Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
122 Cards in this Set
- Front
- Back
|
IN REFERENCE TO ABDOMINAL PAIN (NON TRAUMATIC): IDENTIFY THE 6 CAUSES THAT IS REFERENCED TO ABDOMINAL PAIN.
|
A. GU / UT
B. referred CARDIAC PAIN C. POSSIBLE PREGNANCY / ECTOPIC D. RECENT TRAUMA/ SURGERY E . INSECT BITES F. POISONING / OVERDOSE |
|
|
IN ABDOMINAL PAIN, PROVIDING OXYGEN AS NEEDED IS REFERRED TO WHAT?
|
1 MONITORING PULSE OXIMETRY
2. IF LOC IS DECREASED THEN PROVIDE 100% OXYGEN/BVM WITH ASSISTED VENTILATIONS ARE NEEDED. 3 CONSIDER NEED FOR EARLY INTUBATION |
|
|
WHAT ARE THE 4 STEPS FOR ABDOMINL PAIN (NON TRAUMATIC) CARE?
|
1. OBTAIN THTOUGH HISTORY TO IDENTIFY THE
CAUSE AND REFER TO APPROPRIATE SMO 2. PROVIDE OXXYGEN AS NEEDED 3. CARDIAC MONITOING AND EALLUATE EKG STRIP 4. ESTABLISH VI NS 250C BOLUS IF SBP<90 mmHg. |
|
|
WHAT ARE THE 7 STEPS TAKEN FOR AN UNKNOWN CAUSE OF ALTERED LOC?
|
1. PROVIDE OXYGEN AS NEEDED AND MONITOR
PULSE OXIMETRY 2. PERFORM GLUCOSE CHECK 3. BEGIN CARDIAC MONITORING, RECORD & EVALUATE EKG STRIP 4. ESTABLISH IV NS KVO 5. FOR HYPOGLYCEMIA / HYPERGLYCEMIA, FOLLOW SMO SECTION 409.000 6. NON INTUBATED & DRUG OVERDOSE IS SUSPECTED WITH RESPIRATORY DEPRESSION. ** DO NOT GIVE NARCAN IF PATIENT IS INTUBATED 1) GIVE NARAN 2 MG SLOW IVP, TITRATED TO PATIENTS WITH RESPIRATORY EFFORT & OXYGEN SATURATION OR 2) GIVE NARCAN 2mg INTRA NASAL (IN) 1cc IN EACH NOSTRIL 7. IF THERE IS NO CHANGE IN THE PATIENTS MENTAL STATUS, THEN CONTACT MEDICAL CONTROL |
|
|
HOW WOULD YOU MANAGE THE AIRWAY OF A PATIENT WITH A DECREASED LEVEL OF CONSCIOUSNESS???
|
PROVIDE 100% OXYGEN / BVM WITH ASSISTED VENTILATIONS (AS NEEDED), AND CONSIDER NEED FOR EARLY INTUBATION!
|
|
|
IF AN ALTERED LOC PATIENT IS A PATIENT THAT IS NOT INTUBATED AND A OVERDOSE IS SUSPECTED WITH RESPIRATORY DEPRESSION, WHAT 2 STEPS WOULD BE TAKEN?
|
1 GIVE NARAN 2 mg SLOW IVP, TITRATED TO
PATIENT RESPIRTARY EFFORT & OXYGEN SATURATION 2. GIVE NARCAN 2 mg INTRA NASAL (IN) 1 cc IN EACH NOSTRIL. |
|
|
IF AFTER ALL STEPS ARE TAKEN WITH THE PATIENT WHO HAS AN UNKNOWN LOC AND NO RESPONSE IS SHOWN, WHAT IS YOUR NEXT STEP?
|
CONTACT MEDICAL CONTROL
|
|
|
WHAT IS ANOTHER STEP OF LOC PATIENT CARE?
|
ESTABLISH IV NS KVO
|
|
|
DO NOT GIVE ______________ TO A PATIENT WITH UNNOWN LOC IF HE/SHE IS INTUBATED.
|
NARCAN
|
|
|
WHAT ARE THE 1ST 2 THINGS YOU WOULD DO
TO A PATIENT IF THE PATIENT HAD AN UNKNOWN CAUSE OF LOC? |
PROVIDE OXYGEN AND MONITOR THE PULSE OXIMETRY
|
|
|
If a patient has an altered LOC (unknown cause), part of the steps in treatment includes performing a _______ check.
|
PERFORM A GLUCOSE CHECK
|
|
|
IF A PATIENT SHOWS SIGNS OF AN ALTERED LOC, IS IT POSSIBLE THAT THERE COULD BE A CARDIAC PROBLEM? IF SO, WHAT STEPES SHOULD YOU TAKE?
|
BEGIN CARDIAC MONITORING
RECORD EVALUATE EKG STRIP |
|
|
WHAT ARE THE SIGNS AND SYMPTOMS OF AN ALLERGIC REACTION?
