The most popular pocket reference in emergency nursing - now in a new edition! The Pocket Guide consolidates critical information found in desk references into a convenient 3"x5" pocket-size format that is handy enough to take with you anywhere. ISBN Your tags:.
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The file will be sent to your Kindle account. It may takes up to minutes before you received it. Please note : you need to verify every book you want to send to your Kindle. Check your mailbox for the verification email from Amazon Kindle. Related Booklists. Watch for resedation. Contra—Severe bradycardia, heart block, hypotension, porphyria, renal or hepatic disease. Contra—Dehydration, hypokalemia, hepatic coma, anuria. SE—Hypokalemia, hypotension, dehydration. SE—Bleeding, allergy, dysrhythmias, thrombocytopenia.
Then 0. Use with heparin. For drip: mix 9 mg 4. RX—ACS: 0. May repeat up to 10 mg maximum. Contra—Parkinson disease. Peds—Ages 3—12 yo: 0. Keep PTT 1. SE—Bleeding, allergy, thrombocytopenia, itching. Heparin antagonist: Protamine sulfate, 25 mg IV over 10 minutes 1 mg neutralizes approximately International Units of heparin. May repeat in 10 minutes. Contra—Do not give with Class 1a antiarrhythmics, such as disopyramide, quinidine, and procainamide, or Class III drugs, such as amiodarone and sotalol.
May repeat after 30 minutes. Do not mix with dextrose solutions or furosemide. Contra—Hypertensive crisis, allergy. Use caution in kidney or liver disease, COPD, asthma, ulcers, bleeding disorders, warfarin use, elderly, diabetes.
May double dose every 10 minutes—40 mg, 80 mg, mg, up to mg total dose given. SE—Hypotension, nausea, dizziness, dyspnea. RX—VT with pulse: 1—1. Start drip ASAP. RX—PVCs: 0.
Contra—Renal impairment, angioedema, pregnancy, hypovolemia. RX—Anxiety, sedation: 0. Contra—Acute narrow-angle glaucoma, pregnancy. Start drip of 0. Start drip: 0. Contra—Renal disease, heart block, hypermagnesemia. May repeat if no effect. Contra—Renal impairment, severe dehydration, severe heart disease, pulmonary edema. Start 45 minutes after bolus, infuse over 23 hours.
Contra—GI bleed, diabetes, seizures, systemic fungal infection. SE—Euphoria, peptic ulcer, hyperglycemia, hypokalemia. RX—Myocardial infarction: 5 mg IV slowly over 2—5 minutes, repeated every 5 minutes to a total of 15 mg. Then 50 mg orally, every 6 hours for 48 hours, thereafter increased to mg twice a day.
NOTE: Calcium blockers may potentiate adverse effects. May repeat in 10—15 minutes. RX—Sedation: 1—2 mg IV over 1—2 minutes, titrated to effect. May repeat in 2—5 minutes maximum total dose, 5 mg. Contra—Acute narrow angle glaucoma, shock. Peds—Seizures: 0. Titrate infusion by 0. Milrinone Maintenance Infusion Patient Weight kg 50 60 70 80 90 0. Reduce maintenance infusion for renal impairment.
Drip: 0. May repeat every 5 minutes up to 10 mg. NOTE: Overdose may be reversed with naloxone. Single IM dose, 1 mg. Maximum total IV dose is 1. Give over 60 seconds in renal failure. Contra—Use extreme caution if narcotic dependence is suspected. May try 0. Repeat every 2—3 minutes, if needed, up to 10 mg total dose. Contra—Do not use on a newborn if the mother is addicted to narcotics; may cause withdrawal.
Mix 1. Caution with renal failure and hepatic dysfunction. SE—HA, hypotension, syncope, tachycardia, flushing. Ensure adequate BP. Start at 0. NOTE: Ventilate patient area during use. Contra—Hypovolemia unless as a temporary measure until volume can be replaced ; mesenteric or peripheral vascular thrombosis; ischemic heart disease.
Contra—Hypersensitivity to dolasetron, granisetron. May precipitate with bicarbonate. Contra—Rule out multiple fetuses before administration. Maintenance: 0. Contra—First trimester pregnancy; use reduced dose in newborns, myasthenia gravis. SE—Apnea, prolonged paralysis, tachycardia, hypotension, hypertension. Contra—Porphyria, pulmonary, or hepatic dysfunction.
