Podcast
Questions and Answers
What is the initial step when a patient's blood pressure remains less than 90 mmHg after fluid administration?
What is the initial step when a patient's blood pressure remains less than 90 mmHg after fluid administration?
In the case of bradycardia resulting from Beta Blocker or Calcium Channel Blocker overdose, what is the maximum total dose for atropine sulfate?
In the case of bradycardia resulting from Beta Blocker or Calcium Channel Blocker overdose, what is the maximum total dose for atropine sulfate?
When treating bradycardia due to organophosphate overdose, how often should atropine sulfate be administered?
When treating bradycardia due to organophosphate overdose, how often should atropine sulfate be administered?
What is the preferred treatment for a patient with bradycardia and a high-grade Mobitz II or Third Degree Heart Block?
What is the preferred treatment for a patient with bradycardia and a high-grade Mobitz II or Third Degree Heart Block?
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What should you do if a patient has a heart rate of 40 bpm or less but is otherwise stable?
What should you do if a patient has a heart rate of 40 bpm or less but is otherwise stable?
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What is the first step in managing a patient with suspected alcohol intoxication?
What is the first step in managing a patient with suspected alcohol intoxication?
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What potential EKG finding should you expect in patients with bradycardia?
What potential EKG finding should you expect in patients with bradycardia?
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What should be done to treat a patient experiencing hypoglycemia due to alcohol intoxication?
What should be done to treat a patient experiencing hypoglycemia due to alcohol intoxication?
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Which of the following is a treatment option for a patient with low blood pressure that has not improved after fluid administration?
Which of the following is a treatment option for a patient with low blood pressure that has not improved after fluid administration?
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How should you handle a patient who is agitated and threatening due to alcohol withdrawal?
How should you handle a patient who is agitated and threatening due to alcohol withdrawal?
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What is the starting dosage of premix dopamine to be administered for hypotension?
What is the starting dosage of premix dopamine to be administered for hypotension?
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What is recommended for a patient who may show signs of delirium tremens?
What is recommended for a patient who may show signs of delirium tremens?
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What procedure should be performed to ensure the patient remains stable during transport?
What procedure should be performed to ensure the patient remains stable during transport?
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What is a serious risk when drugs and alcohol are consumed together?
What is a serious risk when drugs and alcohol are consumed together?
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What should be checked after establishing vascular access in an agitated patient?
What should be checked after establishing vascular access in an agitated patient?
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In what situation does the Marchman Act come into play during patient management?
In what situation does the Marchman Act come into play during patient management?
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What initial step should be taken if a patient is suspected of experiencing metabolic acidosis with disrhythmias?
What initial step should be taken if a patient is suspected of experiencing metabolic acidosis with disrhythmias?
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In managing an agitated patient suspected of having excited delirium, what is the primary action if the patient's temperature is above 104°F?
In managing an agitated patient suspected of having excited delirium, what is the primary action if the patient's temperature is above 104°F?
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What is the maximum amount of morphine sulfate that can be administered to a patient experiencing agitation and pain?
What is the maximum amount of morphine sulfate that can be administered to a patient experiencing agitation and pain?
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What is the appropriate action if midazolam has not been given and the agitated patient is shivering?
What is the appropriate action if midazolam has not been given and the agitated patient is shivering?
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Which of the following steps should be taken to manage a patient with suspected hyperthermia effectively?
Which of the following steps should be taken to manage a patient with suspected hyperthermia effectively?
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What volume of cold normal saline should be bolused for a hyperthermic patient?
What volume of cold normal saline should be bolused for a hyperthermic patient?
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Which condition may indicate a metabolic acidosis in a patient's cardiac rhythm monitoring?
Which condition may indicate a metabolic acidosis in a patient's cardiac rhythm monitoring?
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How should sedation be administered to an agitated patient before transferring to the Emergency Department?
How should sedation be administered to an agitated patient before transferring to the Emergency Department?
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Study Notes
Agitated Patient / Excited Delirium Syndrome
- Treat signs of excited delirium, including fever (temperature reading of 104°F (40°C) or higher) or feeling hot to the touch
- Attempt to cool the patient down:
- Remove clothing
- Move to a cooler environment
- Apply ice packs to neck, axillae, and groin areas
- Document baseline temperature before administering cold normal saline
- Establish vascular access and administer cold (34°F) normal saline, 30 mL/kg IV/IO (maximum 2 Liters)
- Administer midazolam (Versed), 5 mg IV/IO or 10 mg IM / IntraNasal if shivering
- Administer morphine sulfate, 5 mg IV/IO/IM if agitated and/or in pain after midazolam (Versed) and systolic BP remains at 90 mmHg or greater
Alcohol Intoxication
- Treat per Agitated Patient protocol if agitated and/or combative
- Consider concurrent drug overdose
- Consider transport to closest appropriate facility for further observation
- Manage individuals with highly caffeinated alcoholic drinks appropriately
- Consider other causes of shock, but do not delay transport
Bradycardia
- Administer atropine sulfate, 1 mg IV every 2-3 minutes to a maximum of 3 mg for Beta Blocker or Calcium Channel Blocker excess / OD
- Administer normal saline, 500 mL IV bolus if patient remains hypotensive
- Administer atropine sulfate, 2 mg IVP every 5 minutes for Organophosphates Overdose until drying of the secretions (atropinization) occurs
- Use external pacing for acute inferior wall myocardial infarction with high-grade Mobitz II or Third Degree Heart Block (complete heart block) and wide QRS complex
- Apply external pacemaker pads without turning the pacer on for heart rate of 40 bpm or less, and observe for signs/symptoms suggesting instability
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Description
This quiz covers the protocols for Emergency Medical Services (EMS) providers to follow when treating patients with medical complaints, including administering oxygen and sodium bicarbonate.
