SOG 430 Flashcards
(90 cards)
1
Q
Suspicion of Abuse
When suspected that abuse or neglect to a child or vulnerable adult has taken place, the following shall be initiated:
A
- Treat all related injuries
- Transport all suspected cases
- If transport is refused:
- Request law enforcement
- Stay with Pt until enforcement arrival
- Notify Rescue District/Battalion Chief
2
Q
Fracture - The evidence of an open long bone fracture, or there are multiple fracture sites or multiple dislocations.
A
Pediatric Trauma Alert “Any One Condition”
3
Q
SOG 5030 Allergic Reaction/Anaphylaxis
A
TX Airway/Breathing - Monitor Spo2 - Admin O2 via proper adjunct >95% - Assist with pt auto-injector epi pen if present -Determine BGL - Assess Temp
4
Q
Florida Statute 401.445
A
Emergency examination and treatment of incapacitated persons
5
Q
Airway - The patient receives active airway assistance beyond the administration of O2
A
Trauma Alert “Any one condition”
6
Q
Circulation - The patient lacks a radial pulse with a sustained heart rate greater than 120 or a systolic blood pressure less than 90 mmHg
A
Trauma Alert “Any One Condition”
7
Q
BMR - The patient has a BMR of 5 on the motor component of the GCS
A
Trauma Alert “Any Two Components”
8
Q
Cutaneous - The pt has a major soft tissue disruption including major degloving injury or major flap avulsion; or 2nd or 3rd degree burns to 10% or more of TBS; or amputation proximal to the ankle or wrist; or any penetrating injury to the head, neck, or torso.
A
Pediatric Trauma Alert “Any One Condition”
9
Q
Treatment for Spinal Trauma ? SOG 2060
A
- Maintain body warmth
- Monitor and record vitals signs every 5 minute
- Provide spinal immobilization
- Airway/breathing; monitor spo2; administer O2 via proper adjunct and maintain 95% or greater; high cervical injury may cause apnea
- Consider SAM pelvic splint
- Control bleeding
- Determine BGL
- Look for underlaying causes
10
Q
Florida Statute 766.103
A
Florida Medical Consent Law
11
Q
Treatment for Trauma Pregnancy ? SOG 2090
A
- Maintain body warmth
- Provide spinal immobilization if indicated
- Immobilizing a pregnant PT greater than 20 weeks
may cause supine hypotension syndrome- After immobilizing the PT, elevate the PT’s right
side of the LSB 6”; this will displace the uterus and
fetus to the left side and off the inferior vena cava
- After immobilizing the PT, elevate the PT’s right
- Immobilizing a pregnant PT greater than 20 weeks
- Airway/breathing; monitor SPo2 and administer O2 via proper adjunct; maintain 95% saturation or greater
- Immobilize impaled object
- Control Bleeding
- Determine BGL
12
Q
SOG 5070 Headache
A
- If sudden severe headache or sudden decrease on LOC, refer to Acute Stroke Protocol
- Headaches with elevated temp, nausea/vomiting and/or altered mental status may be meningitis or neurological
TX
Airway/Breathing - Monitor Spo2
- Admin O2 proper adjunct >95%
- Determine BGL (<60mg/dl)
- Assess Temp
- Look for underlying causes
13
Q
Cutaneous - The patient has 2nd or 3rd degree burns to 15% or more of TBSA; or amputation proximal to the wrist or ankle; or any penetrating injury to the head, neck, torso.
A
Trauma Alert “Any One Condition”
14
Q
Circulation - The patient has sustained heart rate of 120 beats per minute or greater
A
Trauma Alert “Any Two Components”
15
Q
What two considerations must be meet, for an Adult to be considered a “Trauma Alert”, IAW Trauma Scorecard Methodology?
