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Trauma Meds Flashcards

1
Q

Parkland Burn Form for:
form:

A

= (BSA >20% only 2 & 3 degree burns)
= 4 mL x BSA x Weight (kg) = ½ 1st 8 Hrs & ½ next 16Hrs

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2
Q

Acetaminophen) Dynamics:
Indications:
Contra:
Dose:

A

= Nonopioid Analgesic/Antipyretic Fever,
= pain management
= AMS
= IV/IO: 1 gram over 10 - 15 minutes, PO: 15 mg/kg

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3
Q

Diazepam) Dynamics:
Indications:
Contra:
Dose:

A

= Benzodiazepine. Binds w/ GABA receptors causing an influx of Cl
= Tcardia due to stimulant OD, Substained seizures. Anxiety. Sedation.
= Hypersensitivity
= 2.5-10 mg in 2.5 mg increments slow IV/IO/IM

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4
Q

(Diazepam/ Valium) class:
pharmacodynamics:

A

= benzodiazepine (Sedative)
= binds w/ GABA receptors causing a influx of chloride

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5
Q

(Diazepam/ Valium) effects:
dose:

A

= Resp/depress/, N/V, Sedation/amnesia
= 2.5-10mg in 2.5mg increments slow IV/IO/IM

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6
Q

(Diazepam/ Valium) indications:
Contraindications:

A

= Tcardia from stimulant OD, Sustained seizures, Anxiety, Sedation
= hypersensitivity

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7
Q

Etomidate) Dynamics:

Indications:
Contra:
Dose:

A

= Nonbarbiturate, nonbenzodiazepine sedative Interacts w/ GABA receptors. Anesthetic w/o analgesic.
= Sedation / SFI/RSI
= Hypersensitivity
= 0.2-0.4 mg/kg (limit to 1 dose). Onset 30 secs Duration: 5-10 mins

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8
Q

(Etomidate/ Amidate) Advan:
Disadv:

A

= Little effect on B/P. decreases ICP
= Suppresses cortisol, not good for head -injured patients long term.

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9
Q

(Etomidate/ Amidate) Onset:
Duration:

A

= 30 sec
= 5-10 mins

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10
Q

(Etomidate/ Amidate) class
Dose:

A

= Sedative
= 0.2-0.4 mg/kg IV/IO

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11
Q

Fentanyl) Dose:
PTs w/ elevated ICP, IC-hemorrhage, cardiac ischemia, or aortic dissection:

A

= 1mcg/kg w/ (max 100mcg)(IV/O,IN) may repeat PRN in 5-10mins
Max of 1mL per nare if admin/ed IN
= 2-3 mcg/kg IV <sympathetic response (Raised HR & BP) to intubate

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12
Q

(Ketamine/ Ketalar) Advan:
Disadv:

A

= Decreases bronchospasm, little hypotension, amnesia.
= Increases ICP, Hypertension, Tcardia, Laryngospasm, Hallucinations

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13
Q

(Ketamine/ Ketalar) Onset:
Duration:

A

= 30-60 secs
= 10-20mins

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14
Q

(Ketamine/ Ketalar) Class:
Dose:

A

= Sedative
= 1-2 mg/kg IV/IO

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15
Q

Ketorolac (Toradol) Dynamics:
Indications:
Contra:
Dose:

A

= Anti-inflammatory & antipyretic through inhibition of prostaglandins
= Mild-moderate pain, Fever, Inflammation, Renal calculi
= Hypersensitivity, Bronchospasm, Angioedema
= 15mg IV, 30mgIM

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16
Q

Levalbuterol /Xopenex) Indications:
Contra:

A

= Bronchospasm, Allergies/anaphylaxis, Hyperkalemia
= Hypersensitivity

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17
Q

Lorazepam) Dynamics:
Indications:
Contra:
Dose:

A

= Benzodiazepines, Binds w/ GABA receptors causing an influx of Cl
= Sustained seizures, anxiety, sedation, chemical restraint
= Hypersensitivity
= 2-4 mg (may repeat to a max dose of 8 mg)

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18
Q

(Lorazepam/Ativan) class:
Dose:

A

= Sedative
= 0.05 mg/kg IV/IO

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19
Q

Methylene Blue) Dynamics:
Indications:
Contra:
Dose:

A

= Water soluable thiazine dye helps metHb to hemoglobin conversion
= Methemoglobinemia (metHb), Nitrate OD/poisoning
= Hypersensitivity
= 1 mg/kg IV/IO over 5-30 minutes.

