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1. You are riding "shot-gun" in an ambulance (the paramedics are all so nice, they are giving you a ride to work at your ER!) While en route, they get a call for a patient with chest pain and other associated "possible MI" symptoms. They go to the home and pick up the patient, who, from what you can see, is having "crushing" chest pain, shortness of breath, and sweats. What do you expect to see the paramedics do?
1.
1. 0xygen
2. IV Access
3. Cardiac Monitoring
4. Vital Signs
5. Nitroglycerine
6. Narcotics
7. Notify the ER
8. Transport to the ER
9. Ask health history
10. EKG
#'s 1,2,5,7
#'s 4,6,8,10
#'s 3,9
All of the above
2. How long is the "door to drug" interval (the optimal amount of time from when the patient comes in the ER until the moment thromblytics are started)?
2.
1-2 hours
4-5 hours
30-60 minutes
7-10 minutes
Within 24 hours
90-120 minutes
6-8 hours
3. Your initial assessment should include....
3.
Vital signs
Oxygen saturation
12 lead EKG and Physician reading within 3-5 minutes
Brief H&(..targeted for Thrombolytics
Thrombolytic decision
CXR
Blood Work< option>Cardiology consult
All above
4. What are the 4 triads for early assessment?
4.
a. airway-breathing-circulation-defribrillate
b. oxygen-IV-monitor
c. neuro colsult-ct scan-liver enzymes
d. pulse-respirations-blood pressure
e. volume problems-pump probl ems
f. foley catheter-cvp catheter-care plan
a,b,d,e
a,c,d,e
b,c,d,e
a,d,e,f
5.Which is NOT a treatment of Coronary Thrombolysis in the event that there is not information to go by for whether they ever had a bleed...."?
5.
0xygen at 4 liters
Ntg SL then NTG drip
ABG's every 15 minutes
IV Morphine
ASA (Ecotrin)
Thrombolytic agent
IV Heparin
Beta Blockers
Magnesium Sulfate
6. PTCA can be considered early IF you know the patient is NOT a candidate for Thrombolytic therepy..which of the following still allows your patient to have thrombolytics?
6.
Family history of excessive bleeding or ulcer
"Stuttering" infarct
Cardiogenic shock
Pump failure
Patient with HX previous MI
Hx of graft surgery
Avaiability of facility that can off PTCA with 24 hour avaiability