A
Airway - PT respiratory rate of 30 or greater
Circulation - PT has a sustained HR greater than 120 BPM
BMR - PT exhibits a 5 on motor assessment on GCS
Cutaneous - PT has a soft tissue injury from either a major degloving or major flap avulsion greater than 5”; or has gunshot to extremities of the body
LBF - PT reveals signs or symptoms of a single long bone fracture resulting from a MVC or a fall greater than 10’
Age - PT is 55 or older
MOI - PT has been ejected from a motor vehicle or the driver has impacted the steering wheel causing steering wheel deformity (excluding motorcycles, mopeds, ATV, bikes, or open bed of a pick up)
16
Q
If the patient exhibits a GCS of 12 or less the patient should be consider a ______ _____. (excluding pt’s who’s normal GCS is a 12 or less, as established by the pt’s PMHx or preexisting medical condition when known)
A
Trauma Alert
17
Q
Medical Asystole:
A
Apneic, Pulseless, and Systolic that do not meet the unquestionable death criteria.
Resus efforts may be terminated only when all of the following criteria exist:
- Arrest was not witness
- No shocks provided prior to JFRD arrival
- PT is 18 or older
Rhythm remains in systole after providing 20 minutes of ACLS
18
Q
Treatment for Chest Trauma ? SOG 2070
A
- Maintain body warmth
- Provide spinal immobilization
- Airway/breathing; monitor Spo2, maintain oxygen saturation of 95% or greater via proper adjunct
- Immobilize impaled object
- Control bleeding
- Flail Chest; CPAP contraindicated
- Sucking Chest Wound; Apply Vaseline-type occlusive dressing; cover dressing with sterile 4x4; Tape 3 of four sides
19
Q
Consciousness - The pt exhibits an altered mental status that includes drowsiness, lethargy, inability to follow commands, unresponsiveness to voice, totally unresponsive, or in a coma; or there is a presence of paralysis, suspicion of a spinal cord injury, or loss of sensation.
A
Pediatric Trauma Alert “Any One Condition”
20
Q
Airway - The patient has a respiratory rate of 30 or greater.
A
Trauma Alert “Any Two Components”
21
Q
What one consideration must be meet, for an Adult to be concidered a “Trauma Alert”, IAW Trauma Scorecard Methodology?
A
Airway - PT receiving active assistance beyond administration of O2
Circulation - PT lacks a radial pulse, sustained HR greater than 120 BPM or has a systolic of 90 or less
BMR - PT exhibits a 4 or less motor assessment on GCS; or exhibits the presence of paralysis; suspicion of spinal cord injury or loss of sensation
Cutaneous - PT has 2nd/3rd burns to 15% of total body surface are; amputation proximal of wrist or ankle; or penetrating injury to head, neck, or torso
LBF - PT reveals signs or symptoms of 2 or more long bone fracture sites
22
Q
Treatment for Extremity Trauma? SOG 2100
A
- Maintain body warmth
- Provide spinal immobilization
- Airway/breathing; monitor Spo2, maintain oxygen saturation of 95% or greater via proper adjunct
- Immobilize impaled object
- Control bleeding
- Splint all areas of tenderness or deformity; splint dislocations and joints injuries on the position found; consider ice packs to reduce swelling and pain; reduce fractures by axial traction if distal pulses are absent; elevate the extremity when practical; locate, mark and monitor distal pulses; record sensation and motor function before and after splinting
- Amputation; place part in sterile gauze, moisten with NS; keep part cool; dress and splint partial amputations in alignment with extremity, avoid torsion
- Do not clamp vessels
- Alert hospital
23
Q
Treatment for Crush Injuries? SOG 2110
A
- Maintain body warmth
- Provide spinal immobilization
- Airway/breathing; monitor SPo2 and administer O2 via proper adjunct; maintain 95% saturation or greater
- Control bleeding
24
Q
A patient shall be defined as:
A
A person who presents with subjective and/or objective signs and/or symptoms or a complaint which results in evaluation and/or treatment.