|
MILD -- LOCALIZED EDEMA & ITCHING
MODERATE -- SYSTEMIC HIVES, SYSTEMIC ITCHING SEVERE --- ANAPHYLAXIS, RESPIRATORY DISTRESS, WHEEZING, THROAT TIGHTNESS,ALTERED MENTAL STATUS, DECREASED PERFUSION AND HYPOTENSION. |
|
|
WHAT DO YOU DO IF A PATIENT IS IN SEVERE RESPIRATORY DISTRESS, CYANOTIC WITH ALTERED LOC?
|
PROVIDE 100% OXYGEN / BVM WITH ASSISTED
VENTILATIONS |
|
|
IN SEVERE ALLERGIC REACTIONS, WHAT IS THE DOSE OF MEDICATION THAT SHOULD BE GIVEN AND HOW OFTEN CAN IT BE ADMINISTERED?
|
ETT EPINEPHRINE 2 mg
(1:1,000 in 8 ml Normal Saline) may be repeated X 1 in 5 minutes, if no response. |
|
|
WHAT ARE THE 5 MAIN STEPS IN EVALUATING OR TREATING A PATIENT WHO SHOWS SIGNS OR SYMPTOMS OF AN ALLERGIC REACTION?
|
1. LEVEL OF CONSCIOUSNESS & ABC'S
2. OXYGEN AS NEEDED & MONITOR PULSE OXIMETRY 3. DETERMINE SIGNS AND SYMPTOMS & SEVERITY 4. IF IN SEVERE RESPIRATORY DISTRESS, CYANOTIC & WITH AN ALTERED LOC, PROVIDE 100 % OXYGEN/BVM WITH ASSISTED VENTIALTIONS 5 BEGIN CARDIAC MONITORING, RECORD & EVALUATE EKG STRIP |
|
|
IF FOLLOWING THE 5 MAIN STEPS OF EVALUATING AND TREATING A PATIENT WITH AN ALLERGIC REACTION IS NOT RESOLVED, HOW WOULD YOU TREAT "DYSRHYTHMIAS"?
|
REFER TO SMO SECTION 302.000
-BEGIN CARDIAC monitoring including 12 lead, & transfer data to EPCR -establish IV/IO/INT - treatable causes: hypoxia, bradycardia, drugs - administer Lidocaine 1.0 to 1.5mg/KG IV/IOP * repeat doses of lidocaine 0.5 to 0.75 mg/kg may be given every 5 mins up to max dosage of 3mg/KG - if successful in abating the ectopy then initiate a continuous infusion of lidocaine at 2-4mg/min |
|
|
WHAT MEDICATIONS ARE MAO INHIBITORS
|
NARDIAL
MARPLAN EUTONYL PARNATE |
|
|
WHEN A PATIENT HAS AN ALLERGIC REACTION AND THEY ARE IN RESPIRATORY DISTRESS, ACCOMPANIED BY WHEEZING, WHAT SHOULD YOU ADMINISTER?
|
ALBUTEROL 5 mg/ ATROVENT 0.5 mg and refer to
ASTHMA/COPD SMO 404.000 |
|
|
NAME 2 SEVERITIES FOR FOR A PATIENT WHO HAS HAD AN ALLERGIC REACTION?
|
MODERATE
SEVERE |
|
|
THE EMT1'S AND THE PARAMEDIC'S ADMINISTRATION OF MEDICATION IS DIFFERENT. REGARDING ALLERGIC REACTION AND TREATMENTS, HOW DO THEY DIFFER?
|
EMT1 -
ALLOWED TO ADMINISTER AN EPI AUTO INJECTOR- 0.3 cc ADULT & PEDI IM 1:1000. MAY REPEAT After 10 MINUTES with medical control authority PARAMEDIC: THEY CAN ADMINISTER EPINEPHRINE 0.3 mg- 0.5 mg (1:1000) MAY REPEAT EVERY 5 MINUTES ADMINISTER BENADRYL 25 mg iv or 50 mg deep IM ADMINISTER SOLU-MEDROL 125 MG IVP OVER 2 MINUTES |
|
|
USE CAUTION WHEN ADMINISTERING TRICYCLIC ANTIDRPRESSANTS OR MAO INHIBITORS TO A PATIENT WITH AN ALLERGIC REACTION BECAUSE:
|
IT CAN CAUSE HYPERTENSIVE CRISIS
|
|
|
WHAT ARE THE 8 STEPS TAKEN TO CARE FOR A PATIENT WITH ASTHMA / COPD?
|
1. PROVIDE OXYGEN AS NEEDED. Monitor pulse oximetry
2. CONSIDER THE NEED FOR CPAP SMO SECTION 206.000 3. CONSIDER THE NEED FOR EARLY INTUBATION (paramedic) 4. EMT-I FUNCTIONS 5. PARAMEDIC FUNCTIONS. 6. BEGIN CARDIAC MONITORING, RECORD, AND EVALUATE EKG STRIP 7. ESTABLISH IV NS KVO OR INT 8. CONTACT MEDICAL CONTROL FOR FURTHER CARE |
|
|
WHAT FUNCTION DOES A EMT-I DO FOR A PATIENT WITH MILD EXACERBATION of asthma/COPD?
