Medical Interventions

Front 1

Nitroglycerin Trade Name

Back 1

Nitro-bid, Nitrostat, Nirtong, Nitrolingual

Front 2

Nitroglycerin Indications

Back 2

Patient complains of chest pain

Patient has a history of cardiac problems

Physician perscribes Nitroglycerin

Systolic blood pressure greater than 100mm Hg

Medical direction authorizes administration

Front 3

Nitroglycerin Contraindications

Back 3

Hypotension/Systolic BP below 100 mm Hg

Patient has a head injury

Patient is a child or infant

Patient has taken max prescribed dosage

Patient has taken vasodilators w/in 24-48 hours

Front 4

Nitroglycerin Medication Form

Back 4

Tablet or sublingual spray

Front 5

Nitroglycerin Dosage

Back 5

One dose (Max 3). Repeat in 5 minutes if:

1) no relief of pain

2) systolic BP above 100

3) authorization from Medical Direction

Front 6

Nitroglycerin Administration

Back 6

1) complete cardiac assessment

2)Systolic BP greater than 100mm Hg

3) Contact med control if no standing orders

4) Correct: name of patient, medication (belongs to patient), dosage, right time to administer, and correct expiration date

5)determine level of responsiveness (alert)

6)Ask when last dose taken, and its effects

7)Place under tongue and dissolve/absorb

8) recheck BP in 2 min, document administration, and reassess patient

Front 7

Nitroglycerin Actions

Back 7

Relaxes blood vessels, decreased work load on heart

Front 8

Nitroglycerin Side Effects

Back 8

Hypotension, headache, pulse rate change

Front 9

Nitroglycerin Reassessment Strategies

Back 9

Monitor BP

Ask patient about effect on pain relief

Get medical direction before re-administering

Record assessments

Front 10

Aspirin (Acetylsalicylic acid) Trade Name

Back 10

Bayer

Front 11

Aspirin Indications

Back 11

Cardiac chest pain & relief of mild pain, headache, muscle aches

Front 12

Aspirin Contraindications

Back 12

Hypersensitivity, bleeding disorder, asthma

Front 13

Aspirin Medication Form

Back 13

Tablet

Front 14

Aspirin Dosage

Back 14

160-325 mg, chewed

(1/2-1 adult Aspirin or 2-4 children's Aspirin)

Front 15

Aspirin Administration

Back 15

1) Complete cardiac assessment

2) Contact medical control if no standing orders

3) Confirm no contraindications

4) Confirm dosage

5) Ask patient to chew tablets

6) Document administration, dosage, route & time

7) Reassess patient

Front 16

Aspirin Actions

Back 16

Anti-inflammatory, analgesic, antipyretic

Prevents platelets from aggregating, minimizing formation of new clots

Front 17

Aspirin Side Effects

Back 17

Nausea, vomiting, stomach pain, bleeding,

allergic reaction

Front 18

Aspirin Reassessment Strategies

Back 18

Consider administration of Nitroglycerin

Front 19

Oral Glucose Trade Name

Back 19

Glutose, Insta-glucose

Front 20

Oral Glucose Indications

Back 20

Patient with altered mental status and a known history of diabetes

Front 21

Oral Glucose Contraindications

Back 21

Unconsciousness, unable to swallow

Known diabetic who hasn't taken insulin for days

Front 22

Oral Glucose Medication Form

Back 22

Gel, in toothpaste style tube

Front 23

Oral Glucose Dosage

Back 23

One tube

Front 24

Oral Glucose Administration

Back 24

1) Assure indication & that patient is conscious

2) Administer glucose on tongue depressor OR self administered between cheek and gum

3) Perform ongoing assessment

Front 25

Oral Glucose Actions

Back 25

Increases blood sugar

Front 26

Oral Glucose Side Effects

Back 26

None when given properly. May be aspirated in patient without a gag reflex

Front 27

Oral Glucose Reassessment Strategies

Back 27

If patient loses consciousness or seizes, remove tongue depressor from mouth

Front 28

Prescribed Inhaler (MDI) Trade Name

Back 28

Proventil, Ventolin, Alupent, Metaprel, Brethine, Bronkosol, Bronkometer

Front 29

Prescribed Inhaler (MDI) Indications

Back 29

Patient has s/s of a respiratory emergency

Patient is prescribed a hand-held inhaler

Medical direction authorizes use

Front 30

Prescribed Inhaler (MDI) Contraindications

Back 30

Patient is unable to use the device (not alert)

