Term
| Assessment - Look For D.C.A.P.P.-B.T.L.S. |
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Definition
| Deformities Contusions Abrasions Punctures Penetrations Burns Tenderness Lacerations Swelling |
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Term
Assessment - Palpate For
T.I.C. |
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Definition
Tenderness
Instability
Crepitus |
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Term
Assessment in Abdomen - Palpate for
D.R.T. |
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Definition
Distension
Rigidity
Tenderness |
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Term
Neurological Assessment
A.E.I.O.U.-T.I.P.S. |
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Definition
Alcohol, Anaphalaxis, Apnea
Environment, Epilepsy
Insulin
Overdose
Underdose
Trauma
Infection, Ischemia
Psychiatric, Poison
Shock, Stroke |
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Term
Vitals
S.L.E.R.P.T.-B.B.P. |
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Definition
Skin (Color/Condition/Temp)
LOC (A/O*?)
Eyes (Round, Reactive to Light and Size)
Resps (Rate/Rhythm and Depth)
Pulse (Rate/Rhythm and Quality)
Temperature (Tympanic)
Blood Oximetry
Blood Glucose
Please Have Them Ready Every 5 Minutes |
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Term
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Definition
Allergies (Do you have any pertaining to this condition - Food, Medications, Environmental?)
Medications - (Are you on any meds, any herbal,scripts, OTC, rec drugs?)
Past Hx - (Any previous HX that is connected to this occurrence?)
Last Oral Intake/Last Bowel Movement(for abdominal complaints)
Events leading up to the C/C |
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Term
Pain Assessment
O.P.Q.R.S.T.A. |
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Definition
Onset - Did the pain start sudden or come on gradually?
Provoke -What makes the pain worse?
Quality - In your own words, what does the pain feel like?
Radiate - Does the pain stay in one area, or move around?
Severity - On a scale of 1 to 10, 10 being the worse pain you have ever felt, what does this feel like? What are you comparing this to?
Time - How long as this pain been prevalent?
Alleviate - Is there anything that you have done, or we have done to make the pain any less? |
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Term
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Definition
Right Documentation
Right Dose
Right Drug
Right Time
Right Patient
Right Route |
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Term
3 C's and an E of Medication
Check How Many Times? |
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Definition
Colour
Condition
Clarity
Expiry Date
Check 3 Times |
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Term
A.S.A.
Online or Offline?
Full Name?
Effective dosage?
Indication? |
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Definition
-Offline
-Acetylsalicylic Acid
-160-325 mg in 80 mg tablets
-Ischemic Chest Pain |
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Term
A.S.A.
Contraindictaions?
Side Effects? |
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Definition
-Allergy to ASA, Hemophylliac, Unconscious
-GI Upset, Nausea, vomitting, heart burn |
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Term
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Definition
-Asthma - ASA may induce bronchoconstriction in asthmatics.
-Active Ulcer Disease
-Impaired Renal and Hepatic Function
-May increase the risk of Reye's Syndrome |
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Term
A.S.A.
Pharmacodynamics?
Administration? |
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Definition
Pharma-At low doses, appears to impede clotting by blocking prostaglandin synthesis which prevents the formation of platelet aggregating substances.
Admin - Patient must chew and swallow tablets for better absorption rate. |
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Term
Oral Glucose
Online or Offline?
Brand Names?
Effective Dosage?
Indications |
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Definition
-Offline
-Insta-Glucose, Monogel
-25g tube
-signs and symptoms of HYPOglycemia with a CONFIRMED bgl of less than 3.8mmol/L. |
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Term
Oral Glucose
Contraindications?
Side Effects?
Precautions |
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Definition
-Unconcious, any patient who is unable to follow commands/instructions, HYPERglycemia.
-Nausea/Vomiting
-May cause nausea/vomiting due to gag reflex. |
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Term
Oral Glucose
Phamacodynamics?
Administration? |
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Definition
Pharma-a monsaccharide (sugar) that is given orally and is readily absorbed in the intestine.
-Oral Glucose must be swallowed down for the desired absorption rate to be achieved.
-It can be administered via tongue depressor, or by having the patient simply squeeze the content into their mouth and swallowing them down. |
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Term
Salbutamol
Online or Offline?
Brand Name?
Dosage?
Indications? |
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Definition
-Online
-Ventolin
-6-20 puffs, each puff is 100mcg
-severe bronchospasm due to chronic bronchitis or shortness of breath due to asthma. |
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Term
Salbutamol
Contraindication?
Side Effects?
Precautions? |
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Definition
-Allergy to Salbutamol
-Nevousness, headache, tachycardia, heart palpitations, nausea/vomiting, transient muscle cramps, muscle trmors, weakness.
-Do not use with patients presenting with acute heart failure. |
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Term
Salbutamol
Pharmacodynamics?
Administration? |
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Definition
-binds to beta2 receptors promoting bronchodilation.
-Shake can for 30-60 seconds, patient exhales, place over tongue, have patient inhale as spraying. |
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Term
Ipratropium Bromide
Online or Offline?
Brand Name?
Effective Dosage?
Indications? |
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Definition
-Online
-Atrovent
-1-4 puffs as needed to a max of 10, 20mcg/spray
-severe bronchospasm due to chronic bronchitis or shortness of breath due to asthma. |
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Term
Ipratropium Bromide
Contraindications?