|
ADMINISTER NEBULIZED ALBUTEROL 5mg AND ATROVENT 0.5 mg MAY REPEAT X 2 EVERY 15 MIN
|
|
|
WHAT FUNCTION DOES AN EMT-I DO FOR A PATIENT WITH MODERATE TO SEVERE EXACERBATION of asthma/COPD?
|
ADMINISTER NEBULIZED ALBUTEROL 5 mg AND ATROVENT 0.5 mg . MAY REPEAT X 2 EVERY 15 MIN
|
|
|
TO PREVENT BAROTRAUMA SECOND TO HYPERINFLATION, WHAT SHOULD BE DONE TO THE PATIENT WITH ASTHMA / COPD?
|
DELIVER DECREASED TIDAL VOLUMES AT A RATE
8 TO 12/MIN AND ALLOW FOR PROLONGED EXPIRATORY TIME. |
|
|
AFTER THE PARAMEDIC ADMINISTERS SOLU-MEDROL 125 mg IVP OVER 2 MINUTES TO A PATIENT, AND THE PATIENT IS UNABLE TO COOPERATE WITH THE TREATMENT GIVEN AND SHOWS SIGNS OF RESPIRATORY FAILURE, WHAT SHOULD YOU DO NEXT?
|
CONTACT MEDICAL CONTROL FOR SEVERE CASES
ADMINISTER MAGNESIUM SULFATE 2 gm IN 100 CC OVER 15-20 MIN IV ADMINISTER EPINEPHRINE 0.1 - 0.3 (1:1,000) IM. REPEAT X 1 IN 20 MINUTES WHEN ALBUTEROL IS NOT EFFECTIVE, ADMINISTER AEROSOLIZED EPINEPHINE 1:10,000 / 0.5 mg (5ml) |
|
|
ALWAYS USE CAUTION WITH EPINEPHRINE IN CASE OF ADULT PATIENTS ______ YEARS OF AGE, PULSE RATE >________/MIN, HISTORY OF _________ ___________, and SBP > ________.
|
50 YEARS
Pulse >130 / MIN HEART DISEASE sBP > 160mm |
|
|
PATIENTS RECEIVING ALBUTEROL NEBULIZER TREATMENTS MUST BE ______________ TO THE HOSPITAL
|
TRANSPORTED
|
|
|
WHAT SHOULD YOU DO IF YOU ADMINISTER A DRUG TREATMENT AND THE PATIENT REFUSES TRANSPORT?
|
CONTACT MEDICAL CONTROL FORAPPROVAL FOR REFUSAL
|
|
|
WHAT ARE THE 8 STEPS IN PATIENT CARE SHOULD BE TAKEN FOR A PATIENT WHO IS EXPOSED TO CARBON MONOXIDE?
|
1. CONSIDER ACUTE CO POISONING IN THE PATIENT
2. REMOVE PATIENT FROM SITE OF EXPOSURE 3. PROVIDE PROPER AIRWAY MGMT AND OXYGEN BY NRB AT 15 LPM 4 . BEGIN CARDIAC MONITORING, RECORD, AND EVALUATE EKG STRIP 5. ESTABLISH IV NS KVO OR INT 6. MONITOR PATIENT FOR THE FOLLOWING 6 SIGNS: 1. ALTERED LOC 2. HEADACHE 3. WEAKNESS & DIZZINESS 4. NAUSEA & VOMITING 5. RINGING IN THE EARS 6. DEVELOPEMENT OF FLUSHED SKIN ( LATE SIGN) 7. CONTACT MEDICAL CONTROL FOR ADDITIONAL INSTRUCTIONS 8. TRANSPORT TO THE CLOSEST FACILITY |
|
|
WHEN ONE OR MORE PATIENTS IN A GROUP OR HOUSEHOLD HAS SIMILAR COMPLAINTS AND/OR EXHIBITS ONE OR MORE OF THE FOLLOWING SYMPTOMS, CARBON MONOXIDE EXPOSURE SHOULD BE CONSIDERED. WHAT ARE THE SYMPTOMS?
|
DROWSINESS
DIZZINESS WEAKNESS CONFUSION VISUAL DISTURBANCES SYNCOPE SEIZURE FECAL AND URINARY INCONTINENCE MEMORY DISTURBANCE GATE DISTURBANCE MALAISE FLU LIKE SYMPTOMS NAUSEA VOMITING AND ABDOMINAL PAIN |
|
|
In treatment of carbon monoxide exposure, PROVIDE PROPER AIRWAY MANAGEMENT AND OXYGEN BY NRB AT 15 LMP. IF RESPIRATORY EFFORT IS INADEQUATE, WHAT THEN SHOULD YOU PROVIDE?
|
100 % OXYGEN / BVM WITH ASSISTED VENTILATION.