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20
Q

Midazolam (Versed) Dynamics:
Indications:
Contra:
Seizures Dose:
RSI Dose:

A

= Benzodiazepine, binds w/ GABA receptors causing an influx of Cl
= Active seizures, Chemical restraint, Anxiety, RSI/SFI, Sedation
= Hypersensitivity
= 0.2 mg/kg in 2 mg increments IV/IO (max 10 mg). 5 mg IM/IN
= 0.1-0.3 mg/kg slow IV/IO (max 10 mg) Onset: 2-5 mins. Duration: 15-30 mins.

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21
Q

(Midazolam/ Versed) Advan:
Disadv:

A

= Excellent amnesia effects, good sedative
= Hypotension

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22
Q

(Midazolam/ Versed) Onset:
Duration:

A

= 2-5 mins
= 15-30 mins

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23
Q

(Midazolam/ Versed) Class:
Dose:

A

= Sedative
= 0.1-0.3 mg/kg IV/IO

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24
Q

Morphine) Analgesia:
STEMI:
NSTEMI-ACS:

A

= 2-10 mg up to max 20 mg.
= 2-4mg slow IV/O, may admin 2nd dose 2-8mg IV/IO q5-15 mins
= 0.1 mg/kg slow IV/IO or IM up to 10 mg

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25
Morphine) Dynamics: indications: Contra: Analgesia: STEMI: NSTEMI-ACS:
= Narcotic (Schedule II Opioid) Analgesia & sedation via binding to opiate receptor = Ischemic chest pain not relieved by Nitroglycerin = Hypersensitivity. Uncorrected hypotension (<90 SBP) = 2-10 mg up to max 20 mg. = 2-4mg slow IV/O, may admin 2nd dose 2-8mg IV/IO q5-15 mins = 0.1 mg/kg slow IV/IO or IM up to 10 mg
26
(Paralytic/ Neuromuscular blocking meds) 1. 2. 3.
1. Succinylcholine (Anectine) 2. Rocuronium (Norcuron) 3. Vecuronium (Zemuron)
27
(Propofol/ Diprivan) Onset: Duration:
= < 1 min = 5-10mins
28
(Propofol/ Diprivan) Advan: Disadv:
= Rapid onset, good sedative effects = significant hypotension
29
(Propofol/ Diprivan) Class: Dose:
= Sedative = 1-2 mg//kg IV/IO Onset: <1min, Lasts: 5-10mins
30
(Propofol/ Diprivan) Class: Dose:
= Sedative = 1-2 mg//kg IV/IO
31
(Rocuronium/ Norcuron) Contra: Effects:
= Hypersensitivity = Minimal cardiovascular side effects, Skeletal muscle weakness, Malignant hyperthermia
32
(Rocuronium/ Norcuron) TTP: DOP:
= 60-90 secs = 45-120 mins
33
(Sedative meds) 1. 2. 3. 4. 5. 6.
1. Etomidate (Amidate) 2. Midazolam (Versed) 3. Ketamine (Ketalar) 4. Propofol (Diprivan) 5. Lorazepam (Ativan) 6. Diazepam (Valium)
34
(Sodium Bicarb) Suspected Acidosis: Hyperkalemia:
= 1 mEq/kg IV Bolus = 50 mEq IV Bolus
35
Sodium Bicarbonate 8.4%) Dynamics: Indications: Contra: Suspected acidosis Dose: Hyperkalemia Dose:
= Alkalinizing Agent. Increases plasma bicarbonate, buffers excess hydrogen ion concertration, raises blood pH & reverses clinical manifestations of acidosis. = Suspected hyperkalemia, suspected bicarbonateresponsive acidosis (DKA, OD on TCA's, Aspirin or Cocaine) = Patients in cardiac arrest = 1 mEq/kg, Hyperkalemia: = 50 mEq IV bolus.
36
Succinylcholine) Dynamics Indications: Contra: Dose:
= Depolarizing neuromuscular blocker. Binds to Ach recptors = DSI/RSI = Hyperkalemia(burns, crush injury), Increased ICP, Severe trauma = 1-1.5 mg/kg IV/IO. TTP: 45-60 seconds. DOP: 5-10 mins.
37
(Succinylcholine/ Anectine) TTP: DOP:
= 45-60 secs = 5-10 mins
38
(Succinylcholine/ Anectine) Contra: Effects:
= Hyper/K, Neuro/M disease, Crush injury, Burns, raised ICP, trauma = Hyper/K, Muscle fasciculations, Bradycardia, Prolonged paralysis, Malignant hyperthermia, Increased ICP
39
(Succinylcholine/ Anectine) Class: Dose:
= Depolarizing Neuromuscular Blocker paralytic = 1-1.5 mg/kg IV/IO
40
(Vecuronium/ Zemuron) TTP: DOP:
= 1-3 mins = 45-90 mins