Side effect? |
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Definition
-allergy to ipratropium bromide, atropine, soy lethicin or related food products (soybeans, peanuts due to the propellant), children under 5 years old.
-nervousness, headache, tachycardia, heart paplitations, nausea/vomiting, muscle tremors, transient muscle cramps, weakness. |
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Term
Ipratropium Bromide
Precautions?
Phamacodynamics?
Administration? |
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Definition
-patients with narrow angle glaucoma (neb application), avoid release into eyes.
-I.B. inhibits parasympathetic bronchoconstriction, resulting in more open lower airways and bronchodilation.
-shake for 30-60 seconds, patient exhales, place mouth piece over tongue, spray while patient inhales and holding breath. |
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Term
Epinephrine
Online or offline?
Common name?
Effective dosage?
Indications? |
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Definition
-Adreneline
-0.3mg given IM at the lateral aspect of the thigh
-Anaphalaxis |
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Term
Epinephrine
Contraindications?
Side Effects?
Precautions? |
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Definition
-None in emergent setting
-anxiety, headache, heart palpitations, angina, cardiac arrythmias, acute HTN, pallor, SOB, nausea/vomiting.
-use with elderly patients, HTN, cardiac Hx, Pulmonary edema. |
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Term
Epinephrine
Pharmacodynamics?
Administration? |
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Definition
-binds to the A1, B1 and B2 receptors resulting in bronchodilation by drying out mucus membranes.
-admisiter in the lateral aspect of the thigh at a 90deg angle. Hold for 10 seconds, throw sharps away (SHARPS AWAY!) and massage area to promote blood flow to the injection site. |
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Term
Nitroglycerine
Online or Offline?
Common Name?
Dosage?
Indications?
Contraindications? |
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Definition
-Not in EMR scope
-Nitrostat
-0.4mg/spray
-Suspected MI or angina
-Systolic BP less than 100, Viagra within 24 hrs, Cialis within 36 hrs, Levitra within 48 hrs. |
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Term
Nitroglycerin
Side Effects?
Pharmacodynamics? |
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Definition
-lightheadedness, headache, dizziness, nausea/vomiting, syncope (fainting/loss of consciousness)
-relaxes smooth heart muscle, decreasing oxygen consumption. Dilates coronary vessels, increasing circulation and redistributing blood to ischemic tissue. |
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Term
Impaled Objects
When is it acceptable to remove an impaled object? |
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Definition
| -only if the object is obstructing the airway, or if it is interfering with proper hand placement for CPR. Any other situation, log cabin dressing and transport( in alternate position if necessary). |
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Term
Deadly Bleeding (red arterial spurting)
Order of methods to control bleeding? |
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Definition
1.Direct pressure/elevation
2.Pressure dressing
3.pressure point
4.ONLY if not controlled by the first three, a tourniquet may be considered. Obtain ONLINE direction first, if available. |
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Term
Fractures and Dislocations
When can an EMR realign a fracture?
End points for traction splints are? |
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Definition
-when the fracture is not within one of the patients' hand width from a joint, if the pulse at the distal point of the fracture, only one attempt in the field.
-10% of the patients' weight or 15lbs. |
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Term
ICP/Cushings Triad
What are the signs in the Cushing's Triad? |
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Definition
1. Hypertension(Increasing BP, often over 180sys)
2. Bradycardia(decreasing HR, often 60BPM or lower)
3. Cheyne(pron. Shane) Stokes breathing (deep and irregular breathing)
4. Unequal pupils
5. Seizures
6. Nausea/vomiting
7. Unconsciousness |
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Term
ICP/Cushing's Triad
Critical Intervention is? |
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Definition
| Hyper-oxygenate the patient using a BVM with the bag 2/3 full, flowing O2 @15LPM, ventilating 1 breath every 3 seconds or 20/min. If on a backboard, elevate head 15-20 degrees. |
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Term
Flail Chest
Definition?
Critical Intervention? |
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Definition
-2 or more ribs are broken in two or more places. Look for paradoxical motion and palpate for TIC to confirm.
-Hand stabilize the flailed segment
2. Delegate partner to apply bulky dressing and tape it north and south. |
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Term
Sucking Chest Wound
Definition?
Critical intervention? |
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Definition
-there is a hole in the chest involving the lungs, allowing air to enter and escape the chest. Upon examination you would find blood and the hear bubbling and see bloody bubbles.
-seal the wound with gloved hand. Delegate partner to cover with OCCLUSIVE (air and water tight)dressing taped on 3 sides, open side down. |
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Term
Eviscerated Organs
Definition?
Critical Intervention? |
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Definition
-when organs are found protruding outside of the body. usually found in abdomen due to lacerations.
-delegate partner to cover eviserated organs with moist, sterile, NON STICK dressing. Cover with occlusive dressing taped all 4 sides. Cover patient with blanket. Point is to mimick the conditions of the abdomen. |
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Term
Scoop Stretcher
Definition?
How to use? |
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Definition
-A steel tubular lifting device used when a patient has a possible pelvis fracture. It is placed between the patient and backboard.
-take apart the scoop, placing each side on opposite sides of the patient. Bring the scoop in from the sides and re-attach. Use blankets for padding on each side and over the top of the pelvis. Strap from shoulder to hip-shoulder to hip, hip to knee-hip to knee, followed by head blocks and strapping. While transferring patient to backboard, do assessment of posterior. Transfer to backboard and strap in with at least 3 straps. Then strap to wheeled stretcher, again using 3 more straps. |
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