|
|
|
In treatment of carbon monoxide exposure, WHAT ARE THE NEXT 4 STEPS FOLLOWING 100% OXYGEN / BVM WHEN PROVIDING AIRWAY MANAGMENT AND OXYGEN BY NRB AT 15 LPM
|
1. CONSIDER UTILIZING CPAP
2. CONSIDER THE NEED FOR EARLY INTUBATION (paramedic) 3. UTILIZE CARBOXYHEMOGLOBIN PROBE IN LIFEPAK 15' TO MONITOR Sp02, SpCO AND SpMET 4. MONTOR PULSE OXIMETRY |
|
|
In. Treatment of carbon monoxide exposure, BE AWARE, PULSE OXIMETY MAY INDICATE A
____________ _____________ |
FALSE POSITIVE
|
|
|
WHEN EXPOSED TO CARBON MONOXIDE, AT WHAT POINT SHOULD YOU CONSIDER PLACING THE PATIENT ON THE MONITOR?
|
IF A PATIENT IS HYPOTENSIVE, TACHYCARDIC OR HAS UPPER ABOMINAL PAIN, YOU SHOULD DO WHAT?
Or is heading in that direction |
|
|
A STROKE SHOULD BE CONSIDERED IN ANY PATIENT PRESENTING WHAT?
|
ACUTE NEUROLOGICAL DEFICIT OR AN ALTERATION IN LOC
|
|
|
WHAT ARE THE SIGNS AND SYMPTOMS OF A HEMORRHAGIC STROKE?
|
HEADACHE OFTEN SEVERE AND SUDDEN ONSET
NAUSEA AND/OR VOMITING SEIZURES |
|
|
WHAT ARE THE 9 STEPS TO CARING FOR PATIENT WHO HAD A CEREBRAL VASCULAR ACCIDENT OR STOKE?
|
1. PERFORM A THOROUGH SAMPLE HISTORY & A
CINCINNATI STROKE SCALE ASSESSMENT 2. PROVIDE PROPER AIRWAY MGMT AND OXYGEN AT 2-4 LMP IA NASAL CANNULA 3. PERFORM A GLUCOSE CHECK 4. FOR HYPOGLYOCEMIA/HYPERGLYCEMIA, FOLLOW SMO SECTION 409.000 5. ESTABLISH IV/ INT NS AT KVO RATE 6. BEGIN CARDIAC MONITORING, RECORD, AND EVALUATE EKG STRIP 7. RECEIVING HOSPITAL SHOULD BE NOTIFIED IMMEDIATELY OF SUSPECTED STROKE PATIENT 8. STOKE PATIENTS ARE A MEDICAL LOAD AND GO 9. TRANPSORT PATIENT IN A SEMIFOWLERS POSITION, APPROX 30% ELEVATION OF THE HEAD. |
|
|
WHAT DOES CPSS STAND FOR?
|
CINCINNATI PREHOSPITAL STROKE SCALE
|
|
|
WHEN IS CPSS DONE AT A SCENE?
(Prior to or after) moving the patient? |
PRIOR TO MOVING THE PATIENT
|
|
|
WHY SHOULD YOU HAVE THE PATIENT SMILE REAL BIG ?
|
TO LOOK FOR ANY FACIAL DROOPING, UNILATERAL OR BILATERAL. THIS IS A POSTIVE FINDING for stroke
|
|
|
WHY SHOULD YOU HAVE THE PATIENT REPEAT BACK TO YOU THE PHRASE "YOU CANT TEACH AN OLD DOG NEW TRICKS" ?
|
BECAUSE ANYTHING OTHER THAN AN EXACT REPHRASE IS A POSITIVE FINDING FOR A STROKE
|
|
|
BY HAVING THE PATIENT CLOSE THEIR EYES AND HOLD BOTH ARMS STRAIGHT OUT IN FRONT FOR APPROXIMATELY FIVE SECONDS, WHAT WOULD BE A POSITIVE FINDING OF A STROKE?
|
IF ONE OR BOTH ARMS DRIFT DOWN
|
|
|
WHAT IS THE FIRST THING YOU DO WHEN YOU TREAT A PERSON WHO HAS TAKEN AN OVEROSE?
|
CALL POISON CONTROL
|
|
|
WHAT 7 STEPS ARE TAKEN WHEN TREATING A PERSON WHO OVERDOSED?
|
1. CONSIDER CONTACTING POISON CONTROL
2. PROVIDE PROPER AIRWAY MGMT & OXYGEN AS NEEDED 3. BEGIN CARADIC MONITORING, RECORD & EVALUATE EKG STRIP 4 RESTRAIN AS NEEDED 5. NON INTUBATED & DRUG OVEROSE IS SUPSPECTED WITH RESPIRATORY DEPRESSION 6. TREAT SEIZURES PER SMO 7. TREAT DYSRHTHMIAS PER SMO |
|
|
WHEN PROVIDING AIRWAY MANAGMENT AND OXYGEN TO A PATIENT WHO IS BEING TREATED FOR A DRUG OVERDOSE AND THEIR RESPIRATORY EFFORT IS INADEQUATE, WHAT SHOULD YOU DO?
