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Google Keep 9/27/24, 8:52 AM Keep Search Notes...

Google Keep 9/27/24, 8:52 AM Keep Search Notes Take a note… Reminders #pathophysiology PINNED Endocrine First rule of medicine is Intravenous (IV) Specific Medications *Reducing Medication “First, do no harm.” therapy is one of the most Errors* You may administer: Gastro and Urologic invasive… 1. Ensure that a specific 1. Oxygen 1. Use the rights of medication medication is clearly indicated Proficiency in IV therapy and 2. Oral glucose administration: How to Start an IV to treat the patient’s condition. technique is required for most 3. Glucagon a. Right patient 2. Careful assessment of the advanced life support 4. IV dextrose (eg, D50, D25, b. Right medication and patient will help ensure that procedures. or D10) indication Important only beneficial medications are 5. Intravenous fluids—D5W c. Right dose administered.#Important (5% dextrose in water), normal d. Right route IV IV saline, lactated Ringer solution e. Right time Important IV 6. Epinephrine (IM or f. Right patient education Neurologic emergency subcutaneous) g. Right to refuse 7. MDI medications—albuterol i. Right response and 8. Nebulized medications— evaluation Pharmacology Antatgonist albuterol j. Right documentation - Couteract the action of 9. Nitroglycerin—spray, IMPORTANT something solution tablets, paste 2. Use current, reliable Agonists Beta Blocker 10. Nitrous oxide medication reference source - Binds to Receptor and causes - Used to Control Blood 11. Naloxone whenever administering Edit labels a response pressure, and Rhythm 12. Aspirin potentially unfamiliar Disturbances 13. Others based on local… medications or whenever an Archive Important Pharmacology - Beta 2 Selective Drugs cause unusual dose or route of… Bronchodilation with little effect Pharmacology Trash on the Heart Pharmacology Corticosteroids Suppress the Inflammatory response Class IMPORTANT - Suppress the Inflammatory NOTES!! Response Important Pharmacology OTHERS Type 1 Diabetes Adrenal Glands Spleen Large Intestine Colon - Holds Blood and Makes Body doesn't naturally Produce On the Kidneys and Reasorption of Water Insulin leading to Extreme Red Blood Cells control Fight or Flight Blood Glucose Gastro and Urologic Endocrine Endocrine Gastro and Urologic Small Intestine Stomach - Duodenum Solid Organs Hollow Organs - Jejunum - Hydrochloric Acid Liver - Ileum Liver, Spleen, Pancreas, esophagus, stomach, #Important - Bile and Filters toxins Kidneys, and Ovaries. small intestine, - Glucose Sorage Injury Results in Shock and gallbladder, fallopian Gastro and Urologic Important heavy Bleeding Gastro and Urologic tubes Gastro and Urologic Gastro and Urologic Apendicitis Stroke treatment Reassessment #Important Tests : Rebound tenderness Treatment - Stand on toes and Drop Down Assume that a patient with TIA Routine montering (looking for extreme pain) or stroke symptoms is Moniter Bp/ Pupils HR, Bp, RR, Pulse ox, experiencing a stroke. Etco2, glucose, GCS Administer supplemental Gastro and Urologic oxygen. Neurologic emergency Neurologic emergency Establish IV access, and obtain blood samples. Elevate the patient's head 30°. Ensure that the airway is clear. Postictal State https://keep.google.com/#home Page 1 of 4 Google Keep 9/27/24, 8:52 AM Ensure that the airway is clear. Postictal State Watch for seizures and call early for paramedic backup. Idiopathic If patient's condition does not Seizures lasting more than DO NOT give aspirin improve, consider other 4 or 5 minutes or Of no Known Cause.. possible underlying conditions. consecutive seizures without Hypoglycemia return to responsiveness Important Neurologic emergency Neurologic emergency Infection #Important Neurologic emergency Important Neurologic emergency How to Fix a seizure Tonic-clonic seizure Status epilepticus Seizures lasting more than 4 Tonic-clonic seizures seizures Subdural Aura (sensation before the or 5 minutes or consecutive Bleed=Trama seizures without return to seizure) Types of seizures responsiveness Loss of responsiveness Generalized or focal Neurons in a hypermetabolic Tonic phase (wide body Tonic-clonic seizures Neurologic emergency