Pre-Hospital IV and IO Medications Quiz
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Questions and Answers

What is the preferred site for establishing IV access in trauma patients?

  • Upper extremities (correct)
  • Lower extremities
  • External jugular vein
  • Intraosseous line
  • Which sign is commonly associated with abdominal injury indicating internal bleeding?

  • Battle's sign
  • Colle's sign
  • Babinski reflex
  • Grey-Turner sign (correct)
  • What is a critical action to take following the failure of both IV and IO access attempts in a patient with life-threatening conditions?

  • Attempt an external jugular line (correct)
  • Start CPR immediately
  • Initiate a FAST exam
  • Administer oral medication
  • Which of the following factors indicates hypovolemic shock?

    <p>Altered mental status</p> Signup and view all the answers

    For a pregnant patient experiencing trauma, why should warm LR be considered before crystalloids?

    <p>To better restore fetal oxygenation</p> Signup and view all the answers

    What method is recommended for maintaining fluid access in a trauma patient?

    <p>Slow 'to-keep-open' drip</p> Signup and view all the answers

    Which technique may be employed to control pelvic hemorrhage during a penetrating abdominal injury?

    <p>Pelvic Binder</p> Signup and view all the answers

    In assessing abdominal trauma, which finding would suggest possible kidney injury?

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

    What is a potential intervention for a patient exhibiting signs of hypovolemic shock?

    <p>Provide 500ml bolus per IV/IO guideline</p> Signup and view all the answers

    What should be monitored closely in patients over 50 presenting with abdominal pain?

    <p>Risk for life-threatening diagnoses</p> Signup and view all the answers

    What does a rigid, distended abdomen potentially indicate?

    <p>Ectopic pregnancy or internal bleeding</p> Signup and view all the answers

    In managing nausea or vomiting in patients, which medication is appropriate?

    <p>Promethazine 12.5-25mg IV</p> Signup and view all the answers

    When should unstable patients have their vital signs reassessed?

    <p>Every 5 minutes</p> Signup and view all the answers

    Which of the following is NOT a classic symptom of appendicitis?

    <p>Sharp chest pain</p> Signup and view all the answers

    What monitoring should be conducted for a patient experiencing tachycardia and hypotension?

    <p>Consider a 500ml bolus per IV/IO guideline</p> Signup and view all the answers

    What is the primary action to take if Return of Spontaneous Circulation (ROSC) is not achieved?

    <p>Continue CPR</p> Signup and view all the answers

    Which scenario necessitates following the Obstetric Emergency Guideline?

    <p>Ruptured ectopic pregnancy in a childbearing-age patient</p> Signup and view all the answers

    Which condition must be prioritized before administering blood in trauma patients?

    <p>Optimization of Hemostasis</p> Signup and view all the answers

    Which of the following is NOT considered an obvious sign of a condition incompatible with life?

    <p>Traumatic Hemorrhage</p> Signup and view all the answers

    Which assessment symptom suggests potential abdominal trauma?

    <p>Guarding/Rigidity</p> Signup and view all the answers

    In the context of abdominal pain, which associated symptom indicates a more severe underlying issue?

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

    What should be assessed if there is suspicion of tension pneumothorax despite effective CPR?

    <p>Blood Volume Status</p> Signup and view all the answers

    Which sign is a common symptom of hypovolemic shock?

    <p>Cool Clammy Skin</p> Signup and view all the answers

    What initial management step should be considered in cases of severe hypocalcemia following recent blood transfusions?

    <p>Calcium Supplementation</p> Signup and view all the answers

    Study Notes

    Pre-Hospital Care

    • Intraosseous (IO) line allows for administration of all approved pre-hospital fluids and medications, including blood products.
    • At least two functioning IV or IO lines recommended for all trauma or potentially ill patients.
    • Upper extremity IV sites preferred over lower extremity.
    • Utilize a pressure infusion bag for IO with a starting pressure of 300 mmHg.
    • For life-threatening situations with failed IV and IO attempts, external jugular lines are an option.
    • Maintain an open fluid bolus as per protocol, with a minimum "to-keep-open" (TKO) drip.

    Abdominal Injury Signs and Symptoms

    • Altered mental status, tachycardia, and hypotension may indicate serious conditions.
    • Signs: absence of palpable pulses, pale/moist/mottled skin, poor peripheral pulses, hematuria, and abdominal tenderness/distention.
    • Grey-Turner sign, Cullen sign, and Kehr’s sign are specific indicators of internal bleeding.

    Treatment Protocols

    Blunt Abdominal/Pelvic Injury

    • Emphasize serial physical exams and reassessment.
    • Apply pelvic binder and conduct FAST exam if feasible.
    • Focus treatment on resuscitation.

    Penetrating Abdominal/Pelvic Injury

    • Use hemostatic dressing and pack pelvic cavity.
    • Apply pressure dressing, direct and indirect pressure techniques.
    • Deploy abdominal dressing and pelvic binder as necessary, considering AAJT for uncontrolled bleeding.

    Damage Control Resuscitation

    • Implement based on indications (SBP < 100) for penetrating abdominal injuries.

    Special Considerations

    Pregnant Patients

    • Increased risk of aspiration and gastric acidity; maximum O2 should be provided due to higher O2 demands.
    • Use warm lactated Ringer's solution before crystalloids for better fetal oxygenation.
    • Tilt >15 degrees after 20 weeks gestation to prevent Vena Cava Syndrome.

    Cardiopulmonary Resuscitation (CPR) Protocols

    • If ROSC (Return of Spontaneous Circulation) is not achieved: continue CPR, administer blood/IV fluids, and manage fractures and known hemorrhage points.
    • If ROSC is achieved: return to tactical evacuation or prior guidelines.

    Injury Assessment

    • Injuries incompatible with life include severe decapitation or total body disruption.
    • Differentiate between trauma and medical causes of cardiac arrest before proceeding with ALS guidelines after stabilizing hemorrhage.

    Abdominal Pain in Adults

    Signs and Symptoms

    • Varied pain locations (RUQ, RLQ, LUQ, LLQ) and potential symptoms include tenderness, nausea/vomiting, diarrhea, and vaginal bleeding.
    • Associated symptoms can manifest as fever, headache, weakness, and mental status changes.

    Trauma vs Medical Considerations

    • Assess for mechanism of injury (MOI): blunt force or penetrating trauma.
    • Consider potential causes of abdominal pain; significant tachycardia or hypotension may necessitate fluid bolus.
    • Maintain vigilance for ectopic pregnancy in reproductive-age females presenting with abdominal pain.
    • Antacids are contraindicated in renal disease patients, and those over 50 have a higher risk of serious diagnoses.

    Appendicitis Presentation

    • Classic sign: vague periumbilical pain migrating to RLQ may not always be evident; vital signs should be monitored after each intervention.

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    Description

    This quiz focuses on the administration of IV and intraosseous (IO) fluids and medications in pre-hospital settings. Key concepts include site selection, equipment recommendations, and protocols for managing trauma and ill patients. Test your knowledge on best practices in emergency medicine.

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