|
PROVIDE 100% OXYGEN BY BVM WITH ASSISTED VENTILATIONS.
|
|
|
MEDIICAL CONTROL OPTIONS FOR DRUG OVERDOSES
|
SODIUM BICRABONATE 50 mEq IV IF:
DYSRHYTHMIAS ARE PRESENT POTENTIAL TRICYCLIC ANTIDRPRESSANT INGESTION |
|
|
A dystonic reaction occurs as an ___________________ _________________ to a Phenothiazine (Compazine) or butyrophene (Haldol) compound.
|
IDIOSYNCRATIC REACTION
*This reaction is usually not life threatening and results in no long-term effects |
|
|
Although ______________________ is used to treat a dystonic reaction, dystonia is not an allergic reaction.
|
BENADRYL
|
|
|
With a Dystonic Reaction, Field treatment is directed at alleviating patient discomfort in 5 different ways. What are the 5 ways?
|
1. Eye deviation
2. Head deviation to one side 3. Difficulty speaking due to “thick” tongue 4. Involuntary arm or leg twitching or jerking 5. Protruding tongue |
|
|
list the 5 steps of Dystonic Reaction Treatment
|
A) Provide Oxygen as needed. Monitor Pulse
Oximetry. B) If in severe respiratory distress, cyanotic and with altered LOC: • Oxygen/BVM with assisted ventilation C) Begin Cardiac Monitoring, record, and evaluate EKG strip. • Treat dysrhythmias per SMO Section 302.000 D) Establish IV / INT or NS KVO. E) (Paramedic) Administer Benadryl 25 mg IVP/IM. F) Contact Medical Control for additional instructions. |
|
|
what are the 2 important steps taken when treating a patient with Hypoglycemia / Hyperglycemia
|
A) Provide Oxygen as needed.
B) Perform glucose check with Glucometer. |
|
|
what is Hypoglycemia Conscious?
|
when blood sugar Less Than 60 mg/dl and patient is symptomatic of low blood sugar:
|
|
|
what are the symptoms of hypoglycemia conscious?
|
mild confusion, strange affect but still able to cooperate
|
|
|
Hypoglycemia Consious:
When a patient has hypoglycemia and can maintain a patent airway, and swallow without choking, give: |
Instant Glucose 24 grams PO (EMT-I & Paramedic)
Observe for improvement in symptoms |
|
|
Hypoglycemia Conscious:
If improvement occurs over a five-minute period, what should you do ? |
recheck blood glucose, encourage patient transport. If the patient refuses transport, have the patient sign EPCR Refusal.
|
|
|
Hypoglycemia Conscious:
if no improvement over 5 minutes what should be done? |
Proceed to SMO Section 409.002 (Treatment of Hypoglycemia altered/unconscious)
|
|
|
Hypoglycemia Altered/Unconscious:
If blood sugar Less Than 60 mg/dl or Glucometer is unavailable and patient is symptomatic of Hypoglycemia, what should be administered? |
1. Dextrose 50% 25 grams IVP (EMT-I & Paramedic)
a. EMT-I’s Administer 25cc’s / 12.5 grams of Dextrose 50% b. Reassess and recheck glucose level and call Medical Control for additional dosage of Dextrose 50% if needed. 2. Glucagon 1mg IM (Paramedic Only) a. If IV attempts are unsuccessful b. Patients who have been administered Glucagon should be transported. |
|
|
What medication can only a paramedic administer pertaining to a patient with hypoglycemia?
|
Thiamine 100mg IV/IM
|
|
|
_________________________must be given whenever there is evidence of malnutrition or evidence that suggests alcoholism.
|
THIAMINE
|
|
|
Consider ______________ for any unconscious patient WHO HAS HYPOGLYCEMIA
|
NARCAN - GIVEN BY PARAMEDIC ONLY
|
|
|
WHAT DOSAGE OF NARCAN SHOULD BE GIVEN TO A PATIENT WHO IS UNCONSCIOUS DUE TO HYPOGLYCEMIA?
|
Narcan 0.4mg - 2mg IVP
|
|
|
WHAT ARE SOME OTHER OPTIONS FOR DOSAGE OF NARCAN IN A PATIENT WHO IS UNCONSIOUS DUE TO HYPOGLYCEMIA?
|
Other options: Administer Narcan 2 mg Intra Nasal (IN) 1cc in each nostril.
|
|
|
consider a patient has hyperglycemia when the blood sugar is Greater Than 180mg/dl and the following signs and symptoms are exhibited: what are the signs and symptoms?
