Standing Orders Flashcards
6 Rights
Person
Drug
Dose
Time
Route
Documentation
(EZ-IO) Placement
Adult:
Proximal humerus (Prefred method)
Proximal tibia
Distal tibia
Pediatric:
Distal femur
Proximal tibia
Distal tibia
Proximal humerus ( Only if the surgical neck can be palpated.)
IM Injections
All IM injections should be administer in the lateral thigh.
Adults:
21-23 Gauge 1.5 inch 4ml Per Site
Pediatrics:
23 Gauge 1 inch 1ml Per Site
MAD Device (Mucosal Atomization Device)
Versed
Fentanyl
Narcan
Ketamine
0.3-0.5 Desired
Max Dose 1ml Per Nostril
Pediatric Age Classifications
Neonates: Birth - 1 Month
Infants: 1 Month - 1 Year
Children: 1 Year to Puberty
What is the preferred method of vascular access in Pediatrics during cardiac arrest?
IO
AEIOU-TIPS Altered Mental Status
Alcohol
Epilepsy (Seizure)
Insulin (hyper/hypoglycemia)
Overdose/ Oxygen
Uremia (kidney failure)
Trauma
Infection
Psychiatric
Stroke/ Shock
OPPPQRSTA
Onest
Palliative: What makes the symptons better.
Provoke
Previous
Quality
Radiation
Severity of Pain
Time
Associated: What are the assocoated signs and symptoms.
COPD & Asthma SpO2
90%
Oxygen Administration
Nasal Cannula:
2 LPM
* All Stroke Patients
Non-Rebreather:
15 LPM
* 3rd trimester pregnancy:(27 - 40 weeks)
* Decompression sickness: When a diver swims to the surface too quickly, the nitrogen can form tiny bubbles in the blood and/or body tissues.
Carbon monoxide
Cyanide exposure
Overzealous Positive Pressure Ventilation Can Affect
Venous return: The flow of blood from the periphery back to the right atrium
Ventilation Rates Adults
With a pulse: 1 Breath every 6 Seconds
Without a pulse: 1 Breath every 10 Seconds
Patients with ICP: Maintain EtCO2 30-35 SpO2 >90
Ventilation Rates Pediatric
With a pulse: 1 Breath every 3 Seconds
Without a pulse: 1 Breath every 6 Seconds
Patients with ICP: Maintain EtCO2 30-35 SpO2 >90
When is High ETCO2 Acceptable
Cardiac arrest pre/post ROSC
Bronchospasm (Asthma, COPD)
Priority 1
Cardiac arrest or respiratory arrest
Priority 2
Unstable with life threating conditions
Priority 3
Stable patient no immediate life- threating conditions
When Is Placing Patient In Prone Position Acceptable?
Penetrating injury resulting in pt being transported on stomach/ must document airway was controlled
Priority 1: Cardiac Arrest With Shockable Rhythm V-Fib/Pulseless V-Tach Transport
If less than 20 minutes - Closest stemi facility
Greater than 20 minutes - Closest hospital
Priority 2: Trauma Patients Transport
On scene time Should be less than 10 Minutes.
If greater than 10 must document.
Ground transports greater than 25: Transport by air
Trauma arrests in fire care: Transport to SMH
Ground transport greater than 40 Min: Closest ED
Psychiatric Patients Transport
JFK North
Priority 3 Pregnant Patients Transport
Greater than 20 weeks and less than 36 and have complications Transport to SMH.
Stable 36 weeks or greater Transport To The ED of their choice.
Priority 1: Pediatric Patients Transport
Pulseless, ROSC,Unstable Airway.
SMH pediatric.
Trauma Hawk Criteria
Transport time greater than 25 minutes
Extrication time greater than 15
Ground response to scene greater than 10 minutes
MCI with multiple patients with traumatic injuries
