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90 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What is the initial pediatric cardiac arrest does for Epi?
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0.01mg/kg 1:10
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How large is an adequate landing zone?
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100 feet square
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What is the second dose of Epi in pediatric cardiac arrest?
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0.1mg/kg 1:1
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You've given two doses of Epi to your pediatric cardiac arrest victim, now what dose are you going to give your remaining Epi's at? And how often?
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0.2mg/kg
q 5 min |
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Why do we only repeat Atropine once in peds?
See hint |
The pediatric dose is 0.02mg/kg and the max total given is 0.04mg/kg (twice the initial dose)
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What is the pediatric dose for atropine?
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Talk with the helicopter on_______?
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Fire mutual aid
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The pediatric dose for calcium chloride is?
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We don't give it to peds.
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Generally speaking, a glucometer reading of less than _________ indicates hypoglycemia needing treatment with some form of glucose?
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60
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Do not pace a pt who is ___________ or a pt who is less than _________ years old
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hypothermic
16 yo |
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You must be at least ________ years old to ride the CPAP machine. What are the five other contraindications?
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18 yo
Can't get a good mask seal Uncooperative/obtunded pts. Isolated COPD exacerbation Trach pts Pt. can't maintain their own airway/handle secretions |
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Carotid sinus massage can be done on pts between _____ and _____ (inclusive).
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16 and 50 yo
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Other than age, what are the four contraindications to CSM?
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1. carotid bruits
2. unequal carotid pulses 3. hx of carotid endartectomy or atheroscelrotic plaque removal 4. recent MI, CVA, or sx suggesting either process |
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Before you go rubbing anyones neck, what 3 interventions do you need to do, and what three things should you have ready?
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Monitor, IV, and Pulse ox in place.
Pads, atropine and intubation equipment handy. |
CSM
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If there is a carotid bruit on the right, but not the left, it is okay to massage the left carotid.
True? False? |
False
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CSM: Where do you massage and for how long?
How long do you wait between massages? Should you switch to the other side? |
Just below the angle of the jaw, for 5 seconds max. Stop if rate drops.
Wait 1 minute then repeat once. No result, then switch to other side and try it. |
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How can you enhance the effects of CSM?
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Elevate their legs, or have them throw in some val salva while performing CSM
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What equipment do you carry in to a medical incident?
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Airway supplies and oxygen
Monitor Medications Stretcher |
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What equipment do you carry in to a trauma incident?
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Airway supplies and oxygen
BLS supplies Monitor Stretcher |
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ABC stands for?
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Airway, Breath Sounds, Circulation
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As you are listening to breath sounds during your initial assessment, you should also be_____?
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Palpating a radial pulse
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For every 45 minutes of work (or two SCBA bottles, no less than ___ minutes of rehab should be provided
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10
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Vital signs should be taken immediately and every ___ minutes thereafter in the rehab area of an incident.
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20
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During rehab, if a worker has a pulse less than ____ and a systolic BP between _____ and ______, he or she may return to work.
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100bpm
100 and 180 mmHg |
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What are mild effects of organophosphate or nerve agent poisoning?
What is the antidote adult dose? |
Rhinorrhea, Miosis, N/V
Atropine 2mg IV or IM (autoinjector only) |
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What symptom of organophosphate or nerve agent poisoning lets you know the poisoning is having at least moderate effects?
What is the antidote adult dose? |
Addition of SOB
Atropine 2mg IV or IM (autoinjector only), repeat in 10 minutes |
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What are effects of organophosphate poisoning that qualify as severe?
What is the antidote adult dose? |
Addition of seizures, apnea, and GI effects
Atropine 6mg IV or IM (autoinjector only), then Atropine 2mg every 10 minutes. Diazepam 10mg IV. |
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Your toxic exposure pt. is actively seizing. What should you do?
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Give Diazepam 2-10mg IV (Ped: 0.2mg/kg IV, or 0.5mg/kg PR)
Transport ASAP |
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All patient with exposure to toxic gas inhalation should recieve _____.
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Oxygen at 15 LPM by NRB
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Where do we place ice packs to cool a heat stroke pt?
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Axilla, chest, scalp, groin, abdomen.
Also apply cool compresses |
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The pulse oximeter plays an important role in assessing your toxic inhalation patient's oxygenation status. Why is this statement false?
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High levels of SpO2 (even 100%) do not ensure a high degree of oxygenation in these patients.
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The pediatric dose of atropine for organophospate poisoning (give min. maxs and how often to repeat).
See hint? |
0.02mg/kg IV or IO
min: 0.1mg max: 0.5mg child, 1mg adolescent repeat once in 5 minutes |
It exactly the same as for cardiac use.
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The dose of atropine given to a ped arrest or heart problems?