Inhaler is not prescribed to patient

Medical direction hasn't given permission

Patient has taken max dosage

Front 31

Prescribed Inhaler (MDI) Medication Form

Back 31

Hand-held metered dose inhaler (MDI)

Front 32

Prescribed Inhaler (MDI) Dosage

Back 32

Number of inhalations based on medical direction/physician's order (usually 2 puffs)

Front 33

Prescribed Inhaler (MDI) Administration

Back 33

1) Obtain order on line or off line

2) Assure right patient, medication, dose, route, alert, & expiration date

3) Check if patient has taken previous doses

4) Make sure inhaler is room temp/warmer, shake several times

5) Have patient exhale, put lips around opening, and inhale while depressing the inhaler

6) Have patient hold breath to absorb meds

7) re-administer O2, and give 2nd dose if ordered

Front 34

Prescribed Inhaler (MDI) Actions

Back 34

Dilates bronchioles, reduces airway resistance

Front 35

Prescribed Inhaler (MDI) Side Effects

Back 35

Increased pulse rate, tremors, nervousness,

rebound problems from overuse

Front 36

Prescribed Inhaler (MDI) Reassess Strategies

Back 36

Gather vital signs

Perform focused assessment of chest &

respiratory functions

Observe for deterioration & provide PPV

Front 37

Activated Charcoal Trade Name

Back 37

SuperChar, InstaChar, Acidose, Liqui-Char

Front 38

Activated Charcoal Indications

Back 38

Poisoning by mouth

Front 39

Activated Charcoal Contraindications

Back 39

Altered mental status, ingestion of caustics,

inability to swallow

Front 40

Activated Charcoal Medication Form

Back 40

Aqueous solution or power mixed with water

Front 41

Activated Charcoal Dosage

Back 41

Adults & children: 1g of charcoal/kg body weight

Usual adult dose: 25-50g

Usual pediatric dose: 12/5-25g

Front 42

Activated Charcoal Administration

Back 42

1) Consult medical direction

2)Shake container and put in a covered

container with a straw

3)Shake or stir again if not immediately

consumed

4)Record name, dose, route, and time of

administration

5) If patient vomits, repeat the dose once

Front 43

Activated Charcoal Actions

Back 43

Absorbs (binds) to certain poisons and prevents them from being absorbed into the body

Front 44

Activated Charcoal Side Effects

Back 44

Black stools, vomiting

Front 45

Activated Charcoal Reassessment Strategies

Back 45

Be prepared for the patient to vomit or further deteriorate

Front 46

Epinephrine Auto-Injector Trade Name

Back 46

EpiPen, EpiPen Jr.

Front 47

Epinephrine Auto-Injector Indications

Back 47

Patient shows signs of a severe allergic

reaction (respiratory failure or shock)

Medication is prescribed by a physician

Medical direction authorizes use

Front 48

Epinephrine Auto-Injector Contraindications

Back 48

None when used in a life-threatening situation

Front 49

Epinephrine Auto-Injector Medication Form

Back 49

Liquid administered by an auto-injector

Front 50

Epinephrine Auto-Injector Dosage

Back 50

Adult: one adult auto-injector (.3mg)

Pediatric: one pediatric auto-injector (.15mg)

Front 51

Epinephrine Auto-Injector Administration

Back 51

1) Obtain auto-injector and confirm perscription is for patient & medication is not discolored

2) Obtain on-line/off-line medical direction

3) Remove cap and place tip on patient's thigh

4) Push injector in and hold for at least 10 sec

5) Record activity and time & place in sharps

container

Front 52

Epinephrine Auto-Injector Actions

Back 52

Dilates the bronchioles, constricts blood vessels

Front 53

Epinephrine Auto-Injector Side Effects

Back 53

Increased heart rate, pallor, dizziness, chest pain, headache, nausea, vomiting, excitability, anxiety

Front 54

Epinephrine Auto-Injector Reassessment

Strategies

Back 54

Transport & continue focused assessment on Airway, Breathing, & Circulation

Prepare for additional dose of epinephrine

Prepare to initiate CPR/AED

Continue O2

Treat for shock