Term
| adult allergic reaction dose for benadryl |
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Definition
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Term
| pediatric allergic reaction or dystonic reaction dose, routes, and max |
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Definition
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|
Term
| adult allergic reaction dose for albuterol....what must be present |
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Definition
| 5mg/6ml repeat as needed for wheezes |
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Term
| adult anaphylaxis without shock doses. to be used only if? |
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Definition
| only if severe respiratory distress is present epi 1:1000 0.5mg IM if under 40 and if over 40 0.3mg IM then obtain IV access and administer benadryl 50mg IV/IM may repeat x1 in 10 min |
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Term
| cardiac arrest, always perform ______ for at least_______before attaching aed |
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Definition
| cpr for at least 5 cycles |
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Term
| vf/vt prior to base adult protocol |
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Definition
| defibrillate every 2 minutes, IV or IO access, epi 1:10,000 1mg/10ml IV every 3-5 minutes, Amiodarone 300 mg IV/IO if rhythm persists, 150mg IV/IO in 3-5 minutes. consider ALS ariway management if BLS measure are inadequate |
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Term
| CFP for VF/VT TCA and Torsades |
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Definition
| TCA ask for sodium bicarb 1 meq/kg IV/IO, repeat 0.5 meq/kg every 5 minutes. for Torsades, contact for magnesium sulfate 2gm IV/IOover 2 min may repeat x1 in 5 min |
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Term
| if you achieve sustained ROSC greater than 30 seconds.... |
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Definition
| perform 12 lead, transport to stemi receiving center (cmh,robles, st john oxnard) |
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Term
| if hypothermic you will do what for med administration and what defib amount prio to base contact. remember that field determination of death is______ |
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Definition
| push only one round of medications and defib for a max of 6 times. DOD is discouraged |
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Term
| pediatric vf/vt defib specifics |
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Definition
| initial defib at 2 joules/kg, if vf/vt persists than 4 joules/kg repeat every 2 minutes as indicated. |
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Term
| pediatric VF/VT first thing you do after defib |
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Definition
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Term
| peds VF/VT after IV/IO access you then.... |
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Definition
| epi 1:10,000 0.01mg/kg (0.1ml/kg) IV/IO every 3-5 minutes. then amiodarone 5mg/kg repeat 2.5mg/kg if rhythm persists 3-5 minutes later |
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Term
| pediatric VF/VT remember after you have defibrillated, gien epi and amio, you should think about.... |
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Definition
| airway! manage with ALS airway if BLS is unacceptable |
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Term
| if VF/VT stops and then recurs what should you do |
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Definition
| defibrillate at the last successful energy setting |
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Term
| peds VF/VT cfp....for what specific situation. what med would you ask for and how would you give it? |
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Definition
| if strong suspicion of TCA overdose you would ask for sodium bicarbonate give at 1mEq/kg IV/IO and repeated 0.5mEq/kg ever 5 minutes |
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Term
| chest pain ALS prior to base up to and including aspirin |
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Definition
| 12 lead if ***AMI*** transport to stemi, nitroglycerin sl or lingual spray - 0.4mg every 5 min for continued pain....no max, maintain sbp greater than 100 or greater than 90 if normal sbp is less than 100, aspirin 324mg PO |
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Term
| chest pain after you have given aspirin 324mg po..... |
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Definition
| obtain IV access (max 3 attempts), if pain persists morphine per policy and maintain sbp greater than 100mmhg. If patient presents or becomes hypotensive, elevate legs and normal saline bolus of 250ml unless chf is present. |
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Term
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Definition
| add an additional IV attempt to 4 total and if hypotensive and signs of chf are present or no response to fluid therapy....dopamine 10mcg/kg/min |
