Chest Pain Diabetic Emergencies

Cardiac Arrest

Respiratory Distress

Orthopedic Injuries Medications Picture ID

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What is the first medication given to a cardiac patient complaining of chest pain?

Chest Pain 100

Oxygen

Chest Pain 100

What is the normal dose for Oxygen with patient on a nasal cannula?

Chest Pain 200

2 to 6 Liters Per Minute

Chest Pain 200

What is one thing you should always try to obtain as part of your assessment, even if you

are not allowed to interpret it?

Chest Pain 300

12 Lead ECG / EKG

Chest Pain 300

Chest Pain 400

What is the dose for Aspirin?

325 mg POActual dose is 324 mg PO, since the aspirin is 81 mg each = 4 tablets X 81 mg

Chest Pain 400

What is the main contraindication for use of Nitro?

Chest Pain 500

Systolic blood pressure below 100 mmHg

Chest Pain 500

At what general level of blood sugar do we become concerned if our patient is not

really responsive to us?

Diabetic 100

Less than 60 mg/dl

Diabetic 100

How many grams of sugar are in the oral glucose that we, normally carry?

Diabetic 200

15 grams of sugar

Diabetic 200

How can an EMT give glucagon or can they?

Diabetic 300

Yes they can, by Auto InjectorWhich is not available on the market yet.

Diabetic 300

What is the normal dose of Glucagon?

Diabetic 400

0.5 – 1 mg Auto injector for EMT0.5 – 1 mg IM for AEMT & Paramedic

Diabetic 400

How many grams of dextrose is there in a normal amp of D50?

Diabetic 500

25 grams of dextrose

Diabetic 500

What should be assessed first on a cardiac arrest patient?

Cardiac Arrest 100

A – Airway B – BreathingC – Circulation

Cardiac Arrest 100

What should be done first if, you have a bag valve mask and AED present?

Cardiac Arrest 200

Start compressions while you apply the AED

Cardiac Arrest 200

What are the two rhythms that are shockable?

Cardiac Arrest 300

Ventricular TachycardiaVentricular Fibrillation

Cardiac Arrest 300

What is the first medication, after oxygen, on any cardiac arrest and dose?

Cardiac Arrest 400

1mg - Epinephrine 1:10,000

Cardiac Arrest 400

What is the dose and repeat dose for amiodarone in a pulseless patient?

Cardiac Arrest 500

300 mg – Initial dose150 mg – Repeat dose

Cardiac Arrest 500

At what dose should you administer oxygen with a patient with severe respiratory

distress, but has COPD?

Respiratory Distress 100

15 LPM via non-rebreatherThe lack of oxygen out ranks the COPD, and generally you will not knock out the

respiratory drive in the short amount of time we have them.

Respiratory Distress 100

What are 4 general things should you note when taking your vitals, history, and

physical assessment?

Respiratory Distress 200

Lung SoundsDistal EdemaO2 Saturation

Respiratory Rate

Respiratory Distress 200

What is the concentration of Albuterol we carry and how is it administered?

Respiratory Distress 300

2.5 mg in 3 mills and is placed in nebulizer. Oxygen at 6 LPM is connected and ran until

the fluid is gone.

Respiratory Distress 300

What should you do if your patient is showing non-severe respiratory distress

and doesn’t fall in any of the normal categories of respiratory distress?

Respiratory Distress 400

Transport and contact medical control.

Respiratory Distress 400

What are 4 additional drugs that a paramedic can use on a patient with acute

congestive heart failure and the normal doses per protocol?

Respiratory Distress 500

Lasix – 20 – 80 mg over 2 minutesNitroglycerin – 0.4 mg – max dose 1.2 mg

Morphine 2 – 5 mgDopamine – 2 – 20 mcg/kg/min

Respiratory Distress 500

What are the 4 neurovascular that should be assessed before and after splinting?

Orthopedic Injuries 100

PulseCapillary refill

MovementSensation

Orthopedic Injuries 100

We carry 4 splints that could be used for a leg injury. What are they?

Orthopedic Injuries 200

Vacuum SplintHare Traction

Rigid SplintReel Splint

Orthopedic Injuries 200

How do you determine if the splint is the appropriate size?

Orthopedic Injuries 300

It immobilizes the joint above and below the injury.

Orthopedic Injuries 300

What is the normal dose of Morphine?

Orthopedic Injuries 400

2 – 10 mg titrate to pain relief, keeping blood pressure above 100 mmHg systolic

Orthopedic Injuries 400

What is a severe side effect of morphine that needs to be constantly monitored,

other than hypotension?

Orthopedic Injuries 500

Respiratory Depression

Orthopedic Injuries 500

What are the medications that an EMR can administer , per the state medication list?