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0.02mg/kg IV or IO
min: 0.1mg max: 0.5mg child, 1mg adolescent repeat once in 5 minutes |
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The only abdominal pain condition we give analgesia for is?
What can we give for it? |
kidney stone
Adults: 2-10mg MS or nitrous oxide |
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If your abd pain pt has a hx of diabetes, obtain a ______?
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12-lead on scene
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What are two measurements/assessments you want to seriously consider for your abd pain pt?
See hint? |
12-lead
orthostatic vitals |
You'll need your monitor and BP cuff
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A + B + C = Ectopic pregnany (until proven otherwise).
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Syncope
Abd Pain Female of child bearing age |
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What kinds of vomiting should we be concerned about in an infant?
How concerned should we be? |
Projectile and bilious vomiting are surgical emergencies.
General vomitting or spitting up is common. |
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Mild allergic rxn: How much diphenhydramine for the 3 year old?
How much for the 7 month old? |
None & none
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Moderate allergic rxn: How much diphenhydramine for the 3 year old?
How much for the 7 month old? |
1mg/kg
None (no diphenhydramine under 9 months) |
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Severe allergic rxn: How much diphenhydramine for the 3 year old?
How much for the 7 month old? |
1mg/kg
None |
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What s/sx will let us know the patient is having:
a mild allergic reaction? a moderate allergic reaction? a severe anaphylactic reaction? |
urticaria, pruritis
addition of SOB or dyspnea addition of hemodynamic instability and severe respiratory distress |
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What is the treatment for an adult having a severe anaphylactic rxn?
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Epi 0.3-0.5mg SQ 1:1
Albuterol 5mg neb Diphenhydramine 50mg IV or IM NS wide open Methylprednisolone 125mg IV |
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What is the treatment for a ped pt. greater than 9 months old having a severe anaphylactic rxn?
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Epi 0.01mg/kg SQ 1:1000 (max 0.3mg)
Albuterol 2.5mg neb NS 20ml/kg, repeat 10ml/kg infusions prn Diphenhydramine 1mg/kg (max 50mg) |
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What is the treatment for a ped pt. greater than 9 months old having a severe anaphylactic rxn?
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Epi 0.01mg/kg SQ 1:1000 (max 0.3mg)
Albuterol 2.5mg neb NS 20ml/kg, repeat 10ml/kg infusions prn |
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What is the pediatric dose of methylprednisolone in moderate anaphylaxis?
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None. We don't give Solu-Medrol to peds
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Severe anaphylaxis pt not responding to standard treatment, remains hemodynamically unstable and symptomatic. What now for your adult pt? What now for your pediatric pt?
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Adult: Epi 0.1 to 1 mg IV 1:10,000
Dopamine 5-20mcg/kg/min Ped: Epi 0.01-0.1mg/kg IV 1:10,000 Dopamine 5-10mcg/kg/min |
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What are the pediatric (>9 months) and adult doses for SQ Epi in moderate allergic reactions?
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None. Epi is reserved for true anaphylaxis.
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Why mightn't a person having an allergic rxn show the usual s/sx?
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They might be taking beta-blockers
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What is one very basic way we can limit the potential progression of an allergic rxn?
Hint? |
Remove the source (stinger, etc)
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Hymenoptera
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How do we store and transport avulsed/amputated tissue?
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Gently irrigate, wrap in moist sterile gauze, place in plastic bag, place bag on ice.
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What can we give for pain relief for animal bites?
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MS 2-10mg or nitrous
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What bites must be reported?
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Human and dog
Maybe others??? |
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A child's guardians may not refuse transport for the child if you suspect abuse.
True False |
True. Take the child to the hospital.
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This type of back pain isn't under signal five: ______
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Back pain secondary to a fall
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Analgesia can be given for which types of back pain?
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Kidney stones
Musculoskeletal |
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What do we want to find in our pt's hx to green-light the use of analgesia for kidney stone s/sx?
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hx of same or similar pain during previous kidney stone attacks (they must (should) have been stoned in the past :)
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Back pain is a signal that warrants a high index of suspicion and frequent use of _______
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the 12-lead EKG
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Your diabetic pt. with back pain should get a _________
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12-lead on scene
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Cholecystitis presents as _______ quadrant pain(known as ______ sign) radiating to the _______. It commonly strikes whom?
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RUQ
Murphy's sign (pain on palp of right subcostal area during inspiration) to the scapula/shoulder FFFF |
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Back pain may be ________ in etiology.
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Cardiac. Especially in diabetics and females.
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What is the pediatric dose of albuterol for asthma or bronchospasm?
What and how much will you give them if they have severe respiratory distress or stridor? |
2.5-5mg neb, repeat at same
Epi 0.01mg/kg SQ 1:1000 (max 0.3mg) |
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What is the adult dose of albuterol for COPD, asthma, bronchospasm, etc? What else should you give them if one neb doesn't do the trick?
