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90 Cards in this Set

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  • Back
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What is the initial pediatric cardiac arrest does for Epi?
0.01mg/kg 1:10
How large is an adequate landing zone?
100 feet square
What is the second dose of Epi in pediatric cardiac arrest?
0.1mg/kg 1:1
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?
q 5 min
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)
What is the pediatric dose for atropine?
Talk with the helicopter on_______?
Fire mutual aid
The pediatric dose for calcium chloride is?
We don't give it to peds.
Generally speaking, a glucometer reading of less than _________ indicates hypoglycemia needing treatment with some form of glucose?
Do not pace a pt who is ___________ or a pt who is less than _________ years old
16 yo
You must be at least ________ years old to ride the CPAP machine. What are the five other contraindications?
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
Carotid sinus massage can be done on pts between _____ and _____ (inclusive).
16 and 50 yo
Other than age, what are the four contraindications to CSM?
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
Before you go rubbing anyones neck, what 3 interventions do you need to do, and what three things should you have ready?
Monitor, IV, and Pulse ox in place.
Pads, atropine and intubation equipment handy.
If there is a carotid bruit on the right, but not the left, it is okay to massage the left carotid.
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.
How can you enhance the effects of CSM?
Elevate their legs, or have them throw in some val salva while performing CSM
What equipment do you carry in to a medical incident?
Airway supplies and oxygen
What equipment do you carry in to a trauma incident?
Airway supplies and oxygen
BLS supplies
ABC stands for?
Airway, Breath Sounds, Circulation
As you are listening to breath sounds during your initial assessment, you should also be_____?
Palpating a radial pulse
For every 45 minutes of work (or two SCBA bottles, no less than ___ minutes of rehab should be provided
Vital signs should be taken immediately and every ___ minutes thereafter in the rehab area of an incident.
During rehab, if a worker has a pulse less than ____ and a systolic BP between _____ and ______, he or she may return to work.
100 and 180 mmHg
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)
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
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.
Your toxic exposure pt. is actively seizing. What should you do?
Give Diazepam 2-10mg IV (Ped: 0.2mg/kg IV, or 0.5mg/kg PR)
Transport ASAP
All patient with exposure to toxic gas inhalation should recieve _____.
Oxygen at 15 LPM by NRB
Where do we place ice packs to cool a heat stroke pt?
Axilla, chest, scalp, groin, abdomen.
Also apply cool compresses
The pulse oximeter plays an important role in assessing your toxic inhalation patient's oxygenation status. Why is this statement false?
High levels of SpO2 (even 100%) do not ensure a high degree of oxygenation in these patients.
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.
The dose of atropine given to a ped arrest or heart problems?
0.02mg/kg IV or IO
min: 0.1mg
max: 0.5mg child, 1mg adolescent
repeat once in 5 minutes
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
If your abd pain pt has a hx of diabetes, obtain a ______?
12-lead on scene
What are two measurements/assessments you want to seriously consider for your abd pain pt?
See hint?
orthostatic vitals
You'll need your monitor and BP cuff
A + B + C = Ectopic pregnany (until proven otherwise).
Abd Pain
Female of child bearing age
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.
Mild allergic rxn: How much diphenhydramine for the 3 year old?
How much for the 7 month old?
None & none
Moderate allergic rxn: How much diphenhydramine for the 3 year old?
How much for the 7 month old?
None (no diphenhydramine under 9 months)
Severe allergic rxn: How much diphenhydramine for the 3 year old?
How much for the 7 month old?
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
What is the treatment for an adult having a severe anaphylactic rxn?
Epi 0.3-0.5mg SQ 1:1
Albuterol 5mg neb
Diphenhydramine 50mg IV or IM
NS wide open
Methylprednisolone 125mg IV
What is the treatment for a ped pt. greater than 9 months old having a severe anaphylactic rxn?
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)
What is the treatment for a ped pt. greater than 9 months old having a severe anaphylactic rxn?
Epi 0.01mg/kg SQ 1:1000 (max 0.3mg)
Albuterol 2.5mg neb
NS 20ml/kg, repeat 10ml/kg infusions prn
What is the pediatric dose of methylprednisolone in moderate anaphylaxis?
None. We don't give Solu-Medrol to peds
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?
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
What are the pediatric (>9 months) and adult doses for SQ Epi in moderate allergic reactions?
None. Epi is reserved for true anaphylaxis.
Why mightn't a person having an allergic rxn show the usual s/sx?
They might be taking beta-blockers
What is one very basic way we can limit the potential progression of an allergic rxn?
Remove the source (stinger, etc)
How do we store and transport avulsed/amputated tissue?
Gently irrigate, wrap in moist sterile gauze, place in plastic bag, place bag on ice.
What can we give for pain relief for animal bites?
MS 2-10mg or nitrous
What bites must be reported?
Human and dog
Maybe others???
A child's guardians may not refuse transport for the child if you suspect abuse.
True. Take the child to the hospital.
This type of back pain isn't under signal five: ______
Back pain secondary to a fall
Analgesia can be given for which types of back pain?
Kidney stones
What do we want to find in our pt's hx to green-light the use of analgesia for kidney stone s/sx?
hx of same or similar pain during previous kidney stone attacks (they must (should) have been stoned in the past :)
Back pain is a signal that warrants a high index of suspicion and frequent use of _______
the 12-lead EKG
Your diabetic pt. with back pain should get a _________
12-lead on scene
Cholecystitis presents as _______ quadrant pain(known as ______ sign) radiating to the _______. It commonly strikes whom?
Murphy's sign (pain on palp of right subcostal area during inspiration)
to the scapula/shoulder
Back pain may be ________ in etiology.
Cardiac. Especially in diabetics and females.
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)
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
Your first consideration in reversing pediatric cardiac arrest is?
Airway, airway, airway
Three things you want to avoid in your pediatric pt with respiratory distress and epiglottitis like s/sx:_______.
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.
What is the contraindication to epinepherine administration in life threatening situations?
There is none.
What initial treatment do we do for chemical burns?
Strip (off any clothes, jewelry, etc)
Brush (off any powder)
Flush and flush and flush
Make sure the ______ is dispatched to all responses involving chemicals.
hazmat team
We cool thermal burns if we can apply a cooling agent within ____ time frame. We use ___ to cool it for ____minutes.
1-2 min
water, saline
1-2 min
We dress burns with________
clean dry sheets
Two important things to prevent with burns:
We can give analgesia to burn pt's as long as they are ________ and __________.
hemodynamically stable
What two conditions related to burns warant NS w/o?
Hemodynamically unstable
Burns greater than 25% BSA

