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SNHD AEMT protocol study set
Acetylsalicylic Acid - Aspirin Acetylsalicylic Acid (Aspirin) class - Non-steroidal anti-inflammatory (NSAID) Acetylsalicylic Acid (Aspirin) action - Platelet inhibition Acetylsalicylic Acid (Aspirin) dose - Adult: 324mg PO (81mg tablets x 4) Pediatric: not recommended for use Acetylsalicylic Acid (Aspirin) route - PO - Chew and swallow Acetylsalicylic Acid (Aspirin) contraindications - Allergy to aspirin Acetylsalicylic Acid (Aspirin) adverse reactions - None Activated charcoal Class - Adsorbent Activated charcoal Action - Inhibits gastrointestinal absorption of toxic substances Activated charcoal Dose - Adult: 50gm PO Pediatric: 1gm/kg PO; minimum dose 10gm Maximum dose 50gm Activated charcoal
Route - PO Activated charcoal Contraindications - Altered mental status; ingestion of acid, alkalis, or petroleum distillate; an inability to swallow; previous administration of an emetic Activated charcoal Adverse reactions - Nausea Vomiting Albuterol - Proventil Albuterol (Proventil) Class - Sympathomimetic Albuterol (Proventil) Action - Bronchodilator Albuterol (Proventil) Dose - Both adults and pediatrics: 2.5 mg and 3 mL SVN, repeat until improved Albuterol (Proventil) Route - Inhalation by oxygen nebulization Albuterol (Proventil) Contraindications - Hypersensitivity to the drug Albuterol (Proventil) Adverse reactions - Tachycardia palpitations anxiousness headache Bronchodilator metered dose inhaler Class -
Diphenhydramine hydrochloride (Benadryl) Route - IV or deep IM Diphenhydramine hydrochloride (Benadryl) Contraindications - Hypersensitivity to the drug Diphenhydramine hydrochloride (Benadryl) Adverse reactions - Sedation palpations decreased blood pressure headache dries (thickens) bronchial secretions blurred vision Epinephrine Class - Sympathomimetic Epinephrine Action - Bronchodilation positive chronotrope positive initrope Epinephrine Dose - Adult: 1:1000, 0.5 mg IM; may repeat q 15 min. Up to max 1.5 mg pediatric: 0.01 mg/kg IM; max single dose 0.3 mg; may repeat q 15 min. Up to max 0.9 mg Epinephrine Route - IM IV ETT SVN Epinephrine Contraindications - Underlining cardiovascular disease/angina; hypertension; pregnancy;
patient over 40 years of age; hyperthyroidism Epinephrine Adverse reactions - Palpations due to tachycardia or ectopic beats may produce arrhythmia if cardiac disease present; elevation of blood pressure; headache; anxiousness Epinephrine Auto-injector Class - Sympathomimetic Epinephrine Auto-injector Action - Bronchodilation positive chronotrope positive initrope Epinephrine Auto-injector Dose - Both adult and pediatrics: Assist patient with his or her own epinephrine auto-injector Epinephrine Auto-injector Route - IM Epinephrine Auto-injector Contraindications - Underlining cardiovascular disease/angina; hypertension; pregnancy; patient over 40 years of age; hyperthyroidism Epinephrine Auto-injector Adverse reactions - Palpations due to tachycardia or ectopic beats may produce arrhythmia if cardiac disease present; elevation of blood pressure; headache; anxiousness Glucagon Class - Insulin antagonist
Pediatric: See specific protocol for dosing based on weight, age, and concentration Glucose D10 (10% dextrose in 250 ml NS) dose - Both Adult and Pediatrics: 1ml/kg max dose 250ml Glucose D10 (10% dextrose in 250 ml NS) route - Slow IVP IV drip PO Glucose Contraindications - None Glucose Adverse reactions - None Naloxone hydrochloride - Narcan Naloxone hydrochloride (narcan) Class - Narcotic antagonist Naloxone hydrochloride (narcan) Action - Reverses effects of narcotics Naloxone hydrochloride (narcan) Adult Dose - 0.4 - 2.0 mg IN IM IV May repeat if patient slow to respond; titrate to effect; max single dose - 2.0 mg Max total dose - 10mg Naloxone hydrochloride (narcan) Pediatric Dose -
0.1 mg/kg IN IM IV May repeat if patient slow to respond; titrate to effect; max single dose - 2.0 mg Max total dose - 10mg Naloxone hydrochloride (narcan) Route - IN IM IV Naloxone hydrochloride (narcan) Contraindications - Patient with a history of hypersensitivity to the drug; intubated patients; the newly born during initial resuscitation Naloxone hydrochloride (narcan) Adverse reactions - Rapid administration causes projectile vomiting Nitroglycerin Class - Vasodilator Nitroglycerin Action - Dilated systemic arteries and veins; reduces both preload and afterload Nitroglycerin Dose - Adults: Assist patient with own nitro as prescribed; may repeat 3 times. pediatrics: See specific protocol Nitroglycerin Route - Sublingual Spray or tablet Nitroglycerin Contraindications -
(Generalized) are associated with loss of consciousness, incontinence, and oral trauma Focal seizures - Affect only part of the body and are not usually associated with loss of consciousness Hypotension defined as - BP less than 90 systolic, not always reliable, and should be interpreted in context and patients typical BP Hypovolemic shock - Hemorrhage, trauma, G.I. bleeding, ruptured aortic aneurysm, or pregnancy related bleeding Cardiogenic shock - Heart failure, MI, cardiomyopathy, myocardial contusion, toxins Distributive shock - Sepsis, anaphylaxis, neurogenic, toxins Obstructive shock - Pericardial Tampanade, Pulmonary embolus, tension pneumothorax Trauma centers - University medical center, level one. Sunrise Hospital, level two. Saint Rose sienna, level Three. Pediatric destinations - Saint Rose sienna. Summerlin medical center. Sunrise hospital. University medical center.
