NREMTP Review-Jonathon 🚑🚒
Tachydysrhythmias (SVT, V-tach w/ pulses, Rapid A-Fib)
Stable
CP or Palpitations
Alert & Oriented
SBP >100 mmHg
No syncope
Unstable
Hypotension-less than 100
AMS/ALOC
Syncope
Poor skin signs
SVT-Stable
Vagal Maneuvers (Bearing Down (Blowing into a straw/syringe), Diving Reflex, CSM-Carotid Sinus Massage
Adenosine 6 mg....MR at 12 mg
Cardioversion
SVT-Unstable
Immediate cardioversion
Symptomatic Bradycardia
Atropine 1 mg
TCP
Clinical Judgement Questions
ALWAYS look at who you are working with
ALWAYS look at the time of day
ALWAYS look at your weather and road conditions
ALWAYS look at your ETA in time/Distance to the hospitals
If the ETA is >30 min, considering a helicopter (Weather permitting)
****Remember, for the NREMTP Exam, Initiating an IV/IO most of the time will be en route
PEEP
At the end of exhalation, it gives back pressure to open the alveoli and prevent atelectasis (Collapsed alveoli)
CPAP
Continuous pressure on inhalation
Bi-Pap
CPAP + PEEP
Fio2-Fractional Inspired O2
The % of oxygen a pt. is receiving
Atmospheric oxygen
21% Fio2
If the Spo2 is abnormal, we adjust the Fio2
Nasal Cannula-1-6 lpm
1 L-24%
2 L-28%
3 L-32%
4 L-36%
5 L-40%
6 L-44%
Simple Face Mask (Partial re-breather)-6-10 lpm
6 L-44%
7 L-48%
8 L-52%
9 L-56%
10 L-60%
Dialysis
A machine which acts as the kidneys to detoxify the blood for renal failure patients
AV Fistula
Shunt
The toxins that accumulate in the kidneys (Blood, Nitrogen)=Urea
Uremia
Accumulation of toxins in the blood.
Can travel to the brain causing neurological deficits
Seizures, Unresponsive, ICP
Potassium (Electrolyte)
Responsible for nerve conduction and muscle contraction
ACID!!!!!!!!!
The higher K+ goes, the more acidotic a pt. becomes
Lives inside the cells
Intracellular
Hyperkalemia
Metabolic Acidosis
Renal Failure
Crush Injuries
Burns
Calcium Chloride-A cardiac protectant, it protects the heart from fatal dysrhythmias (v-fib/v-tach)
Sodium Bicarbonate-buffering and neutralizing agent. Increase ph levels
Albuterol-It pulls potassium from the blood, and puts it back into the cells
