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Conditions for ASA (Cardiac Ischemia), 3 conditions
- Age: > 18 years
- LOA: Unaltered
- Other: Ability to chew
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Conditions for Nitro (Cardiac Ischemia), 5 conditions
- Age: > 18 years
- LOA: Unaltered
- HR: 60 - 159 BPM
- SBP: Normotension (> 100 mmHg)
- Other: Prior history of nitroglycerin use OR IV access obtained
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Contraindications for ASA, 4 conditions
- Allergy or sensitivity to ASA or other NSAIDS
- If asthmatic, no prior use of ASA
- Current Active bleeding
- CVA or TBI in previous 24 hours
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Contraindications for Nitroglycerin (Cardiac Ischemia)
- Allergy or sensitivity to nitrates
- Phosphodiesterase inhibitor use within previous 48 hours
- SBP drops by one-third or more of its intial value after nitro is administered
- 12-lead ECG compatible with right ventricular infarct
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Dose, interval and max number of doses for nitroglycerin
- Dose: 0.4 mg
- Dosing interval: 5 min
- Max number of dose: 6 doses
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Indications for Acute Cardiogenic Pulmonary Edema
- Moderate to severe respiratory distress AND
- Suspected acute cardiogenic pulmonary edema
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Conditions for Nitro (Pulmonary Edema), 4 conditions
- Age: > 18 years
- HR: 60 - 159 BPM
- SBP: Normotensive
- Other: Ascertain prior history of nitroglycerin use OR establish IV access
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Contraindications for Nitro (Acute cardiogenic pulmonary edema), 3 indications
- Allergy or sensitivity to nitrates
- Phosphodiesterase inhibitor use within the previous 48 hours
- SBP drops by one-third or more of its initial value after nitro is administered
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SBP required when administering nitro for acute cardiogenic pulmonary edema when IV not established
> 140 mmHg
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SBP required when administering nitro for acute cardiogenic pulmonary edema when IV is established
SBP 100 mmHg to <140 mmHg
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(5) Indications for Hypoglycemia
- Confusion
- Low LOA/LOC
- Agitation
- Seizure
- Symptoms of stroke
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(2) Contraindications for Glucagon
- Allergy or sensitivity to glucagon
- Pheochromocytoma
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Dose, interval and max dose for glucagon in an individual < 25 kg
- Dose: 0.5 mg
- Dosing Interval: 20 min
- Max number of doses: 2
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Dose, interval and max dose for glucagon in an individual > 25 kg
- Dose: 1 mg
- Dosing interval: 20 min
- Max number of doses: 2
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What needs to be done if a patient who was hypoglycemic refuses transport
Final set of vitals including blood glucomtery
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Indications for Bronchoconstriction Medical directive
- Respiratory distress AND
- Suspected bronchoconstriction
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(2) Conditions for Epinephrine in Brocnhoconstriction medical directive
- BVM ventilation required
- History of asthma
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Contraindications for Salbutamol
Allergy or sensitivity to salbutamol
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Contraindications for Epinephrine
Allergy or sensitivity to epinephrine
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Dose for salbutamol in patients <25 kg
- MDI: 6 puffs (600 mcg)
- NEB: 2.5 mg
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Dose for salbutamol in patients > 25 kg
- MDI: 8 puffs (800 mcg)
- NEB: 5 mg
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Dosing Interval for salbutamol
5 - 15 min. PRN
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Max number of doses for salbutamol
3
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1 puff of via MDI for salbutamol how how much medication
100 mcg
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Dose for epinephrine
0.01 m/kg rounded to nearest 0.05 mg
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Max dose for epinephrine
0.5 mg
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Max number of doses for epinephrine
1
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Contraindications for MDI
- Patient has known or suspected fever
- Declared febrile respiratory illness outbreak by the local medical officer of health
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How many breaths between administrating salbutamol via MDI
4 breaths
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Indications for severe allergic reaction
- Exposure to probable allergen
- Wheezing, Hypotension, Urticaria, Stridor, Edema
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Contraindications to epinephrine
allergy or sensitivity to epinephrine
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Dose for diphenhydramine in patients with weight between >25 kg to <50 kg
25 mg
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Dose for diphenhydramine in patients with weight > 50 kg
50 mg
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Max number of doses for diphenhydramine
1
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Indications for Croup
- Severe respiratory distress AND
- Stridor at rest AND
- Current history of upper respiratory tract infection AND
- Barking cough or recent history of a barking cough
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Conditions for croup
- Age: <8 years
- HR: <200 bpm
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Dose of epinephrine for patients with croup Age > 1 year
5.0 mg NEB
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Dose of epinephrine for patients with croup Age < 1 year weight > 5 kg
2.5 mg NEB
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Dose of epinephrine for patients with croup Age < 1 year weight < 5 kg
0.5 mg in 2 mL saline NEB
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Max number of doses of epinephrine for patients with croup
1
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