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43 Cards in this Set

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Normal Saline - Class
Electrolyte / Isotonic Crystalloid
Normal Saline - Actions
Electrolyte solution which is equivalent osmotically to blood.

Increases the circulating volume of the vascular system. (2/3 of infused volume leaves vascular space within 1 hour)
Normal Saline - Indications
Definitive therapy or anticipated
___________________________

Shock Hypovolemia

Shock Normovolemia: anaphylactic, neurogenic

Suspected intra-abdominal catastrophe or aortic aneurysm

Anaphalaxis
___________________________

Shock: Cardiogenic or Septic

Dysrhythmias
___________________________

Crush injury with extended entrapment = or > 2 hrs or extremity or torso
___________________________

Burn patients with = or > 20% 2nd degree or = or > 5% 3rd degree
___________________________

Respiratory distress with croup-like cough
Normal Saline - Dosage / Route

for

Definitive therapy or anticipated
ADULT & PEDS:

IV SO; adjust prn
Normal Saline - Dosage / Route

for

Shock Hypovolemia

Shock Normovolemia: anaphylactic, neurogenic

Suspected intra-abdominal catastrophe or aortic aneurysm

Anaphalaxis
ADULT:

IV 500ml bolus; MR to maintain BP 90 systolic

PEDS "non-cardiogenic":

IV/IO per drug chart; MR to maintain BP = or > [70+(2xAge)]
Normal Saline - Dosage / Route

for

Shock: Cardiogenic or Septic

Dysrhythmias
ADULT:

IV bolus to max 250ml with clear lungs; MR to maintain BP 90 systolic

PEDS"cardiogenic":

IV/IO per drug chart with clear lungs; MR x1 to maintain BP = or > [70+(2xAge)]
Normal Saline - Dosage / Route

for

Crush injury with extended entrapment = or > 2 hrs or extremity or torso
ADULT:

IV 1000ml bolus when extremity released - BHO

PEDS:

IV per drug chart when extremity released - BHO
Normal Saline - Dosage / Route

for

Burn patients with = or > 20% 2nd degree or = or > 5% 3rd degree
ADULT:

= or > 15 y/o - 500ml/hr then TKO

PEDS:

5-14 y/o - 250ml/hr then TKO
<5 y/o - 150ml/hr then TKO
Normal Saline - Dosage / Route

for

Respiratory distress with croup-like cough
ADULT & PEDS:

5ml via nebulizer
Normal Saline - Contras
Rales for fluid boluses
Normal Saline - Side Effects
None
Normal Saline - Concentration
1000ml - 10gtts/ml

or

250ml - 60gtts/ml
Normal Saline - Special Information
Contents of 0.9% solution:

- 154MEQ NA/Liter
- 154MEQ CL/Liter
___________________________

Flow Rates:

- 18G=80ml/min wide open (maxi tubing)
- 14G=160ml/min wide open (maxi tubing)
___________________________

TKO:

- MAXI - 1gtt/12sec OR 5gtts/min
- MINI - 1gtt/2sec OR 30gtts/min
Albuterol - Alternative Names
Proventil, Ventolin
Albuterol - Class
Sympathomimetic
Albuterol - Actions
Activates the beta-2 adrenergic receptors to relax bronchial smooth muscles.

Bronchodilation, relieves bronchospasms, and reduces airway resistance.

ONSET - 5 min
PEAK - 1 hour
DURATION - 3-4 hours
Albuterol - Indications
Respiratory distress with Bronchospasms:
- Respiratory origin
- Allergic reaction
- Burns
Albuterol - Dosage / Route
ADULT:

6ml (0.083%) via nebulizer; MR

PEDS:

Per drug chart via nebulizer; MR
Albuterol - Contras
None
Albuterol - Side Effects
Tachycardia / Palpitations
Dizziness / Headache
Tremors / Nervousness
Albuterol - Concentration
2.5mg / 3ml
Albuterol - Special Information
Handheld mouthpiece - 4-6L O2

Mask or ET Tube - 6-10L O2

Use with caution in pregnancy

Check lung sounds, o2 sat and resp rate before and after administration.
Atrovent - Alternative Names
Ipratropium Bromide
Atrovent - Class
Anticholinergic
Atrovent - Actions
Antagonizes the action of acetylcholine preventing the interacton with muscarinic receptors in bronchial smooth muscle causing bronchodilation.

Bronchodilation, site specific (in lung - not systemic)

ONSET - 15-30 min
PEAK - 1-2 hrs
DURATION - 4-5 hrs
Atrovent - Indications
Respiratory distress with Bronchospasms:
- Respiratory origin
- Allergic reaction
- Burns
Atrovent - Dosage / Route
ADULT:

2.5 (0.02%) via nebulizer added to first dose Albuterol

PEDS:

Per drug chart via nebulizer added to first dose of Albuterol
Atrovent - Contras
None
Atrovent - Side Effects
Nausea
GI Distress
Nervous / Dizzyness
Headache
Palpitations
Blurred Vision / Eye irritation (with direct contact of mist)
Atrovent - Concentration
0.5mg / 2.5ml (0.02% unit dose vial)
Atrovent - Special Information
Handheld mouthpiece - 4-6L O2
Mask / ET Tube - 6-10 O2

Avoid direct contact with eyes, consider using mouthpiece instead of mask.

Administer even with patient self-administration prior to medic arrival.

Check lung sounds, o2 sat and resp rate before and after administration.
Versed - Alternate Names
Midazolam
Versed - Class
Benzodiazepine
Versed - Actions
CNS Depressant

Produces retrograde amnesia, then sedation

Stops and prevents seizures

ONSET - IV=2-5min IM=15mins
DURATION - 1-4hrs
Versed - Indications
Seizures
- Generalized seizures lasting = or > 5mins
- Focal seizures with respiratory compromise
- Recurrent seizures without lucid interval
- Eclamptic seizures of any duration
___________________________

Precardioversion
- Conscious VT - Adult only
- SVT - Adult and Peds
- A-fib/flutter if rhythm refractory to Rx or symptoms are severe
___________________________

Pacemaker insertion with capture
Versed - Dosage / Route

For

Seizures
ADULT
0.1mg/kg slow IVP (1mg/min) to max of 5mg - SO
MR x1 in 10" - SO

If no IV
IM - Double the IV Dose

PEDS
Per Drug Chart IV/IM
Versed - Dosage / Route

For

Precardioversion
- Conscious VT
ADULT ONLY
1-5mg slow IVP (1mg/min) - SO
(if age = or > 60 consider lower dose with attention to age and hydration status)
Versed - Dosage / Route

For

Precardioversion
- SVT
ADULT
1-5mg slow IVP (1mg/min) - BHO (if age = or > 60 consider lower dose with attention to age and hydration status)

PEDS
Per drug chart slow IVP (1mg/min) - BHPO
Versed - Dosage / Route

For

Precardioversion
- A-Fib/Flutter (if rhythm refractory to Rx or symptoms are severe

Pacemaker insertion with capture
ADULT ONLY
1-5mg slow IVP (1mg/min) - BHPO
(if age = or > 60 consider lower dose with attention to age and hydration status)
Versed - Contras
None
Versed - Side Effects
Respiratory depression / Apnea
Drowsiness / Confusion
Hypotension
Versed - Concentration
5mg/1ml OR 10mg/2ml
Versed - Special Information
Give at 1mg/min rate for IVP

No pinching tube, give with TKO rate

Discontinue if seizure stops

Some patients respond to as little as 1mg

Monitor respiratory rate and O2 sat, especially with ETOH or other sedatives, CNS depressants.

Used for amnesia effect not sedation

Controlled substance