Procedures Flashcards
(132 cards)
1
Q
Location and depth of compressions in adults?
A
Hand of heel between nipples
2 inches
2
Q
If advanced airway is in place in adults you should give?
A
Unsynchronized ventilations
1 every 6 seconds
1 every 10 compressions
3
Q
Where do you place hand for compressions on child?
A
Mid sternum
4
Q
How do you place your hands for compressions in 1 rescuer CPR for infants?
A
Two fingers on the sternum
One finger below the nipple line
5
Q
How deep do you go for infant compressions?
A
Half depth of chest for 1 rescuer CPR
1 and 1/2 inches for 2 rescuer CPR
6
Q
How do you place you hands for 2 rescuer infant CPR?
A
Two thumbs side by side at the center of the breast bone just below the nipple line
Squeeze the infants posterior chest with encircled fingers
7
Q
When doing a jaw thrust maneuver where do you grasp?
A
Angles of the patients mandible and lift upward
8
Q
Adult rescue breathing?
A
10 to 12 a minute
9
Q
Pediatric rescue breathing?
A
12 to 20 a minute
10
Q
Advanced airway placement or CPR being performed ventilation rate?
A
8 to 10 a minute
11
Q
What does 1 rescuer do in 2 person CPR?
A
Squeeze bag for 1 second while watching for chest rise
Apply continuous cricoid pressure
12
Q
When should you not use NPA?
A
When frontal head of midfacial trauma where criboform place may be fractured
13
Q
What position should a patients head be in when placing a NPA?
A
Neutral
14
Q
How do you open the patients airway when inserting an OPA?
A
Tongue jawlift maneuver
15
Q
What should be monitored while suctioning?
A
HR
Oxygen saturation
Clinical appearance
16
Q
What should you do in bradycardia occurs during suctioning?
A
Admin 02 until returns to normal
17
Q
What position should a patient head be in prior to inserting a king tube?
A
Neutral
18
Q
What maneuver should be used by 1 hand while passing king tube through the other?
A
Tongue/Jaw lift
19
Q
What degree should you insert a king tube at?
A
45 to 90
Rotate it midline as it passes the tounge
20
Q
How far should you advance a king tube?
A
Advanced it until the base of the connector gastric access lumen is aligned with the patients teeth or gums
Do not use excessive force
21
Q
When placing a king tube after inflating pharyngeal cuff with the recommended volume of air you should?
A
Ventilate with BVM
Withdrawal tube until air is readily passing and good compliance is felt
22
Q
Where should tape be applied to when securing a king tube with tape?
A
Maxillary region of patients face
23
Q
What position should patients head be in when attempting Orotracheal intubation?
A
Hyperextension
24
Q
How quickly must you perform laryngoscopy in?
A
Less than 30 seconds
25
How far should you advance a Orotracheal tube?
Through the glottic opening until the proximal end of the cuff disappears past the vocal cords
26
If a patient is having difficulty tolerating intubation you can?
Sedate with Versed 0.02 mg/kg IV
27
How should you place the patient neck for pediatric needle cricothyroidotomy?
Hyperextend the neck
28
How can you locate the cricothyroid membrane?
Palpate the depression caudal(toward the feet) to the midline Adam's apple
29
What equipment is necessary for needle cricothyroidotomy for pediatrics?
14 gauge over the needle catheter
10 cc syringe
15 mm adaptor from 3 or 3.5 ET tube
30
At what angle direct your 14 gauge over the needle catheter when inserting through skin and cricothyroid membrane?
45 degree angle caudally(toward the feet)
31
If a patient is less than what age should you refer to needle cricotyroidotomy procedure?
12
32
When using a scalpel what direction incision do you make through the cricothyroid membrane?
Vertical
Horizontal is second incision
33
Once the scalpel has passed through the cricothyroid membrane you should?
Insert the handle into the opening and twist the handle to open the space between the cricoid and thyroid cartilages
34
Why must you not aim the knife cephalad when opening the space between the thyroid and cricoid cartilages?
Injury to the vocal cords may occur
35
Which size tube should be inserted through the incision for cricothyroidotomy?
6 ET or tracheostomy
36
Signs of an autistic patient?
No babble or cooing by age of 1
Has not gestured, pointed, waived by 1
Hasn't spoken a word by 16 months
Hasn't spoken 2 word phrases by 2
37
Signs and symptoms of tension Pneumothorax ?
Absent of decreased breath sounds on affected side
Poor ventilation despite open airway
Tracheal deviation away from side of injury
Neck vein distention
Tympany to percussion on affected side
Shock
Decreased Sp02/end tidal CO2
38
Why may neck vein distention not occur in tension pneumothorax?
