April 2015 CE
Site code # 107200E-1215
Summer Emergencies
Pacemaker Rhythms
QuickTrach Device
Objectives by
Reviewed/revised by Sharon Hopkins, RN, BSN, EMT-P
To view on the Advocate Condell website visit:
http://www.advocatehealth.com/condell/2015-ems-continuingeducation
Date of CE presentation: April, 2015
Topic: Summer Emergencies
Behavioral Objectives:
Upon successful completion of this module, the EMS provider will be able to:
1. Distinguish the difference between heat cramps, heat exhaustion, and
heatstroke.
2. List the steps of assessment for the patient involved in water emergencies.
3. Analyze signs and symptoms to determine the level of allergic reaction a
patient is experiencing.
4. Actively participate in review of selected Region X SOP’s as related to the
topics presented.
5. Review pacemaker rhythms.
6. Actively participate in case scenario discussion.
7. Actively participate at the paramedic level in return demonstration of insertion
of the Quick Trach.
8. Actively participate in ventilating a manikin at the appropriate ventilation rate
for the situation.
9. Successfully complete the post quiz with a score of 80% or better.
Bibliography:
Bledsoe, B., Porter, R., Cherry, R. Paramedic Care Principles & Practices, 4th
edition. Brady. 2013.
Region X SOP’s; IDPH Approved April 10, 2014.
Mistovich, J., Karren, K. Prehospital Emergency Care 9th Edition. Brady.
2010.
http://www.scientificamerican.com/article/why-does-lactic-acid-buil/
http://www.icufaqs.org/Pacemakers.doc
http://www.cdc.gov/HAI/organisms/cdiff/Cdiff_infect.html
http://www.cdc.gov/norovirus/preventing-infection.html
Converting Temperatures
0F
= 9/5 0C + 32
0C
= 5/9 (0F – 32)
Example: 990F = ? C0
= 5/9 (990F – 32)
= 5/9 (67)
0C = 5 x 67
9
0C = 335
9
0C = 335  9
0C = 37.2
0C
0C
Relative Humidity / Temperature Chart
Process for Transfer of Heat
-
Conduction – direct contact surface to surface
-
Convection – air currents
-
Radiation – infrared rays
-
Evaporation – change of water to vapor
-
Respiration – mechanics of convection, radiation, and evaporation
Measuring Body Temperature
Normal body temperature 98.60F (370C)
Rectal and tympanic 0.5 to 10F higher than oral
99.10F = 37.20C
99.60F = 37.50C
Axillary – 0.5 – 10F lower than oral
98.10F = 36.70C
97.60F = 36.4 0C
Medications for Allergic Reactions/Anaphylaxis
Antihistamine
Benadryl – to stop the release of histamines causing the signs and
symptoms noted
If given IVP, administer slowly watching for hypotensive response
Can cause sleepiness
Needs to be repeated over time (generally every 4-6 hours) to maintain
Effects
Vasoconstrictor, bronchodilator
Epinephrine – to support perfusion and open airways
Relatively short half-life so may need to be repeated fairly frequently
(every 5 minutes as needed)
Can cause tachycardia which could be harmful in elderly and patients with
history of cardiac problems
If need arises to be given IVP in person who is alive, use VERY cautiously
and push slowly
Bronchodilator
Albuterol and Atrovent nebulizer treatment
Patient needs encouragement to slow ventilation rate down, inhale slowly
and periodically hold their breath
Medication must get to the lungs to have any positive effect
Using an EpiPen
Effects to Levels of TCP Settings
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20 mA – a prickly sensation to skin
30 mA – slight thumping sensation to chest
40 mA – definite thumping to chest
50 mA – coughing triggered
60 mA – diaphragm pacing and coughing
70 mA – coughing and knocking on chest wall
80 mA – more uncomfortable
90 mA – strong, painful knock on chest wall
100 mA – Pain level very intense
QuickTrach Device