Burn centers - University medical center Sexual assault centers - Sunrise hospital, for patients less than 13 years old. Sunrise hospital, university medical center for patients 13 years old to 17 years old. University medical Center for patients 18 years old and up Stroke destinations - All hospitals except: Boulder City Hospital. Mesa view hospital. Mike O'Callaghan federal hospital. North Vista Hospital. Hypothermia centers - All hospitals except: Boulder city hospital. Mesa view hospital. Mike O'Callaghan federal hospital. North Vista Hospital. Saint Rose San Martin. In any cardiac arrest and postarrest resuscitation what should you never do? - Hyperventilate What is the most important airway device and also the most difficult to use correctly? - The bag valve mask Difficult BVM ventilations acronym - Moans Difficult BVM ventilations - moans - M: difficult Mask seal, due to facial hair, anatomy, blood/secretion/trauma. O: Obese or late pregnancy. A: Age greater than 55. N: No teeth- roll gauze and place between gums and cheek to improve seal. S: Stiff or increased airway pressure - asthma, COPD, obese, pregnant. Difficult extraglottic device placement acronym -
Torso, 18 front & 18 back. Legs, 14. Arms, 9. Parkland formula - 4 mL times weight in kilograms,times BSA burned = total amount of fluid for 24 hours. Give half in the first eight hours, remainder over the next 16 Superficial - 1stยฐ burn - Red and painful Partial thickness - 2ndยฐ burn - Blistering Full thickness - 3rdยฐ burn - Painless or charred What are burn patients considered - Trauma patients You are on scene for a 14-year-old female patient who was sexually assaulted. The patient requires transport to the hospital for further examination. Using the general pediatric assessment protocol, this patient should be transported to? - Either UMC, or sunrise Hospital You are called to the scene for a man who has suffered and inhalation injury after an explosion at a factory. Which hospital should the patient be transported to? - UMC What is the pediatric dose of Narcan? - 0.1 mg per kilogram. IM/IM/IV. Max single dose 2 mg. Max total dose to 10 mg. In the pediatric drowning protocol, after a general patient assessment has been completed, the highest priority should be protecting the airway and adequate ventilation. True or false? - True You are called to a hotel for a male in seizure. Upon arrival, you find that the patient has stopped Seizure activity, but is still unresponsive. After ensuring adequate airway, you check the patients BGL. The patient should be administered glucose if it is noted to be below what MG/DL - 60 MG/DL On all patients suspected of alcohol as the cause of an altered mental status the EMS provider should rule out what other causes? - Infection,
trauma, insulin - hypo/hyperglycemia. In the termination of resuscitation protocol, resuscitation started in the field may be discontinued only by a physician order when the following conditions have been met for a medical arrest: the patient remains in persistent a-systole or agonal rhythm and has a capnography less than 10 MMHG after 20 minutes of appropriate paramedic resuscitation, to include: - CPR, effective ventilation with 100% oxygen, administration of appropriate ACLS medications You arrive on scene for a two-year-old male who was reported to have fallen. The parents inform you that the patient crawled up onto a ladder that had been left by some workers and fell approximately 8 feet to the ground. The patient is 3 feet tall and weighs 55 pounds. He is alert and oriented and acting appropriately per his parents, but Wences when you touch his lower back. Using this information does the patient meets criteria for transport to a trauma center? True or false? - True, children go to a trauma center for falls greater than 10 feet or two times the height of the child A trauma patient with a GCS of 14 must be transported to a trauma center? True or false? - False, a patient with a GCS of 13 or less must be transported to a trauma center. All pediatric step one and step two trauma calls that occur within the Clark County are to be transported to UMC trauma, and medical directions for the treatment of the patient must originate at that center? True or false? - True. And airway adjunct should be inserted in a cardiac arrest patients, with breaths per minute, being performed at a rate of at least what? - At least eight breaths per minute A pregnant patient who presents with a cord presentation should be placed in which position? - Place on elbows and knees with hips elevated Pediatric drowning victims should have CPR performed compressions/ventilation ratio of 15:2? True or false? - True. for drowning victims, Emphasis should be on oxygenation/ventilation. Use traditional 15:2 CPR, not continuous compressions. Adult drowning victims, use traditional 30:2 CPR Patients who are suffering from pain should initially be treated with the following treatment? - Comfort measures, I.E.
