lab test 1......

9 Rs

• right route

• right to refuse

• right response

• right patient

• right dose

• right time

• right education

• right medication

• right documentation

all steps before administering medication

what vitals are in A

is airway patent

what vitals are in B

• breathing rate rhythm quality

• lung sounds, chest rise and fall

• pulse ox

what vitals are in C

• pulse rate rhythm quality

• blood pressure

• skin color and temp

what vitals are in D

BGL, PERRLA, LOC

DCAPBTLS

• deformities

• contusions

• abrasions

• punctures/penetration

• burns

• tenderness

• laceration

• swelling

order for trauma/medical (review)

1. BSI/scene safety

2. # & location of patients

3. MOI or NOI

4. C spine precautions

5. call additional resources

6. XABCDE

7. transport??

8. SAMPLE

9. OPQRST

rescue breath rate for infants and peds and adults

1 breath every 3 seconds for ped and infant

1 breath every 6 sec for adults

suction: indications, contraindication, how do u use and mesaure, max doses for each

• indication: u doing cpr and gotta suction

• contra:

• turn it on and kink the end of it till pressure reaches 300 mm Hg.

  • test it by putting ur finger on it

  • suction only till u can see and suction on the way out

• measure it by putting tip on earlobe and corner of mouth

• hard tip for mouth soft tip for anywhere else

adults: 15 sec

peds: 10 sec

infants: 5 sec

NPA: ndications, contraindication, how do u use and mesaure

• indication: needing breath to faciliate more

  • intact gag reflex

  • conscious

• contraindication: nosebeed

  • facial trauma/burns, nose fracture

• measure from tip of nose to corner of mouth

• lube it, put the bevel in facing the septum. usually right nostril bc its bigger and it will go in easier. if left nostril you have to rotate it

what stuff do u have to lube

this strap, NPA, OPA, supagalottic airways

OPA: indications, contraindication, how do u use and mesaure

• indication: unconscious

  • no gag reflex

  • facilitate breaths and keep airway open

• contra:

  • gag reflex

• to measure put tip of mouth to jawline

• lube

• head tilt chin lift or jaw thrust

• insert at a 90 degree angle using cross finger technique and then twist it to the side so that it is on the lips resting

nasal cannula: indications, contraindication, how many LPM, how much oxygen delivery. how to put on

• indication: pulse ox in low 90s

• contra: facial trauma

• 1-6 LPM

• delivers 24-44% o2

• put on by putting prong into the nose facing down into the airway on patients chest not behind them anddd around their ears and tighten them

NRB: indications, contraindication, how many LPM, how much oxygen delivery. how to put on

• indication: pulse ox pretty low like 80s

• contra:

• 10-15 LPM

• up to 90% o2

• wait for mask to inflate w o2 and put it around their head and close metal bracket

BVM: indications, contraindication, how many LPM, how much oxygen delivery. how to put on, rescue breath rate

• indication: someone cannot breathe by themselves

• contra:

• 15-20 LPM so connect to low pressure

• 90-100% o2 if connected to o2 but if not then just 21%

• use CE clamp

• can be attached to supagalottic airways to make it better

• use an NPA or OPA unless counterindicaated

• 1 every 6 seconds for adults and 3 seconds for kids

CPAP: indications, contraindication, how to put on

• indications: fluid in lungs

  • COPD

  • pulmonary edema

  • severe respiratory distress

  • CHF

  • breathing spontaneously

  • conscious and alert

  • able to follow commands

  • systolic over 100

• contra:

  • systolic below 100

  • unconscious

  • cannot tolerate mask

  • active GI bleeding

  • facial trauma

  • signs and symptoms of pneumothroaax or chest injury

what r the two medications in a nebulizer

atravan and albuterol

IGEL: indications, contraindications, how to measure, how to put on.

• indications: no gag reflex

  • unconscious

  • needs deeper airway

  • cardiac arrest

  • prolonged ventilations

• contra: gag reflex

  • less than 4 feet tall or under 12 yo

• measured by weight

  • Size 3 for 30-60 kg, Size 4 for 50-90 kg, Size 5 for 90+ kg)

• put it on byyyy lubing it, putting it in until u feel resistance, and putting the straps over it

• attach the bvm and capnography

• Listen to epigastric sounds to see if air in stomac

why do u listen to epigastric sounds w supagalottic airways

to make sure ur not putting air into the stomach

how can you tell if the supagalottic airway is working

• no epigastric sounds

• condensation in the BVM

• bilateral chest rise and fall

king tube: indications, contraindication, how to put on, how to measure

• indications: no gag reflex

  • unconscious

  • unable to vent w just bvm

  • cardiac arrest

  • prolonged ventilations

• contra: gag reflex

  • conscious

• put on by testing it by inflating the distal cuff and seeing if the other one inflates. then you deflate it and put it in and do the distal cuff so u know its inflating in the body

• measured by height

  • size 3: 4-5 ft

  • size 4: 5-6 ft

  • size 5: 6+ ft

nebulizer: indications, contraindication, how to put on

• indications: asthma, wheezing

• contra: high heart rate

• bronchodilator

• watch video before u say how its done

tell me everything yk abt the o2 bottle

• D cylinder

• made of aluminum

• ik its o2 bc its green tip and says o2

• the all green ones are made of steel

• its tested every 5 years uding hydrostatic testing where its put in water and see if theres leaks

• u alwasys lie it down when not in use and hold it w two hands bc its pressurized and it can explore

• holds 350 L compressed oxygen and 2000 psi

• replaced 500 psi

parts

• start off at the stem

• to put it in service open it a little to let debris out and close it again

• this is the regulator. in it u have:

  • the t screw,

  • the yoke,

  • the pin index system,

  • the high pressure valve which u cant control, t

  • he low pressure/therapeutic valve,

  • and the bordoun gauge which is not affected by gravity so it can be at any orientation

  • flow meter where u control LPM