Medications 100

Medication Method Application

Antidote – any Auto Injector Self or peer care

Aspirin Oral Chest pain of suspected ischemic origin only

Atropine/Pralidoxime Chloride Auto injector Cholinergic/nerve gas poisoning

Epinephrine Auto Injector Anaphylactic Reactions

Glucose Oral Acute hypoglycemiaMedicated Inhaler – Pt. Assist only

Nebulizer or metered dose Acute asthmatic attacks, bronchospasm

Medications 100

What are the medications that an EMT can administer , per the state medication list?

Medications 200

Medication Method Application

Activated Charcoal Oral Non-caustic overdoses

Antidote – Any Auto Injector Self or peer care

Aspin Oral Chest pain of suspected ischemic origin only

Atropine/Pralidoxime Chloride Auto Injector Cholinergic / nerve gas poisoning

Beta Agonist Determined by protocol or direct contact with a physician Dyspnea and wheezing

Epinephrine Auto injector Anaphylactic reactions

Glucagon Auto injector Diabetic intervention

Glucose Oral Acute hypoglycemia

IV fluids without medications or nutrients; not initiate; monitor, maintain and shut off

Gravity feed or pump Established by medical protocols

Medicated inhaler – Pt. assist only Nebulized, metered dose inhaler Not specified

Nitroglycerine Sublingual, oral spray Chest pain of suspected ischemic origin only

Over the counter oral medications Oral Not specified

Medications 200

What are the medications that an AEMT can administer, per the state medication

list?

Medications 300

Medications Method Application

Activated charcoal Oral Non-caustic overdose

Albuterol inhaler Aerosolized, inhaled, nebulized Acute asthmatic attacks, bronchospasm

Albuterol and Ipratropium – premixed combined Aerosolized, nebulized Acute asthmatic attacks, bronchospasm

AmiodaroneIO bolus or IV bolus only; either bolus may be repeated. Continuous infusion not allowed

Pulseless ventricular tachycardia; refractory v-fib and interfacility transfers only

Antidote – any Auto injector Self of peer care

Aspirin Oral Chest pain of suspected ischemic origin only

Atropine / Pralidoxime chloride Auto Injector Cholinergic / nerve gas poisoning

Atrovent (ipratropium) – pt. assist only Nebulized, metered dose inhaler Dyspnea and wheezing

Benzodiazepine IM, IO, IV, intranasal, rectal Status epilepticus only

Beta agonist Determined by protocol or direct contact with a physician Dyspnea and wheezing

Dextrose solutions – (D10, D25, D50) IO, IV Acute hypoglycemia

Diphenhydramine hydrochloride IM, IV, Oral Acute allergic reactions

Dopamine hydrochloride IV with pump only Maintenance during interfacility transfer only

Epinephrine Auto injector Anaphylactic reactions

Epinephrine 1:10,000 IO, IV Cardiac arrest only

Fentanyl IO, IV, Intranasal Non cardiac pain relief only

Glucagon IM Acute hypoglycemia where oral glucose or IO/IV medications cannot be given

Next Slide

Medications 300

Medications Method Application

Glucose Oral Acute hypoglycemia

Ipratropium Nebulized, inhalation Acute asthmatic attacks, bronchospasm

IV electrolytes/antibiotic additives IV pump only Maintenance during interfacility transfer only

IV fluids without medications or nutrients; monitor, maintain and shut off IV gravity or pump Established by medical protocol

IV solutions – any combination of fluids IO, IV Medication administration, volume expansion

LidocaineIO bolus or IV bolus only; either bolus may be repeated. Continuous infusion not allowed.

Pulseless ventricular tachycardia; refractory v-fib and interfacility transfers only

Medicated inhaler – pt. assisted only Nebulized or metered dose Acute asthmatic attacks, bronchospasm

Morphine IO, IV Noncardiac pain relief only

Naloxone IM, IO, IV, SQ, Intranasal Reversal of narcotic overdose

Nitroglycerine/nitro preparation Dermal, oral, oral spray sublingual Anginal pain relief

Nitrous oxide Inhalation Pain relief

Ondansetron Oral, IV, IO, IM Nausea/vomiting

Over the counter oral medications Oral Not specified

Keep in mind some AEMT protocols for medication administration state “Consider pain control with direct contact with Medical or Service Director”

Medications 300

What is common name for Ondansetron and its dose?

Medications 400

Zofran – 4mg oral or IV

Medications 400

What are some contraindications for administration of nitroglycerin?

Medications 500

HypersensitivitySystolic BP less than 100 mmHg

Erectile dysfunction medication in the last 24 hours

Severe anemiaIncreased intracranial pressure

Medications 500

What device is this?

Picture ID 100

Hare Traction

Picture ID 100

What is this device?

Picture ID 200

Morgan Lens

Picture ID 200

What size catheter is this?

Picture ID 300

20 gauge

Picture ID 300

What is this device?

Picture ID 400

Capnography nasal sampling line

Picture ID 400

What is this device?

Picture ID 400

CPR assistance device to help with chest recoil

Picture ID 400