|
Warm flush skin, Nausea/Vomiting, Altered LOC, Rapid respirations, Dehydration, Acetone breath
|
|
|
what are the Signs and symptoms of Diabetic Keto Acidosis (DKA)
|
Warm flushed skin, Nausea/ Vomiting, Acetone breath, Altered LOC, Rapid respirations, Signs of hemodynamic compromise due to fluid loss, Dehydration
|
|
|
Treatment Nausea/Vomiting:
If patient is nauseated or recently vomited: (Paramedic Only) what do you administer? |
paramedic only:
1. Administer Zofran 4 mg IVP |
|
|
Treatment of Nausea/Vomiting:
consider ___________ patients with altered mental status who are vomiting (Paramedic Only) |
intubating
|
|
|
Treatment of Nausea/Vomiting:
If desired effect is not seen within 15 minutes of treatment, what do you need to do? |
contact Medical Control for further orders.
|
|
|
when treating a patient with Psychological/Behavioral what is the first priority?
|
First priority is the safety of all EMS personnel.
|
|
|
When performing a full evaluationg and assessment on pts with psychological/behavioral issues, you should observe them for _________.
|
Observe for signs of trauma, injury, overdose or infection.
|
|
|
when is it necessary to have restraints on a patient with psychological behavior?
|
when the patient is an immediate life-threatening danger to self and/or others
|
|
|
Always attempt to establish communication with a patient with psychological behavior in a firm, clear,
and honest manner. You should also _________. |
never leave patient alone
|
|
|
for what reason should Law Enforcement accompany a patient with psychological behavior in hand cuffs?
|
for safety reasons
|
|
|
what are the 5 steps that should be taken when treating a person who has seizures?
|
A) Provide proper airway management and oxygen
as needed. B) Perform glucose check C) Begin Cardiac Monitoring, record, and evaluate EKG strip. D) For Hypoglycemia / Hyperglycemia, refer to SMO Section 409.000 E) Establish IV / INT or NS KVO. |
|
|
In treating ALS Care – Active Seizures patients, what medication should be administered ?
|
Administer Ativan 2mg slow IVP. May repeat Ativan 2mg slow IVP for maximum of 4mg. or
**IF NO IV ACCESS AVAILABLE: Administer Versed (Midazolam) 10 mg intranasal (IN) |
|
|
when treating a patient who is suspected of having poisoning what is the first thing you should do?
|
consider contacting Poison Control
|
|
|
For EXTERNAL exposure poisoning, what are the 4 steps in treating the patient?
|
1. Prevent exposure to EMS personnel.
2. Move patient to safety and decon (decontaminate) completely prior to transport. 3. Disrobe down to underwear (remove underwear if they are contaminated). 4. Irrigation takes priority over transportation unless irrigation can be continued enroute to ED. |
|
|
what is the dose of VERSED given to a 4 year old?
|
3.6 mg
= 10 + x ( 2) |
|
|
what formula would you use to assess the weight
of a child? |
the children's weight in kg is equal to
10 + 2 x (age in years) =2y/o =10+2 x (2) =14 KG |
|
|
what is the dose of VERSED given to a 12 year old?
|
6.8 mg
=10 + (2 x age in years) =34kg =34 x .2 |
|
|
what is the dose of VERSED given to a small teenager?
|
40 kg
=8.0 mg |
|
|
the volume of Versed is based on the calculated dose Plus 0.12 ml dead space and rounded off to the next ____________
|
highest 0.1
|
|
|
what is the calculation for Versed in adults over 50 kg?
|
10 mg (2 ml) of Versed
|
|
|
ALS Care- Prehospital intranasal Versed:
what is the procedure for administration of intranasal versed? |
1 load syringe
2 place atomizer within the nostril 3 briskly compress syringe to administer 1/2 of the volume 4 remove & repeat in other nostril so all meds are administered 5 continue ventilating patient as needed |
|
|
what do you do if a seizure persists 5 minutes after treating?
|
consider repeating 1/2 dose of Versed either intranasally or intravenously
|
|
|
WHAT ARE 5 TYPES OF ORGANOPHOSPHATES OR NERVE GASES?
|
PESTICIDES
VX SARIN TBAUN SOMAN |
|
|
WHAT ARE THE SIGNS / SYMPTOMS OF TOXIDROME
|
SLUDGE:
SALIVATION LACRIMATION URINATION DEFECATION GASTROENTIRITIS EMESIS DUMBELLS: DIARRHEA, URINATION, MIOSIS (PINPOINT PUPILS), BRADYCARDIA/BRONCHOSPASM, EMESIS, LACRIMATION (TEARING), SALIVATION/SWEATING |
|
|
ORGANOPHOSPHATES OR NERVE GAS:
WHAT SHOULDNT YOU DO WHEN ENTERING A HOT ZONE? |
YOU SHOULDNT GO IN WITHOUT APPROPRIATE TRAINING AND PROTECTIVE GEAR
|
|
|
WHAT STEPS SHOULD YOU TAKE IF A PATIENT IS EXPOSED TO ORGANOPHOSPHATES OR NERVE GASES?