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Term
| ED physician order only for chest pain expect what med for what situations? |
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Definition
| for ventricular ectopy pvcs greater than 10/min, multifocal pvcs, or unsustained v-tach,AMIO 150mg IVPB |
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Term
| 3 indications for ondansetron (zofran) |
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Definition
| moderate to severe nausea or vomiting. potential for airway compromise secondary to suspected/actual head injury when cervical immobilization is used. patient has a history of nausea/vomiting post narcotic administration, and MS is indicated |
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Term
| ondansetron tx order for adult. whats the difference for peds? |
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Definition
| IV access, Ondansetron 4mg PO ODT may repeat x1 in 10 min, or IV/IM 4mg may repeat x1 in 10 min. peds difference is no repeat x1 and must be at least 4 years old or contraindicated. |
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Term
| prior to best contact sustained Vtach tx protocol patient is stable. what defines stable? and tx. |
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Definition
| stable is defined as mild to moderate chest pain/SOB. give AMIO 150mg IVPB or 10 min |
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Term
| prior to base sustained vtach unstable patient. what defines unstable and your tx? |
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Definition
| unstable is ALOC, signs of shock of CHF. TX goes Sedate and cardiovert. Midazolam IV 2mg make sure your diluted solution is 1MG to 1ML final concentration of 5mg/5ml. Synchronize cardiovert at set energy settings. Amiodarone IVPB 150mg over 10 mins. |
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Term
| sustained vtach base hospital orders only. |
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Definition
| for torsades, magnesium sulfate IVPB - 2gm in 50mL D5W infused over 5 minuts may repeat x1 if torsades continues or recurs. |
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Term
| unstable polymorphic vtach you? |
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Definition
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Term
| physician order only for any conversion after defib |
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Definition
| if has not been given already, amio 150mg IVPB over 10 minutes. |
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Term
| adult altered neuro function prior to base |
|
Definition
*iv access
*if bs less than 60 d50 iv-25ml
*or glucagon if no access, IM 1mg
recheck in 5 min after d50 or 10min after glucagon...if bs still less than 60 administer another 25ml of d50 |
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Term
| when dealing with altered neuro function what should you consider? |
|
Definition
| aeioutips....check pupils and chance for stroke and bs |
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Term
| pediatric altered neuro function if bs less than 60 and age less than 2 what interventions must take place? and doses |
|
Definition
if less than 2 d25 IV-2mL/kg
glucagon IM if no access 0.1mg/kg max of 1 mg |
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Term
| pediatric altered neuro if over 2 what are your interventions? |
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Definition
| check bs....if under 60 and over age 2, d50 IV-1mL/kg or use glucagon IM 0.1mg/kg |
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Term
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Definition
| in 5 minutes if you use d50 10min if using glucagon. |
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Term
| behavioral emergency time! adult doses for midazolam. all of it is prior to base |
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Definition
IV 2mg repeat 1mg every 2 min as need until max of 5mg
or
IM 0.1mg/kg max of 5mg |
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|
Term
| pediatric iv midazolam dose |
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Definition
| ahaha trick question....no iv dose for midazolam on peds. |
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Term
| pediatric midazolam for behavioral emergencies |
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Definition
| IM 0.1mg/kg max of 5mg same as adult |
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Term
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Definition
| iv access and monitor for allergic reactions |
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|
Term
| what marine animal sting do you not use heat for? |
|
Definition
| jellyfish, per protocol....all others can have heat applied |
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Term
| als prior to base for adults |
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Definition
IV access
Morphine per policy
if burns greater than 10% tbsa then IV bolus 1 liter |
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|
Term
| pediatric burn iv/io bolus |
