Questions and Correct CORRECT

Standardized Procedure- Emergency Standing Orders at Sharp Healthcare Questions and Correct CORRECT ANSWERwers Latest Version 2023 ASYSTOLE - CORRECT ANSWER 1. CPR (2 min)

• O2 at 15ml/min ambu bag (8-10 breaths/min)
• Epinephrine (1:10,000) 1mg IVP/IO, repeat q3-5 min as long as asystole persists.

BRADYCARDIA UNSTABLE (Heart Rate <60bpm) - CORRECT ANSWER 1. O2 at minimum 10ml/mim NRBM

• If trCORRECT ANSWER venous leads or epicardial pacing wires present, connect to

a pulse generator and initiate pacing control.

• Atropine 0.5mg IVP/IO, repeat q3-5min up to a total of 0.04mg/kg (or 3mg)
• TrCORRECT ANSWER cutaneous pacing as soon as available
• If above algorithm is ineffective, start dopamine 400mg/250ml D5W infusion at

5mcg/kg/minute. Titrate until SBP =/> 90mmHg and/or MAP >60mmHg up to 20mcg/kg/min.

• If no response from above algorithm, initiate Isuprel infusion 1-10mcg/min IV/IO)

CHEST PAIN - CORRECT ANSWER 1. Consider giving aspirin 325mg, if no dose was given on this date

• O2 start at minimum 4L/min NC
• NTG 0.4mg SL if BP >/= 90 mmHG and /pr MAP >60mmHg and HR >50,may repeat

every 3-5min x 2.

• Morphine Suldate 2mg, if SBP >/= 90, IVP/IO q5 min up to a total of 10mg
• 12 Lead EKG

Circulation, Airway,Breathing - CORRECT ANSWER CPR- cardiopulmonary resuscitation which includes Circulation with compressions , airway assessment and breathing. Compressions are administered for 2 minutes at >100 compressions/min between all interventions. During CPR, O2 should be delivered by 15L inspired O2 by bag mask (8-10 breaths/min)

DOCUMENTATION - CORRECT ANSWER Will be made by RN performing ESO

standardized procedure including:

Unstable or life-threatening condition, precipitating factors if any, treatment/medications administered, biphasic defibrillation or joules, pt's response to interventions, and when/which physician was notified. Code blue will be completed for all cardiac and respiratory arrest events. The RRT record will be completed for all RRT events that utilize ESOs.

Emergency Standing Orders (ESO) - CORRECT ANSWER Preestablished medical orders, approved by appropriate medical staff to be administered in the absence of a 1 / 2

physician. These orders specify emergent treatment interventions for life threatening conditions.

ESO Competent Nurse - CORRECT ANSWER RN who has successfully demonstrated the knowledge and skills in identification and treatment of life threatening conditions

General Procedure for all Life-Threatening Patient Conditions- If IV access is not available what medications can be given and how is it administered? - CORRECT ANSWER c. If IV access is not available: Narcan, Atropine, and Epinephrine may be administered via endotracheal route at doses of 2 times the IV dose diluted in 10ml NS flush

General Procedure for all Life-Threatening Patient Conditions- In applicable situations, what should be readily available? - CORRECT ANSWER e. Oxygen

General Procedure for all Life-Threatening Patient Conditions- what kind of access should a nurse obtain? - CORRECT ANSWER a. Obtain IV/intraosseous (IO) access (large bore cannula in the antecubital vein should be the first target for IV access if a central line is not present)

General Procedure for all Life-Threatening Patient Conditions- what kind of fluid should be started to KVO? - CORRECT ANSWER b. Begin IV infusion of Normal Saline (NS) to keep vein open (KVO)

General Procedure for all Life-Threatening Patient Conditions- what's the process after giving each medication? - CORRECT ANSWER d. Flush IV line with 20ml of NS after each IV medication given and elevate extremity if applicable.

How do you order specific treatments for the unstable or life-threatening condition? - CORRECT ANSWER It will be ordered electronically in Cerner by the RN as a standardized procedure, or the Code Blue Record will be completed by RN and signed by the physician, then placed in the chart, this acts as an oder sheet

HYPOGLYCEMIA - CORRECT ANSWER Follow the Hypoglycemic Standardized Procedure for ANY patient with a serum glucose or fingerstick <70mg/dl (<60mg/dl if pregnant)

HYPOTENSION (SYMPTOMATIC)

For Immediate Post Anesthesia Patients - CORRECT ANSWER ONLY

ADMINISTERED BY PACU OR ICU NURSES:

• O2 at min 10L/min NRBM
• Infuse 250 ml LR or NS. Repeat in 5 min if no clinical improvement.
• If fluid bolus ineffective, Ephedrine 5mg IVP/IO
• If no improvement within 3 min, repeat Ephedrine at 10mg IVP/IO
• In the presence of obvious blood loss, draw stat H&H and Type & Cross 2 units

PRBCs.

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