BASIC EMERGENCY KIT, MEDICATIONS/DRUGS, VITAL SIGNS, ASSESSMENT OF EMERGENCIES

HEALTHCARE PROFESSIONALS/PROVIDERS

Refers to all individuals who have the skill and ability to provide preventive, curative, & rehabilitative care for the service of others

OXYGEN DELIVERY SYSTEM

PORTABLE APPARATUS for administering oxygen which has 2 OXYGEN CYLINDERS (D size) that is equipped with pressure reduction valves & flow meters

OXYGEN DELIVERY SYSTEM

Each cylinder contains 340L EACH & allows a FLOW RATE of 10L/MINUTE for 30 MINUTES

SIMPLE MASK

no reservoir or valve

PARTIAL MASK

simple mask & reservoir

NON-REBREATHER MASK

recommended oxygen face mask

NON-REBREATHER MASK

composed of a simple mask, reservoir, & a one-way valve)

NON-REBREATHER MASK

prevents the patient’s exhaled air from mixing with the oxygen in the

reservoir bag

BASIC SET OF OROPHARYNGEAL AIRWAYS OR GUEDEL AIRWAYS

preventing the tongue from covering the epiglottis

POCKET MASK WITH OXYGEN PORT

For “mouth-to-mouth” resuscitation

SELF-INFLATING BAG VALVE MASK (BVM) OR ARTIFICIAL MANUAL BREATHING UNIT/AMBU BAG (1L SIZE)

Staff must be appropriately trained to use this apparatus

VARIETY OF WELL-FITTING ADULT & CHILD FACE MASKS

attaches to the self-inflating bag

PORTABLE SUCTION MACHINE

With appropriate suction catheters & tubing (Yankauer suction tubes or suction catheters)

SPACER DEVICES FOR INHALATION OF BRONCHODILATORS

Empty/hollow tube-like device that is used with a metered-dose inhaler (MDI)

SPACER DEVICES FOR INHALATION OF BRONCHODILATORS

Ensures that more amount of the medication reaches the lungs

AUTOMATED EXTERNAL DEFIBRILLATOR

Delivers a dose of high energy electric shock to the heart through the chest wall

COLLAPSE-TO-SHOCK TIME

< 3 mins

AUTOMATED BLOOD GLUCOSE MEASURING DEVICES (GLUCOSE METER OR GLUCOMETER)

measures blood glucose levels with a drop of blood after a finger prick

PULSE OXIMETER

Typically measures saturation of peripheral oxygen in arterial blood (SpO2) & pulse rate (PR)

PULSE OXIMETER

Essential during conscious sedation

NORMAL SpO2

94-99%

EQUIPMENT FOR ADMINISTERING DRUGS VIA THE INTRAMUSCULAR (IM) ROUTE

Disposable sterile syringes (2mL/2cc and 10mL/10cc sizes)

EQUIPMENT FOR ADMINISTERING DRUGS VIA THE INTRAMUSCULAR (IM) ROUTE

Disposable sterile needles (gauge 19 & gauge 21)

INTRAMUSCULAR INJECTIONS

Used for giving most emergency drugs

Outer lateral aspect of the thigh where the VASTUS LATERALIS MUSCLE has no large arteries or nerves running through it

MOST ACCESSIBLE INTRAMUSCULAR SITE

IM INJECTION

can be administered through clotting at the mid-point between the pelvis & the knee

CORTICOSTEROID

NOT INCLUDED in the emergency kit as recommended by the Resuscitation Council

INTRAVENOUS (IV) medications

emergency kit does NOT INCLUDE any ______

1MG ADRENALINE (EPINEPHRINE) INJECTION 1:1,000

emergency medication for anaphylaxis

0.5 ml of 1:1,000 solution via the IM route & repeat after 5 minutes if necessary

DOSAGE OF ADRENALINE IN ADULTS

1mg glucagon injection

emergency medication for hypoglycemia (unconscious patient)

