MED QUIZ

Pain Medications

Mild Pain: Tylenol 1g PO. Offirmev 1g over 10 minutes IV.

Moderate Pain: Fentanyl 1mcg/kg IV or 2mcg/kg IN.

Ketamine 20mg IV or 50mg IM. Repeat x3 times q 10 min. (Trauma & Hemodinamically unstable)

Ketorolac 15mg IV or 30mg IM for musculoskeletal or kidney stone pain.

Blood Administration Criteria

+12 years old

Hemaglobin <6

Traumatic Penetrating/Blunt injury

Systolic BP 90 or less. HR >120

Positive FAST

Nausea Medications

Zofran 8mg PO, IV, IM,

Dorperidol 1.25mg IV

Asthma Medication

Primary Tx: Albuterol 2.5mg & Atrovent 0.5mg nebulizer @ 6LPM.

Methylprednisolone 125mg IV

Moderate: Epinephrine (1:1000) 0.3mg IM

Magnesium 50% 2g in 100 D5W given over 10 min. IV

Severe: Epinephrine (1:100,000) 10mcg IV.

Ketamine 0.3mg/kg (Max dose of 50mg) in 50 ml NS given over 2-3 minutes.

What is Sodium Bicarbonate not compatible with?

Calcium

T/F Etomidate can be used as an infusion.

FALSE.

After how many shocks is Esmolol indicated?

3 Shocks.

Nitroglycerin

Nitroglycerin dilates the coronary arteries and increases blood flow to the heart. Reduces the left ventricular preload and after load reducing the myocardial oxygen demand.

Epinephrine Vs. Norepinephrine

Epinephrine: Vasoconstrictor, Bronchodilator, Increases HR. Post Arrest, Anaphylaxis

Norepinephrine: Vasoconstrictor. Sepsis

Carbon Monoxide Poisoning Medication

Cyanokit 5g in 200ml NS IV. Over 15 min.

Intubation of hemodynamically unstable patient

Norepinephrine push dose. (16mcg/ml) 0.5ml.

Attempt to pre oxygenate pt to SpO2 >94% with BVM.

Have all necessary supplies ready: tube, igel, bougie, tube tamer, Mcgrath, suction, ETCO2.

MEDS: Ketamine 2mg/kg for sedation. Rocuronium 1mg/kg for paralyzing.

Attempt to intubate without SpO2 falling below 90%

Confirm placement with ETCO2, lung sounds, rise & fall of chest.

Ketamine 1mg/kg for continued sedation.

Norepinephrine infusion 8mcg/min IV. (30ml/hour)

Nicardipine BP Goals

Target BP is 10-15% reduction in SBP

Behavior Severity Score and Tx

1. Confused

2. Irritable

3. Boistrous

4. Verbally Threatening

5. Physically threatening

6. Attacking objects

7. Attacking people

1-3 Versed 5mg IM; 2.5mg IV OR Droperidol 5mg IM; 2.5mg IV

4-6 Versed 5mg IM; 2.5mg IV AND Droperidol 5mg IM; 2.5mg IV

7 Ketamine 4mg/kg (max of 500mg)

OPIOD Overdose

Naloxone 2mg IM; 1mg IV

Triptylines Overdose

Sodium Bicarbonate 1meq/kg IV (max dose of 100meq)

Medications approved for AEMT with P2 partner

Dextrose IV

Glucagon IM

P1 - All medications under P2 supervision

Acetaminophen PO

Ondansetron IV, PO

Dyphenhydramine IV

Naloxone IN/IV/IM

With a P2 partner: What skills are within scope of practice?

AEMT Medication administration

Airway management via supraglottic device

IV access excluding EJ

Without a P2 partner,  which medications are approved for the AEMT/P1 level?

all AEMT medications

Methylprednisolone IV

Epinephrine IV

all EMT medications

Fentanyl IV

Midazolam IM

Nitro IV

Sepsis Management

O2 if needed.

Fluids. NS

Norepinephrine (16mcg/ml) 0.5ml IVP. Follow with infusion (16mcg/ml) 8mcg/min. Titrate as needed.

Ofirmev 1g over 10 minutes.

Consider antibiotics if known source of infection.

Crush Injury Treatment for >4hours

Keep warm and prevent hypothermia.

1L NS

Pain Management (Ketamine 20mg or Fentanyl 1mcg/kg)

Calcium 1g slow IV push

Sodium bicarbonate 50 mEq

Albuterol 90mcg MDI x2

Treatment for Penetrating Trauma

Control bleeding

Keep warm and prevent hypothermia.

NS 250ml

Blood

Pain control (Ketamine 20mg or Fentanyl 1mcg/kg)

Ondansetron 8mg for nausea PRN

Ceftriaxone 2g IV for amputation or contaminated wounds

Calcium 1g IV

TXA 2g slow IV or in 50ml NS

TBI treatment

Maintain SpO2 of >90%

Manage airway

NS 250ml Titrate to maintain blood pressure of 100-110/systolic

Blood

TXA 2g slow IV or in 50ml NS