1. You continue to perform CPR. You elect to call medical control and report the situation. Until you are sure that the outcome is going to be terminal you continue your efforts. What is the optimal ventilation rate you would provide now?
2. You check for a pulse and it is adequate with chest compressions. Why is the Sp02 not registering on your arrival?
3. Carbon monoxide (CO) poisoning is common from:
4. Levels of carbon monoxide can come from industrial and household pollution. Industrial plants can produce many types of toxic chemical levels and other harmful gases such as cyanide and formaldehyde, which are very toxic and lethal over time. Levels of CO above are considered harmful with several hours of exposure.
5. Symptoms of CO poisoning start with the common signs and symptoms such as:
6. CO levels of ppm can be lethal in two to three breaths or in less than several minutes of exposure.
7. This patient likely is suffering from severe hypoxia. CO poisoning causes the CO to combine with oxygen to form:
8. The CO can also affect:
9. During resuscitation the only antidote for CO poisoning would be to utilize:
10. Higher levels of CO poisoning causes:
11. As CO levels increase, is caused.
12. Chronic CO poisoning causes:
13. CO also binds to the hemeprotien myoglobin in muscle. It has a high affinity for myoglobin which is somewhere around to times greater than that of oxygen.
14. The fire team is back and there are no other occupants in the house. You elect to transport immediately as there is a short transport time. Medical control advises you to continue resuscitation until first-line medications are administered or:
15. The affinity between hemoglobin and CO is approximately 230 times stronger than the affinity between hemoglobin and oxygen so:
16. As you start to transport the patient you notice a fast visible wide complex rhythm on the monitor. You suspect it to be:
17. Your first action would be to:
18. Following several minutes your partner successfully intubates the patient with a 7.5 cuffed endotracheal tube on his first attempt. During ventilations with the BVM you notice some foamy secretions coming up the endotracheal tube. You decide it is likely pulmonary edema, which can be seen in CO poisoning as well as many other complications. The patient still has a pulse now as well. Your best actions would be to:
19. The patient’s BP comes back at around 60 systolic. The interventions that can help this would be to:
20. The patient appears to have seizure-like movements now. What would be the recommended therapy to decrease these movements?
21. The patient has runs of ventricular tachycardia now that is not perfusing when you checked. The therapies that can assist this would be:
22. Upon arrival at the hospital the patient has a portable chest X-ray done to verify tube location and for other medical complications. The CXR looks terrible and the emergency physician suspects the worst possibilities as a differential diagnosis. The differential diagnosis in this case might also demonstrate signs such as ___________________ on the patchy, poor looking X-ray.
23. Upon arrival the patient goes back into a pulseless wide complex tachycardia arrest. The arterial blood gas states the pH is 6.85 now. The next interventions should include:
24. After 30 minutes of recurrent episodes of pulseless ventricular tachycardia the patient goes into a PEA and then finally asystole. The differential diagnosis should include:
25. The physician in charge of the code, along with the EMS and ER staff, has done everything possible with everyone assisting on the code to the best of their capabilities. The physician uses the fast scan to check the heart now. There is no heart motion. The next appropriate action would be to:
