Emergency Medical Treatment and Antidotes, Exams of Nursing

Download Emergency Medical Treatment and Antidotes and more Exams Nursing in PDF only on Docsity! Flight Paramedic Certification Exam Agent Aspirin (ASA) - Answers -Antidote Bicarb Agent Benzodiazepines - Answers -Antidote Flumazenil (Romazicon) Agent Beta Blockers - Answers -Antidote Glucagon Agent Calcium Channel Blockers - Answers -Antidote Calcium Gluconate Agent Cocaine - Answers -Antidote Benzodiazepines Agent Pit Vipers - Answers -Antidote CroFab, FabAV Agent Cyanide - Answers -Antidote Amyl Nitrate (inhaled), Sodium Nitrate (IV), Sodium Thiosulfate (IV) Agent Digitalis - Answers -Antidote Digibind, Digoxin Fab Agent Dilantin - Answers -Antidote Supportive care Agent Ethylene Glycol (Anti-Freeze) - Answers -Antidote IV Ethanol, Fomepizole (Antizol) Agent Hydrocarbons - Answers -Antidote Intubate Agent Isoniazid (INH) - Answers -Antidote Pyridoxine Agent Iron - Answers -Antidote Defroxamine Agent Methanol - Answers -Antidote IV Ethanol Agent Opiods - Answers -Antidote Naloxone (Narcan) Agent Organophosphates - Answers -Antidote Atropine, 2 Pam Chloride Agent Tricyclic Antidepressants - Answers -Antidote Bicarb Agent Tylenol - Answers -Antidote Mucomyst, Acetadote Pediatric age range Neonate - Answers -Birth to 28 days Pediatric age range Infant - Answers -28 days to 1 year Pediatric age range Toddler - Answers -1 to 2 years Pediatric age range Child - Answers -> 2 years Pediatric Normal BP formula - Answers -90 + (2 x age) Gas Laws Charle's Law Definition - Answers -At a constant pressure, the volume of a gas is directly proportional to the absolute temperature of the gas Gas Laws Gay-Lussac's Law Equation - Answers -P1 x T2 = P2 x T1 Gas Laws Gay-Lussac's Law Definition - Answers -Directly proportional relationship between temperature and pressure DCS is related to what gas law? - Answers -Henry's Law DCS Type 1 S/S, Tx - Answers -Pain Itching Swelling Recompression on TT5 DCS Type 2 S/S, Tx - Answers -Any neurologic sign Pain in two or more joint Pain the t-shirt or shorts area Hypovolemic Shock Recompression on TT6 Cutis Marmorata S/S, Tx - Answers -Mottled Skin Recompression on TT6 AGE is due to what gas law? - Answers -Boyle's Law What happens with an AGE - Answers -Breath holding on ascent, over inflation of alveoli, possible pneumothorax, gas pushes through membrane into pulmonary capillaries, gas bubbles block vessels, lead to ischemia and infarct of tissues AGE S/S, Tx - Answers -Any neurologic sign with Hx of hyperbaric exposure Recompression on TT6 Atmospheric calculations 33ft of sea water = - Answers -1 atmosphere Atmospheric calculations surface atmosphere + 33ft of sea water = - Answers -2 atmospheres absolute (2ATA) Atmospheric zones Physiologic Zone - Answers -Sea level to 10,000 ft MSL Night vision decreased beginning at 5,000 ft MSL Atmospheric zones Physiologically Deficient Zone - Answers -10,000 ft - 50,000 ft MSL Oxygen required to survive Atmospheric zones Physiologically Deficient Zone Time of Useful Consciousness at 30,000 ft MSL - Answers -90 Seconds Atmospheric zones Physiologically Deficient Zone Rapid cabin depressurization leads to... - Answers -Cutting Time of Useful Consciousness in HALF Atmospheric Zones Space Equivalent Zone - Answers ->50,000 ft MSL Types of hypoxia Hypemic - Answers -Reduction in O2 carrying ability Anemia, hemorrhage Types of hypoxia Histotoxic - Answers -Poisoning of the cytochrome oxidase system Cyanide, CO, alcohol Types of hypoxia Hypoxic - Answers -Not enough oxygen in the air altitude, deficiency in alveolar O2 exchange, pneumothorax Types of hypoxia Stagnant - Answers -Reduced cardiac output High G forces, cardiogenic shock Stages of hypoxia - Answers -Indifferent - some loss of night vision Compensatory - ⇧HR, vent, slowed judgement Disturbance - drunk Critical - death Stressors of flight Self imposed - Answers -Dehydration Exhaustion Alcohol Tobacco Hypoglycemia Stressors of flight Inherent - Answers -Thermal Changes ⇩ Humidity Gravitational forces Fatigue ⇩ Partial pressure of O2 Barometric pressure change Noise Vibration G Forces - Gx Direction of Force Toleration Example - Answers -Anterior/Posterior Best tolerated Accelerating/decelerating in your car G Forces - Gz Direction Toleration Example - Answers -Vertical Falling from a roof and landing on your feet G Forces - Gy Direction Toleration Example - Answers -Lateral Least tolerated Being T-Boned in a car wreck Altitude Effects Every 1,000 ft increase causes temp to drop... - Answers -2° Celcius Altitude Effects Barondontalgia - Answers -Occurs on ascent Air trapped in filling expands (Boyle's Law) CAMTS Weather minimums Mountainous - Local Day - Answers -800' ceiling 3 mile visibility CAMTS Weather minimums Mountainous - Local Night w/ NVGs or TAWS - Answers -1000' ceiling 3 mile visibility CAMTS Weather minimums Mountainous - Cross Country Day - Answers -1000' ceiling 3 mile visibility CAMTS Weather minimums Mountainous - Cross Country Night w/ NVGs or TAWS - Answers -1000' ceiling 5 mile visibility CAMTS If bad weather is encountered in flight... - Answers -divert to the nearest facility CAMTS #1 cause of crash... - Answers -Bad weather CAMTS #2 cause of crash... - Answers -Night flight Diagnostic Signs S3 - Answers -Congestive Heart Failure Diagnostic Signs S4 - Answers -Myocardial Infarction Diagnostic Signs Turtles Sign - Answers -Shoulder dystocia When the fetus crowns and then goes back in Diagnostic Signs McRobert's Maneuver - Answers -Shoulder dystocia Hyperflex the mother's legs to abdomen Diagnostic Signs Mauriceau's Maneuver - Answers -Breech delivery A method of delivering the head in an assisted breech delivery in which the infant's body is supported by the right forearm while traction is made upon the shoulders by the left hand. Diagnostic Signs Steeple Sign - Answers -Croup The radiologic image of subglottic narrowing from edema, suggestive of a steeple Diagnostic Signs Waddell's Triad - Answers -Pediatric hit by car Femur fracture Head injury Intra-abdominal or intra-thoracic injury Diagnostic Signs Cushing's Triad - Answers -ICP Irregular breathing Widening pulse pressures Bradycardia Diagnostic Signs Babinski's Sign - Answers -Spinal cord injury The big toes goes up and the toes fan out when the sole of the foot is firmly stroked Diagnostic Signs Brudzinski's Sign - Answers -Meningitis Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed. Diagnostic Signs Kernig's Sign - Answers -Meningitis Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees. Diagnostic Signs Grey-Turner's Sign - Answers -Pancreatitis Bruising of the flanks Diagnostic Signs Cullen's Sign - Answers -Pancreatitis Periumbilical swelling and bruising Diagnostic Signs Chvostek's Sign - Answers -Hypocalcemia Tapping on the face at a point just anterior to the ear and just below the zygomatic bone leading to twitching of the ipsilateral facial muscles Diagnostic Signs Trousseau's Sign - Answers -Hypocalcemia Inflating a sphygmomanometer cuff above systolic blood pressure for several minutes causing muscular contraction including flexion of the wrist and metacarpophalangeal joints, hyperextension of the fingers, and flexion of the thumb on the palm Diagnostic Signs Virchow's Sign - Answers -DVT Hypercoagulability Hemodynamic changes (stasis, turbulence) Endothelial injury/dysfunction Diagnostic Signs Kehr's Sign - Answers -Splenic injury