RX—Hypotension: 0. Use caution in patients with heart block, hyperthyroidism, bradycardia, severe arteriosclerosis. Use central line if possible. Flush line after each dose. Peds—Nausea and vomiting: 0. Peds—Sedation: 0. Reduce dose for elderly, debilitated, or neurosurgical patient. Reduce dose if patient has received large doses of narcotics. Repeat dose after 2 minutes to a total of 0. Repeat dose in 30 minutes. Flush with NS before and after.
Contra—Active internal bleeding. Any within 3 months: stroke, AV malformation, neoplasm, aneurysm, recent trauma, recent surgery. Bleeding disorders, LP within 7 days. Contra—Caution if impaired hepatic or respiratory function or if severe obesity. Contra—Alkalosis, hypocalcemia, CHF, hypovolemia, hypernatremia. May cause hyperkalemia, arrhythmias, cardiac arrest. Contra—Newborns, neuromuscular disease.
SE—Apnea, weakness, bronchospasm. May repeat with 5—10 mg every 15—30 minutes maximum dose, 20 mg. Mix mg in mL of D5W 0. SE—Hypotension, AV block, bradycardia, asystole. May give second dose in 30 minutes, up to 10 mg.
Report possible abuse to police, ED staff, and child welfare office. Call for police assistance if needed to remove patient from the scene. Do not confront the alleged abuser. Document your findings and any statements made by child, parent, or others. Provide medical care as needed. If sexual abuse, do not allow patient to wash. There may be a delay in seeking medical care. The child may not cling to mother. Older Adult Maltreatment Fractures or bruises at various stages of healing; unexplained bruises or cigarette burns on the torso or extremities; soft tissue injuries from signs of restraint use; head injuries; malnourishment, listlessness, dehydration unexplained; poor hygiene, inappropriate clothing; decubitus ulcer, urine and feces on body and clothing; unusual interaction between caregiver and patient.
Medications: new medications, insulin or oral hypoglycemic, pill count and date filled, last oral intake? Does mother have urge to push or to move bowels? Has amniotic sac ruptured? Medications—any medical problems?
Give infant to mother to nurse at breast. Get Apgar scores at 1 and 5 minutes after birth. If excessive postpartum bleeding, treat for shock, massage uterus to aid contraction, have mother nurse infant, start large bore IV catheter and consider oxytocin IV infusion or IM administration, transport without waiting for placenta to deliver. Bring it with you to the hospital.
Most births are normal—reassure the mother. A score of 4—6 indicates moderate depression. Rapid transport. Support presenting part, place mother in Trendelenburg and knee-chest position, administer O2, begin rapid transport, start IV catheter en route.
Cord around neck: Unwrap cord from neck and deliver normally, keep face clear, suction mouth and nose. Infant not breathing: Stimulate with dry towel, rub back, flick soles of feet with finger. Suction mouth and nose. If infant does not respond, contact OLMC and reassess quality of ventilation efforts, lung sounds pneumothorax? Failure to respond usually indicates hypoxia. If patient cannot talk or has stridor or cyanosis 2.
Perform Heimlich maneuver use chest thrusts if patient is pregnant or obese , repeat until successful or patient is unconscious 3. Perform chest compressions 5. Ventilate with 2 breaths, if unable. Reposition head; attempt to ventilate, if unable. Perform chest compressions 9. Consider laryngoscopy and removal of object by forceps, ET intubation, transtracheal ventilation, cricothyrotomy If patient resumes breathing, place in the recovery position For Unresponsive Choking Adult or Child 1.
Determine unresponsiveness 2. Call for assistance 3. Position patient supine on hard, flat surface 4. Attempt to ventilate, if unable. Reposition head and chin; attempt to ventilate, if unable. Confirm obstruction: if infant cannot make sounds, breathe, cry, or is cyanotic 2. Invert infant on arm: support head by cupping face in hand; perform 5 back slaps and 5 chest thrusts until object is expelled 3.