state rigidity) Pseudoseizures Goals of prehospital care Hypertonic phase (arched Absence seizures Stop the seizure back and rigidity) Status epilepticus ( lasting - Benzodiazepines Clonic phase (rhythmic Over 5 min or 2 over 30 min) Valium, Versed contraction of major muscle Left hemisphere problems Ensure adequate ABCs and groups) Neurologic emergency May cause aphasia, glucose levels Postseizure (major muscles paralysis of the right side of the relax) body Postictal phase (rest period of Neurologic emergency Right hemisphere problems the brain) Can cause paralysis of the left Signs and symptoms Of side of the body Neurologic emergency Cva Words may be slurred and hard to understand Transient ischemic attack Bleeding in the brain (TIA) Facial drooping Intracerebral hemorrhage Normal processes in the body Sudden weakness or numbness will destroy a blood clot in the If ICP rises sharply or Decreased or absent movement Neurologic emergency brain. blood pressure falls and sensation on one side of Stroke symptoms subside on critically, patients may the body their own within 24 hours. experience serious problems. Ataxia or loss of balance Warning sign of an acute Cushings Triad Sudden vision loss in one eye stroke in the future HTN, bradycardia, Pressure required to EVERY TIA is an Emergency. fast/irregular respirations Neurologic emergency adequately Prefuse the Prehospital treatment to brain decrease ICP is not effective. Neurologic emergency Controlled hyperventilation The substances fill the skull Maintain ETCO2 at 30-35 1. Brain CmH20 CVA 2. Blood 3. CSF Neurologic emergency Neurologic emergency CVA Hemmorrhagic: If ICP Raises People at high risk have Chronic poorly controlled Hypertension Neurologic emergency ICP increase Stroke Ichemic CVA Amount of blood Ava to the Interruption of Blood Flow to Blood vessel Is blocked brain drops the brain that is sudden and so the tissue distal to the results in less brain function Step 3: Spikes bag Intracranial Contents shift 1. Checks solution for: Proper (herniation) Interrution of the cerebral blood Neurologic emergency solution flow may result from Thrombus, 2. Clarity or particulate matter Atrieal Rupture, Cerebral Neurologic emergency Expiration date Embolism 3. Protective covers on tail ports Step 4: Performs 4. Checks administration set for: Drip rating Neurologic emergency venipuncture Step 2: Selects, checks, 5. Tangled tubing assembles equipment 1. Tears sufficient tape to 6. Protective covers on both secure IV ends - IV solution 2. Opens antiseptic swabs, 7. Flow clamp up almost to drip - Administration set gauze pads, occlusive dressing chamber and closed - Catheter Step 1: 3. takes appropriate PPE 8. Removes protective cover on - Sharps container precautions drip chamber while maintaining - Universal start kit (antiseptic Clearly explains 4. Identifies appropriate sterility swabs, gauze pads, venous procedure to patient potential site for cannulation 9. Removes protective cover on tourniquet, occlusive bandage, 5. Applies tourniquet properly IV bag tail port while… antibiotic gel, syringe, etc.) How to Start an IV 6. Palpates and identifies suitable vein How to Start an IV How to Start an IV 7. Cleanses site, starting from the center and moving outward in a circular motion Step 5: Affective 8. Removes IV needle and catheter from package and… Crystalloid solutions Hypertonic #solution 1. Accepts evaluation and #IV criticism professionally How to Start an IV a. Osmolarity higher than 2. Shows willingness to learn serum 3. Interacts with simulated a. Dissolved crystals in water b. Have more ionic patient and other personnel in https://keep.google.com/#home Page 2 of 4 Google Keep 9/27/24, 8:52 AM a. Dissolved crystals in water b. Have more ionic patient and other personnel in b. Contain compounds that concentration than serum professional manner quickly disassociate in a c. Shift body fluids into the Hypotonic #solution solution vascular space and pull fluid How to Start an IV c. Best choice for the and electrolytes from the - Lower concentration of prehospital care of injured intracellular and interstitial sodium than the cell patients with body fluid loss compartments into the - Hydrate the