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50 Cards in this Set
- Front
- Back
A-V-P-U
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A:Alert V:Reponds to Verbal Stimuli P:Responds to Painful Stimuli U:Unresponsive
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2 Actions that should be taken when a priority patient is identified
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1. Expidite transport
2. ALS Support, if it does not delay transport, try for ALS intercept otherwise |
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9 Categories of Priority patients
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1. Unresponsive
2. Responsive by cannot follow commands 3. Difficulty breathing 4. Shock 5. Uncontrolled breathing 6. Severe pain 7. Chest pain w/ BP < 100mmHG 8. Complicated childbirth 9. Poor general impression |
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Adult indicators of inadequate breathing
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< 8 respirations /min
or > 24 respirations /min |
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Quality of breath can be placed in 4 categories
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1. Normal
2. Shallow 3. Labored 4. Noisy |
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2 factors which should be observed when assessing breathing
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1. Rate
2. Quality |
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4 abnormal skin colors
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1. Pale (pallor) - Poor pefusion/impaired bloodflow
2. Cyanotic (blue/gray) - Inadequate oxygenation or poor perfusion 3. Flushed (red) - Late sign of carbon monoxide exposure 4. Jaundice (yellow) - Liver abnormalilties |
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Methods to obtain SAMPLE history for an unresponsive patient
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1. Information from Family, friends, or bystanders
2. Medical ID |
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S-A-M-P-L-E
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S - Signs and sympotms
A - Allergies M - Medications taken P - Patient past history L - Last oral intake or menstral period E - Events leading to illness or injury |
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O-P-Q-R-S-T
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O - Onset
P - Provacations Q - Quality R - Radiation S - Severity T - Time |
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General situation that would not require a detailed physical exam
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1. Patient with isolated trauma injury
2. Alert medical patient with specific complaint |
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The intervals for performing an on-going assessment
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1. Every 15 minutes for stable patient
2. Every 5 minutes for unstable patient |
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5 components of baseline vitals
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1. Respiration - Rate & quality
2. Pulse - Rate & quality 3. Skin - Color, temperature, condition 4. Pupils - Size, reactivity 5. Blood Pressure - Ausculation, palpation |
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Differentiate between signs and symptoms
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1. Sign - Something the rescuer seer, feels, or hears
2. Symptom - Something the patient tells about his condition |
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D-C-A-P B-T-L-S
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D - Deformities
C - Contusions A - Abrasions P - Puncture, penetrations, paradoxical movement B - Burns T - Tenderness L - Lacerations S - Swelling |
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O2 Tank capacity
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Portable:
D - 350 L, E - 625 L--- Onboard: M - 3000 L, H - 6900 L |
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Acute Abdomen - Signs & Symtoms
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Abdominal Pain,
Guarding, Tachypnea, Referred Pain, Anorexia, N/V, Abdominal Distension, Bloody diarrhea, Tachycardia, Hypotension, Fever, Rebound tenderness |
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Acute Abdomen - Exam
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1. Place patient in supine position
2. Gently palpate |
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Acute Abdomen - Etiology
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GI disturbances
Female reporductive - Ovaries, ectopic pregnancy Anneurysm |
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Acute Abdomen - Care
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ABC
O2 No P.O No Pain meds Aniticpate shock Monitor vitals Transport |
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Normal flow rates for :
Nonrebreather mask Nasal cannula Pocket mask BVM |
Nonrebreather mask - 15 lpm
Nasal cannula - 1 - 6 lpm Pocket mask - 15 lpm BVM - 15 lpm |
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Normal CO2 levels in body
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35 - 45
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Types of shock
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Compensated:
Tachycardia - Maintain cardiac output Tachypnea - Increase oxygenation Cool pale skin - Shunting of blood to core away from skin Nausea - Shunting of blood to crore away from G/I Thirst - Body recognition for more fluids Confusion,agitation - Poor perfusion of the brain Decompensated: S/S of compensated Drop of B/P < 90 mmHg Must be aggresively treated Can lead to organ failure Irreversable S/S of decompensated Fatal |
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Oxygen delivery devices
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Nonrebreather mask
12 - 15 lpm 80 - 90% Nasal Cannula 1 - 6 lpm 24 - 44% |
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Types of flowmeters
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Bourdon Gauge
PSI and Flow gauges Inaccurate at low flow rates Rugged Can't compensate for backpressure Pressure Compensated Flowmeter Must be upright Not practical for protable O2 Constant Flow w/ Selector Valve Stepped increments for flow adjustment Rugged |
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O2 Cylinder Duration of Flow
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Cylinder Constants
D = 0.16 E = 0.28 M = 1.56 G = 2.41 H = 3.14 K = 3.14 (Gauge Presssure - 200) * Cyl Constant/Flow Rate |
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Normal Rates of Rspiration
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Adult
12 - 20 Child 15 - 30 Infant 25 - 50 |
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Hypothermia - Mild
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Cold
Shivering Pale Lethargic Reduced LOC |
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Frostbite - Signs & Symptoms
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Occurs in extremities
