Critical Care Paramedic Actual
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Cardiac Enzymes - ✔✔Myoglobin-first to elevate, hard to distinguish MI
Ck-MB-Cardiac Ck, peaks after 18 hours
Trop I, stays elevated after starts, but after CkMb
If pt has elevated CkMB and Trop, we are late in the Game
When you think of Septal/Anterior Wall Mi's Think... - ✔✔Papillary Muscle Involvement and
possible Flash PE (papillary muscle not pulling tendon of chordae to close mitral valve)
If inferior Wall MI, we want to know? - ✔✔how high? is there R. Ventricular involvement, move
lead 4 over..
If every rhythm possible MI? - ✔✔AV Node Involvement, need coronary vasodilation and preload
St-Elevation means.. - ✔✔Transmural, has progressed across muscle, -1mm in two
anatomically contiguous leads (same region of heart), or 2mm in single lead
a q wave must be - ✔✔first neg. deflection
is the q wave significant? - ✔✔1/3 qrs amplitude,
ST depression can signify? - ✔✔Transmural somewhere else, sub-endocardial wall MI, has
not progressed yet
, Which Leads to where? - ✔✔II, III, AVF=RCA (inferior)
V1,V2=Septal,
v2-6=lateral/anterior
I, AVL-Also lateral
For Posterior Wall - ✔✔Flip EKG upside down and look at anterior wall leads
Dilt Drip - ✔✔For Afib RVR and SVT, titrate up from 5mg/hr to 15mg/hr
Dopamine Drip - ✔✔Start around 2mcg/kg/min, and titrate up to around 20, dobutamine similar
Toradol works for - ✔✔Fever, Pain, 30mg, can go 30-60 IM
Propofol Drip - ✔✔5-50 mcg/kg/min
Phenergan Dose - ✔✔12.5 to 25 mg IV, may repeat in 10
Zofran Dose - ✔✔4-8 mg if not actively vomiting,
Oxytocin - ✔✔10 units IM after placental delivery,
For HTN and Aortic Dissection, starting dose for labetalol - ✔✔20mg over 2 mins, double dose
and repeat in ten
HTN crisis is defined by...(caution) - ✔✔sustained Sys over 180 and Diastolic over 120, we do
not want to drop MAP more than 25% in 30-60mins, keep map above 90
Calculate MAP - ✔✔Systolic + 2x(Diastolic)/3
Exam2 with Questions and 100%
Correct Answers| Pass Guaranteed
Cardiac Enzymes - ✔✔Myoglobin-first to elevate, hard to distinguish MI
Ck-MB-Cardiac Ck, peaks after 18 hours
Trop I, stays elevated after starts, but after CkMb
If pt has elevated CkMB and Trop, we are late in the Game
When you think of Septal/Anterior Wall Mi's Think... - ✔✔Papillary Muscle Involvement and
possible Flash PE (papillary muscle not pulling tendon of chordae to close mitral valve)
If inferior Wall MI, we want to know? - ✔✔how high? is there R. Ventricular involvement, move
lead 4 over..
If every rhythm possible MI? - ✔✔AV Node Involvement, need coronary vasodilation and preload
St-Elevation means.. - ✔✔Transmural, has progressed across muscle, -1mm in two
anatomically contiguous leads (same region of heart), or 2mm in single lead
a q wave must be - ✔✔first neg. deflection
is the q wave significant? - ✔✔1/3 qrs amplitude,
ST depression can signify? - ✔✔Transmural somewhere else, sub-endocardial wall MI, has
not progressed yet
, Which Leads to where? - ✔✔II, III, AVF=RCA (inferior)
V1,V2=Septal,
v2-6=lateral/anterior
I, AVL-Also lateral
For Posterior Wall - ✔✔Flip EKG upside down and look at anterior wall leads
Dilt Drip - ✔✔For Afib RVR and SVT, titrate up from 5mg/hr to 15mg/hr
Dopamine Drip - ✔✔Start around 2mcg/kg/min, and titrate up to around 20, dobutamine similar
Toradol works for - ✔✔Fever, Pain, 30mg, can go 30-60 IM
Propofol Drip - ✔✔5-50 mcg/kg/min
Phenergan Dose - ✔✔12.5 to 25 mg IV, may repeat in 10
Zofran Dose - ✔✔4-8 mg if not actively vomiting,
Oxytocin - ✔✔10 units IM after placental delivery,
For HTN and Aortic Dissection, starting dose for labetalol - ✔✔20mg over 2 mins, double dose
and repeat in ten
HTN crisis is defined by...(caution) - ✔✔sustained Sys over 180 and Diastolic over 120, we do
not want to drop MAP more than 25% in 30-60mins, keep map above 90
Calculate MAP - ✔✔Systolic + 2x(Diastolic)/3