Referred pain to the left shoulder Diagnostic Signs Ballance's Sign - Answers -Coagulated blood in the abdomen A dull percussion resonance sound heard on the right flank of a patient lying in the left decubitus position, an indication of a ruptured spleen. The sound is caused by an accumulation of liquid blood on the right side and coagulated blood on the left. Diagnostic Signs Coopernail's Sign - Answers -Pelvic fracture Bruising of the skin of the perineum, scrotum, or labia. Diagnostic Signs CAMTS Emergency Locator Transmitter - Answers -Self activated at 4Gs Transmit freq 121.5 MHz Upgraded transmit freq 406 MHz Emergency Medical Treatment and Active Labor Act - Answers -You must act if someone requires emergency care to sustain life or is in active labor "150 yard" rule Sending physician is responsible until they arrive at the next facility Standard of Care - Answers -Presence of Duty Breach of Duty Foreseeability Causation Injury Damages Duty to Report - Answers -Child abuse Elder abuse Violent crime Intubation indications - Answers -Unable to swallow Patient can not ventilate GCS<8 Inhalation burns Anaphylaxis Apnea Obstruction Respiratory failure LEMON stands for... - Answers -Look Evaluate 3-3-2 Mallampati (I-IV) Obstructions Neck mobility Mallampati I - Answers -Soft palate, uvula, anterior/posterior tonsillar pillars visible Mallampati II - Answers -Tonsillar pillars hidden by tongue Mallampati III - Answers -Only the base of the uvula can be seen Mallampati IV - Answers -Uvula can not be seen Macintosh blade interacts with... - Answers -Lifts the vallecula Miller blade interacts with... - Answers -Lifts the epiglottis Sellick's Maneuver is... - Answers -Direct downward pressure on the thyroid cartilage BURP Maneuver is... - Answers -Backward Upward Rightward Pressure Failed airway algorithm - Answers -Patient requires a secured airway 3 attempts of direct laryngoscopy unsuccessful Ventilate the patient by BVM Unable to ventilate/oxygenate SaO2>90% Cricothyroidotomy indicated Chest X-ray for placement of ETT should place the tip at... - Answers -2-3 cm above the carina T2 T3 vertebrae The distal cuff of an ETT should be inflated to _________ to _____________ - Answers -20-30 mmHg, prevent mucosal tissue damage 7 Ps of intubation - Answers -Preparation Preoxygenate Pretreatment Paralysis with induction Protect and position Placement with proof Post intubation management LOAD (RSI Pretreatment) - Answers -Lidocaine Opiates Atropine for infants Defasiculating Dose NMB Succinylcholine - Answers -Depolarizing Neuromuscular Blocking Agent Causes fasiculations Requires refrigeration NMB Succinylcholine Dose Onset Duration - Answers -1-2 mg/kg 1-2 min onset 4-6 min duration NMB Succinylcholine Contraindications - Answers -Crush injuries Eye injuries Narrow angle glaucoma History of malignant hyperthermia Burns > 24 hrs Hyperkalemia Any nervous system disorder Malignant hyperthermia S/S Tx - Answers -Masseter spasm/trismus Sustained tetanic muscle contractions Rapid increase in temp Increased ETCO2 Tachycardia Mixed acidosis Dantrolene Sodium (Dantrium) 3.0 mg/kg Do not give calcium channel blockers NMB Vecuronium (Norcuron) - Answers -Non-depolarizing NMB Does not cause fasiculations Does not need to be refrigerated NMB Vecuronium Dose Onset Duration - Answers -0.04-0.06 mg/kg IVP following Succ. 0.01-0.015 mg/kg maintenance 4-6 mins 30-45 mins NMB Rocuronium (Zemeron) - Answers -Non-depolarizing NMB Does not cause fasiculations Requires refrigeration NMB Rocuronium ERV Expiratory Reserve Volume is... - Answers -The amount of air that can be forcefully exhaled in addition to normal tidal volume VC Vital Capacity - Answers -IRV + Vt + ERV = VC RV Residual