Severe hemorrhage
39
What is the location for chest decompression?
2nd or 3rd inter coastal space
Between the 3 and 4th or 4th and 5th ribs
Midcalvicular line
40
How do you make a one way valve prior to completing chest decompression?
Insert 14 gauge 3 to 3 1/2 inch IV catheter through the finger of a sterile glove that has been moistened with water
41
When performing chest decompression you should insert catheter through?
Parietal pleura until air escapes under pressure
42
What fingers can you place CO monitoring device Rad-57 on?
Any one but thumb or pinky
43
Where si the rad-57 calibrated to penetrate?
Mid nail, not cuticle
44
How long does it take for the RAd-57 to calibrate on patient?
5 to 8 seconds
45
What level SpCO should up on rad-57?
1-99%
46
CO level 0-4?
Minor headache
47
CO level 5-9?
Headache
48
CO level 10-19?
Dyspnea, headache
49
CO level 20-29?
Nausea, dizziness, headache
50
CO level 30-39?
Vomiting, altered LOC, Severe headache
51
CO level 40-49?
Confusion, syncope, Tachcyardia
52
CO level 50-59?
Seizures, shock, Apnea, coma
53
CO level 60 and up?
Coma, death
54
What position should a patient be in prior to using CPAP?
High fowlers
55
Prior to securing a CPAP mask to a patients face you should?
Hold it to their face
| When patient is comfortable you may strap it to there face
56
Is it ok to have air leaks from the CPAP mask?
Yes, unless it is from the eye area
57
What is the starting dose for cyanokit?
5g
58
The hydrooxycarbolomin is to be reconstituted with?
100 mL per vial of 0.9% sodium chloride injection
59
How long should you rock or rotate the cyanokit vial to mix?
30 seconds
| Do not shake
60
How long should you infuse the 1st and 2nd vials of hydroxycarbolomin over?
75 minutes
61
V1 placement?
4th intercoastal space
| Right of sternum
62
V2 placement?
4th intercoastal space
| Left of sternum
63
V3 placement
Between V4 and V5
64
V4 placement?
5th intercoastal space
| Midcalvicular line
65
V5
5th intercoastal space
| Anterior axillary line
66
V6 placement?
5th intercoastal space
| Midaxillary line
67
What HR should you set external pacemaker to?
70-80
68
How can you tell when electrical capture has been achieved in external pacing?
Pacer spike followed by wide QRS
69
Where should you check for a pulse when pacing?
Right carotid
Right femoral
Either brachial pulse to to muscle twitching
70
If electrical capture is present but not pulse is present you should?
Treat for asystole/PEA
71
If no electrical capture is achieved in pacing you should?
```
Increase pacer to max energy
Recheck all settings
Cables
Battery charge
Electrode placement
Patients own rhythm
```
72
How can you ensure adequate rinsing behind eyelid?
Hold the lid with your thumb and index finger
73
How should you flush the eye to avoid contamination of the other eye?
Away form the nose for minimum of 20 minutes
74
When should you consider removing a football helmet?
Facemask cannot be removed after reasonable amount of time
Chin strap does not hold patients head securely
Prevents immobilization during transport
75
Where should you position tip of EPipen auto injector?
Other thigh, midway between knee and waist
76
What is the minimum amount of time you should hold a autoinjector in place?
10 seconds
| Until medication is fully injected
77
To inject site with Duodote pen you should?
Swing and firmly push the green tip against the outer thigh at 90 degree angle
78
What size needle should be used for IM medication administration?
21-23
| 1-1.5 inches long
79
Contraindications for IN medication adminsitration?
Facial trauma
Epistaxis
Nasal congestion
Any recognized nasal mucosal abnormality
80
What position should patient be in prior to IN medication administration?
Recumbent or supine
81
3 sites for IO adminisitration?
Proximal tibia
Proximal humerus
Distal tibia
82
Proximal tibia IO site?
Approx 2 cm below patella
| 2 cm medial to the tibial tuberosity
83
Proximal humerus IO site?
Directly on the most prominent aspect of the greater tubercle
84
Distal tibia IO site?
Approx 3cm proximal to the most prominent aspect of the medial malleolus
85
Proximal humerus EZ IO site is permitted in pediatrics when?
Landmarks are clearly identified
86
How do you find the proximal humerus site?
Rest patients hand on their abdomen and elbow is adducted(close to the body)
Slide thumb up the anterior shaft of the humerus until you feel the great tubercle(surgical neck)
Approx 1 cm above the surgical neck is the insertion site
87
What is the prefered IO site for patients who are responsive to pain?