Cold Pain Numbness Initial Redness, changing to whtie or gray Treatment: Remove form hostile environment Blanket Transport |
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Barbituates - Signs & Symptoms
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Contricted pupils
Diaphoretic Coma Bardaycardia Bradypnea Hypotension |
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Amphetamines - Signs & Symptoms
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Dialated pupils
Diaphoretic Seizures/Tremors/Anxiety Tachypnea Tacycardia Hypertension |
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Narcotics - Signs & Symptoms
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Constricted pupils
Pulmonary edema Decreased LOC Coma Depressed Respirations (Slow and shallow) Bardycardia Hypotension |
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Flail Segment
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3 or more ribs broken in 2 or more places
Paradoxical movement of chest wall Dyspnea Pain on respiration |
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Myocardial Contusion - Signs & Symptoms
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Only early S/S will be irregular pulse
Cardiac dyssrhythmias Cardiogenic shock |
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Pulmonary Contusion - Signs & Symptoms
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Results from rapid deceleration forces and develops over several hours
Cyanosis Hemptysis Pulmonary edema Dyspnea Tachypnea Tachycardia |
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Traumatic Asphyxia - Signs & Symptoms
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Bulgins, bloodshot eyes
JVD Bulging tongue Rapid cyanosis |
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Hemothorax - Signs & Symptoms
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Blood in thorax
Dyspnea Decreased or absent breath sound on affected side Hemoptysis Tachypnea Tachycardia Hypotension |
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Spontaneous Pneumothorax - Signs & Symptoms
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Occurs in young, thin, athletic males or patients with long standing COPD
Dyspnea Sudden onset of pain Decreased or absent breath sounds on affected side Will progress to Tension Pneumothorax if untreated |
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Simple Pneumothorax - Signs & Symptoms
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Usuall results form blunt injury to chest
Dyspnea Chest pain Decreased or absent breath sounds on affected side Will progress to Tension Pneumothorax if untreated |
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Oxygen (O2) Pharmacology
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Indications: All hypoxia or ischemia, known or suspected
Physiological Actions: Increases O2 tension in blood Theraputic Effects: Reduces/reverses hypoxia/ischemia Contraindications: none Precautions: possible respiratory depression with COPD Side Effects: Drying of mucous membranes if not humidified Dosage/Route: NC 2-6 lpm, NRB 10-15 lpm, BVM 10-15 lpm |
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Activated Charcoal (Actidose)Pharmacology
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Indications: Poisoning or overdose by mouth
Physiological Actions: Gastrointestinal absorbent Theraputic Effects: Absorbs & prevents physiological uptake of oral poisons or chemicals Contraindications: Ipecac adminstration within 1 hour, unconciousness Precautions: Very distasteful, may need to be mixed (soda, pudding) Side Effects: N/V, Black stools Dosage/Route: 0.5 - 1G/kg PO/NG |
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Albuterol (Proventil, Ventolin) Pharmacology
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Indications: Dyspnea w/ bronchospasm (indicated by wheezes/silence) due to asthma or exacerbation of COPD
Physiological Actions: Smooth muscle relaxant Theraputic Effects: Broncodilation (lasts 2-3 hrs.) Contraindications: Poor tidal volume, tacydysrhythmias, ventricula entropy, CHF/pulmonary edema, severely obtunded/unconcious patient Precautions: DX if heart rate ^ by >= 20 bpm or dysrhythmias appear Side Effects: Tachydysrhytmias, vetricular ectopy, N/V, anxiety, palpatations Dosage/Route: 2.5 mg in 3 ml of NS by nebulized inhalation @ 6 lpm. May be repeated once in 10 minutes PRN or 90 mcg per spray with Handheld Meter Dose Inhaler |
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Epinephrine (Adrenaline)
1:1,000 EPI-PEN Pharmacology |
Indications: Allergic reactions, anaphylaxis
Physiological Actions: Mimics sympathetic nervous system Theraputic Effects: Bronchodilation, ^ systemic vascular resistence, ^ heart rate Contraindications: Myocardial Ischemia, hypertension, tachydysrhythmias, pulomonay edema Precuations: Causes ^ myocardial O2 demand & ^ heart rate Side Effects: Ventricular ectopy, tachydysrythmias, angina, hypertension, palpatations Dosage/Route: adult: 0.3 mg IM |
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Oral Glucose (Gutose, Insta-glucose) Pharmacology
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Indications: Hypoglycemia, established/suspected
Physiological Actions: Carbohydrate glucose source Theraputic Effects: Raises blood glucose level Contraindications: Decreased mental status (NPO) Precautions: Distateful; "smear" on oral mucosa in patients w/ altered LOC Side Effects: None Dosage/Route: 25-80G PO |
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Nitroglycerin (NTG, Nitrostat) Pharmacology
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Indications: Chest pain secondary to angina/MI
Physilogical Actions: Smooth muscle relaxant, dilates arterial and venous vessels, decreases cardiac work, vasodilation of coronary arteries, increases perfusion of ischemic mycardium Theraputic Effects: vasodilation, BP reduction, coronary artery dilation, pain relief within 2 minutes, therputic effects within 30 minutes Contraindications: ^ ICP, hypotension, hypovolemia, Viagra, Cealis, Levitra usage Precuations: Recheck BP before each dose, prepare to support hypotension with positioning & fluids, patients may develop tolerance, drug deteriorates rapidly once opened, light sensitive Side Effects: Hypotension, headache, syncope, dizziness, flushing, tachycardia Dosage/Route: 0.4 mg SL (tablet or spray); repeat very 5 minutes x 2 |
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Albuterol Dosage
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2.5 mg in 3 ml NS Nebulized
90 mcg per spray with Handheld Meter Dose Inhaler |
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Activated Charcoal Dosage
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.5 - 1G/kg PO
25 - 50G |
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Epipen Dosage
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0.3 mg IM
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Oral Glucose Dosage
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25 - 80G PO
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Nitro Dosage
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0.4 mg SL
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