15g glucose gel/powder/drink or 3-4 glucose tablets (1 tablet = 4g or 5g)

Dosage of glucose tablets in adults

100 MCG/ACTUATION OF SALBUTAMOL (beta-2 agonist) AEROSOL INHALER/METERED-DOSE INHALER (MDI)

emergency medication of acute exacerbation of asthma

direct actuation of 1-2 puffs (1 puff = 100 mcg) with 4 breaths after 1 puff (this is repeated every 3-6 hours)

dosage of salbutamol in adults

1mg glucagon via the IM route

Dosage of glucagon in adults

ORAL GLUCOSE TABLETS / GELS / POWDER / DRINKS

Emergency medication for hypoglycemia (conscious patient)

10 MG/ML OF MIDAZOLAM

emergency medication for STATUS EPILEPTICUS

STATUS EPILEPTICUS

seizure that lasts more than 5 minutes or seizures occur in quick succession with no recovery periods between each episode

10mg

Dosage of midazolam in > 10 yrs old

7.5mg

Dosage of midazolam in children aged 5-10 yrs old

5mg

Dosage of midazolam on children < 5 y/o

NASAL ATOMIZER

mucosal atomization device or MAD), and it is administered to both nostrils

BUCCAL/OROMUSCULAR ROUTE

in what route does Pre-filled oral syringes or buccal liquid form of the drug (BUCCOLAM) is available for ease of administration on the opposite sides of the buccal vestibule is admistered?

400 MCG/METERED-DOSE OF GLYCERYL TRINITRATE SPRAY (NITROGLYCERIN)

Emergency medication for angina pectoris

1-2 sublingual sprays of glyceryl trinitrate

Dosage of glyceryl trinitrate in adults

Angina pectoris

Severe chest pain just behind the breastbone

NITRATES

must NOT BE GIVEN to patients who have recently taken SILDENAFIL

300mg dispersible tablet of aspirin

Emergency medication for myocardial infarction

300 mg dispersible aspirin (chewed & not swallowed as a whole)

Dosage of dispersible aspirin in adults

FLUMANEZIL (ROMAZICON) in 5ML VIALS

Needed when conscious sedation will be used

FLUMANEZIL (ROMAZICON) in 5ML VIALS

Used to reverse the sedative effects of benzodiazepines when used during surgery/other medical procedures or with benzodiazepine overdose cases

FLUMANEZIL (ROMAZICON) in 5ML VIALS

Only approved by the FDA for intravenous (IV) administration

FLUMANEZIL (ROMAZICON) in 5ML VIALS

Administration via the intramuscular (IM) route is not evidence-based

0.01 mg/kg is for IV administration; maximum of 0.2 mg/dose is for the IM route

Dosage of flumanezil in adults

VITAL SIGNS

Measurements of the body’s most basic functions

BODY TEMPERATURE

Done using thermometers

ORAL

Most common site —> sublingual area

AXILLA

Preferred site for children

<0.3 – 0.4 degrees Fahrenheit

Temperature of axilla

>0.5 – 0.7 degrees Fahrenheit

Temperature of rectum/anal

TYMPANIC MEMBRANE

Most favorable site for adults & children

36.5 - 37.2 degrees Celsius or 97.8 – 99 degrees

Fahrenheit

Normal value of CORE BODY TEMPERATURE

20 – 40 degrees Celsius or 68 – 104 degrees Fahrenheit

Normal value of surface body temperature

HEART RATE/PULSE RATE

Rhythmic dilation of an artery caused by the contraction & expansion of the arterial wall as is blood pushed out of the heart

60-100 BPM

Normal pulse rate

MANUAL AND MONITOR METHOD

Two methods to detect pulse rate

MANUAL METHOD

Palpation using two adjacent fingers, usually the forefinger/index

finger & middle finger (thumb is never used for palpation

MONITOR METHOD

Provides a more accurate measurement through the use of a heart rate monitor, an electroencephalogram (EEG), or an electrocardiogram (ECG)