cells while intravascular compartment depleting the vascular d. Help stabilize blood Isotonic #solution compartment IV solution pressure, increase urine output - May be needed for a patient on and reduce edema LR's and 0.9% Normal Saline dialysis when diuretic therapy e. Rarely used in prehospital 1. Nearly the same osmolarity dehydrates the cells setting as serum and other body fluids. - May also be used for f. Careful monitoring is 2. Expand the contents of the hyperglycemic conditions such The three categories needed to guard against… intravascular compartment as diabetic ketoacidosis when related to tonicity are without shifting fluid to or from high serum glucose levels draw IV solution other compartments. fluid out of the cells. i. Isotonic: 0.9% sodium 3. Lactated Ringer solution is - Dangerous to use because chloride (normal saline), generally used in the field for they can cause a sudden fluid lactated Ringer patients who have lost large shift from… ii. Hypotonic: D5W amounts of blood. iii. Hypertonic: 3.0% saline, Dehydration 4. D5W is a special type of IV solution blood products, and albumin isotonic solution. As long as it Causes remains in the bag, it is… IV IV IV solution Perfusion Perfusion occurs in the capillaries as a result of high Tonicity of the solution: ACTIVE TRANSPORT Osmosis hydrostatic pressures and the effects of osmotic osmosis in the capillary beds Active transport Osmosis pressure… a. Movement of water across a. Method used to move Glucose and oxygen needed 1. An isotonic solution has the compounds to create or a cell membrane same concentration of sodium maintain an imbalance of b. Occurs when there are as does the cell. charges different concentrations on 2. A hypertonic solution has a b. Example: each side of a membrane IV greater concentration of sodium sodium/potassium pump c. Increasing the than does the cell. concentration of sodium in the 3. A hypotonic solution has a extracellular fluid decreases the lower concentration of sodium IV water in the fluid. Water moves out of the cell to create a than does the cell. Diffusion #remember balance of water molecules and to dilute the increased #Important IV concentrations of sodium. Diffusion Hypokalemia (low d. Osmotic pressure: a. Compounds or charges potassium) can result in increased, yet balanced,… concentrated on one side of a decreased skeletal muscle cell membrane will move across Cation: an electrolyte with function, gastrointestinal (GI) IV it to an area of lower an overall positive charge disturbances, and alterations in concentration. cardiac function. Anion: an electrolyte with an Important IV overall negative charge Hyperkalemia (high potassium) #IV can result in hyperstimulation AEMT’s responsibility of neural cell transmission, associated with drug resulting in cardiac arrest. Important IV orders (Peaked T wave) Medication 1. Confirm the rights of Administration medication administration 2. Procedure for - standing orders may allow IV administering any medication: medications to be administered Pharmacokinetics: - Obtain an Order from Med before contacting the physician. Movement of Drugs Control (offline/online) - Local policies and procedures Through the Body - Understand what meds you are designed to guide you in have specific situations. - Drugs modify existing Fluids and Electrolytes - Make sure you understand the functions of tissues and physician’s orders. organs. Crystalloid Solutions c. Repeat any orders, word for IV They do not give new functions Hypertonic (LRs) word, for verification. Inquire to tissues or organs. Hypotonic (Saline) about any medication Generally cause multiple Isotonic allergies.Verify the proper actions rather than a single medication and prescription. effect - When administering a Pharmacology Immunologic IV medication, know the: Medications a. Onset of action b. Duration of action Immuniosuppressant c. Termination of action Medications Pancreas - Oragan Transplant 3. Onset, duration, and Respiratory Drugs - have an autoimmune Many Hemoglycemic dieasease termination of action affect the Medications Oxygen - Most Commonly Used therapeutic index. Medication in Pre-hospital Sulfonylures increase insulin Setting a. Ratio