25
Treatment for Head Trauma ? SOG 2040
- Maintain body warmth
- Provide spinal immobilization (All helmets other than football should be removed)
- Airway/breathing; monitor spo2; administer O2 via proper adjunct and maintain 95% or greater
- Consider SAM pelvic splint
- Control bleeding
- Determine BGL
- Look for underlaying causes
- Control Bleeding
- Determine BGL
26
SOG 5090 Seizures
TX
- Maintain aspiration prophylaxis by placing pt in recovery position
- If trauma suspected, immobilize using proper technique
- If the Pt is actively seizing, protect the Pt from further injury
Airway/Breathing
- Monitor Spo2
- Admin O2 proper adjunct >95%
- Determine BGL
27
SOG 5040 Altered Consciousness
TX
- Maintain aspiration prophylaxis by placing pt in recovery position
- If trauma suspected, immobilize using proper technique
- Airway/Breathing - Monitor Spo2
- Admin O2 proper adjunct >95%
- Determine BGL
- Assess Temp
- Look for underlying cause
28
An agent with power of attorney may ______ revoke a ___ and request that JFRD _____ or _____ CPR on the patient, even if a _______ exists.
```
verbally
DNRO
initiate
continue
DNRO
```
29
Size - Pediatric trauma pt weighing 11 kg or less; or the body length is = to this weight on a pediatric length and weight emergency tape (the equivalent to 33" in measurement or less).
Trauma Alert "Any Two Components"
30
SOG 5080 Nausea/Vomiting
```
TX
Airway/Breathing
- Monitor Spo2
- Admin O2 proper adjunct >95%
- Determine BGL (<60mg/dl)
- Assess Temp
```
31
Circulation - The carotid or femoral pulse is palpable, but the radial or pedal pulse are not; or the systolic is less than 90 mmHg
Trauma Alert "Any Two Components"
32
Airway - In order to maintain optimal ventilation, the pt is intubated; or breathing is assisted through such measures as a manual jaw thrust, continuous suction, or through the use of other adjuncts to assist ventilation.
Pediatric Trauma Alert "Any One Condition"
33
Florida Statute 743.064
Emergency medical care or treatment to minors without parental consent
34
Resuscitation may only be withheld or withdrawn upon presentation of a valid _____ as described in JFRD Resuscitation Protocols ______.
DNRO
| 1130
35
Baker Act is an _______ mental health commitment by __ ______ if the patient meets any of the following criteria:
Mentally _______, danger to ____ or others;
_________ or ________.
```
involuntary
Law Enforcement
incompetent
self
Suicidal
Homicidal
```
36
SOG 5010 Abdominal Pain/Flank Pain
TX
- Place pt in position of comfort
- Airway/Breathing - Monitor Spo2
- Admin O2 proper adjunct >95%
- Determine BGL
- Assess Temp
37
Treatment for Abdominal Trauma ? SOG 2080
- Maintain body warmth
- Provide spinal immobilization
- Airway/breathing; monitor SPo2 and administer O2 via proper adjunct; maintain 95% saturation or greater
- Immobilize impaled object
- Control Bleeding
- Abdominal Evisceration; never replace evisceration; cover with a moist sterile dressing with NS; secure dressing in place if possible
38
BMR - Patient exhibits a score of 4 or less on the motor component of GCS; or exhibits paralysis; or suspicion of a spinal cord injury; or loss of sensation.
Trauma Alert "Any One Condition"
39
Patient restraints are to be ______ only when _______ and in those situations where the patient is _______ behavior deemed to present a danger to _______ and others.
