McLean County Skill Sheet

Indications for Igel

cardiac arrest, failed intubation, difficult airway, unconscious apneic airway, need for CPR, passive oxygenation

Contraindications for Igel

burns, intact gag reflex, esophageal disease, airway obstruction/trauma, lockjaw, foreign body, caustic ingestions

Indications for CPAP

CHF, respiratory distress (below 90%), apnea, pulmonary edema

Contraindications for CPAP

BP below 100, respiratory arrest, cannot protect own airway, facial trauma/deformity, recent facial or gastric surgery, airway infection (pneumonia)

Indications for wound packing

deep or irregularly shaped wounds, junctional area wounds, traumatic wounds

Contraindications for wound packing

Neck, abdomen, chest wounds

Indications for quick clot

moderate to severe bleeding due to trauma

Contraindications to quick clot

allergy to it, deep or internal bleeding, eye or airway injuries, open skull fracture, exposed tendons or nerves, infected wounds

Indications for a defibrillator

cardiac arrest, Supra ventricular tachycardia, ventricular fibrillation, pulse less ventricular tachycardia (SVT, Vfib, VT)

Contraindications for defibrillator

asystole, PEA, wet pt/condtions

SIRS criteria (sepsis)

two or more of the following:

Temperature > 38°C (100.4°F) or < 36°C (96.8°F)

Heart rate > 90 bpm

Respiratory rate > 20 breaths/min or PaCO₂ < 32 mmHg

aSOFA criteria (sepsis)

The criteria – two or more of the following:

Altered mental status (GCS < 15)

Respiratory rate ≥ 22 breaths/min

Systolic blood pressure ≤ 100 mmHg

NEWS2 measurements (sepsis score support)

• Respiratory rate

• Oxygen saturation

• Supplemental oxygen use

• Temperature

• Systolic blood pressure

• Heart rate

• Level of consciousness (AVPU scale)

Miami sepsis score

1- Body temp > 38c (100.4f) or < 35.5c (96.0f)

 1- Respiratory rate > 22/minute

2- Shock Index > 0.7 (Heart rate/Systolic BP)

Miami Sepsis Score 3-4 with signs or history of an infection

sepsis protocol

1. Routine Medical Care.

2. Early notification to receiving facility of a “sepsis alert” if patient meet above criteria.

3. Reassess patient and vital signs every 5 minutes.

4. Initiate advanced level intercept.

5. Check blood glucose level.

6. Apply, obtain, and transmit 12-lead ECG.

7. If the temperature is >104.0o F, place a cold pack in each armpit as well as the posterior neck. Remove

   the cold packs if shivering begins.

what is HTN?

persistently high blood pressure.

force of blood pushing against the walls of your arteries as your heart pumps blood

130->180/89->120

what is hypotension?

blood pressure is abnormally low. For most adults,

90/60 mmHg.

not enough blood flow to organs potentially

primary HTN causes

lifestyle factors

age

genetics

gender

secondary HTN causes

• Kidney Disease

• Adrenal Gland Disorders:

• Thyroid Problems

• Sleep Apnea

• Certain Medications: Some medications, like birth control pills or decongestants

• Congenital Conditions: Heart defects present at birth

• Pregnancy

• Tumors 

• Fibromuscular dysplasia

• atherosclerosis

• vasculitis

what med treats hypertension? hypotension?

• beta blockers

• ACE inhibitors

• diuretics

• calcium channel blockers

• pressors

heat stroke protocol

1. Routine Medical Care.

2. Move to cool environment.

3. Cool patient (place cold packs on central pulse points).

4. Do not massage cramping muscle.

5. Perform 12-lead ECG and transmit to receiving facility.

6. If heat stroke is not suspected and patient is not nauseated, give 1-2 glasses of electrolyte containing solution (i.e. Gatorade), if available.

symptoms of heat stroke

• Confusion

• Irrational behavior

• Loss of consciousness

• Convulsions

• A lack of sweating (in most instances)

• Hot, dry skin

• Contracted pupils

• An abnormally high body temperature (a temperature of 104°F as determined by emergency medical personnel)

Symptoms of heat exhaustion

• Headache

• Nausea

• Excessive sweating

• Enlarged pupils

• Vertigo (i.e., spinning sensation)

• Weakness

• Thirst

• Giddiness

heat collapse

a loss of consciousness occurs when the brain does not receive enough oxygen due to blood pooling in the body's extremities