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54 Cards in this Set
- Front
- Back
True or False ET drug administration is no longer the standard of care within this region. |
True |
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True or False ET drug administration continues to be an option for pediatric patients. |
True |
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Name two situations in which IO access can be attempted in an adult with failed IV access. |
(1) cardiac arrest (2) decompensated shock |
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In cases of adults in cardiac arrest or decompensated shock in which IV access is unobtainable after no more than ____ attempts, IO access should be attempted. |
two |
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IO access should be attempted via... |
...an approved extremity approach. |
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If establishing an IO in a conscious adult or pediatric patient, administer _____ of _____ Lidocaine via IO port, slowly, up to a max of _____ prior to any other administration. |
0.5 mg/kg 2% presevative-free 50 mg |
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Administer initial dose of Lidocaine via IO port over ____ (seconds/minutes). |
2-3 minutes |
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What is the initial IO dose of Lidocaine? |
0.5 mg/kg |
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What is the maximum initial dose of IO Lidocaine? |
50 mg |
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Why must 2% preservative-free Lidocaine be infused so slowly? |
to prevent it from being sent directly into the central circulation |
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For continued discomfort or pain due to infusion, repeat IO Lidocaine at a dose of _____ slowly over _____ (seconds/minutes). |
0.25 mg/kg 30 seconds |
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What is the repeat dose of IO Lidocaine? |
0.25 mg/kg |
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What is the maximum repeat dose of IO Lidocaine? |
25 mg |
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The maximum initial and repeat doses of IO Lidocaine are ____ and ____. |
50 mg
25 mg |
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Medication intended to remain in the _____, such as a local anesthetic, must be administered very slowly until the desired anesthetic effect is achieved. |
medullary space |
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In the absence of IV access, the following six meds are approved for atomized IN: |
(1) Glucagon (2) Fentanyl (3) Ketamine (4) Midazolam (5) Lorazepam (6) Naloxone
"Good Friends Kiss My Lovely Nose" |
|
Contraindication(s) for IN administration |
epistaxis |
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The pharmacology table refers to ______ patients under _____. |
adult
40 kg |
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The pharmacology table refers to patients beginning at the age of ____ (and over) who weigh under ____. |
15
40kg |
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40 kg is roughly ____ lbs. |
88 lbs |
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List the five drugs on the Pharmacology table. |
(1) Amiodarone (2) Atropine Sulfate (3) Epinephrine (4) Furosemide (Lasix) (5) Sodium Bicarbonate
"Anorexics Are Emaciated For Sure" |
|
dose of Amio for adult patients under 40 kg or 88 lbs |
5 mg/kg |
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dose of Atropine for adult patients under 40 kg or 88 lbs |
0.02 mg/kg (minimum dose 0.1 mg) |
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What is the minimum dose of atropine, per the Pharmocology Table? |
0.1 mg |
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dose of Epi for adult patients under 40 kg or 88 lbs |
0.01 mg/kg/dose |
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dose of Furosemide for adult patients under 40 kg or 88 lbs |
1 mg/kg/dose |
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dose of Sodium Bicarb for adult patients under 40 kg or 88 lbs |
1 mEq/kg/dose |
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Per the Pharm Table, the dose of Epi 1:1,000 should not exceed ____ IM. |
0.3 mg |
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Per the Pharm Table, dosing should not exceed... |
...dose from appropriate adult protocol. |
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Aspirin should not be administered to... |
...patients with known hypersensitivity to it. |
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_______ are not a contraindication to aspirin. |
Gastrointestinal complaints |
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Ondansetron has been associated with ______, possibly resulting in ______. |
prolonged QT torsades |
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Ondansetron should be used with caution in patients with ______ and ______. |
(1) Hx cardiac disease (2) meds that prolong QT |
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Ondansetron should not be administered to patients with... |
...a history of familial QT prolongation. |
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Diphenhydramine has _____-like action. |
atropine |
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Diphenydramine must be used with caution in patients with a history of any of the following four conditions. |
(1) Increased intraocular pressure (2) Hyperthyroidism (3) Cardiovascular disease (4) Hypotension
"I Have Cardiac History" |
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_____ may be used interchangeably with _____ for IV and IO infusion. |
0.9% NS
RL |
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Diltiazem should be used with caution in patients with a history of any of the following five conditions: |
(1) Liver disease (2) Kidney disease (3) CHF (4) AV conduction abnormalities (5) Hypotension
"Let's Keep Cardizem At Half" |
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When Diltiazem must be used with caution... |
...alert medical control of the condition and cut the dose in half. |
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Nitroglycerine shall not be administered to patients who have used _____ within the past _____ hours. |
erectile dysfunction meds
72 hours |
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True or False IO access via the sternum is considered acceptable in the NYC region. |
False. It is considered unacceptable. |
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True or False Drug administration via the IO route will utilize doses identical to those used for IV administration. |
True. |
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True or False
Paramedics may only access PICC lines with prior permission of medical control. |
False.
Paramedics may, under Standing Order, consider using PICC lines for Cardiac Arrest and unstable patients in which IV access is UTO. |
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True or False
PICC lines in the neck or chest can be accessed under standing orders. |
False.
Only upper extremity PICC lines may be accessed under standing orders. |
|
True or False
PICC lines in the neck or chest may be accessed under standing orders. |
False.
Only upper extremity PICC lines may be accessed under standing orders. |
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If a central line that is not in the upper extremities is encountered, which the Paramedic feels could be used for patient care, the Paramedic... |
...must contact OLMC for approval on a case by case basis. |
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True or False
Dialysis catheters or shunts shall not be accessed in the out-of-hospital environment. |
True |
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Catheter ports requiring breaking of skin by a needle are often called... |
..."Hickman Ports" or "Port-A-Caths". |
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True or False
Catheter ports requiring breaking of skin by a needle may be used prehospitally. |
False.
Hickman Ports, Port-A-Caths, etc., shall not be used prehospitally. |
|
True or False
Paramedics may use the patient's own needles or equipment to access pre-existing ports. |
False. |
|
True or False.
Paramedics may troubleshoot or attempt to clear central lines. |
False.
It is beyond the EMS Scope of Practice to troubleshoot, maintain, remove, re-insert, or otherwise manipulate central lines. |
|
Any central line that cannot be easily flushed with _____cc of sterile normal saline, should be considered NOT functional. |
10 |
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All vasopressor infusions must be administered via ____G or larger IV, or an IO, via an IV flow regulating device. |
18G |
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Give three examples of an IV flow regulating device. |
(1) adjustable flow regulator (2) rate control extension set (3) infusion pump |