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Asthma Attack: Not just a routine call!

Asthma Attack: Not just a routine call!. Zumbro Valley Emergency Nurses Association April 9, 2014. Peer Review Disclaimer.

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Asthma Attack: Not just a routine call!

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  1. Asthma Attack: Not just a routine call! Zumbro Valley Emergency Nurses Association April 9, 2014

  2. Peer Review Disclaimer CONFIDENTIAL PEER REVIEW INFORMATION: These documents contain quality data and/or peer review information and are privileged and confidential and subject to protections from discovery under applicable state law, including without limitation, Minnesota Statutes §§ 145.61-.67; Florida Statutes §§ 766.101-1016, 395.0191,395.0193, and 395.0197; Arizona Revised Statutes §§ 36-445-445.04 and 36-2401-2404; Iowa Code § 147.135; and Wisconsin Statutes §§ 146.37-.38.

  3. Panel Introductions Emergency Communications Center Terry Paul Stewartville Fire Department Lisa Jelinek Jamey Kime Gold Cross Ambulance Chris Evanson Saint Marys Emergency Department Dr. Dennis Laudon

  4. Objectives After this case review, participants should be able to: ● Discuss prehospital care of asthma attacks and identify 4 agencies involved in the described case ● Describe the pathophysiology of asthma ● Identify and describe 2 principles of ECMO

  5. Emergency Communications Center

  6. 911 Call

  7. Stewartville First Response

  8. Gold Cross Ambulance

  9. Initial Assessment 0425 Young adult Hispanic female supine on a bedroom floor unresponsive with SFD performing CPR. Unknown downtime, but viable patient. SFD reports non compliant airway. Rescue inhaler laying on the floor. Reports of asthma history with patient.

  10. Pieces of the Puzzle

  11. Goals • Restore Pulses • Control Airway • Treat Underlying Causes • Definitive Care

  12. Treatment On Scene • Cardiac Monitor 0427 • Agonal • IV 0429 • 0.9% Sodium Chloride • EPI 1:10,000 x2 • Airway 0433 • Suction • Intubation • Bag-Valve High Flow O2 • ETCO2

  13. Ongoing Assessment 0441 Still unresponsive. Change seen on monitor. Carotid pulse checked and present.

  14. Vitals: BP 128/78 HR 117 RR 16 Assisted SpO2 89% Transporting to SMH 0450

  15. Treatment During Transport • IV 0456 • 0.9% Sodium Chloride TKO • Sodium Bi-Carb 50 mEq • Airway 0458 • BVM High Flow O2 • Monitor ETCO2 and SpO2 • Duo-Neb

  16. Transfer of Care 0505 Met with ED staff in Critical Care. Explained what was going on and why. Start the arduous task of getting equipment back in order and typing the report.

  17. Saint Marys Emergency Department

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