Quick Call notes Flashcards
Anaphylaxis
O2 / Remove Stinger EPI IM - 0.3mg Benadryl - 50mg IV/IM ECG SPO2 Albuterol - 2.5mg CPAP EPI - IV - 0.1mg IV slow slow push
Allergic reaction
Remove Sting/injection site
Benadryl
Abdominal Pain
Determine if hemodynamic stability / respiratory / Mentation/ AAA.
or pulse greater then 120 with hypo-perfusion.
-IV
Severe pain morphine
ECG for upper abd pain
Dystonic
IV
Benadryl - 50mg IV preferred or IM
General OD
IV
ECG / SPO2
Gag or unable to protect airway - decreased sensorium
Beta Blocker OD
IV Fluid Challenge - 500 ml Atropine - 1mg Glucagon - 2u Epi IV - 0.1 mg iv
*key- SBP <70
Calcium Channel Blocker OD
IV
Fluid - 500ml
Atropine - 1mg IV
Epi IV - 0.1mg IVP - slow
TCA
IV
Fluid - 500ml
Sodium Bicarb - 1mlEq/kg
- *key to running protocol**
- HR >120
- QRS>.12
- PVC >6/min
- SBP <90
- seizure
Shock
Large Bore IV
ECG
Stroke
Advanced airway as needed BGL ECG Cincinnatti IV TKO Determine Onset < 4 hrs Go to stroke center.
Discomfort/pain of suspected cardiac origin -
1st rule out other causes
Pulse OX
ECG
Nitro 0.4mg SL (SBP >90) R-5min…titrate to pain relief. (make sure no use of PDE-5 inhibitors)….if so use morphine first 2mg
ASA 324mg (4 chewable)
IV/12 lead
Cath Lab
….if after 3rd nitro no relief of pain…paramedic may admin Morphine.
SVT - Narrow Stable
12 lead Valsalva Adenosine 6mg Adenosine 12mg Transport
SVT Wide - Stable
12 lead
Transport
SVT - Stable - Irregular
12 lead
transport
SVT Unstable Narrow
Versed - 2mg IM/IN or 1-6mg iv
Cardiovert- 100-200-360
If stable tx-
if unstable…Cardiovert max dose- then tx
SVT unstable Wide complex
Versed - IV 1-6, or 2mg IM/IN r-5 x 2
Cardiovert -100/200/360
Stable - Amiodarone 150mg/10min
Unstable -
150mg IVP
Cardiovert max dose
Adult Bradycardia
- 3 criteria
- algorithm
- SBP<50, S/S Hypoperfusion
- IV / 12 lead
If type 2 2degree or 3rd straight to cardioversion
-if not atropine 0.5mg
TCP - Medicate with Versed ( 2mg IM/IN, 1-6 IV)
- start @ 80bpm and up milliamps until capture.
No TCP - Atropine 0.5 mg - 1mg IV/IO every 3-5min until 3mg given
If neither are helping move to Dopamine ( must still meet brady criteria)
- Get base hospital orders
- 10mcg/kg/min
Avoid Atropine in acute mI
Asthma/ COPD
- mild wheezing
- sob
- cough
ECG/O2/Pulse ox
Albuterol 2.5-5mg prn
Asthma/COPD
- Cyanosis
- Accessory muscle use
- Inability to speak more then 3 words
- Severe wheezing or SOB
ECG/ O2/ SPO2
Albuterol 5mg CPAP IV EPI - 0.3mg IM ***must get base order if older than 40 or SBP <180
CHF vs COPD
- Med List
- JVD
- Peripheral Edema
- Frothy pink sputum
- BP
- Smoker
CHF/Pulmonary Edema
- mild wheezing
- SOB
- cough
- wheezing*
- Albuterol 2.5-5mg
-Nitro 0.4mg if SBP>90, q5 *NO PED5**
IV
CHF/Pulmonary Edema
- Cyanosis
- Accessory muscle use
- Inability to speak >3words/min
- Rales Ronchi JVD
- Diaphoresis pedal edema
Albuterol 2.5-5mg if wheezing
Nitro BP - *No PED 5 * - q5
90-150 - 0.4mg
150-200 - 0.8mg
200+ = 1.2mg
CPAP
- 1” Nitro Paste
- Remove paste if SBP 90
If SBP continuously below 90 consider Dopamine with base contact - 10mcg/kg/min
ALOC
- 3 Protocols
- Other Factors
Hypoglycemia
Narcotic Overdose
Seizure
ALOC - Suspected Diabetic
- Reasons to suspect
- protocol
GCS<60
PO- Oral glucose - Juice - must first test gag with water
IV Access - 25gm of 50% dextrose
Glucagon- 1U Im
Consider IO access if no response to Glucagon after 5min
ECG
Tx
