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Exam (elaborations)

Clinical Guidelines in Primary Care

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Clinical Guidelines in Primary Care

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  • September 13, 2024
  • 6
  • 2024/2025
  • Exam (elaborations)
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TEST BANK For Clinical Guidelines in Primary Care 4th Edition
By Hollier
move to i gel after how many failed intubation attempts? - ANSWER:2

sedation meds for post intubation - ANSWER:ketamine or versed plus fentanyl

when is drug assisted airway indicated in peds? - ANSWER:only after all less invasive
procedures have failed

4 reasons to consider RSI - ANSWER:- failure to protect airway (GCS < 9)
-failure to ventilate/ oxygenate (severe copd/ asthma)
- anticipated clinical course (airway burns) (head injury)
- to facilitate safety (combative or excited delerium)

bradycardia protocol criteria - ANSWER:HR < 60 with symptoms of ALOC, chest
pain ,SOB, or hemodynamic instability

symptomatic bradycardia protocol - ANSWER:-place pads on PT
- obtain BGL, vitals, iv access, and 12-lead
- atropine if 1st degree, 2nd degree type 1, or increased vagal tone
- pacing if persistent bradycardia with evidence of cardiopulmonary compromise
- use fentanyl + versed to sedate if BP allows
- consider push dose epi if arrest is imminent

consider lucas placement after _______ minutes of cpr? - ANSWER:6

pediatric arrest when should io access be considered? - ANSWER:first

adult arrest when should io access be used? - ANSWER:use iv access if you have a
good site first
move to io after 2 failed iv attempts

if still in v-fib/ v-tach after 3 shocks consider... - ANSWER:changing pad placement or
use dual sequential defibrillation

if pt wakes up during lucas cpr and still don't have a pulse consider... -
ANSWER:ketamine 2 mg/kg max 200 mg iv

when should you not resuscitate in location found? - ANSWER:if scene is not safe

preferred vasopressor for post rosc management - ANSWER:norepi

chest pain / stemi protocol - ANSWER:- 12 lead within 10 minutes

, - iv access
- aspirin, nitro, fentanyl as indicated
- pads on if stemi
- st agnes

difficulty breathing protocol - ANSWER:-titrate oxygen to 93-98
- always utilize etco2
- if bronchospasm give duoneb (> 20 kg)
- if suspected croup give racemic epi
- 12 lead iv access
- if pulmonary edema consider nitro + cpap as indicated
- if severe asthma consider IM epi
- moderate to severe asthma/ copd give dex
- severe asthma/ copd with no improvements give mag sulfate
- if imminent arrest consider push dose epi

tachycardia protocol (bpm> 100) - ANSWER:-iv access, bgl, 12 lead
- place pads on pt
- vagal maneuver if rhythm is regular
- stable narrow give adenosine
- print monitor during administration
- stable wide give amiodarone
- if irregular give diltiazem (not peds)
- if torsades give mag sulfate
-unstable give sedation as indicated and cardiovert

if pt crowning... - ANSWER:do not transport, prepare ppe/ ob kit and deliver

if not crowning... - ANSWER:transport immediately

cut cord ____ inches from neonate - ANSWER:6

when do you cut cord - ANSWER:after it stops pulsating or at least 1 minute post
delivery

calculate apgar at ___,____, and _____ minutes - ANSWER:1, 5 , 10

placental delivery considerations - ANSWER:-10-30 minutes post delivery
- place in plastic bag and keep with pt
- don't pull cord

if baby is preterm <______ gestation, apgar < _____, not breathing crying _______ -
ANSWER:36, 7, resuscitate

postpartum hemorrhage protocol - ANSWER:- fundal massage
-breast feeding
- iv fluid bolus

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