41
(Vecuronium/ Zemuron) Contra: Effects:
= hypersensitivity = Minimal cardiovascular side effects, Skeletal muscle weakness, Malignant hyperthermia
42
Methylene Blue) Dose:
= 1 mg/kg IV/IO over 5-30 mins
43
Morphine) Analgesia dose:
= Analgesia: 2-10 mg up to max 20 mg
44
Norepinephrine) Dynamics: Indications: Contra: Dose:
= αß adrenergic agonist (α > ß effects) = Normovolemic hypoBP, Sepsis, Cardiogenic shock = Shouldn't use in hypovol/ til' vol/ replacement occurred = 0.1-0.5 mcg/kg/min IV/IO infusion
45
Ondansetron (Zofran) Dynamics: Indications: Contra: Dose:
= Selective serotonin 5-HT3 receptor blocker = Prevention & control of Nausea and/or vomiting = Hypersensitivity, QT prolonged = 4-8 mg IV slow push, IM, PO.
46
Levalbuterol (Xopenex) Dynamics: Indications: Contra: Dose:
= ß Agonist w/ preference for ß2 receptors. Has
47
Ketamine) Sedation Dose: Analgesia/Pain Dose:
= 1-2 mg/kg Onset: 30-60 secs, Lasts: 10-20 mins = 0.2 mg/kg IV/IO (max single dose 20mg) 0.5 mg/kg IM/IN (if no IV/IO)
48
Norepinephrine) Dynamics: Indications: Contra: Dose:
= αß adrenergic agonist (α > ß effects) = Normovolemic hypoBP, Sepsis, Cardiogenic shock = Shouldn't use in hypovol/ til' vol/ replacement occurred = 0.1-0.5 mcg/kg/min IV/IO infusion
49
Tranexamic Acid (TXA) Dynamics: Indications: Contra: Dose:
= Binds to plasminogen, blocking plasminogen fibrin interactions (fibrinolysis) = Sig/ hemorrhage, either in/external (after external hemorrhage is controlled) = SP 3 hrs past injury, allergy/Sensitivity, Suspected thromboembolism 1 gram over 10 minutes (mix in 50 mL bag of NS), Followed by 1 gram over 8 hours (500 mL bag NS).
50
Vecuronium) Dynamics: Indications: Contra: Dose:
= Nondepolarizing neuromuscular blocker Binds to ACh receptors = DSI/RSI = Hypersensitivity = 0.1-0.2 mg/kg IV/IO. TTP: 1-3 mins DOP: 45-90mins
51
Fentanyl) Dynamics: Indications: Contra: Dose:
=Synthetic Narcotic (Schedule II Opioid) = Analgesia & sedation via binding to opiate receptor, sig/ more potent than morphine (100 mcg = 10 mg of Morphine) = Moderate-Severe pain = Hypersensitivity, SBP<90 =1mcg/kg to a max dose 100 mcg (IV/IO/IM/) may repeat PRN in 5-10 = 1mcg/kg IN may repeat PRN 5-10mins (Max 1mL PRN if admin/ed IN)
52
Hydroxocobalamin) Dynamics: Indications: Contra: Dose:
Binds with cyanide to form nontoxic cyanacobalamin (Vitamin B12), preventing its toxic effects. Suspected cyanide poisoning Hypersensitivity 5 grams IV/IO over 15 minutes. May repeat a 2nd 5 gram dose for a max of 10 grams
53
Lorazepam) Dynamics: Indications: Contra: Dose:
= Benzo Binds w/ GABA receptors causing an influx of Cl = Sustained seizures, anxiety, sedation, chem restraint = Hypersensitivity = 2-4 mg (may repeat to a max dose of 8 mg)
54
Rocuronium) Dynamics: Indications: Contra: Dose:
= Nondepolarizing neuromuscular blocker Binds to ACh receptors = DSI/RSI = Hypersensitivity = 0.6-1.2 mg/kg. TTP: 60-90 seconds. DOP: 45-120 minutes
55
Albuterol) bronchospasm= Hyperkalemic=
2.5mg/3mg via SVN→ repeat 15-20mins as needed 10-20mg via LVN over 15 mins→ repeat as needed
56
Any eye trauma PT: Zofran contra=
= vomiting &/ B/c +ocular pressure = prolonged QT
57
Bohr Effect: Influences by: What does it do to hemoglobin:
= Acid> Hemoglobin droping oxy off in body = + CO2, +temp, -pH+ BPG 2,3 in body = -oxy affinity
58
Calcium Chloride) standard dose: Hypotension after Diltiazem admin:
=0.5-1gram slow IV over 3-5mins =following admin/ of Diltiazem: 250-500mg
59
Diazepam) Dynamics: Indications: Contra: Dose:
