vasodilator, decreased oxygen demand, increased oxygen supply. Used for chest pain, suspected infarction.
Dose is 0.4 mg sublingual via spray or tablet.
Side effects are tachycardia, hypotension, headache, burning under the tongue, and nausea/vomiting).
Contraindications are expired, not prescribed, hypotension, recent use of viagra/cialis/levitra, head injury, or lack of medical direction.
Purpose is to identify and treat immediate and threatening injuries. If c-spine is needed then do it immediately
General impression (age, sex, level of distress, overall appearance)
Determine LOC (conscious and alert, conscious and altered, unconscious)
AVPU (awake and alert, responsive to voice, responsive to pain, unresponsive)
If conscious and alert, determine if they know their name, where they are, what year/month it is, and if they can describe the MOI/NOI
Manual maneuvers as needed (head tilt chin lift, jaw thrust)
Suction as needed
Mechanical airway adjunct as needed (OPA, NPA)
Assess rate, quality, and auscultate
Provide supplemental oxygen and artificial ventilations as needed
Manage life threatening breathing conditions (flail chest and sucking chest wound)
Assess pulse, initiate CPR as needed (should be done immediately for unconscious patients)
Assess and control life threatening bleeding using direct pressure
Check skin color and capillary refill time
Rapid head to toe scan (Used to identify any remaining life threats, shouldn't take longer than 90 seconds. Inspection, palpation, and auscultation as needed)
Transport priority (Determine if they should be transported rapidly or if care can be continued on scene)
Anaphylactic= Due to a severe allergic reaction, Signs and symptoms are hives/swelling/itching/flushed skin, weak pulse, hypotension, severe dyspnea, wheezing, respiratory failure
Neurogenic= Caused by spinal cord damage typically in the cervical region. It interferes with the normal pathway between the central and peripheral NS, which affects compensation mechanisms. Signs and symptoms are hypotension, warm skin (because the nervous system cannot stimulate peripheral NS), non tachycardic, paralysis, respiratory paralysis
Septic shock= Due to severe infection. Causes vessels to not constrict well, so the body doesn't compensate well. Signs and symptoms are fever/chills/weakness, altered LOC, increased respirations, tachycardia, hypotensions, pale/cool skin, weak peripheral pulses
Psychogenic= Pseudo-shock caused by vasodilation that leads to fainting. Not dangerous, doesn't affect the brain
Place on dry sheets after delivery
Dry baby, then replace with wet linens
Warm baby, place on mother's stomach
If baby isn't crying, attempt tactile stimulation
Important: respirations, heart rate, and color
If baby isn't breathing adequately then provide oxygen, do not give more than 30 seconds.
<60 heart rate: compressions at 3:1 ratio, reassess every 30 seconds
60-100 heart rate, provide ventilations and reassess every 30 seconds
>100 heart rate assess skin color
APGAR (appearance, pulse, grimace,activity, respirations. 0-2 points for each 2 is best)
Tone: movement, muscle tone, etc
Interactivity: alertness, reactivity to stimuli, interaction with environment
Consolability: can they be consoled by their parents/caregivers?
Look: can they fix their gaze or are they out of it
Speech/cry: speech in older, cry in younger
How hard are they working to breathe? Look for accessory muscle use, abnormal lung sounds, grunting, tripod positioning, head bobbing, nasal flaring
Assess skin color