Term
| under general ALS what 5 topics are paramedics able to utilize? |
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Definition
1. basic airway/high-flow o2, BVM and advanced airway PRN
2. Cardiac monitor/document rhythm prn
3. Venous access prn
4. if indicated, blood glucose test; if less than 60 administer 50ml of d50 slow ivp. For pediatric under 2yrs give 2ml/kg of D25. If over 2yrs 1ml/kg of D50 up to 50ml
5. peds tape |
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Term
| for prior to base as it pertains to respiratory distress, for suspected narcotic OD with hypoventilation. What is the use for Naloxone/Narcan adult and pediatric? can you repeat doses? |
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Definition
Adult: 2mg IM/IN or 0.8mg-2mg IVP titrated to adequate respirations/tidal volume
Peds: 0.1mg/kg IV/IM/IN
May repeat as needed! |
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Term
| respiratory distress for Bronchospasm/Wheezing. Albuterol doses? Repeat? |
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Definition
Adult: 5mg via hand-held nebulizer
Pediatric: less than 1yr - 2.5mg. over 1yr - 5.0mg
May repeat one time prn |
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Term
| prior to base for respiratory distree for cardiac related rales. doses for nitroglycerin and repating. what else can you do for SOB with rales? |
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Definition
SBP greater than or equal to 100=0.4mg
SBP greater than or equal to 150=0.8mg
SBP greater than or equal to 200=1.2mg
may repeat two times in 3-5minutes based on repeat BP
CPAP! max pressure of 10cmh20 (yes I know amr does not have cpap....yet. |
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Term
| prior to base treatment for chest pain. Aspirin and Nitro doses. if positive for MI transport where? if not then transport to? |
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Definition
Aspirin 162mg PO. Nitro- 0.4mg may repeat 2 times every 3-5minutes if SBP>100.
If MI go to closest STEMI center, if not then MAR. |
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Term
| Prior to base treatment for seizures not including your general ALS. repeat doses too. |
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Definition
Midazolam
Adult: 2-5mg slow IVP titrated to control seizure or 5mg IM if no IV access
Pediatric: 0.1mg/kg IVP titrated to control seizure or 0.1mg/kg IM/IN max of 5mg
may repeat midazolam one time in 5 minutes to a max of 10mg for adults and 5mg for peds all routes. |
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Term
| ALOC prior to base contact. |
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Definition
after general als which includes dextrose for adults and peds.if blood sugar less than 60 and unable to obtain IV, Glucagon 1mg (does not specify if thats just adult or if that includes peds)
if narcotic overdose, narcan Adult: 2mg IM/IN or 0.8mg-2.0mg IVP titrated to adequate respirations. PEDS: 0.1mg/kg IV/IM/IN |
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Term
| IV access falls under what part of prior to base contact |
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Definition
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Term
| prior to base for Shock. perform a need T if what? |
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Definition
general als. NS fluid challenge, set to TKO if rales or cardiogenic shock.
Adult gets 10ml/kg Peds 20ml/kg
Perform needle T if suspected tension pneumo and SBP less than or equal to 80mmhg. |
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Term
| prior to base pain management for isolated extremity injuries and burns. |
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Definition
Morphine for moderate to severe pain ADULT: 2-4mg slow ivp titrated for pain relief or 2-4mg IM if no IV access, may repeat once.
Pediatric: 0.1mg/kg slow IVP or IM. DO NOT REPEAT. max 4mg all routes for peds. |
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Term
| prior to base pain management for crush injuries, adult and peds dose including max doses. |
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Definition
Morphine-
Adult: 2-12mg slow IVP titrated for pain; 4-12mg IM if unable to get IV. Maximum of 20mg all routes
Pediatric: 0.1mg/kg slow IVP or IM. DO NOT REPEAT, 4mg total all routes. |
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Term
| if base hospital contact cannot be made...then what? |
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Definition
| contact shall be made with full patient report prior to leaving the receiving facility. |
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Term
| prior to base for symptomatic bradycardia for adults |
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Definition
general ALS. If HR less than or equal to 40 and SBP less than or equal to 80, atropine 0.5mg IVP. if no improvement then TCP following dept. guidelines.
If suspected hyperkalemia, albuterol 5mg via nebulizer 2x. |
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Term
| prior to base for symptomatic bradycardia, Pediatric HR less than or equal to 60. |
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Definition
assist respirations with BVM PRN.
Intubate PRN if 12 and older or 40kg and heavier.
King airway if 12 and older AND 4feet tall.
CPR if 8 years and younger and HR under 60 after effective ventilations. |
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Term
| prior to base contact for anaphylaxis with adequate perfusion |
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Definition
1. Epinephrine:
Adult 0.3mg of 1:1000 IM
Peds 0.01mg/kg 1:1000 IM max dose of 0.3mg for 30kg or greater.
2. Albuterol, if wheezing:
Adult 5mg via hand held neb
Ped 5mg if over 1 year, 2.5mg if under 1 year. |
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Term
| prior to base for anaphylaxis with poor perfusion |
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Definition
1. epi - adult 0.1mg (1:10,000) slow IVP. 0.5mg of 1:1000 IM if no IV
Peds - 0.01mg/kg (1:10,000) max single dose of 0.1mg for patients 10kg or greater. If no IV, 0.01mg/kg (1:1000) IM max of 0.3mg for those who weigh 30kg or more.
2. NS fluid challenge. adult - 10ml/kg
peds 20ml/kg |
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Term
| prior to base for SVT, narrow QRS>150bpm and adequate perfusion. |
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Definition
After general als
Adult:
1. valsalva maneuver
2. if no conversion, adenosine 6mg rapid IVP and 10-20ml NSbolus
3. if no conversion 12mg rapid IVP, 10-20ml ns push after |
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Term
| SVT with narrow QRS>150bpm prior to base and poor perfusion. adult and peds |
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Definition
Adult:
1. adenosine 12mg rapid IVP followed by 10-20ml NS. if no conversion, repeat once in 1-2minutes
2. synchronized cardioversion, may repeat one time.
peds: NS fluid challenge 20ml/kg |
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