What and how much will you give them if they have severe respiratory distress or stridor? |
5mg neb
methylprednisolone 125mg IV Epi 0.3-0.5mg SQ 1:1000 for severe distress |
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Your first consideration in reversing pediatric cardiac arrest is?
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Airway, airway, airway
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Three things you want to avoid in your pediatric pt with respiratory distress and epiglottitis like s/sx:_______.
Why? Why is it important to get a good history of the events leading up to the respiratory distress? |
Invasive oral exams
Finger sweeps Supine positioning You may precipitate a catastrophic total airway occlusion. Hx. is important, we want to be sure the drooling stridorous child is not that way due to a hard candy, etc partially occluding the airway. |
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What is the contraindication to epinepherine administration in life threatening situations?
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There is none.
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What initial treatment do we do for chemical burns?
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Strip (off any clothes, jewelry, etc)
Brush (off any powder) Flush and flush and flush |
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Make sure the ______ is dispatched to all responses involving chemicals.
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hazmat team
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We cool thermal burns if we can apply a cooling agent within ____ time frame. We use ___ to cool it for ____minutes.
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1-2 min
water, saline 1-2 min |
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We dress burns with________
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clean dry sheets
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Two important things to prevent with burns:
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hypothermia
infection |
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We can give analgesia to burn pt's as long as they are ________ and __________.
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adult
hemodynamically stable |
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What two conditions related to burns warant NS w/o?
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Hemodynamically unstable
Burns greater than 25% BSA Otherwise TKO |
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Pediatric trauma and medical conditions producing hypotension generally get NS at:
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20ml/kg
repeated at 10ml/kg prn |
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Pediatric arrest conditions get NS at:
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20ml/kg
repeated at 20ml/kg |
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You can start an IV through partial thickness burns.
True False |
True, if needed
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What are considered significant burns?
Which of them can be taken to Prebyterian? |
Partial or full thickness burns:
> 25% of total BSA Involving hands, feet, face, genitals, eyes, ears Crossing major joints Circumferential involvement High voltage etiology Associated inhalation injury Associated major trauma None. All go to CMC. |
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Other than decontamination, we generally treat burns from the various sources alike.
True False |
True.
Fluids and (analgesics for adults) |
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What is the treatment for toxic inhalation?
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Oxygen
Albuterol More albuterol Methylprednisolone for adults CPAP if adult and awake |
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What are the four routes for toxins to enter the body?
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Absorption
Inhalation Injection Ingestion |
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Why should you consider transporting your toxic inhalation patient to CMC or Presbyterian?
Hint? |
They have hyperbaric oxygen chambers
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Carbon Monoxide
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Adults are defibrillated at:
1st shock: 2nd shock: subsequent shocks: |
150J for all shocks
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Peds are defibrillated at:
1st shock: 2nd shock: subsequent shocks: Max watt-seconds for any one shock____? |
2J/kg
4J/kg 4J/kg 150J (One Joule = one watt-second) |
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In adult pulseless VT/VF what is our Lidocaine dosing and schedule?
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1.5 mg/kg
repeat at 0.5 mg/kg every 3-5 minutes to a max of 3 mg/kg |
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When do we alter our lidocaine doses?
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For pts over 70, or with CHF, liver dysfunction or shock we would half the doses
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Epi is repeated every ___ min in arrest situations
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Adult: 5 min
Ped: 3-5 min |
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What is the dose of Magnesium in cardiac situations?
Do we use Magnesium for peds? If so, how much? |
Generally, 1-2 Grams over 1-2 min.
For Torsades, 2 Grams over 1-2 min. Yes, but only with Torsades. Give 50mg/kg. Max. of 2 Grams |
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What are 6 situations when we give Lidocaine?
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VF
Pulseless VT Torsades VT with pulse both stable and unstable Symptomatic ventricular ectopy Prior to intubation suspected head injury/increased ICP pts |
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What are the adult and pediatric doses for sodium bicarb in arrest situations? When do we give it?
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1MEQ/kg repeated at 0.5MEQ/kg every 10 minutes.
When the total arrest time is in excess of 15 minutes (sooner, if a sodium bicarb treatable condition is identified) |
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When is the one time we give sodium bicarb to peds?
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Cardiac arrest
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To pronounce dead the adult medical cardiac arrest pt. that you are working, at least three conditions must be met (in addition to the psychosocial and safety considerations that go into making the decision). What are the three? What additional condition must be met with PEA?
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Total resuscitation time in excess of 20 minutes
No ROSC ETCO2 of less than 10mmHg PEA: If the arrest was witnessed AND the pt. is less than 70 yo, there must be no suspicion of pulmonary embolism. |
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