protocol/formulary

Card Set Information

Author:
alyspins
ID:
206077
Filename:
protocol/formulary
Updated:
2013-03-09 18:43:27
Tags:
formulary
Folders:

Description:
formulary
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user alyspins on FreezingBlue Flashcards. What would you like to do?


  1. mandatory notifications :cardiac arrest after/during admin of paralytic, pain management or antiarrhythmic agents
    • can't maintain airway w/in credentials
    • harm to pt, bystander, crew
    • needle or surgical airway
    • field terminations
    • MCI
  2. consent :18 or younger consent if: Active duty
    • 16+ and residing away from parent&own finances
    • consents to infectious, contagious or communicable disease treatment required by law to be reported
    • unmarried &pregnant to hospital or treatment related to pregnancy
    • exam and treatment for addiction
    • married or emancipated
  3. fridge meds :36-46F
    • Diltiazem(cardizem)
    • lorazepam
    • rocuronium
    • Succinylcholine(anectine)
  4. geographical area of response :Madison/Burleson/Grimes or Brazos county
    • mutual aid request in all counties w/ MOA estb
    • counties in Texas w/ contract/request of SJREMS
    • respond to request from agency w/ authority
    • immediate vicinity of actual/perceived ER til responsible EMS etc able to respond
    • incidents authorized by EMS Director/medical director
  5. pain management :BOTH airway/O2 as appropriate
  6. RSII :BOTH: airway/O2
    • PREOXYGENATE Pt
    • assess BGL
  7. chemical restraint :BOTH airway/O2
    • scene safety
    • BGL
    • 12 lead ECG for tazer pt
    • remv tazer barbs if not in face/groin/breast/spine=HOSP
    • albuterol 2.5 mg via neb if signs of bronchospasm
  8. Air Medical use :GCS<10
    • blunt/penetratin abdomen pelvis neck or head/pregnant
    • amputation (except single digit)
    • crushing
    • scalping/degloving
    • spinal cord=>paralysis or deformity
    • major burns 2/3rd BSA>9%; hands,feet,face or perinuem; electrical, inhalation or chem burns
    • Presenting significant injury FROM
    • ejection from MVA
    • extrication time>20 min
    • fall from >12'
  9. Level 1 trauma :VITAL SIGNS
    • BP<90
    • Respirations<10 or >29
    • AMS GCS<13
    • Revised trauma score<11
    • Pediatric Trauma score <9
    • TRAUMA
    • penetrating jead, neck, torso or groin
    • Burns >20%BSA
    • amputation above wrist/ankle
    • paralysis
    • flail chest
    • long bone FX
    • open or suspected skull FX
    • unstable or suspected pelvis FX
  10. level 2 trauma :ejection/death of other occupant/ signif MOI MVA
    • fall>12'
    • auto pedestrian
    • steering wheel damage
    • motorcycle atv or bike impact
    • serious assault/altercation
  11. Paramedic required to manage :Chest pain
    • SOB
    • AMS not typical of ot
    • abdominal pain
    • HR>110
    • BP systolic >160 or <100; diastolic >90 or <40
    • pulse ox<92%
  12. cardiac/hyperkalemia arrest managment :BOTH: ABCs, AED(Defib then 2min compressions prior to pulse check)
    • 2 min compressions pre defib if not witnessed CA by EMS
    • airway adjunct
    • core temp
    • BGL
  13. Post resucitation :BOTH: O2/ventilation
    • 12 lead ECG
    • core temp
  14. Bradycardia :BOTH: airway/O2
    12 Lead ECG
  15. atrial fibrillation unstable/stable :suspected with PT w/ irregular pulses
    • BOTH: airway/O2
    • determine time of onset
    • 12 lead ECG
  16. narrow complex tachycardia unstable/stable :ADULT: airway/02
    • vagal maneuvers
    • NO carotid massage
    • 12 lead ECG
    • PEDI: airway/O2
    • 12 lead ECG
  17. wide complex tachycardia unstable :ADULT: airway/02
