NH EMS Protocol - Medical Protocols Flashcards

Questions and Answers

What is the ventilation rate of an adult?

12-20 bpm

What is the ventilation rate of a child?

12-20 bpm

What is the ventilation rate of an infant?

20-30 bpm

Define pediatric respiratory distress.

Able to maintain adequate oxygenation by using extra effort to move air. Signup and view all the answers

What are signs of pediatric respiratory failure?

RR < 20 bpm for < 6 years old OR RR < 12 bpm for < 16 years old OR > 60 bpm for any child; cyanosis; marked tachycardia or bradycardia; poor peripheral perfusion; decreased muscle tone; depressed mental status. Signup and view all the answers

What should be considered for non-traumatic abdominal pain in adults?

Routine patient care and consider 12-lead EKG for upper/epigastric pain. Signup and view all the answers

What is the definition of anaphylaxis?

Known or likely allergen exposure AND hypotension or respiratory compromise. Signup and view all the answers

What are signs of anaphylaxis?

Angioedema, swelling of face/lip/tongue, throat tightening, voice change, shortness of breath, wheeze, stridor, cyanosis, poor perfusion, hypotension, urticaria, itching, vomiting, abdominal pain. Signup and view all the answers

What is the definition of an Apparent Life-Threatening Event (ALTE)?

An event involving a frightening episode in a child less than 2 years that includes apnea, cyanosis, limpness, or choking. Signup and view all the answers

What should be done for patients in behavioral emergencies?

Approach using the SAFER model and determine if pt is under mental health care. Signup and view all the answers

Match the following definitions to their corresponding terms:

Pulmonary Embolism = Obstructive shock Allergy response = Distributive shock Heart Failure = Cardiogenic shock Dehydration = Hypovolemic shock Signup and view all the answers

What are the signs of compensated shock in adults?

Anxiety, tachycardia, tachypnea, diaphoresis. Signup and view all the answers

What is the minimum glucose level that denotes hypoglycemia?

< 70 mg/dL Signup and view all the answers

When should ibuprofen be avoided?

When the patient has NSAID allergy, aspirin-sensitive asthma, renal insufficiency, pregnancy, or known peptic ulcer disease. Signup and view all the answers

What is recommended for fever in adults with a temperature above 101.5?

Consider administering 500-1000 mg of acetaminophen or ibuprofen as indicated. Signup and view all the answers

What is the proper care for newborns immediately after birth?

Keep baby warm and dry, avoid excessive suctioning, clamp and cut umbilical cord, and assess breathing. Signup and view all the answers

What is the preferred oxygen treatment for smoke inhalation?

100% O2 via non-rebreather mask or bag-valve mask. Signup and view all the answers

Study Notes

Ventilation Rates

Adult ventilation rate: 12-20 breaths per minute (bpm)
Child ventilation rate: 12-20 bpm
Infant ventilation rate: 20-30 bpm

Pediatric Respiratory Distress and Failure

Pediatric respiratory distress definition: Adequate oxygenation with extra effort to move air.
Signs of distress: Increased respiratory rate, sniffing position, nasal flaring, abnormal breath sounds, head bobbing, intercostal retractions, mild tachycardia.
Pediatric respiratory failure criteria: Respiratory rate < 20 bpm (< 6 years), < 12 bpm (< 16 years), > 60 bpm for any child; cyanosis, tachy/bradycardia, poor peripheral perfusion, decreased muscle tone, depressed mental status.

Anaphylaxis and Allergic Reactions

Adult treatment for anaphylaxis: Administer epinephrine (0.3 mg) IM, ensure prompt transport; further dosing as needed with medical control contact.
Pediatric anaphylaxis: Epinephrine (0.15 mg) IM for children < 25 kg; adult dose if > 25 kg; contact medical control for additional dosing.
Anaphylaxis definition: Exposure to known/likely allergen causing hypotension or respiratory compromise.
Signs of anaphylaxis: Angioedema, swelling of face/lips/tongue, throat tightness, shortness of breath, wheezing, stridor, hypotension, urticaria, vomiting, abdominal pain.

Childbirth Protocol

Assess for signs: Bleeding, discharge, crowning, prolapsed cord, breech, limb presentation.
Transport considerations: No digital examination unless treating complications; mother in left-lateral recumbent for delivery.
Postpartum care includes assessing for hemorrhage and massaging the uterus.

Fever Management

Adult fever (>101.5°F): Obtain temperature, passive cooling, adjust clothing, and administer medications as needed.
Pediatric fever: Rectal temperature assessment in infants < 3 months; consider acetaminophen or ibuprofen based on prior medication timing.
Aspirin should never be given to children, especially with fevers.
Serious problem indicators: Persistent vomiting, difficulty breathing, chest pain, severe headache, and other symptoms requiring immediate attention.

Hyperglycemia and Diabetic Emergencies

Hyperglycemia categorized as > 250 mg/dL for both adults and pediatrics; glucose reading is critical.
Diabetic ketoacidosis symptoms: Elevated glucose, weakness, altered mental status, abdominal pain, fruity breath, tachypnea.
Hyperglycemic hyperosmolar nonketotic syndrome (HHNS) signs: Glucose > 600 mg/dL; profound dehydration without significant ketoacidosis.

Shock and Sepsis Protocol

Signs of compensated shock in adults: Anxiety, tachycardia, tachypnea, diaphoresis.
Pediatric compensated shock signs: Delayed cap refill, decreased peripheral pulses, AMS, mild tachycardia.
Sepsis criteria includes maintaining oxygen saturation above 94%; immediate transport is critical after a positive sepsis screen.

Stroke Assessment

Perform Cincinnati Pre-Hospital Stroke Scale: Evaluate facial droop, arm drift, and speech.
Notify the hospital for "Stroke Alert" with onset time and symptoms if any test positive.
Elevate stretcher head by 30 degrees and acquire a 12-lead if necessary.

Smoke Inhalation Management

Administer 100% oxygen via NRB or BVM; use Rad-57 for CO level measurement.
Symptoms to watch: Headache, confusion, dyspnea, seizure, changes in LOC, varying pupil reactions.

Nerve Agents and Poisoning

Recognize signs of organophosphate poisoning: SLUDGEM (salivation, lacrimation, urination, defecation, gastric upset, emesis, miosis) and KILLER B's (bradycardia, bronchorrhea, bronchospasm); administer antidote upon symptom appearance.

Hypothermia Management

For both adults and pediatrics: Avoid rough movement, keep warm, dry, administer glucose, and maintain a horizontal position.

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Description

This quiz features flashcards on key ventilation rates and definitions related to pediatric respiratory care, tailored for healthcare professionals in emergency medical services. Test your knowledge on vital signs, respiratory distress criteria, and appropriate ventilation techniques for different age groups from adults to infants.