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Definition
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Term
| if given orders during cardiac arrest for adult suspected calcium channel blocker overdose what are the meds and doses |
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Definition
calcium chloride IV/IO - 1gm repeat x1 in 10 min
glucagon IV/IO 2mg...may give up to 10mg if available |
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|
Term
| adult cardiac arrest vf/vt dose for torsades |
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Definition
| IV/IO 2gm over 2 min...may repeat x 1 in 5min |
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Term
| adult and peds dose for cardiac arrest beta blocker overdose related |
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Definition
base hospital orders only*
*adult glucagon 2 mg IV/IO may give up to 10mg if available
*peds glucagon 0.1mg/kg may give up to 10mg |
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Term
| peds cardiac arrest calcium channel blocker overdose |
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Definition
calcium chloride IV/IO 20mg/kg repeat x1 in 10min
glucagon IV/IO 0.1mg/kg may give up to 10 mg if avail. |
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Term
| cardiac arrest adult and peds tx for tca overdose |
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Definition
| sodium bicarb 1mEq/kg repeat 0.5 mEq/kg every 5 min |
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|
Term
| adult and pediatric crush injury/syndrome als prior to base shit |
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Definition
*IV access
*maintain body heat
*release compression
*monitor for cardiac dysrhythmias |
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Term
| adult cfp for actual crush syndrom |
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Definition
*initiated 2nd IV access
*1 liter IV bolus of normal saline
*sodium bicarb - IV mix 1mEq/kg added to 1st liter of saline
*albuterol via nebulizer 5mg/6ml repeat x2
*morphine per policy 705
*if dysrhythmias give calcium chloride over 1 min |
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|
Term
| adult and pediatric hospital orders for ongoing extended entrapment and no response to fluid therapy |
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Definition
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Term
| pediatric crush syndrome cfp. doses for calcium chloride and albuterol |
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Definition
calcium chloride IV/IO 20mg/kg
albuterol if less than 2 nebulized tx of 2.5mg/3ml
if over 2, adult dose
all of albuterol doses is repeat x2 |
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Term
| pediatric opiated overdose with respirations less than 12/min |
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Definition
| narcan IV/IM/IO 0.1mg/kg initial max of 2mg. may repeat as need to maintain resp greater than 12/min |
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|
Term
| adult and pediatric activated charcoal doses |
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Definition
| 1gm/kg for both with a max of 50grams for adults and 25grams for peds |
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Term
| adult opiate overdose with resp less than 12 a min |
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Definition
IM 2mg, IV 0.4mg every minute with max of 2mg
*may repeat as needed to maintain respirations greater 12/min |
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Term
| adult pain control policy. recheck vitals when? |
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Definition
IV 2-4mg over 1-2min. repeat every 3 min as needed for pain relief. max 10mg.
recheck vitals before and after each administration hold if bp less than 100 |
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|
Term
| pediatric allergic reaction - anaphylaxis without shock treatments |
|
Definition
*epi 1:1000 IM .01mg/kg max of 0.3mg
*IVaccess
*benadryl IV/IM 1mg/kg max of 50mg may repeat x1 in 10 min |
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|
Term
| pediatric anaphylaxis with shock |
|
Definition
*treatments as above then initiate 2nd IV if possible or establish IO
*IV bolus 20ml/kg
IF profound shock...epi 1:10,000 IV/IO 0.01mg/kg increments to a max of 0.3mg/kg over 1-2 min slow ivp |
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|
Term
| CFP pediatric allergic reaction, anaphylaxis without shock |
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Definition
| repeat epinephrine 1:1000 IM 0.01mg/kg every 5 min x2 as needed |
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|
Term
| CFP pediatric allergic reaction - anaphylaxis with shock |
|
Definition
*for continued shock repeat bolus of saline 20ml/kg IV/IO
*epi 1:1,000 IM 0.01mg/kg every 5min x2 as needed |
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|
Term
| adult prior to base for profound shock of allergic reaction. |
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Definition
*make sure you have your second IV started, performed the previous interventions and given a liter bolus.