of a drug’s lethal dose Pharmacology secretion from the Pancreatic - Does have Inappropriate uses for… beta cells Xanthines Relax smooth Pharmacology https://keep.google.com/#home Page 3 of 4 Google Keep 9/27/24, 8:52 AM Xanthines Relax smooth Pharmacology Glucagon- injected IM muscles of bronchioles and increase blood Flow Cardiac Meds - Second line treatment - Relive airway constriction by Main Cardiac Electrolytes Pharmacology Relaxing smooth muscles of - Sodium Depressents bronchioles - Potassium - Increase blood Flow - Calcium Slow Brain activity - Stimulate CNS - apams - Anti axiety and Scitofrinnia Effects on the Heart (example: Stimulants Corticosteroids Suppress the Have a Chronotropic Response) - Inflammatory response - Chronotropic (Rate): Heart Dression Treated with Excite the CNS - Suppress the Inflammatory Rate Positive and Negative - SSRI, MAOI, TCA - Increase Excitatory Response effect. Positive is Faster and Neurotransmitters People… Negative is Slower -Increase he release of - Inotropic (Electric conduction/ dopamine and Norepinephrine Pharmacology Force): Positive inotropes and Pharmacology - Can cause nervous irritability, Negative inotropes. Positive tremors and Headaches inotropes strengthen the force of the heartbeat. Negative Pharmacology inotropes weaken the… Anticonvulsants Analgesics and Pharmacology Antagonists Used to Treat Seizures - Influx of sodium into Cells Analgesics (Fent, Morphine, Parasympathetic - Decreases cells ability to Ketamine) depolarize - Medications that Relieve pain Agonists to Parasympathetic n and induce analgesia Sympathetic Nervous system Pharmacology System - Also called Cholenergic Opiod agonists Medications Sympathomimetics - similar to or Derived from - Presents with SLUDGEM - Mimiics Sypathetic Nervous plant systems system - CNS depressants - Atropine Used in pediatric Classification Sympatholytics Intubation (speeds up HR, Dries -Inhibits sympathetic Nervous Narcan - Slow Administration up Secretions) - Body System system - Can Cause PE and Flash PE - Class of agent Beta Blocker - Will wake up Combative, Pharmacology - Mechanism of action - Used to Control Blood Agitated, Vomit/ Diarrhea pressure, and Rhythm - Primary Objective to Return Disturbances Pharmacology Respiratory Drive not wake - Beta 2 Selective Drugs cause them up Bronchodilation with little effect - OD will present with Pinpoint AEMT SCOPE OF on the Heart Pupils PRACTICE … Scope Special considerations Pharmacology - You are Legally, Morally and Pharmacology Pregnancy ethically responsible for every - Contact med control for drug you administer permission - It must be safe and - Expect benefits weighted therapeutically Effective against threat to baby Potency Factors - Always Keep a field guide or Make sure we are wasting - Delay if possible until you get other reference handy -temperature meds Appropriately to the hospital -Keeps a record Children -Light - Have a witness Pharmacology - Kids have a reduced metabolic - moisture - Capacity - Shelf life - Children Metablolize - Pharmacology Medications Faster than adults Geriatric Pharmacology Prescription: Given By - Hepatic and Gastointest Doctor Functions are delayed therefore Over-the-counter: You can buy meds take longer to take effect at the store - Often take many medications Drug Profile Pharmacology Chapter Pharmacology 13 - Study of drugs. and their effects on the body Pharmacology - Dose: AMOUNT - Study of drugs. and their - Action: Under Stand effects on the body - Unintended effects: - Dose: AMOUNT Undireable effects the drug - Action: Under Stand causes - Unintended effects: - Untoward Effects: Effects Undireable effects the drug That can be harmful to the Pt causes - Toxicity Risk: that a substance - Untoward Effects: Effects will pose a heath hazard to an That can be harmful to the Pt Individual or organism - Toxicity Risk: that a substance - Indications: When to give the will pose a heath hazard to an medication Individual or organism - Contraindication: Times when - Indications: When to give the you shouldn't give said… medication - Contraindication: Times when you shouldn't give said… Pharmacology Open-source licenses https://keep.google.com/#home Page 4 of 4