THUMB

Never used for palpation

CAROTID ARTERY/PULSE

THROAT (anterior to the larynx & inferior to the mandible)

BRACHIAL ARTERY/PULSE

INNER FOREARM (antecubital fossa)

RADIAL ARTERY/PULSE

INNER WRIST (in line with the base of the thumb)

FEMORAL ARTERY/PULSE

GROIN (inguinal region)

SUPERFICIAL TEMPORAL ARTERY/PULSE

TEMPLE (in front of the ear)

POPLITEAL ARTERY/PULSE

BACK OF THE KNEE (popliteal fossa)

DORSALIS PEDIS ARTERY/PULSE

INSTEP (groove between the 1st & 2nd toes that is slightly medial to the Dorsum of the foot)

POSTERIOR TIBIAL ARTERY/PULSE

ANKLE (slightly inferior to the medial malleolus)

APICAL PULSE

APEX OF THE HEART (heard when

the diaphragm of a stethoscope is

placed over the point of maximal

impulse or PMI (5th intercostal space

for adults and 4th intercostal space in

children)

RESPIRATORY RATE

Established by direct observation of the patient’s chest movement when breathing or through the use of a stethoscope

EUPNEA

Normal breathing

APNEA

cessation of breathing

BRADYPNEA

decreased respiratory rate: <12 breaths per minute

TACHYPNEA

increased respiratory rate: >20 breaths per minute

oxygen (O2) & carbon dioxide (CO2)

During respiration: ________ are exchanged in the body

120/80 mmHg

NORMAL BLOOD PRESSURE

1ST FORCE (SYSTOLIC)

blood pumps out of the heart and into the arteries

2nd force (DIASTOLIC)

Heart rests between heart beats

AUSCULTATORY METHOD/MANUAL METHOD/RIVA ROCCI KOROTKOFF METHOD

Uses a sphygmomanometer

(aneroid) and a stethoscope over the

brachial artery at the antecubital

fossa

AUSCULTATORY METHOD/MANUAL METHOD/RIVA ROCCI KOROTKOFF METHOD

Done by listening to Korotkoff

sounds (series of blood flow or

tapping sounds that are audible with

a stethoscope as the BP cuff it’s

gradually deflated)

AUSCULTATORY METHOD/MANUAL METHOD/RIVA ROCCI KOROTKOFF METHOD

Many variables (e.g., skill or ability of

the operator & presence of loud

external noise from the surrounding

area) can affect the accuracy of this

method

OSCILLOMETRIC METHOD

Done by measuring the pressure

variations in the BP cuff caused by the oscillation of blood flow through

the brachial artery

OSCILLOMETRIC METHOD

BP values are then calculated by an

empirically derived algorithm

OSCILLOMETRIC METHOD

Most automated (electronic) blood

pressure monitors utilize this method

since it is less susceptible to external

noise

AIRWAY

GOALS: identify foreign body obstruction (complete or

partial) & including stridor (i.e., high-pitched vibrating

breath sound that is harsher or louder than a wheeze)

BREATHING

GOALS: look, listen & feel for general signs of

respiratory distress by documenting the respiratory

rate (RR), observing the use of accessory muscles of

respiration (neck muscles), and check for presence of

wheezing (whistling & rattling sound during breathing)

or cyanosis (bluish discoloration of the skin & mucous

membrane)

CIRCULATION

GOALS: evaluate skin color & temperature, document

pulse rate (PR), and estimate capillary refill time (NV

for capillary refill time: <2 seconds)

PROFOUND HYPOXIA

diminished concentration of oxygen in arterial blood

HYPERCAPNIA OR HYPERCARBIA

(excessive carbon dioxide levels in the

bloodstream)

CEREBRAL HYPOPERFUSION

brain exhibits a decrease in blood supply

COMMON CAUSES OF UNCONSCIOUSNESS

Profound hypoxia

Hypercapnia or hypercarbia

Cerebral hypoperfusion

Recent administration of sedatives or analgesic drugs