|
1 PROTECT YOURSELF FROM EXPOSURE
2 DECONTAMINATE THE PATIENT 3. REMOVE CLOTHING 4. WASH WITH COPIOUS AMOUNTS OF WATER 5 IF PATIENT IS HAVING MULTIPLE SYMPTOMS,, UTILIZE ONE DUODOTE AUTO INJECTOR 6 TRANSPORT AFTER DECONTAMINATION NOTIFY HOSPITAL 7 BEGIN CARDIAC MONTORIN, RECORD AND EVALUATE EKG STRIP |
|
|
A DUODOTE AUTO INJECTOR KIT CONTAINS 2 AUTO
INJECTORS.WHAT ARE THEY? |
2 mg ATROPHINE -- INJECT FIRST
600 mg 2 PAMC1 - INJECT SECOND |
|
|
UTILIZATION OF DUODOTE AUTO INJECTOR IS SECONDARY TO WHAT?
|
DECONTAMINATION
|
|
|
WHAT IS MANDATORY FOR A PERSON WHO DOES SELF INJECTIONS WITH DUODOTE AUTO INJECTOR?
|
EVACUATION
DECONTAMINATION AND MEDICAL EVLALUATION |
|
|
CYANIDE TOXICITY:
YOU SHOULD MAINTAIN A HIGH INDEX OF SUSPICION DURING SUSPECTED TERRORISM EVENT OR IN CONJUCTION WITH _________. |
FIRE IN AN ENCLOSED SPACE
|
|
|
WHAT SIGNS DOES A PATIENT HAVE WHEN EXHIBITING CYANIDE TOXICTY?
|
FLUSHING
CHERRY RED LIPS TACHYCARDIA TACHYPNEA HEADACHE NAUSEA HYPOTENTION CONFUSION COMA |
|
|
In treatment of a pt with a cerebral vascular accident, if respiratory effort is inadequate provide __________. Consider the need for EARLY INTUBATION (paramedic).
|
Provide 100% oxygen/BVM with assisted ventilations.
|
|
|
IN TREATMENT OF DRUG OVERDOSE, HOW SHOULD YOU ADMINISTER NARCAN?
|
*DO NOT GIVE NARCAN IF PT IS INTUBATED
1. NARCAN 0.4MG-2MG IVP TITRATED TO RESPIRATORY EFFORT AND OXYGEN SATURATION OR IM IF IV CANNOT BE ACCESSED. 2. OTHER OPTIONS ADMINISTER NARCAN 2MG INTRA NASAL (IN) 1CC IN EACH NOSTRIL 3. CONSIDER RESTRAINTS BEFORE ADMINISTERING NARCAN |
|
|
What are the 5 steps in treatment of hypoglycemia altered/unconscious?
|
A. If blood sugar less than 60 mg/dl or glucometere is unavailable and pt is symptomatic of hypoglycemia:
1. Dextrose 50% 25gms IVP 2. Glucagon 1mg IM (paramedic only) B. Consider Thiamine 100mg IV/IM (paramedic only) c. COnsider Narcan for any unconscious pt (paramedic only) D. Recheck glucose level after 5 mins E. Begin Cardiac monitoring, record, and evaluate EKG strip |
|
|
What are the 5 steps in treatment of Hyperglycemia?
|
a. Assess for blood sugar greater than 180mg/dl and specific signs/symptoms
B. Assess for signs/symptoms of DKA C. Establish an IV NS 250cc bolus D. Begin cardiac monitoring, record, and evaluate EKG strip E. Contact Medical Control |
|
|
What are 6 steps in treatment of Nausea/Vomiting?
|
A. Provide oxygen as needed.
B. Initiate IV NS KVO C. If pt is nauseated or recently vomited: (Paramedic Only) Administer Zofran 4 mg IVP D. Begin cardiac monitoring, record, and evaluate EKG strip E. Consider intubated pts with altered mental status who are vomiting (paramedic only) F. IF desired effect is not seen w/in 15 mins, contact medical control for further orders. |
|
|
When treating pts with psychological/behavioral issues, you should obtain:
|
history of possible recent crisis, emotional trauma, bizarre or abrupt changes in behavior or suicidal thoughts or intentions
|
|
|
List steps in treating for poisoning?
|
A. Consider contacting poison control
B. Refer GCFES Opertating Guidelines Ch6, Section 500 Hazardous Material if appropriate C. Provide proper airway management and oxygen as needed D. Begin cardiac monitoring, record, and evaluate EKG strip E. Follow steps for external exposures F. Perform glucose check G. Establish IV/INT or NS KVO as needed H. Follow SMO for hypo/hyperglycemia I. if LOC or respirations decreased then administer NArcan 2mg IV, titrated to resp effort or IM if no IV access (paramedic only) J. Treat Burns per SMO K. Treat seizures per SMO L. Treat arrhythmias per SMO |
|
|
What are the 3 steps in treatment of person with cyanide toxicity?
|
1. ABC's
2. High flow oxygen by 100% non-rebreather (also helps carbon monoxide exposure and thermal lung injuries) 3. If index of suspicion is high and patient is not responding to other therapies, transport and notifiy medical control |
|
|
Narcan can be administered,
A. RIVP only B. IN, SIVP C. IN, SIVP, IO, IM D. SIVP only SMO 402.00 F |
C. IN, SIVP, IO, IM
|
|
|
In addition to localized edema, itching, and systemic hives found in mild to moderate allergic reaction what are the 6 characteristics of a severe allergic reaction?