= Benzodiazepine Binds with GABA receptors causing an influx of Cl = TachyC from stimulant OD, Sustained seizure, Anxiety, Sedation, = Hypersensitivity = 2.5-10 mg in 2.5 mg increments slow IV/IO/IM.
60
Fentanyl) 1. 2 dynamics: 3 Indications: 4 Contraindications: 5 Adverse Effects: 6 Adult & Pediatric Dose same:
1 = quicker but
61
Fentanyl): IN route:
=1mcg/kg to max of 100mcg (IV/IO/IN) → may repeat PRN in 5-10mins =Max of 1mL per nare admin/ed IN
62
Haldane Effect: Influences by: What does it do to the hemoglobin?
= Alk> Hemoglobin Loves oxy in Lungs = -CO2, -temp, +pH -BPG 2,3, in Lungs, = +oxy affinity
63
Hydroxocobalamin)
= 5Gs IV/O over 15 mins. May repeat 2nd 5G dose (max 10G)
64
If you were administering isotonic crystalloid solutions, how much would move out of the intravascular compartment within 1 hour?
2/3s would move out
65
Ketamine) dynamics: Indications: Contraindications: (Pain Management) Adult & Pediatric Dose: Dissociation dose:
= + sympathetic response, Sedative-hypnotic & analgesic med = Moderate to severe pain ØSFI/RSI = History of hypersensitivity to the med, Hypertension = 0.2mg/kg/1-2mins w/ max single dose 20mg(.5mg/kg IN/M) = 1-2mg/kg ((0.5 mg/kg IN/IM)
66
ketamine) Sedation Dose: Pain dose:
= Sedation: 1-2 mg/kg Onset: 30-60 secs, Duration: 10-20 mins = Pain: 0.2 mg/kg IV/IO (max single dose 20 mg), 0.5 mg/kg IM/IN (if no IV/IO)
67
Methylene Blue)
= 1 mg/kg IV/IO over 5-30 mins
68
Morphine & fent drop BP by:
= body releasing Histamines
69
Morphine) 1 2 Pharmacodynamics: 3 Indications: 4 Contraindications: 5 Adverse Effects: 6 Adult Dose: 7 Pediatric Dose:
1= (not same as Morphine Sulfate) 2= Narc (opioid) Schedule II & releases histamine 3= Moderate to severe pain 4= SBP< 90, Known hypersensitivity 5= HypoBP, Syncope, Tachy/BradyC, Resp/Depres/Apnea , N/V 6= 2-10mg or 0.1 mg/kg to max dose 20 mg 7= 0.1 mg/kg IV/IO (slow) or IM up to 10 mg
70
Oxy Dissociation Curve: Bohr Effect: Haldane Effect:
= H-globin “Train” taking & dropping oxy = Acidotic with R-shift of hemoglobin w/ decrease oxy affinity = Alkalotic w/ L-shift Loves oxy in Lungs
71
(Rocuronium/ Norcuron) Class: Dose:
= Nondepolarizing Neuromuscular Blocker paralytic = 0.6-1.2 mg/kg IV/IO (If succinylcholine is contraindicated)
72
Rocuronium) Dynamics Indications: Contra: Dose:
= Nondepolarizing neuromuscular blocker. Binds to ACh receptors =DSI/RSI = Hypersensitivity = 0.6-1.2 mg/kg. TTP: 60-90 secs. DOP: 45-120 mins
73
Stridor w/ inhalation burns: Bad Airway burns might might need:
= AKA “crowing” larynx last defense against heat then swells 2/3s so intubate asap bc only worsens (Press chest & follow bubbles) = Might need to nasal endotracheal intubation w/ BAAM & Endotrol tube (ET w/ trigger) BAAM> High=inhale &Low=exhale
74
(Vecuronium/ Zemuron) Class: Dose:
= Nondepolarizing Neuromuscular Blocker Paralytic = 0.1 -0.2 mg/kg IV/IO
75
Vecuronium) Dynamics: Indications: Contra: Dose:
= Nondepolarizing neuromuscular blocker. Binds to ACh receptors = DSI/RSI = Hypersensitivity = 0.1-0.2 mg/kg IV/IO. TTP: 1-3 mins. DOP: 45-90 mins.
76
Water is contained in what 3 compartments in the human body? What are the percentages?
60% of body weight is water 45%=intracellular & 15% extracellular (outside cell) Interstitial 10.5% Intravascular 4.5%
77
Hydrostatic pressure in the vascular system & what creates it? Oncotic pressure in the vascular system and what creates it?
=Pressure from heart in blood vessels & forces water to cross the capillary membrane into the interstitial space. =Pulling water back into the blood vessels by the presence of large proteins in the blood (pulling back in)

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