*then epi 1:10,000 slow IVP 0.1mg (1ml) increments max of 0.3mg over 1-2 min |
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Term
| CFP for adult allergic reaction - anaphylaxis without shock |
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Definition
| repeat epi 1:1,000 IM 0.3mg every 5 min x2 as needed |
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|
Term
| Adult CFP for allergic reaction - anaphylaxis with shock... |
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Definition
*repeat normal saline IV bolus 1 liter
*repeat epinephrine IM 0.3mg every 5min x2 as needed |
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Term
| adult hypovolemic shock prior to base. use caution with? continue to evaluate? if vitals return to normal limits? |
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Definition
IV bolus 1 liter
use caution with cardiac or renal history
continue to evaluate lung sounds. if signs of chf, decrease iv to tko
if vitals reutrn to normal limits decrease iv to tko. |
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|
Term
| adult prior to base hypovolemic shock from traumatic injury |
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Definition
*dont delay transport for first iv attempt
*attempt second IV while enroute to ED
*consider blood tubing |
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|
Term
| adult cfp for hypovolemic shock |
|
Definition
| repeat normal saline IV bolus of 1 liter if shock persists |
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|
Term
| pediatric hypovolemic shock prior to base. caution with? continue to evaluate what? if vitals return to normal limits? |
|
Definition
*IV/IO access
*saline bolus of 20ml/kg
*caution with cardiac and or renal history
*continue to evaluate lung sounds. if signs of chf, decrease iv to tko
*if vital signs return to within normal limits, decrease iv to tko |
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|
Term
| peds prior to base for hypovolemic shock and traumatic injury |
|
Definition
*do not delay transport for first iv attempt
*attempt second iv while enroute to ED
*consider blood tubing |
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|
Term
| peds cfp for persistant hypovolemic shock |
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Definition
| repeat salin bolus of 20ml/kg IV/IO |
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|
Term
| newborn resuscitation IV bolus dose |
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Definition
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|
Term
| pediatric morphine is given for? |
|
Definition
| burns and isolated extremity injuries only |
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|
Term
| pediatric morphine give IV |
|
Definition
| 0.1mg/kg over 1-2 min may repeat x1 after 3 min as needed for pain relief. max of 0.2mg/kg or 10mg |
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|
Term
| pediatric IM morphine dose |
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Definition
|
|
Term
|
Definition
| 0.1mg/kg over 1-2 min may repeat x1 after 3 min as needed for pain relief. max repeat dose of 10mg. max total dose of 20mg or 0.4mg/kg |
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|
Term
|
Definition
| 0.2mg/kg max repeat dose of 10mg |
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|
Term
| adult CFP for morphine being given IV |
|
Definition
| 2-4mg over 1-2min max repeat dose of 10mg. max total dose of 20mg |
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|
Term
| adult CFP for morphine given IM |
|
Definition
| 0.1mg/kg max repeat dose of 10mg |
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|
Term
| 3rd trimester pregnancy seizure with no known history of seizures. |
|
Definition
| mag sulfate 2gm IVPB in 50ml of D5W infused over 5 min...MUST repeat x1. |
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|
Term
| prior to base for adult persistant seizures. |
|
Definition
midazolam IV 2mg repeat 1mg every 2 minutes as needed to a max of 5mg
IM - 0.1mg/kg max 5mg |
|
|
Term
| prior to base shortness of breath - pulmonary edema |
|
Definition
*nitro 0.4mg spray every min x3 then repeat every 2 min no max dose
*cpap
*12 lead
*iv access
*if wheezes use albuterol 5mg/6ml |
|
|
Term
| cfp for shortness of breath due to pulmonary edema |
|
Definition
*lasix iv 40mg only if currently prescribed lasix or bumex.
*if patient becomes or presents with hypotension...dopamine IVPB 10mcg/kg/min |
|
|
Term
| there are 7 things to determine for a childbirth assessment |
|
Definition
*number of pregnancies (GRAVIDA)
*number of deliveries (para)
*due date (weeks of gestation)
*onset/duration/frequency/intesity of contractions
*if a rupture of membranes has occurred (including color/date/time)
*if any expected complications during pregnancy are present
*presence of crowning or any abnormal presenting part at perineum |
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|
Term
|
Definition
|
|
Term
| adult nerve agent poisoning base hospital orders only. medications and doses for hot/warm zones |
|
Definition
atropine IM 2mg every 5 min until symptoms are relieved.
pralidoxime im 600mg if available, single dose only |
|
|
Term
| cold zone treatment for nerve agent poisoning. |
|
Definition
*first obtain iv access
*atropine IV 2mg every 1min. repeat until symptoms are relieved.