SMO 403.000 C3 |
-Respiratory Distress
-Wheezing -Throat Tightness -Altered Mental Status -Hypoperfusion -Hypotension |
|
|
What is the dose of Benadryl, in an allergic reaction?
A. 25 mg IV, 50 mg IM B. 25 mg IV C. 50 mg IV D. 12.5 mg IV SMO 403.001 A2b |
A. 25 mg IV, 50 mg IM
|
|
|
When Albuterol is ineffective in a patient with severe Asthma, you may contact medical control for orders of nebulized Epinephrine at what concentration and dose?
A. 1:10,000/1 mg B. 1:10,000/0.5 mg C. 1:1,000/1 mg D. 1:1,000/0.5 mg SMO 404.000 D |
B. 1:10,000/0.5 mg
1/2 of a big EPI box |
|
|
What is the frontline drug and dose for a patient suffering from a Dystonic reaction?
A. Ativan, 2 mg IV B. Versed, 5 mg IV C. Sodium bicarbonate, 1 mEq/mg D. Benadryl, 25 mg SMO 408.001 E |
D. Benadryl, 25 mg
|
|
|
Thiamine should be given along with D50 in patients suffering from hypoglycemia and there is evidence of______________ .
A. alcoholism and malnourishment B. CVA C. drug overdose D. trauma SMO 409.002 B |
A. alcoholism and malnourishment
|
|
|
A 23 YOM patient remains actively seizing after you have administered 2 mg of Ativan IV. What can you do next?
A. administer 12.g mg Phenergan to keep the patient from vomiting B. contact medical control for orders of Versed C. administer a second dose of Ativan 2 mg D. administer oral glucose SMO 412.001 A |
C. administer a second dose of Ativan 2 mg
|
|
|
What is the max dose/s of Versed you can administer to a seizure patient prior to contacting medical control?
A. 10 mg IN B. 10 mg IN then 5 mg IN/IV C. 5 mg IV then 10 mg IN D. 5 mg IN SMO 412.001 B and 412.002 E |
B. 10 mg IN then 5 mg IN/IV
-10 mg initially, then 1/2 dose after 5 minutes if still Seizing |
|
|
. What is the number first concern in poisonings / exposures?
A. scene safety B. what is the substance involved C. how old the patient is D. where is the ERG SMO 413.000 E |
A. scene safety
|
|
|
In regards to the patient suffering from CO poisoning, which of the following is a LATE SIGN of exposure?
A. headache B. dizziness C. flushed skin D. ringing in the ears SMO 405.000 F |
C. flushed skin
|
|
|
You arrive on scene to find a 32 YOF patient presenting with localized edema, systemic hives, and systemic itching. This patient is suffering from a ____________allergic reaction.
A. mild B. moderate C. severe D. she is suffering from a panic attack SMO 403.000 C |
B. moderate
|
|
|
Narcan can be administered to a patient with an ETT in place.
A. True B. False SMO 407.000 E |
B. False
|
|
|
Which of the following could lead to a patient suffering from a psychological problem?
A. Trauma B. Overdose C. Infection D. All of the above SMO 411.000 C |
D. All of the above
|
|
|
What is the minimum weight of a patient in order to administer 10 mg of Versed?
A. 25 kg B. 50 kg C. 75 kg D. 100 kg SMO 412.002 |
B. 50 kg
|
|
|
After your first nebulized breathing treatment is complete you may administer___________ additional treatments prior to contacting medical control.
A. 2 B. 3 C. 1 D. 4 SMO 404.000 D |
A. 2
|
|
|
What is the dose of Solumedrol in an allergic reaction?
A. 3 mg/kg B. 125 mg RIVP C. 125 mg SIVP D. 1 mg SMO 403.000 2c |
C. 125 mg SIVP
|
|
|
Of the following what is considered a positive finding in a Stroke assessment?
A. equal grip strength B. speaking clearly C. pupils PERRL D. unilateral facial droop SMO 406.001 A-D |
D. unilateral facial droop
|
|
|
You have a 53 YOF patient complaining of nausea and vomiting for 24 hours with no other associated symptoms. What is the dose of Zofran for this patient?
A. 4 mg B. 1 mg/kg C. 8 mg D. dose must be determined by medical control SMO 410.00 C1 |
A. 4 mg
|
|
|
What does the acronym SLUDGE stand for?
S________ L_________ U________ D_________ G________ E_________ SMO 414.000 A |
-Salivation
-Lacrimation -Urination -Defacation -Gastroenteritis -Emesis |
