Medical protocols

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Author:
Ericallarose
ID:
141592
Filename:
Medical protocols
Updated:
2012-03-14 17:38:26
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Protocols
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Protocols
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  1. Pulseless v-fib or v-tach
    • 5 cycles cpr
    • iv - et tubes
    • 5 cycles check rythem
    • epi 1:10000 1 mg iv ( repeat ever 3-5 mins.)
    • amioderone 300mg
    • Medcom options
    • Epi/shocl
    • amioderone 150/shock
    • epi/shocl
    • mag sulf 1-2 grams/ shock
    • epi/shock
  2. When defibrillating how many joules for the first shock both types of machines?
    • bipasic- 120-200 monophasic 360
    • second shock max joules
  3. PEA / asystole
    • IV-ET tube
    • 5 cycles
    • epi 1:10000 1 mg iv repeat 3-5 mins
    • if rate is less than 60 Atropine 1mg IV 3-5 mins
    • if no shockable continue cpr
    • medcom
    • epi
    • atropine
    • if tension pneumothorax needle decompress
    • Consider AMS- trauma- field termination
  4. Return of pulse after cardiac arrest
    • Airway
    • IV
    • Monitor EKG
    • consider protocol apprpriate to presenting condition
  5. V-Tach with a pulse
    • iv-et-02
    • Monitor ekg
    • Medcom
    • Lido 1.5 mg/kg IV push
    • Sync or unsync cardioversion 50-360 joules
    • Pre Medicate for
    • Lido 1-1.5 mg/kg iv
    • Lido Drip 2-4 mg/min
    • Me Sul 1-2 grams iv over 1-2 mins
    • Adenosine 6 mg RAPID
    • Adenosine 12mg RAPID
  6. What Meds are given to pre medicate before cardioversion?
    • Diazepam 2-10 mg iv push
    • Midazolam ( Versed) 2-5 mg iv
    • Morphine 2-10 mg iv
  7. Narrow Complex Tach
    • 02 iv et Monitor
    • Medcom
    • Valsalva
    • IF pt is alert Adenosine 6mg RAPID
    • Adenosine 12mg Rapid
    • synhronized cardioversion 50-360 joules
    • pre med
    • adenosine 6 mg
    • adenosine 12 mg
    • fluid challenge
  8. symtomatic bradycardia
    • 02-iv monitor ekg
    • medcom
    • if HR less then 50 and decreased cardiac output atropine.5 mg ( will not work on complete heart block or 2nd degree type 2)
    • transcuaneous pacing- Premed
    • Dopamine 2-20 mg/kg/ min yv drip
    • epi 2-10 microg/min drip 1:10000
    • Fluid challenge
  9. Ventricular Ectopy
    • o2-iv-monitor
    • Medcom
    • Lidocaine 1-1.5 mg/kg iv push
    • Licosaine 2-4 mg/min iv drip
    • Meg Sulfate 1-2 grams iv ver 1-2 mins
  10. Acute Resratory Distress
    • 02
    • Albuterol or levalbuterol ( 1.25 mg dose) and iprotropium( atrovent) 5oo mcg- Albuterol may be repeated once is symptoms persists.
    • monitor ekg
    • iv access
    • Medcom
    • Epi 1:1000 .3-.5 mg sc
    • albuterol or levalbuterol
    • atrovent
  11. Respiratory Arrest / agonal respirations
    • Establish airway- use magil forceps to remove object
    • Et tube
    • IV
    • Monitor EKG
    • Consider AMS or needle compress
  12. Cardiogenic shock without dysrhythmia
    • Monitor ekg iv
    • Medcom
    • Fluid Challense
    • Dopamine 2-20ug/kg/min
  13. Chest Pain ( agina or suspected AMI) acutre miocardial infraction
  14. IV o2
    • Aspril 325 chewed
    • Nitro 1/150 gr Sl if B greater than 120 or 100 with IV
    • Medcom
    • Nitro
    • Lido IV ( 1-1.5 mg/kg ) Lido drip ( 2- 4 mg/min)
    • Mag Sulfate
  15. Acute Pulmonary Edema
    • IV - o2- monitor
    • Diastolic greater than 100 Nitro
    • Medcom-
    • Furosemide ( lasix) 40-80 mg iv push
    • Dopamine IV drip 2-20 mcg/ kg/min
    • Morphine
  16. AMS
    • iv- monitor
    • Thiamine 100 mg iv
    • D50 over 1-2 mins if bs less than 80
    • Glucagon 1 mg IM if no IV
    • Medcom
    • Nalozone .4mg iv,im ( respiratory depression)

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