2017 Nyc Remac - Gop Als - Prehospital Sedation

Front 1

Definition: Prehospital Sedation is a fully monitored pharmacologic intervention applied in instances where patients may need short-term analgesic and/or anxiolytic therapy for...

Back 1

...procedures that may be painful or anxiety producing.

Front 2

Three indications for Prehospital Sedation.

Back 2

(1) ET Intubation

(2) Synchronized Cardioversion

(3) Transcutaneous Pacing

Front 3

True or False

Sedation of Seizure Patients falls under the GOP definition of Prehospital Sedation.

Back 3

False.

Prehospital Sedation pertains to procedures.

Front 4

True or False

PPMC is required for Prehospital Sedation.

Back 4

True.

Front 5

Name the two categories of Prehospital Sedation "indications" that are listed in the GOP protocol.

Back 5

(1) Endotracheal Intubation

(2) Synched Cardioverion OR Transcutaneous Pacing

Front 6

Which phamacologic intervention applies to Synchronized Cardioversion only?

Back 6

Etomidate 0.15 mg/kg IVB

Max total dose 20 mg

Front 7

Name the drugs (without doses) that appear in the Prehospital Sedation options for ET Intubation.

Back 7

(a) Diazepam

(b) Midazolam

(c) Etomidate followed by Diazapam or Lorazepam

Front 8

Name the drugs (without doses) that appear in the Prehospital Sedation options for Synchronized Cardioversion.

Back 8

(a) Diazepam

(b) Midazolam

(c) Etomidate

Front 9

Name the drugs (without doses) that appear in the Prehospital Sedation options for Transutaneous Pacing.

Back 9

(a) Diazepam

(b) Midazolam

Front 10

Patients receiving prehospital sedation must be continuously administered _____ and must be continuously monitored using _____ and _____.

Back 10

high concentration oxygen

cardiac monitoring

pulse oximetry

Front 11

Dose and route(s) of Diazepam when used as the sole sedative for ET intubation.

Back 11

5-10 mg, IV bolus

Repeat doses at 5-10 mg as needed

(Max total 20 mg)

Front 12

Dose and route(s) of Midazolam for ET intubation.

Back 12

1-2 mg, IV/IN bolus

Repeat doses at 1 mg as needed

(Max total 5 mg)

Front 13

Sequence, dose and route(s) of Etomidate, Diazapam and Lorazepam for ET intubation.

Back 13

Etomidate

0.3 mg/kg, IV bolus

(max 40 mg)

After intubation, Diazepam

5 mg IV bolus

OR

Lorazepam

2mg IV or IM

Front 14

Dose and route(s) of Diazepam for Cardioversion and Pacing.

Back 14

5-10 mg, IV bolus

Repeat doses at 5-10 mg as needed

(Max total 20 mg)

Front 15

Dose and route(s) of Midazolam for Cardioversion and Pacing.

Back 15

1-2 mg, IV/IN bolus

Repeat doses at 1 mg as needed

(Max total 5 mg)

Front 16

Name the difference(s) in the prescribed use of Midazolam in ET Intubation versus Cardioversion/Pacing (option "b").

Back 16

There is no difference. The text in option "b" is identical for both interventions.

Front 17

When used as a primary sedative (option "a"), name the difference(s) in the prescribed use of Diazepam in ET Intubation versus Cardioversion/Pacing.

Back 17

There is no difference. The text in option "a" is identical for both interventions.

Front 18

Name the difference(s) in the prescribed use of Etomidate in ET Intubation versus Cardioversion/Pacing (option "c").

Back 18

(1) Lorazepam or Diazepam for continued sedation are indicated for ET intubation only

(2) 1/2 dose/kg and max is used for cardioversion (.15 mg/kg, max 20)

(3) Etomidate is not used for pacing

Front 19

Dose and route(s) of Etomidate for Cardioversion.

Back 19

0.15 mg/kg IV bolus

(Max total 20 mg)

Front 20

Dose and route(s) of Etomidate for Pacing.

Back 20

Etomidate is not used for pacing.

(short acting)

Front 21

In the GOP Prehospital Sedation protocol, which is the only drug that can be given IN?

Back 21

Midazolam

Front 22

In the GOP Prehospital Sedation protocol, which is the only drug that can be given IM?

Back 22

Lorazepam

Front 23

When is Lorazepam administered by itself in the GOP Prehospital Sedation protocol?

Back 23

Never.

(It appears only once in Prehospital Sedation, following Etomidate in intubation.)

Front 24

What is the repeat dose of Diazepam for continued sedation following Etomidate?

Back 24

There is no repeat indicated in the protocol.

Front 25

What is the repeat dose of Lorazepam for continued sedation following Etomidate?

Back 25

There is no repeat indicated in the protocol.

Front 26

The max dose of Etomidate for intubation is ____ that of cardioversion.

Back 26

double

(40mg vs 20mg)

Front 27

The max dose of Etomidate for cardioversion is ____ that of intubation.

Back 27

1/2

(20mg vs 40mg)

Front 28

The dose/kg of Etomidate for cardioversion is ____ that of intubation.

Back 28

1/2

(0.15 mg/kg vs 0.3 mg/kg)

Front 29

The dose/kg of Etomidate for intubation is ____ that of cardioversion.

Back 29

twice

(0.3 mg/kg vs 0.15 mg/kg)

Front 30

Initial Dose of Diazepam as a standalone sedative in all Prehospital Sedation interventions.

Back 30

5-10 mg

Front 31

Initial Dose of Midazolam in all Prehospital Sedation interventions.

Back 31

1-2 mg

Front 32

Repeat Doses of Diazepam as a standalone sedative in all Prehospital Sedation interventions.

Back 32

5-10 mg

Front 33

Repeat Doses of Midazolam in all Prehospital Sedation interventions.

Back 33

1 mg

Front 34

Name the Prehospital Sedation drug(s) administered in mg/kg.

Back 34

Etomidate

Front 35

Prehospital Sedation may be required for patients who are _____ prior to procedures.

Back 35

conscious

Front 36

Administer oxygen by _____ at _____ during laryngoscopy and intubation.

Back 36

nasal cannula

maximum flow rate