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66 Cards in this Set
- Front
- Back
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pharmacology is?
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study of drugs
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medication
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a drug or other substance that is a remedy for illness
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drug
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chemical substance that is used to treat or prevent disease
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administer v assist
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admin- emt take all steps to give patient med
assist- emt prepare med and then hand it over to patient who will then take it |
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med that are administered by emt
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oxygen
oral glucose activated charcoal aspirin |
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meds assisted by emt
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bronchodilator-
metered dose or small volume nebulizer -nitroglycerin -epinephrine |
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oxygen
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admin as 100 percent compresses gas
-indicated in any hypoxia, or may become hypoxic |
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oral glucose
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-primary energy source for body cells
-only source of energy for brain cells -admin to patient with history of diabetes with suspected hypoglycemia |
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activated charcoal
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fine black powder designed to absorb or bind to ingested poison
-removed from many protocols |
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aspirin
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admin to patient having chest discomfort or pain that is related to lack of oxygen
-may keep vessels that deliver 02 to heart from closing completely |
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metered dose inhaler
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-used for resp disease (asthma, emphysema, copd, chronic bronchitus)
-beta 2 atagonist causes bronchioles to dilate |
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small volume nebulizer
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same effect as mdi
-put into special chamber and compressed air runs through it to create vapor -mdi one inhalation svn over a period of time |
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nitroglycerin
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vasodilator for cardiac patients, dilates blood vessels in body
-major side effect is hypotension, should not be taken with erectile drugs or if systolic bp below 100 |
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epinephrine
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-used for sever allergic reactions
-body reacts by dilating blood vessels and constricting bronchioles -epi constricts blood vessels and dilates bronchioles |
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medication names
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-chemical name (drugs chem stucture)
-generic name-still reflect chem characteristics but shorter -trade name- brand name when drug released -official name-drug meets req of usp it is given official name |
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routes of admin
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-sublingual-under the tongue, patient must be alert (nitro tablets or spray)
-inhalation- gas or aersol inhaled by patient (oxygen bronchodilators) (must be spontaneously breathing) -oral-drug is swallowed, patient must be responsive (aspirin, oral glucose, activated charcoal) -intramuscular injection-drug injected into muscle mass (epi) |
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medication forms
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-compressed powder or tablet
-liquid -gel (ex:glucose) -suspension-mixed in suitable liquid -fine powder for inhalation -small volume nebulizer -gas -spray |
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essential med info
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indications
contraindications-situations where drug shall not be given due to potential harm -dose-how much of drug given to patient -admin-route to be given -actions-effect drug has on body side effects |
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receiving online med direction to give a med what should you do?
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you must verify by restating back the drug, the dose, and the route
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five rights of med
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an easy way to check what needs to be checked prior to admin
-right patient -right med -right route -right dose -right date |
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documentation of med administered
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document drug, route, dose time, and report any changes in patients condition
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shock
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inadequate tissue perfusion (hypoperfusion)
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three basic etiologies of shock
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inadequate volume (loss of blood or plasma)
-inadequate pump function (from injury or mechanical obstruction such as pericardial tamponade or tension pnuemonthorax inadequate vessel tone-vessel tone must be maintained for adequate bp (injury to spinal cord or chemical mediators out of whack) |
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categories of shock
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hyovolemic
1.hemorrhagic hypovolemic 2.nonhemorrhagic hypovolemic 3.burn shock distibutive 1 anaphalactic 2 septic 3 nueorgenic cardiogenic obstuctive metabolic or respiratory |
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most common cause of hypovolemic shock?
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hemorrhage
-hypovolemic is also most common type of shock |
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hypovolemic shock
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shock caused from low blood volume
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distributive shock
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decrease in intravascular volume caused by massive system vasodilation and an increase in capillary permeability (allows fluid to leak out of cap. and into interstitial space
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cardiogenic shock
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ineffective pump function of heart
-typically when more than 40 percent of left ventricle has been lost (chf, heart attack, or abnormal rhythms) |
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obstructive shock
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condition that obstructs forward blood flow
-pulmonary embolism (large clot that obstructs blood flow into lungs), tension pneumothorax, pericardial tamponade |
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metabolic or resp shock
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dysfunction in abilty of oxygen to diffuse into blood, be carried by hemoglobin, off load at cell, or be used effectively for cell metabolism
-cyanide poison, carbon monoxide, |
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hemmorrhagic hypovolemic shock
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loss of whole blood
-stopping bleeding is first step in managing |
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nonhemorrhagic hypovolemic shock
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loss of fluid from intravascular space
-plasma, water, electrolytes -causes sever diarrhea, vomiting, excessive sweating, excessive urination |
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burn shock
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damaged capillary allows plasma proteins to leak out and collect in interstitial space-this then pulls fluid out of cap as well.