Volume - Answers -The amount of air left in the respiratory tract following forceful exhalation TLC Total Lung Capacity - Answers -IRV + Vt + ERV + RV = TLC Respiratory dead space - Answers -The surfaces of the airway that are not involved in gas exchange Central chemoreceptors are located in the________ and are driven by ________ - Answers -Medulla/Pons, CO2 and H+ levels Peripheral chemoreceptors are located in the _______ and are driven by ________ - Answers -Aortic arch/carotid bodies, O2, CO2, H+ Hypercarbic respiratory failure is... Evidenced by... Treated by... - Answers -Inability to remove CO2 Respiratory acidosis ⇧ Vt, then rate Hypoxic respiratory failure is... Evidenced by... Treated by... - Answers -Inability to diffuse O2 Low PaO2 ⇧ Vt and O2 concentration, then rate Apneustic respirations are... - Answers -An abnormal pattern of breathing characterized by deep, gasping inspiration with a pause at full inspiration followed by a brief, insufficient release. Decerebrate posturing - Answers -Apneustic respirations Ataxic respirations are... - Answers -An abnormal pattern of breathing characterized by complete irregularity of breathing, with irregular pauses and increasing periods of apnea Caused by damage to the medulla secondary to trauma - Answers -Ataxic respirations Biots respiration are... - Answers -An abnormal patter of breathing characterized by groups of quick, shallow inspirations followed by regular or irregular periods of apnea Opioids, TBI, stroke - Answers -Biots respirations Cheyne-Stokes respirations... - Answers -Are a progressively deeper sometimes faster breathing, followed by a gradual decrease that results in a temporary apnea Decorticate posturing, Cushing △, herniation - Answers -Cheyenne-Stokes respirations Kussmaul's respirations... - Answers -Gradually become deep, labored, and gasping Associated with DKA Gold standard for oxygenation - Answers -SpO2 Gold standard for ventilation - Answers -ETCO2 Ventilator acquired pneumonia is... - Answers -The number one cause of iatrogenic death in the U.S. Curare cleft are... - Answers -Tick marks seen on capnography, the patient is choking, check ETT Pt needs to be resedated and reparalyzed Ventilator settings Vt (tidal volume) - Answers -7-8 cc/kg Ventilator settings F (rate) - Answers -8-20/min Ventilator settings Ve (minute volume) - Answers -F x Vt (4-8 L/min) Ventilator settings I:E (inspiratory:expiratory ratio) - Answers -1:2 Ventilator settings FiO2 (fraction of inspired oxygen) - Answers -0.21 to 1.0 (21% - 100%) Ventilator settings Pplat (plateau pressure) - Answers -<30 Ventilator settings PEEP (positive end expiratory pressure) - Answers -5 Ventilator settings PEFR (peak expiratory flow rate) - Answers -500 to 700 L/min males, 380 to 500 L/min females Ventilator modes Controlled mandatory ventilation (CMV) - Answers -Sedated, apneic, or paralyzed patients Patient has no ability to initiate breaths Like "sucking on an empty bottle" Ventilator modes Synchronized intermittent mandatory ventilation (SIMV) - Answers -Senses patient is taking breath and assists Back up rate setting possible Preferred for patients with respiratory drive Like CPAP or BPAP Ventilator modes Assist-control ventilation (AC) - Answers -Patient can initiate Machine can initiate Full tidal volume regardless of effort Used with ARDS Can hyperventilate Ventilator modes Pressure support ventilation (PSV) - Answers -Assists the patient Patient determines minute volume Ventilator modes Continuous positive airway pressure (CPAP) - Answers -Uses mild air pressure to keep airway open Ventilator modes Bilevel continuous positive airway pressure - Answers -Used in pneumonia, COPD, and asthma Pressure alarms