Hypotension Management
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Questions and Answers

What is the dose of epinephrine to be administered in case of hypotension?

  • 0.1-0.5 mg/mL
  • 1-2 mg/mL
  • 0.5-1 mg/mL
  • 0.05-0.1 mg/mL (correct)

    • What is the administration rate of epinephrine in hypotension?

  • Given over 1-3 minutes (correct)
  • Given rapidly over 30 seconds
  • Given over 3-5 minutes
  • Given over 5-10 minutes

    • What is the maximum total dose of epinephrine that can be given?

  • 5 mg
  • 1 mg
  • 2 mg
  • 3 mg (correct)

    • What is the dose of D50W to be administered in case of hypotension?

    <p>0.5-1 mL</p> Signup and view all the answers

    What medication is added if the patient is bradycardic?

    <p>Atropine</p> Signup and view all the answers

    What is the dose of Atropine to be administered in case of bradycardia?

    <p>0.5-1 mg</p> Signup and view all the answers

    What is the administration route for Glucagon in case of hypotension?

    <p>IM</p> Signup and view all the answers

    What is the dose of Glucagon to be administered in case of hypotension?

    <p>1 mg/mL</p> Signup and view all the answers

    What is the initial dose of Methylprednisolone if the patient is experiencing Laryngeal Edema?

    <p>40-60 mg IV</p> Signup and view all the answers

    What is the dose of Naloxone administered to the patient?

    <p>0.1-0.4 mg IV</p> Signup and view all the answers

    How many puffs of Albuterol are administered to the patient?

    <p>2 puffs</p> Signup and view all the answers

    What is the rate of oxygen administered to the patient?

    <p>10 L/minute</p> Signup and view all the answers

    What is the dose of lorazepam administered to the patient?

    <p>0.1 mg/kg</p> Signup and view all the answers

    What is the maximum dose of lorazepam that can be administered?

    <p>4 mg</p> Signup and view all the answers

    What is the size of the area to which 15 mg of medication is applied?

    <p>1 x 3 inch area</p> Signup and view all the answers

    What is the rate at which the IV medication is administered?

    <p>1-2 minutes</p> Signup and view all the answers

    What is the first step in responding to a medical emergency?

    <p>Call Emergency Response</p> Signup and view all the answers

    What is the primary purpose of assessing breathing during a medical emergency?

    <p>To look, listen, and feel for signs of breathing</p> Signup and view all the answers

    What is the recommended dose of Diphenhydramine (Benadryl) for a severe allergic reaction?

    <p>25–50 mg IV over 1–2 minutes</p> Signup and view all the answers

    What is the primary purpose of administering oxygen by mask during a medical emergency?

    <p>To support breathing and prevent respiratory distress</p> Signup and view all the answers

    What is the recommended medication for treating a seizure during a medical emergency?

    <p>None of the above</p> Signup and view all the answers

    What is the primary purpose of monitoring vitals during a medical emergency?

    <p>To track the patient's overall condition and respond accordingly</p> Signup and view all the answers

    What is the recommended dose of Nitroglycerin tablet for treating hypertension crisis?

    <p>0.4 mg sublingual</p> Signup and view all the answers

    When should you call the Emergency Response Team?

    <p>Immediately after identifying a medical emergency</p> Signup and view all the answers

    What is the recommended dosage of epinephrine for adults?

    <p>0.3 mg</p> Signup and view all the answers

    What is the benefit of using an epinephrine autoinjector for treatment of contrast reactions?

    <p>Shorter time to administration and fewer errors</p> Signup and view all the answers

    What is the recommended method of administering epinephrine for anaphylaxis?

    <p>Intramuscular injection</p> Signup and view all the answers

    What is the risk associated with intravenous bolus of epinephrine?

    <p>Higher risk of cardiovascular complications</p> Signup and view all the answers

    What is the weight threshold for administering 0.3 mg of epinephrine to children?

    <p>30 kg</p> Signup and view all the answers

    What is the conclusion of the study on epinephrine autoinjectors for treatment of contrast reactions?

    <p>Significantly greater degree of provider comfort and shorter time to administration</p> Signup and view all the answers

    What is the benefit of intramuscular epinephrine administration?

    <p>Lower risk of overdose and adverse cardiovascular events</p> Signup and view all the answers

    What is the purpose of using an epinephrine autoinjector?

    <p>To treat anaphylaxis</p> Signup and view all the answers

    What is the eGFR threshold below which CIN risk increases?

    <p>eGFR &lt; 30</p> Signup and view all the answers

    What is the classification of Contrast Induced Nephropathy (CIN)?

    <p>Acute kidney injury</p> Signup and view all the answers

    What is the primary mechanism of Gadolinium-based Contrast Agents (GBCAs)?

    <p>By decreasing the relaxation time of hydrogen nuclei</p> Signup and view all the answers

    What is the classification of Magnevist?

    <p>Linear Ionic</p> Signup and view all the answers

    What is the primary route of excretion for Extracellular GBCAs?

    <p>Renal</p> Signup and view all the answers

    What is the characteristic of Hepatobiliary GBCAs?

    <p>High T1 relaxivity</p> Signup and view all the answers

    What is the primary feature of Nephrogenic Systemic Fibrosis (NSF)?

    <p>Thickening and hardening of skin</p> Signup and view all the answers

    What is the group of patients at highest risk for developing NSF?

    <p>CKD stage 4 and 5</p> Signup and view all the answers

    What is the primary pathophysiological mechanism of NSF?

    <p>Free Gd ion dissociation</p> Signup and view all the answers

    What is the approximate number of reported NSF cases as of 2012?

    <p>727</p> Signup and view all the answers

    Study Notes

    Hypotension Treatment

    • Airway management: give oxygen by mask at 10 L/minute
    • If tachycardic, add epinephrine (0.05-0.1 mg IV bolus)
    • If bradycardic, add atropine (0.5-1 mg IV slowly)
    • Consider dextrose 50% (D50W) if hypoglycemic
    • Glucagon (1 mg/mL) if no IV access
    • Stabilize and assess the patient (airway, breathing, circulation, neuro deficit)

    Contrast Reactions

    • Recognition and treatment of contrast reactions
    • Contrast Induced Nephropathy (CIN) remains controversial
    • CIN prevention: volume expansion, alternative modalities, and limiting contrast volume
    • Emergency responsive contrast reaction kit

    Gadolinium-based Contrast Agents

    • GBCAs clinical chemistry and classifications
    • Nephrogenic Systemic Fibrosis (NSF) associated with GBCAs
    • NSF symptoms: thickening, hardening, discoloration of skin and subcutaneous tissues
    • NSF diagnosis: skin biopsy
    • Pathophysiology: prolonged circulation of GBCAs, Gd free ion dissociation, and precipitation in tissues
    • GBCAs clinical categories: extracellular agents, hepatobiliary agents, and blood pool agents

    NSF Epidemiology

    • First described as Nephrogenic Fibrosing Dermopathy in 1997
    • Renamed Nephrogenic Systemic Fibrosis in 2004/05 following identification of systemic involvement
    • Role of gadolinium identified in 2006
    • As of 2012, 727 reported cases of NSF: 505 from Omniscan exposure, 35 from OptiMARK exposure, and 170 from Magnevist exposure

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    Description

    This quiz covers the steps to manage hypotension, including Bolus dosages and IV access considerations.

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