Otherwise TKO
Pediatric trauma and medical conditions producing hypotension generally get NS at:
repeated at 10ml/kg prn
Pediatric arrest conditions get NS at:
repeated at 20ml/kg
You can start an IV through partial thickness burns.

True, if needed
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.
Other than decontamination, we generally treat burns from the various sources alike.
Fluids and (analgesics for adults)
What is the treatment for toxic inhalation?
More albuterol
Methylprednisolone for adults
CPAP if adult and awake
What are the four routes for toxins to enter the body?
Why should you consider transporting your toxic inhalation patient to CMC or Presbyterian?
They have hyperbaric oxygen chambers
Carbon Monoxide
Adults are defibrillated at:
1st shock:
2nd shock:
subsequent shocks:
150J for all shocks
Peds are defibrillated at:
1st shock:
2nd shock:
subsequent shocks:
Max watt-seconds for any one shock____?
(One Joule = one watt-second)
In adult pulseless VT/VF what is our Lidocaine dosing and schedule?
1.5 mg/kg
repeat at 0.5 mg/kg every 3-5 minutes
to a max of 3 mg/kg
When do we alter our lidocaine doses?
For pts over 70, or with CHF, liver dysfunction or shock we would half the doses
Epi is repeated every ___ min in arrest situations
Adult: 5 min
Ped: 3-5 min
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
What are 6 situations when we give Lidocaine?
Pulseless VT
VT with pulse both stable and unstable
Symptomatic ventricular ectopy
Prior to intubation suspected head injury/increased ICP pts
What are the adult and pediatric doses for sodium bicarb in arrest situations? When do we give it?
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)
When is the one time we give sodium bicarb to peds?
Cardiac arrest
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?
Total resuscitation time in excess of 20 minutes
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.