Repeat until successful 4. If patient becomes unconscious, start CPR 5. Perform chest compressions 6. Reposition head and chin; attempt to ventilate again 8. When was insulin last taken? Mental status, high glucose level on strip test, skin signs, dehydration? Respirations: deep and rapid? Breath odor: acetone, fruity? Monitor ECG. Last insulin dose? Last meal? Mental status? Consider glucagon IM if IV not possible. Do not give oral glucose if airway is compromised.
Caution: Hypoglycemia can mimic a stroke or intoxication. Seizures, coma, and confusion are common symptoms. When in doubt about the diagnosis, give glucose IV or PO. Meds: prescribed and OTC medications, recent medication changes, adherence with medications, last oral intake?
Always consider precipitating cause. Abruptio placenta: Separation of placenta from uterine wall. Give O2, prepare for emergency C-section. Placenta previa: Placenta covers cervical os, can occur during second and third trimester.
Transport quietly and gently. Consider and treat causes. L Start CPR hand placement higher on sternum than usual; use continuous cricoid pressure for ventilations. Give standard ACLS drugs and doses. Start IV fluids above the diaphragm—fluid bolus for hypovolemia. Hyperventilation of unknown origin can be shock, sepsis, stroke, drug OD. These Assess anatomy of patients should be transported injury preferentially to the highest level of care within the trauma system.
These Assess mechanism of patients should be transported injury and evidence of preferentially to the highest level high-energy impact of care within the trauma system. The apex of the pyramid crosses the bridge of the nose, and the base of the fracture extends above the level of the upper teeth.
A CSF leak is possible. Frequently associated with a fx mandible. SE—There may be no symptoms, but acetaminophen is toxic to the liver. Acetylcysteine may be given in the ED. SE—Pain, GI tract chemical burns, lip burns, vomiting. RX—Give milk or water, milk of magnesia, egg white, prevent aspiration. Transport patient in sitting position, if possible.
Cautions—Do not induce vomiting. RX—Give milk or water, prevent aspiration. Activated charcoal 50— g orally. Maintain normal body temperature. Benzodiazepine as adjunct. Cautions—Protect yourself against the violent patient. Cautions—Onset of coma and seizures can be sudden. Do not induce vomiting. Cautions—Coma usually means some other substance or cause is also involved. OD is almost always in combination with other drugs. Hyperbaric treatment in severe cases. Cautions—O2 saturation monitor can give false high reading with CO exposure.
Control HTN. Monitor VS and core temperature: cool patient if hyperthermic. Minimize sensory stimulation. Consider activated charcoal for oral cocaine ingestion. Do not give b-blockers. Cautions—Do not give b-blockers. RX—ABCs, manage airway, ventilate.
RX—Calm and reassure the patient. Be supportive. Cautions—Watch for violent and unexpected behavior. Cautions—Consider other concurrent overdoses. Cautions—Protect yourself first! Do not become contaminated. Consider benzodiazepines or antipsychotics eg, haloperidol Cautions—Protect yourself against the violent patient. Examine patient for trauma that may have occurred due to anesthetic effect of PCP. SE—EPS, dystonias, painful muscle spasms, respiratory depression, hypotension, torsades de pointes.
Consider activated charcoal 50— g orally. IV fluids for hypotension. Consider intubation for the unconscious patient. I speak a little Spanish. What is your name? No entiendo. Can you speak more slowly please? Sit up.
How are you? Do you have neck or back pain? Were you unconscious? Move your fingers and toes. Mueva los dedos de las manos y los pies. What day is today? Where is this? Where are you? What is your telephone number? When were you born? Sit here please. Lie down please. Do you have pain?
Show me where it hurts with your hand. Breathe deeply through your mouth. Respire profundo por la boca. Breathe slowly … Respire lentamente … What medicine s do you take? Have you been drinking? Have you taken any drugs? Do you have chest pain? Have you had this pain before? How long ago? Are you sick to your stomach?
Are you pregnant? Do you need to vomit? You will be okay. Va a estar bien. You are going to be okay. It is not serious. No es grave. It is serious.
Es grave. Por favor, no se mueva. Do you want to go to the hospital? To which hospital? You must go to the hospital. Tiene que ir al hospital. Le vamos a llevar al hospital. We are going to give you oxygen. We are going to apply a C-collar.
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