utilized
necessary
exhibiting
themselves
40
After evaluating the PT using the Trauma Scorecard Methodology, the PT was not identified as a trauma alert PT, they will then be evaluated using a elements of the Glasgow Coma Scale. What score is used for considering a trauma alert PT
12 or less, the PT is considered a "Trauma Alert" (excluding PT's whose normal GCS is 12 or less from PMHX)
41
Parameter for the Adult GCS
Eye Opening
Best Verbal Response
Best Motor Response
```
Eye: 4 Spontaneous
3 Speech
2 Pain
1 None
Verbal: 5 Oriented
4 Confused
3 Inappropriate
2 Incomprehensible
1 None
BMR: 6 Obeys
5 Localizes
4 Withdraws
3 Flexion
2 Extension
1 None
```
42
Treatment for Soft Tissue Trauma SOG 2130
- Maintain body warmth
- Provide spinal immobilization
- Airway/breathing; monitor Spo2; administer O2 via proper adjunct to maintain 95%
- Immobilize impaled object in place
- Control bleeding with direct pressure
- Return tissue flap to the original position
43
SOG 5060 Nose Bleed
```
TX
Airway/Breathing
- Monitor Spo2
- Admin O2 proper adjunct >95%
- Determine BGL (<60mg/dl)
- Assess Temp
- Look for underlying causes
If other injuries do not exist, prevent aspiration of blood by placing pt in the a sitting position w/head leaning forward
- Suction as required
- Control bleeding by pinching nostrils and pack gauze between the upper lip and gum to provide pressure
```
44
Mechanism of Injury - The patient has been ejected from a motor vehicle or the driver of the motor vehicle has impacted the steering wheel causing steering wheel deformity. (excluding any MC, moped, ATV, bike, or the open body of a pick-up truck)
Trauma Alert "Any Two Components"
45
Long Bone Fracture - The patient reveals signs or symptoms of a single LBF resulting from a motor vehicle accident or fall from an elevation 10 feet or greater.
Trauma Alert "Any Two Components"
46
SOG 5100 Shock Medical
```
Shock Pt may deteriorate rapidly. Signs of poor perfusion include cool mottled skin, diminished pulses, altered metal status, increased cap refill >3 sec, tachycardia and systolic <90mm/Hg.
- Place pt in supine with legs elevated
- Maintain body warmth
Airway/Breathing
- Monitor Spo2
- Admin O2 proper adjunct >95%
- Determine BGL
- Assess Temp
- Look for underlying causes
```
47
Age - The patient is 55 or greater
Trauma Alert "Any Two Components"
48
However an agent with power of attorney ___ ____ verbally _____ consent for ___ in the absence of a DNRO.
may not
withhold
CPR
49
Cutaneous - The patient has a soft tissue loss from either a major deformity or a major flap avulsion greater than 5"; or has sustained a gun shot wound to the extremities of the body.
Trauma Alert "Any Two Components"
50
JFRD units arrive at a crash scene and anyone indicates that are "__" and the ______ sees no ____ or _______ that would warrant evaluation or treatment, no _____ ____ has been made.
```
ok
technician
signs
symptoms
patient encounter
```
51
Consciousness - The pt exhibits symptoms of amnesia; or there is a loss of consciousness.
Trauma Alert "Any Two Components"
52
The JFRD is responsible for the _____ of the patient and all ______ treatment at the scene of the emergency. Law enforcement is responsible for _______ ______ and _____ scene safety.
welfare
medical
traffic control
general
53
A vulnerable adult is defined as one who, _____ ___ ____ _____ or disability, may be unable to adequately provide for their own care or protection.
due to their age
54
Assessing Pediatric Trauma Pt's: Trauma pt's with the anatomical and physical characteristics of a person _____ years or less will be assessed as a pediatric pt.
15
55
Treatment for Shock Trauma ? SOG 2030
- Maintain body warmth
- Provide spinal immobilization
- Airway/breathing; monitor spo2; administer O2 via proper adjunct and maintain 95% or greater
- Consider SAM pelvic splint
- Control bleeding
- Determine BGL
- Look for underlaying causes
56
SOG 5050 Diabetic
TX
Airway/Breathing
- Monitor Spo2
- Admin O2 proper adjunct >95%
- Determine BGL (<60mg/dl)
- Assess Temp
- Look for underlying causes
- Conscious and Alert Pt with a BGL less than 60mg/dl admin oral Glucose paste 15 grams
- Repeat once in 20 minutes if BGL is still below 60mg/dl
Contra - Altered Mental Status and Difficult Swallowing
57
The document must specifically state that the agent's POA includes all ____ ___ decisions on behalf of the patient; and is intended to be __________ even if the patient is ________.
health care
exercisable
incapacitated
58
Acute hypothermic patients in cardiac arrest _____ shall be treated and transported. Includes submersion victims less than 60 minutes.