    • NO carotid massage
    • 12 lead ECG
    • PEDI: airway/O2
    • 12 lead ECG
  18. wide complex tachycardia stable :ADULT: airway/02
    • vagal maneuvers
    • NO carotid massage
    • 12 lead ECG
    • PEDI: airway/O2
    • 12 lead ECG
  19. Acute Coronary syndromes :Adult: airway/O2
    • 12 lead ECG w/in 5 min
    • 324mg Asprin PO
    • contact OLMC
    • PEDI: OLMC
  20. Pulmonary Edema :BOTH: airway/O2
    • 12 Lead ECG
    • if systolic <80/90=> remove CPAP if not effective/LOC altered
  21. malignant hypertensionh :BOTH: airway/O2
    12 Lead ECG
  22. hypoperfusion :orthostatic vitals if possible
    • trendelenburg
    • 12 lead ecg
  23. stroke/CVA :ADULT: airway/o2 (maintain SO2 >95%)
    • Cincinnati stroke score
    • BGL
    • 12 lead
    • PEDI:
    • airway/o2
    • 12 lead
    • OLMC
  24. stroke/CVA destination :<3 hrs: closest stroke facility
    • 3-6 hrs:level 1-SJRHC; st. luke, methodist
    • >6 level 1 or 2 facilities
  25. allergic reaction :ADULT: EpiPen(.15mgIM BLS only)
    • assist MDI
    • albuterol 2.5mg/3mL every 5 min(if in extremis)
    • PEDI:EpiPen(.3mgIM BLS only)
    • assist MDI
    • albuterol 2.5mg/3mL every 5-10 min(if in extremis)
  26. diabetic emergencies :ADULT: airway/O2
    • BGL
    • oral glucose 15gPO to maintain BGL>60
    • focus on up BGL then discontinuing BGL
    • unconsious=12 lead
    • PEDI: airway/O2
    • BGL
    • oral glucose 7.5g PO to maintain BGL>60
    • focus on up BGL then discontinuing BGL
    • unconsious=12 lead
  27. nausea and vomiting :BOTH airway/O2 as appropriate
  28. narcotic overdose :BOTH: airway/O2
    • 12 lead
    • BGL; <60=> hypoglycemia
    • shallow resp, altered LOC; unresponsive/pinpoint pupils; tachycardia; hypotension
  29. dystonic reaction overdose :BOTH: airway/O2
    • 12 Lead ECG
    • deviation of eyes, protrusion of tounge, forced jaw opening; difficulty speaking, facial grimace
  30. cyclic antidepressant overdose :BOTH: airway/O2
    • 12 Lead ECG
    • tachycardia>120; wide qrs; hypotenstion
  31. calcium channel blocker :BOTH: airway/O2
    • 12 Lead ECG
    • bradycardia; conduction delay; hypotension; lethargy; slurred speech; nausea and vomiting
  32. organophosphate :BOTH: airway/O2
    • 12 Lead ECG
    • SLUDGE(salivation, lacrimation, urination,defecation, GI cramping,emesis) muscle fasciculation; altered LOC; diarrheal wheezing; pinpoint pupils
  33. gestinal complications overall :airway/02
    • >20 weeks=> transport on left side
    • tilt backboard 15 degrees if must immobilize
  34. obsterics uterine inversion :PT supine
    • leave placenta and cord
    • 1 attempt to replace uterus w/ palm(push fundus toward vagina)
  35. abruptio placenta :complaint of sever, constant abdominal pain (seperation of placenta form wall)
  36. placenta previa :painless bright red vaginal bleeding
  37. abortion :tissues or nonviable fetus present
    collect tissue or fetal parts; place in paperbag then into plastic bag
  38. prolapsed cord/limb :leave cord; 2 gloved fingers into vagina; check cord pulse
    • keep head off cord and mosit w/ sterile saline
    • mom in knee-chest position
    • transport and notify ASAP
  39. breach birth :if possible get to hospital
    • request paramedic responder
    • assist mom in holding legs flexed-support baby legs-don't pull
    • gentle traction upward as head passes pubis
    • "V" on either side of nose to allow breathing if head not deliver
  40. asthma :ADULT: airway/O2
    • CPAP
    • albuterol 2.5 mg nebulizer
    • 12 lead
    • PEDI: airway/O2
    • albuterol 2.5 mg nebulizer
  41. seizures :BOTH: airway/O2
    • be prepared to assist ventilation
    • BGL
