Sharp 2021 CEP
2 person/dual CPR - ANS - 30:2
Ambu bag - ANS - 8-10 breath/min
chest pain - ANS - O2 @ 4L; titrate spO2 > 94%
ntg 0.4mg SL if sbp >90 or map >60 or HR >50 repeat q3-5min x2
morpgine 2mg if sbp >90 q 5min (max 10)
asa 325mg po crushed or chewed
if hypotension 250ml NS/LR (if no pulm congestion)
stat 12 lead ecg
CPR rate - ANS - 100-120
hypoglycemia - ANS - <70 ml, obstetric >60
signs: tachy, palpitations, restless, diaphoretic, shaky, lightheaded, pallor, dilated pupil,
ALOC, nightmares
Hypotension- symptomatic - ANS - O2 @ 10L NRB
250 mL NS/LR bolus, repeat in 5 min
if Sbp <90 start dop 400mg/300mL at 5-20 mcg/kg/min, titrate till sbp >90 or map >60
if blood loss: type and cross 2 units PRBC
if suspecting sepsis follow sepsis algorithm: serum lactate, blood cx x2, more fluids,
RRT & MD
If no of access give narcan, epi, atropine via - ANS - ET tune 2-2.5x the dose diluted w
10ml NS
increased icp - ANS - 1st sign is decreased LOC; later signs include hemiparesis,
unilateral or bilateral fixed and dilated pupils, decorticate or decerebrate posturing
raise hob >30 if not hypotensive, head midline
hyperventilate intubated 100% fiO2 to maintain pCO2 26-30mmHg
Draw K, Na, BUN, Cr, Glucose, serum osmolality & ABG
, Med for asystole - ANS - EPi
1mg IVP q3-5min
PEA w/out pulse - ANS - Correct H&T's; hypovolemia, hypoxia, hypothermia,
hypo/hyperkalemia, hydrogen ion acidosis, hypoglycemia, OD, tension pneumothorax,
thrombus, toxins, tamponade
CPR
O2 @ 15L ambu
Epi 1mg IVP repeat q 3-5min
If hypovolemia, 250mL NS/LR, may repeat in 5 min
stat cxr
Respiratory depression post narcotic benzo adm - ANS - O2 @ 10 L NRB
NARCOTIC-
APNEA: NARCAN 0.4MG IVP ONCE (MAX 0.4MG)
RR <10: 0.1MG IVP Q1MIN (MAX 0.4)
BENZO:
ROMAZICON: 1.2MG Q45 SEC (MAX 0.6)
respiratory distress - ANS - signs: Increased RR, use of accessory muscles, ALOC,
cyanotic nail beds
O2 @10L NRB
stat cxr
if bronchospasm: albuterol 0.5ml in 3mL aerosol inhalation
RRT- initiate ABG
RRT-initiate NIV for copd, asthma, acute chf, bridge to mechanical vent
contraindication for NIV: unable to clear secretions, respiratory arrest, unable to
maintain airway, aspiration risk, pneumothorax, epistaxis, recent facial trauma, AMS,
unable to tolerate
second degree type 1 - ANS - aka wenkebach
progressive longation of pr interval until P is dropped
2 person/dual CPR - ANS - 30:2
Ambu bag - ANS - 8-10 breath/min
chest pain - ANS - O2 @ 4L; titrate spO2 > 94%
ntg 0.4mg SL if sbp >90 or map >60 or HR >50 repeat q3-5min x2
morpgine 2mg if sbp >90 q 5min (max 10)
asa 325mg po crushed or chewed
if hypotension 250ml NS/LR (if no pulm congestion)
stat 12 lead ecg
CPR rate - ANS - 100-120
hypoglycemia - ANS - <70 ml, obstetric >60
signs: tachy, palpitations, restless, diaphoretic, shaky, lightheaded, pallor, dilated pupil,
ALOC, nightmares
Hypotension- symptomatic - ANS - O2 @ 10L NRB
250 mL NS/LR bolus, repeat in 5 min
if Sbp <90 start dop 400mg/300mL at 5-20 mcg/kg/min, titrate till sbp >90 or map >60
if blood loss: type and cross 2 units PRBC
if suspecting sepsis follow sepsis algorithm: serum lactate, blood cx x2, more fluids,
RRT & MD
If no of access give narcan, epi, atropine via - ANS - ET tune 2-2.5x the dose diluted w
10ml NS
increased icp - ANS - 1st sign is decreased LOC; later signs include hemiparesis,
unilateral or bilateral fixed and dilated pupils, decorticate or decerebrate posturing
raise hob >30 if not hypotensive, head midline
hyperventilate intubated 100% fiO2 to maintain pCO2 26-30mmHg
Draw K, Na, BUN, Cr, Glucose, serum osmolality & ABG
, Med for asystole - ANS - EPi
1mg IVP q3-5min
PEA w/out pulse - ANS - Correct H&T's; hypovolemia, hypoxia, hypothermia,
hypo/hyperkalemia, hydrogen ion acidosis, hypoglycemia, OD, tension pneumothorax,
thrombus, toxins, tamponade
CPR
O2 @ 15L ambu
Epi 1mg IVP repeat q 3-5min
If hypovolemia, 250mL NS/LR, may repeat in 5 min
stat cxr
Respiratory depression post narcotic benzo adm - ANS - O2 @ 10 L NRB
NARCOTIC-
APNEA: NARCAN 0.4MG IVP ONCE (MAX 0.4MG)
RR <10: 0.1MG IVP Q1MIN (MAX 0.4)
BENZO:
ROMAZICON: 1.2MG Q45 SEC (MAX 0.6)
respiratory distress - ANS - signs: Increased RR, use of accessory muscles, ALOC,
cyanotic nail beds
O2 @10L NRB
stat cxr
if bronchospasm: albuterol 0.5ml in 3mL aerosol inhalation
RRT- initiate ABG
RRT-initiate NIV for copd, asthma, acute chf, bridge to mechanical vent
contraindication for NIV: unable to clear secretions, respiratory arrest, unable to
maintain airway, aspiration risk, pneumothorax, epistaxis, recent facial trauma, AMS,
unable to tolerate
second degree type 1 - ANS - aka wenkebach
progressive longation of pr interval until P is dropped