SHALL
59
Circulation - The pt has a faint or non palpable carotid or femoral pulse; or the pt has a systolic pressure less than 50.
Pediatric Trauma Alert "Any One Condition"
60
If a patient is incapacitated or otherwise not _______ competent, decisions regarding the patients medial treatment can be made by an _____ with _____ __ ____.
mentally
agent
power of attorney
61
Unquestionable Death Criteria
| Patients meeting the following criteria shall be considered DOA:
```
Unresponsive, Apneic, and Pulseles.
In addition to the above:
Lividity
Clear signs of decay or visible decomposition
Rigor mortis
Open cranium with exposed brain matter
Decapitated or severed trunk
```
62
A patient is consider to have given informed consent when any of the three following occur:
Patient gives _____ permission to treat
Patient gives ______ permission to treat
Patient does _____ ____ as you begin assessment
verbal
written
not object
63
Treatment for Taser Trauma SOG 2120
PT Transport
- Hx of delirium, mania, irrational bizarre behavior before being taser
- Abnormal vitals
- Hx of amphetamine or hallucinogenic drug use
- Cardiac Hx
- Altered mental status or aggressive
- Evidence of hyperthermia
- Any PT that meets the JFRD transport criteria
Treatment
- Maintain body warmth
- Provide spinal immobilization
- Airway/breathing; monitor Spo2, maintain oxygen saturation of 95% or greater via proper adjunct
- Immobilize impaled object
- Control bleeding
- Determine BGL
64
A person that arrives at a fire station requesting a blood pressure check and also verbalizes a compliant will be considered a __________ and a full ________ must be completed.
patient
| PCR
65
SOG 4060 Hyperventilation
Many serious medical problems can cause hyperventilation. Consider possibly underlying causes
TX
Air/Breathing
- Determine Depth, Rate, Quality
- Assess lung sounds
- Admin O2 via NRB until Hyperventilations has resolved
- Monitor Spo2
- Do not admin Co2 rebreathing techniques
- Assess Temp
- Determine BGL
66
SOG 5110 Syncope
```
TX
- Maintain aspiration prophylaxis by placing pt in recovery position
- If trauma suspected, immobilize using proper technique
Airway/Breathing
- Monitor Spo2
- Admin O2 proper adjunct >95%
- Determine BGL
- Assess Temp
- Look for underlying causes
```
67
Fracture - Pt reveals signs or symptoms of a single close bone fracture.
Trauma Alert "Any Two Components"
68
In order to give informed consent, a patient must be legally allowed to act as an _______. This means that the patient must be:
At least _____ years of age.
OR
Emancipated - ____ than ____ and married or legally ____ from custody of parent or guardian
Exceptions -
An unmarried pregnant minor may give consent for medical problems related to her pregnancy
An unmarried minor _____ may give consent for her ___
```
Adult
18
Less
18
released
mother
child
```
69
A _____ ____ is dependent on neither treatment nor transport not nor cooperation from the patient. If a technician perceives a medical problem that requires evaluation, a patient _______ has been made and a full ___ must be completed.
patient encounter
encounter
PCR
70
The agent must be a person who is ____ years of ager or older, who must ______ JFRD with a _____ power of attorney document, signed by the ______ and ____ witness.
```
18
present
notarized
patient
2
```
71
To be considered mentally competent, One must be:
Awake, _____, and fully oriented to ___, place, _____, event. No sign of ______ impairment, Not mentally incompetent, at risk to ______ or suicide or _____.