    • ADULT: 12 lead
    • urge to transport
  42. COPD :BOTH:airway/O2
    • albuterol 2.5 mg nebulizer
    • ADULT:
    • 12 lead
    • CPAP
  43. sepsis :Adult:airway/O2-sat>95%
    • CPAP for pulomonary edema peep at or below 5
    • PEDI: airway/O2
  44. general trauma guidelines :see book
  45. general trauma management :airway/02
    • manual Cspine
    • control bleeding/tourniquet if needed
    • tetracaine to 2-4 drops for eye injury
    • assess what facility and mode of transport is necessary for the pt condition
  46. amputation :BOTH: airway/O2; general tauma guideline
    • wrap body part- sterile guaze moistened by saline
    • place in plastic bag/containe then into cold water
    • tourniquet as needed
    • don't delay transport for prolonged extrication of body parts
  47. burns :airway/O2
    • stop burning process
    • dress wounds
    • 2/3rd degrees BSA<10%=> wet sterile
    • 2/3rd degrees BSA>10%=> dry sterile dressing
    • ID entry/exit wounds
    • remove items that may constrict w/ swelling
    • mark for swelling
    • brush off dry chem and flush (eyes flush>20 min)
    • maintain body heat
    • transport to burn center via air med if possible
  48. crush injury :BOTH airway/O2 as appropriate
  49. near drowning :airway/O2
    • core temp
    • BGL
    • CPAP immediate for breathing PT
    • note how long and type of water submerged; type of weather etc
  50. insect/spider bite :BOTH airway/O2 as appropriate
  51. snakebite :airway/O2
    • keep PT calm
    • treat for shock and preserve body heat
    • remove constricting articles
    • keep bitten immobilized
    • keep bite @ or below heart
    • mark edema to determine rate and amt of swelling
  52. acetaminophen (tylenol) :nonopioid analgesic antipyretic
    • prostaglandin inhibition
    • Indication: fever
    • contra: liver/renal disease; alcoholism
    • effect:liver toxicity
    • dosage:650-1000mg PO adult
    • pedi: 15mg/kg PO of elixir
  53. albuterol :med: B2 adrenergicv bronchodilator
    relaxes bronchial muscles
  54. Indication:respiratory distress from asthma, COPD or some types of pulmonary edema
  55. contra:arrhythmias; hypertension; cardiovascular disorder
    • effect:body tremors, headache, insomnia; hypertension; arrhythmias; bronchospasms; tachycardia; uticaria; rash
    • dosage:2.5 mg/3ml "bullet" nebulized
  56. aspirin :ASA: analgesic, antipyretic and anti-inflamatory
    • Indication:chest pain; suspected MI
    • contra:hypersensitivity; anticoagulant therapy; known/suspected bleeding or hemorrhage
    • effect: prolonge debleeding time; nausea/vomitting; Gastic irritation
    • dosage:324 mg PO (4x82 mg tabs)
  57. dextrose(glucose) :Indication:hypoglycemia
    • contra:intracranial hemorrhage; increased interc pressure; cerebral edema
    • effect: necrosis if extravasation; hyperglycemia; neurologic in OH PT
    • dosage:15 g PO in adult PT
    • 7.5-15 g PO in pedi PT
  58. epi :endogenous catecholamine
    • stimulate beta receptors of heart, vasculature
    • bronchodialtion
    • vasodilation
    • Indication: asthma; cardiac arrest; anaphylaxis; bradycardia
    • contra:hypovolemia shock; ischemic heart disease;
    • effect:arrhythmial tachycardia; palpitations; precipitation of angial pain; increased bloodpressure; anxiety
    • dosage:
  59. tetracaine :local anesthetic agent of ester linkage
    • prevents initation and transmission of nerve impulses
    • Indication: burns to eye
    • contra:hypersensitivity; open or disrupted globe
    • effect:stingin, burning, conjunctiva redness
    • dosage:1-2 drops prn in injured eye

What would you like to do?

Home > Flashcards > Print Preview