: 0.08-0.1 mg/kg/IV/IO Ped: 0.1 mg/kg/IV/IO
79
Ketamine (Ketalar) Class
Sedative/hypnotic and analgesic
80
Ketamine (Ketalar) Action
causes dissociative state
81
Ketamine (Ketalar) Indications
induction agent for RSI
82
Ketamine (Ketalar) Contraindications
Hypersensitivity | Significantly elevated BP
83
Ketamine (Ketalar) Precautions / Side Effects
Prec: hallucinations can occur / emergency airway and resuscitation equipment/med must be available SE: hallucinations / increased skeletal muscle tone
84
Insulin (Humilin, Novolin, Iletin) Class
Hormone (hypoglycemic agent)
85
Insulin (Humilin, Novolin, Iletin) Actions
Causes uptake of glucose by the cells Decreases BGL Promotes glucose storage
86
Insulin (Humilin, Novolin, Iletin) Indications
Elevated BGL | DKA
87
Insulin (Humilin, Novolin, Iletin) Contraindications
Avoid overcompensation of BGL; if possible administration should wait until the pt is in the ED
88
Insulin (Humilin, Novolin, Iletin) Precautions / Side Effects
Prec: excessive dose may induce hypoglycemia / glucose should be available SE: few in emergency situation
89
Insulin (Humilin, Novolin, Iletin) Dose
Adult: 10-25 units IV followed by infusions of 0.1units/kg/hr Ped: based on BGL
90
Epi 1:1000 Class
Sympathomimetic
91
Epi 1:1000 Action
Bronchodilation
92
Epi 1:1000 Indications
Bronchial asthma Exacerbation of COPD Allergic reactions Pediatric cardiac arrest (after initial epinephrine dosage)
93
Epi 1:1000 Contraindications
underlying cardiovascular disease hypertension pregnancy tachy-arrhythmias
94
Epi 1:1000 Precautions / Side Effects
Prec: protect from light / BP, pulse, ECG must be constantly monitored SE: palpitations/tachycardia / anxiousness / headache / tremors
95
Epi 1:1000 Dose
Adult: 0.3-0.5mg/IM Ped: 0.01mg/kg/IM up to 0.3mg
96
Oxytocin (Pitocin) Class
Hormone (oxytocic)
97
Oxytocin (Pitocin) Action
causes uterine contraction causes lactation slows postpartum vaginal bleeding
98
Oxytocin (Pitocin) Indications
postpartum vaginal bleeding
99
Oxytocin (Pitocin) Contraindications
any condition other than postpartum bleeding | Cesarean section
100
Oxytocin (Pitocin) Precautions / Side Effects
Prec: ensure the placenta has delivered and that there is not another fetus before administering OD can cause uterine rupture Hypertension SE: anaphylaxis / cardiac arrhythmias
101
Oxytocin (Pitocin) Dose
10-20units/IV in 500mL of D5W administered according to uterine response 3-10units/IM
102
Metoclopramide (Reglan) Class
Antiemetic
103
Metoclopramide (Reglan) Actions
antiemetic | reduces gastro-esophageal reflux
104
Metoclopramide (Reglan) Indications
N/V | Gastro-esophageal reflux
105
Metoclopramide (Reglan) Contraindications
GI hemorrhage Bowel obstruction/perforation Hx of hypersensitivity
106
Metoclopramide (Reglan) Precautions / Side Effects
Prec: extrapyramidal (dystonic) symptoms have been reported SE: may impair mental and physical ability / drowsiness
107
Metoclopramide (Reglan) Dose
10-20mg/IM 10mg/IV/1-2min Peds: rarely used
108
Droperidol (Inapsine) Class
Butyrophenone antipsychotic/antiemetic
109
Droperidol (Inapsine) Actions
antagonizes the effects of medications that act on the chemoreceptor trigger zone (CTZ) reduces anxiety and produces sedation
110
Droperidol (Inapsine) Indications
Acute psychosis | N/V
111
Droperidol (Inapsine) Contraindications
hypersensitivity
112
Droperidol (Inapsine) Precautions / Side Effects
Prec: "black box" warning for "QT" interval prolongation Use with caution in the elderly, debilitated, or poor-risk pts Monitor vitals and ECG SE: drowsiness; EPS symptoms (dystonia); dizziness; restlessness; hypotension; tachycardia
113
Droperidol (Inapsine) Dose
Adult: 2.5-10mg/IV Ped: 0.088-0.165mg/kg/IV (children >2yrs)
114
Ketorolac (Toradol) Class
NSAID agent
115
Ketorolac (Toradol) Actions
anti inflammatory | analgesic (peripherally acting)
116
Ketorolac (Toradol) Indications
mild to moderate pain
117
Ketorolac (Toradol) Contraindications
hypersensitivity | allergy to Aspirin
118
Ketorolac (Toradol) Precautions / Side Effects
Prec: GI irritation or hemorrhage can occur SE: edema; rash; heartburn
119
Ketorolac (Toradol) Dose
Adult: 15-30mg/IV / 30-60mg/IM Ped: 0.5mg/kg (max of 30mg)
120
Acetaminophen (Tylenol) Class
Non-narcotic analgesic / antipyretic
121
Acetaminophen (Tylenol) Actions
inhibits cyclooxygenase
122
Acetaminophen (Tylenol) Indications
mild to moderate pain | fever
123
Acetaminophen (Tylenol) Contraindications
hypersensitivity
124
Acetaminophen (Tylenol) Precautions / Side Effects
Prec: use with caution in children <3yrs and in pts with known liver disease SE: minimal within recommended dosage range
125
Acetaminophen (Tylenol) Dose
Adult: 325-650mg/PO every 4-6hrs (up to 1gram for antipyretic) Ped: 10-15mg/kg/PO every 4-6hrs
126
Ibuprofen (Motrin, Advil) Class
NSAID
127
Ibuprofen (Motrin, Advil) Action
anti-inflammatory | prostaglandin inhibitor
128
Ibuprofen (Motrin, Advil) Indications
Mild to moderate pain | Fever
129
Ibuprofen (Motrin, Advil) Contraindications
hypersensitivity | pts taking other NSAIDs
130
Ibuprofen (Motrin, Advil) Precautions / Side Effects
Prec: GI bleeding / upset stomach SE: heartburn; N/V; wheezing

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