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anaphylactic shock
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chemical mediators that are released in response to anaphylactic reaction cause massive systematic vasodilation and broncodilation
-awy management, vent, and oxygenation key |
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septic shock
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infection that release bacteria and toxins into blood, causes vessels in body to dilate, fluid leak out of vessels into interstitial space
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nuerogenic shock
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spinal injury cause loss of sympathetic tone below site which causes vasodilation
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cardiogenic shock
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often due to mi, chf, or abnormal cardiac rhythm , reduces force of left ventricle
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bodies response to shock two major pathways
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direct sympathetic nerve stimulation (increase hr,increase force of vent contraction, vasoconstriction, stimulation of epi and noepi from adrenal gland
-release of hormones (epinephrine and norepinephrine cause vasoconstriction, increase hr and contraction, increased electrical impulse, some hormones decrease urine output |
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3 stages of shock in order
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compensatory
decompensatory irreversible |
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compensatory shock
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able to maintain near normal bp and perfusion of vital organs
-blood shunted away from nonessential areas to core of body -narrow pulse pressure may be a early sign |
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decompensatory shock
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bodies compensatory mechanisms are no longer able to maintain a bp and perfusion of vital organs
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irreversible
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regardless of intervention patient outcome is death
-cell, tissue, and organ damage so bad that no matter what treatment provided organ death is evitable |
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shock assesment history
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pay attention to beta blockers and calcium channel blockers
-they keep hr from rising dramatically making it appear patient is not in compensatory shock when they are -patient on diuretics may have less blood volume prior to shock and deteriorate more rapidly |
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signs of poor perfusion
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-altered mental status
-pale, cool, clammy kin -decreased cap refill -decreased urine output -weak or absent peripheral pulses |
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age considerations for shock
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-newborns do not compensate well
-children compensate well and then crash -geriatric does not compensate well and meds may prevent some s/s of shock |
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resuscitation
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bringing patient back from potential or apparent death
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cardiac arrest
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stop of cardiac function with patient displaying no pulse, nor breathing, and unresponsive
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sudden death
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death within 1 hr of s/s
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how soon to brain cells die following cardiac arrest?
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4 to 6 minutes
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3 phases of cardiac arrest
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1.electrical - arrest to 4 min
2.circulatory- 4-10 min 3.metabolic 10-on |
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electrical phase
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arrest to 4 min
heart still good supply of 02 and glucose -heart prepared for defib here |
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circulatory phase or cardiac arrest
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4- 10 minutes
-02 stores exhausted and myocardial cells shift to anaerobic, very little energy production -heart not prepared for defib, 2 minutes of cpr prior to defib |
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metabolic phase of cardiac arrest
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10 minutes-on
-heart starved of 02 and large amount of acid buildup -beginning of organ death -resuscitation typically not favorable |
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downtime
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time patient in cardiac arrest until high quality cpr performed
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total downtime
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arrest until patient delivered to er
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return of spontaneous circulation
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patient regain spontaneous pulse during resuscitation effort
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survival
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patient discharged from hospital
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chain of survival
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1. early access
2. early cpr 3. early defib (shock within 3 to 5 min) 4. ealry als |
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what can immediate cpr do for patient in vfib?
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double or even triple chances of survival
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defibrillation
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electrical shock delivered to help heart restore a normal rhythm
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2 single most critical factors to successful resuscitation
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high quality compression and early defib
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most effective productive single intervention following defib
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cpr for 2 minutes and then recheck pulse
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advantages of aeds
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-speed of operation
-safer, more effective delivery -more efficient monitoring |
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energy of aeds
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monopahsic (older) 200, 300, 360
biphasic- 150-200 joules |
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2 rhythms aed can shock
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vfib and v tach
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2 rhythms aed cant shock
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asytole
pulseless electrical activity (organized rhythm but heart so weak it fails to pump) |