Proximal humerus
88
How do you find the distal tibia IO site?
Place one finger directly over the medial malleolus
Move 3cm proximal and palpate the anterior and posterior borders
Assure your insertion site is on the flat center aspect of the bone
89
What weight do you use the pink IO needle for?
3 - 39 kg
90
What weight do you use the blue IO needle for?
Over 40 kg
91
At what point do you apply steady downward pressure with the IO?
When it touches the bone
92
When do you release trigger on IO gun?
Where there is a give or a pop
When the needle reaches the desired depth of 5mm
93
What are the preferred sites for venipuncture IV?
Hand
Forearm
Antercubital fossa
94
What angle should you insert an IV catherter?
30-45 with bevel up
95
When you feel the needle pop into the vein and observe flashback of blood into the chamber you should?
Advance needle 0.5 cm farther
96
How long should a patient breath as camly, deeply, and evenly as possible when being administered medication via nebulizer?
Until no more mist is present
| 5 to 15 minutes
97
How do you insert a morgans lens?
Have patient look down
Insert it into upper eye lid
Have patient look up
Retract lower lid to drop lens into place
98
How do you prevent accidental lens removal of morgans lens?
Tap tubing to forehead
99
What position does a patient need to be in to use broselow tape?
Supine
100
When end of broselow tape should be placed at to of patients head?
Red
101
What position should you place a patient in prior to restraining them?
Supine on a backboard
102
What should you check for after physically restraining a patient?
Circulatory
Neurological
Respiratory compromise
103
What should be documented when physically restraining a patient?
Justification
Time
Duration
104
Pulse oximeters are used for detection of hypoxemia in?
Arterial oxyhemoglobin
105
Where should a pulse oximeter be placed?
Finger or toe
106
Normal oxygen saturation?
92-100
107
Mild distress oxygen saturation?
90-92
108
Moderate distress oxygen saturation?
80-89%
109
Severe distress oxygen saturation?
Less than 80%
110
What can cause false high oxygen saturation readings?
Carbon monoxide poisoning
| Trauma
111
What can give false low readings of oxygen saturation?
Deeply pigmented patients may diminish light transmission
Nail polish or fake nails
Patient movement
Low blood flow status
112
Spinal immobilization decision assessment?
```
Neurological deficit(focal deficit, tingling, reduced strength, numb in extremities)
Significant trauma mech and extreme ages
AMS
Intoxication or mental impairment
Distracting, painful injury
Point tenderness or pain range of motion
```
113
Space of invasion of more than how many feet indicates significant trauma?
1 foot
114
What position should you immobilize a patients head in?
Neutral, in line position
115
contraindications for in line spinal immobilization?
```
Neck spasm
Increased pain
Onset of neurological deficit
Compromised of airway or ventilation
Injuries so severe head represents misalighnment that no longer appears to extend from midline of shoulders
```
116
How far above the patient should you position hat back board next to?
1-2 feet
117
What direction should you not move a patient with possible spinal injuries?
Lateral
118
Why should a patients arms be placed on their side during spinal immobilization?
To prevent should girdle movement
119
How can you prevent side to side movement of the spinal immobilization patient?
Straps across iliac crest and mid to distal thigh
| Or at the pelvis with groin loops
120
How far above the patients head should the pediatric immobilizer be when placing them on it?
6 to 12 inches
121
The KED should be positioned so the device fits securely under the patients?
Axilla
122
What should be left loose on the KED until the patients head is immobilized?
Uppermost torso strap
123
How can you prevent excessive movement of patient when fastening groin straps?
Adjust one side at a time
124
Which head strap on the KED should be applied first?
Forehead strap
| Then chin strap
125
Which strap do you apply first when using the hare splint?
Angle strap
126
Where do you place the ischial pad on the hare splint?
Illiac crest
127
You should tighten the ratchet and release manual traction with the hare splint until?
Patient has relief of pain or muscle spasm
128
What should be done prior to ice water vagal maneuver?
ECG
IV
Conscious and cooperative patients
129
What are the contraindications for vagal maneuvers?
ACS
Hypertension
Heart transplant
130
Stop vagal maneuvers if?
Patient becomes confused
HR drops below 100
Asystole occurs
131
What are the 2 approved vagal maneuvers?
Ice water immersions
| Valsalva
132
How is the valsalva maneuver performed?
```
Have patient inhale and hold breath
Bear down
Hold for 20 to 30 seconds
Try to turn face red
Blow forcefully through a straw or IV catheter for as long as possible
```