Heat exhaustion - Consist of dehydration, salt depletion, dizziness, fever, AMS, headache, cramping, N/V. Vital signs usually consist of tachycardia, hypertension and elevated temperature. Heat stroke - Consist of dehydration, tachycardia, hypotension, temperature greater than 104ยฐF (40ยฐC), and AMS Mild hypothermia - Temperature between 90ยฐ and 95ยฐF Moderate hypothermia - Temperature between 82ยฐ and 90ยฐF Severe hypothermia - Temperatures less than 82ยฐF In the setting of pregnancy, hypertension is defined as? - Greater than 140 systolic or greater than 90 diastolic. or a relative increase of 30 systolic and 20 diastolic from the patient's normal pre-pregnancy blood pressure What position would you transport a patient in that is showing signs of preeclampsia? - Left lateral position Any pregnant patient involved in an MVC should be seen by a physician for evaluation, true or false? - True What is a pediatric fluid bolus - 20 ml/kg; may repeat to a maximum of 60 ml/kg If a pediatric patient is suspected of being in DKA, do not exceed how many ml/kg normal saline? - Do not exceed 20 ml/kg normal saline
Can narcan be used on the newborn - Narcan is not recommended for use with the newly born What is the estimated minimum systolic blood pressure calculation for pediatrics? - Age in years times 2 + 70 What ages does the systolic blood pressure calculation apply to? - Up to age 10 You supplemental oxygen to maintain an oxygen saturation of what? - Of greater than 94%; or greater than 90% for patients on home oxygen for chronic conditions Cervical stabilization is indicated in any patient who has... - A: midline cervical spinal tenderness. B: focal neurologic deficit. C: altered mental status. D: evidence of drug and/or alcohol intoxication. E: any painful, distracting injury. If all of these are negative cervical stabilization is not indicated. When should cervical stabilization not be performed? - A: penetrating trauma to the head and or neck and no evidence of spinal injury. B: injuries where placement of the color might compromise patient assessment, airway management, ventilation and or hemorrhage control. C: patients in cardiac arrest. When are backboards indicated? - Backboards are only indicated for extrication and patient movement. Patients are not to be transported on backboards, unless movement off the backboard would delay immediate transfer of patients with life-threatening injuries or acute spinal injuries. With cervical stabilization what is not recommended? - Tape, had straps, wedges, and had and/or next support devices are not recommended. What are the indications for an extra glottic airway device? - This procedure may be performed on any patient and which attempts at basic airway and ventilation support our unsuccessful and who has at least one of the following:
B: plays the tip of the MAD snuggly again for nostril, and then slightly up an outward, towards the tip of the year. C: bristly compress the syringe to deliver half the medication and to the nostril. D: move the device over to the opposite nostril and administer the remaining medication. Traction splint indication - This procedure may be performed on any patient with an isolated closed midshaft femur fracture Traction splint contraindications - A: pelvic fracture or instability. B: knee, lower leg, or ankle instability. Vascular access indications - This procedure may be performed on any patient whenever there is a potential need for: A: intravenous drug administration. B: need to administer IV fluids for volume expansion. Vascular access contraindications - None Vascular access key procedural considerations - Vascular access attempt should not unnecessarily delay transport, attempts should be completed en route. All attempts are to be documented on the PCR. Saline locks maybe used when appropriate and flushed with a 3 cc bolus of normal saline as needed. Extension tubing should be used on all IV lines. What are the obvious signs of death - Body decomposition. Decapitation. Transection of thorax. Incineration. What are the four presumptive signs of death that must be present - Unresponsiveness. Apnea. Pulselessness. Fixed, dilated pupils. What are the conclusive signs of death - Dependent lividity of any degree.
Rigor mortis. Massive trauma to the head, neck or chest with visible Oregon distraction. How many presumptive signs of death and how many conclusive signs of death do you need to determine prehospital death. - All four presumptive signs of death and at least one conclusive sign of death How deep should your chest compressions be for an adult cardiac arrest patient - 2 inches or greater How deep should your chest compressions be for an infant patient - One and a half inches How deep should your chest compressions be for a child patient - 2 inches When should continuous chest compressions, CCC, be used - Only adult cardiac arrest patients Where should cardiac arrest patience be transported to - Transported to the closest facility Where do all step one trauma calls go to - University medical center or sunrise Hospital and medical center Where do all step two trauma calls go to - University medical center or sunrise Hospital and medical center Where do all step three trauma calls go to - University medical center. Sunrise hospital and medical center. Saint Rose sienna Where do all step four trauma calls go to - Saint Rose sienna Where do all pediatric step one trauma calls go to - University medical center Where do all pediatric step two trauma calls go to - University medical center