```
alert
person
time
mental
self-harm
homicide
```
72
Long Bone Fracture - The patient reveals signs or symptoms of two or more long bone fracture sites (humerus, radius, ulna, femur, tibia, or fibula).
Trauma Alert "Any One Condition"
73
Indications to remove football helmets during treatment for Head Trauma ? SOG 2050
- Helmet in place with no shoulder pads
- Head/facial trauma
- Cervical/spinal regions unstable because helmet fits poorly
- Airway management cannot be achieved
- PT in Cardiac Arrest
74
SOG 5020 Alcohol Related Illness
```
TX
- Maintain aspiration prophylaxis by placing pt in the recovery position
- If trauma is suspected, immobilize using proper technique
Airway/Breathing
- Monitor Spo2
- Admin O2 proper adjunct >95%
- Determine BGL
- Assess Temp
```
75
Trauma Death Criteria:
Apneic
Pulseless
Cardiac rhythm is asystole or wide complex ventricular rhythm of 30 or less without a pulse, document time and call code
76
SOG 6030 excited delirium
Physical signs of excited delirium include:
- Unfounded fear and panic
- Shouting nonsensical
- Bizarre behavior
- Hyperactivity and thrashing about
- Unexplained strength/endurance
- Profuse sweating
- Shedding clothes/nudity
- Decreased sensitivity to pain
A previously combative patient who become suddenly client should raise a red flag
Excited delirium can mimic several medical conditions including hypoxia, hypoglycemia, stroke, or intracranial bleeding. All patients should be transported
TX
- Request law enforcement if not already on scene
- Attempt to calm/quite environment
- Respond with confidence
- Inquire about resolving cause of anger
- Express sympathy and concern
- Apply restraints if needed and not already in place by law-enforcement
- Approved restraint include: soft limb, stretcher straps, wide cloth
- Restrained patients shall be placed in the supine position
- No patient will be restrained in the prone or hogtied position
- Restraints shall not prohibit evaluation of the patient's medical status or injury
- Frequently assess patient to ensure airway is patent, limp circulation is adequate and restraints can be released quickly if patient's condition deteriorates
- When restraints are used circulation to the extremities shall be evaluated at least every five minutes
JFRD personnel shall never leave the restraint patient unattended
Airway/Breathing
- Monitor Spo2
- Admin O2 proper adjunct >95%
- Determine BGL/Temperature
77
SOG 6020 Decompression Sickness
TX
- Maintain body warmth
- If trauma suspected immobilize pt using proper technique
- Place pt in recovery position
Airway/Breathing
- Monitor Spo2
- Provide 100% o2 via NRB
- Determine BGL
- Assess Temp
**Retrieve dive computer and ensure transport with pt or try to obtain depth and length of dive from pt or bystanders**
****Transport to closet most appropriate ER; there currently is no emergent hyperbaric treatment chamber in Duval County****
78
SOG 6050 Hyperthermia
```
TX
- Move pt to cooler environment and remove any clothing or gear
- Treat heat stroke aggressively
Airway/Breathing
- Monitor Spo2
- Admin O2 proper adjunct >95%
- Determine BGL
- Assess temperature
Apply cooling measures (ice packs, wet towels to neck, axillae, groin)
```
79
SOG 6070 Bites and Stings
If signs of allergic reaction noted, follow SOG 5030
TX
Airway/Breathing
- Monitor Spo2
- Admin O2 proper adjunct >95%
Insect and Spiders
- Remove stinger if present and cleanse with peroxide
Marine stings
- Remove any clinging tentacles by salt water rinse (if unavailable NS)
- Avoid using fresh water
- Irrigate affected eye with NS