*atropine IM 2mg every 5 min until symptoms are relieved
*pralidoxime (2-pam) IM 600mg if available, single dose only. |
|
|
Term
| after you have treated with atropine and pralidoxime if what begins treated it with what and how much dose? adult only |
|
Definition
midazolam IV 2mg repeat 1mg every 2 minutes as needed. max 5mg.
IM 0.1mg/kg max 5mg |
|
|
Term
| adult and pediatric doses for diazepam |
|
Definition
adult: 5mg IV/IM every 10min titrated to effect max of 30mg
pediatric: 0.1mg/kg IV/IM/IO (max inital dose of 5mg)over 2-3 minutes every 10minutes titrated to effect. max total dose 10mg |
|
|
Term
| pediatric nerve agent poisoning hot/warm zone |
|
Definition
| IM 0.05mg/kg every 5 minutes. minimum dose of 0.1mg repeat until symptoms are relieved |
|
|
Term
| pediatric nerve agent poisoning cold zone treatments |
|
Definition
atropine IV 0.05mg/kg minimum of 0.1mg every minute until symptoms are relieved.
atropine IM 0.05mg/kg minimum of 0.1mg every 5 mins until symptoms are relieved |
|
|
Term
| pediatric dose for seizure IV and IM |
|
Definition
| IV is a trick question only IM 0.1mg/kg max of 5 mg |
|
|
Term
| peds and adult dose for tca overdose |
|
Definition
| sodium bicarbonate 1mEq/ml base order only |
|
|
Term
| adult dose for organophosphate poisoning |
|
Definition
| atropine IV 2mg every 1 minute until symptoms are relieved |
|
|
Term
| pediatric tx for organophosphate poisoning |
|
Definition
| atropine IV/IO 0.02mg/kg every 1 min until symptoms are relieved. minimum dose of 0.1mg |
|
|
Term
| tca overdose and charcoal? |
|
Definition
|
|
Term
| adult prior to base for shortness of breath - wheezes/other hint what is policy 715 for first consideration. |
|
Definition
*perform needle thoracostomy if indicated per policy 715.
*albuterol 5mg/6ml repeat as needed for wheezes.
*if severe distress use tx for moderate distress then use epi 1:1000 IM 0.3mg if under 40.
*cpap for either moderate or severe distress
*IV access |
|
|
Term
| adult cfp for shortness of breath with wheezes/other |
|
Definition
*for severe distress.
*epi 1:1000 IM 0.3mg if under 40. if no change is apparent 10 minutes after first epi administration
*40 year old and greater. epi 1:1000 0.3mg. only if apparent asthma. only if age less than 60 years old. only if no improvement with initial therapies |
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|
Term
| pediatric prior to base for shortness of breath wheezes/other up to epi. |
|
Definition
*needle T if indicated
*albuterol, under 2.. 2.5mg/3ml...over 2 5mg/ml. repeat as needed.
*for severe distress epi 1:1000 IM 0.01mg/kg max of 0.3mg |
|
|
Term
| pediatric prior to base for suspected croup. |
|
Definition
| normal saline nebulizer/aerosolized mask 5ml |
|
|
Term
| always consider cpap for sob make sure pt is at least....? |
|
Definition
|
|
Term
| cfp for pediatric sob wheezes/other |
|
Definition
for severe distress
*if no change is apparent 10minutes after first epinephrine administration. repeat epinephrine 1:1000 IM 0.01mg/kg max of 0.3mg |
|
|
Term
| base orders for pediatric shortness of breath. used if? |
|
Definition
suspected croup.
*no improvement with normal saline nebulizer. if less than 2, epi 1:1000 2.5ml via nebulizer. if over 2 epi 1:1000 5ml via nebulizer |
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|
Term
| chest pain - acute coronary syndrome. administer oxygen if.... |
|
Definition
| dyspnea, signs of heart failure or shock, or SA02 less than 94% |
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