Snake Bites
- If constricting band is in place upon arrival, remove
- Mark initial edematous area with pen and note time
- Attempt to identify type of snake
- Apply sterile dressing
80
SOG 6080 Overdose/Poison
If substance is known, contact Poison Control. Provide al information requested by PC representative (1800-222-1222)
Airway/Breathing
- Monitor Spo2
- Admin O2 proper adjunct >95%
- Determine BGL
- Assess temperature
** Wear appropriate PPE**
****Aute Dystonic Reaction to anti-psychotics***
- Signs and Symptoms included painful muscle spams of the face, neck, and back
81
SOG 6090 Carbon Monoxide/Cyanide Exposure
REQUEST HAZMAT
- Wear proper Personal Protective Barrier
- Remove Pt to an environment with fresh air
- Determine the COHb
Abnormal value
Non-smoker - Greater than 5%
Smoker - Greater than 10%
Airway/Breathing
- Monitor Spo2 (readings may be falsely high from CO
- Admin O2 100% via NRB
- Determine BGL
****Transport to closet most appropriate ER; there currently is no emergent hyperbaric treatment chamber in Duval County****
82
SOG 7010 Vaginal Bleeding
```
Place Pt in POC
Airway/Breathing
- Monitor Spo2
- Admin O2 proper adjunct >95%
- Determine BGL
- Apply pads to vaginal area for significant bleeding
- Determine LMP
If pregnant and greater than 26 weeks
- Place Pt in recovery position (left side)
```
83
SOG 7020 Pre-Eclampsia/Eclampsia
TX
Airway/Breathing
- Monitor Spo2
- Admin O2 proper adjunct >95%
- Determine BGL
- Assess Temp
Place Pt on left side if greater than 20 weeks pregnant
Pre-Eclampsia
- PE may reveal BP greater than 140/90, Tachycardia, Tachypnea, Pulmonary Edema, confusion, and generalized edema
Eclampsia
- PE may reveal seizure and BP greater than 160/110
84
SOG 7040 Newborn Stabilization/Resuscitation
Normal newborns require no stabilization beyond drying, warming, positioning, suctioning, and tactile stimulation.
Assessment
APGAR 0 1 2
Appearance blue Acrocyanosis Pink
Pulse Absent <100 >100
Grimace No Resp Weak Cry Sneeze/Cough
Vigorous Cry
Activity LimpSome Motion Active Motion
Respirations Absent Slow/Irreg Normal
Vigorous Cry
85
SOG 7040 Newborn Stabilization/Resuscitation
TX
If complication present, request second Rescue
- During Delivery, Suction mouth then nostrils; should be done after the delivery of the head
- Thoroughly dry newborn with towls or blankets; wrap
- Admin tactile stimulation
- Assess APGAR at 1 and 5 min post delivery
- Position infant in supine position with neck in neutral position
- Re-assess every 30 sec
- Determine BGL (heel stick)
Airway/Breathing
- Assess rate and effort
- Acrocyanosis; sats may remain less than normal up to 10 minutes
- Admin blow-by O2
- HR less than 100 with labored breathing, apnea, persistent central cyanosis and/or no muscle tone
- Provide 100% O2 at 40-60 breaths/min via BVM
- HR less than 60 - Admin chest compressions at 120 per/min; Provide 100% O2 at 40-60 breaths/min via BVM
86
Normal Respirations/Pulse/Systolic for Infant
Infant: less than 1 year
Respirations: 30-60
Pulse: 100-160
Systolic: 60 or Strong Pulse
87
Normal Respirations/Pulse/Systolic for Toddler
Toddler: 1-3 years old
Respirations: 24-40
Pulse: 90-150
Systolic: 70 or Strong Pulse
88
Normal Respirations/Pulse/Systolic for Pre-Schooler
Pre-Schooler: 4/5 years old
Respirations: 22-34
Pulse: 80-140
Systolic: 75
89
Normal Respirations/Pulse/Systolic for School age
School-age: 6-12 years old
Respirations: 18-30
Pulse: 70-120
Systolic: 80
90
Normal Respirations/Pulse/Systolic for Adolescent
Adolescent: 13-18 years old
Respirations: 12-20
Pulse: 60-100
Systolic: 90
