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Emergency Medi
| Question | Answer |
|---|---|
| what are the ABCDE of trauma | airway, breathing, circulation, disability/exposure |
| components of glasgow coma scale, number of points for each | Eye opening (1-4), Motor (1-6), verbal (1-5) |
| components of eye portion of glasgow coma scale | 1=doesn't open eyes, 2=opens to pain, 3=opens to command, 4=opens spont |
| components of motor portion of glasgow coma scale | 1=no mvmt, 2=decerebrate (extension), 3=decorticate (flexion), 4=wdrawal from pain, 5=localizes pain, 6=motor on command |
| components of verbal portion of glasgow coma scale | 1=none, 2=insensible, 3=inapprop words, 4=confusion, 5=appropriate and oriented |
| oriented x3 refers to | person, place, time |
| what is fluid replacement ratio for lost blood in trauma | 3:1 (NS or LR) |
| what are 3 zones of neck | 1=below cricoid, 3=above angle of mandible |
| tx for penetrating trauma to 3 zones of neck | 1=aortography, 2=2D doppler and exploration as needed, 3=aortography and triple endoscopy |
| tx for penetrating trauma to thorax | unstable pts need intubation and bilateral chest tubes; thoracotomy if remain unstable |
| tx gunshot to abd? Stab wound? | gun shot=ex lap; stab wound=ex lap if unstable or peritoneal signs (otherwise CT or focused abd sonography for trauma (FAST)) |
| diaphragmatic rupture more often occurs on L or R | L (liver protects it on R) |
| tx for musculoskel | if no neurovascular injury debride and repair, if vascular need arteriogram first |
| what's best for prophyl infxn musculo skel penetrating trauma | early irrigation and debridement > Abx (although Abx and tetanus given) |
| descibe 1st, 2nd, 3rd degree burns | 1=epidermic, painful, no blisters; 2=partial dermis, painful, blisters; 3=full dermis, painless, area is white and charred |
| formula for estimating burn area | head and ea arm ea 9%, back and chest ea 18%, palm 1% |
| how much fluid for burn victim | parkland formula: 4x pt wgt x%BSA; give 1/2 in 1st 8 hrs, the other 1/2 in the remaining 16 |
| should IV Abx be given to burn? What is MC infxn | no; Pseudo |
| when trxr burn pt to burn center | full thick >5%, partial >10%, full or partial covers critical areas, chemical, electrical, lightning, inhalation injury |
| red cheeks, fused dilated pupils, drowsy--what toxin? Tx? | anti His OD, give physiostigmine |
| N/V, sz, fused dilated pupils--what toxin? Tx? | anti His OD, give physiostigmine |
| dilated responsive pupils, dry mucus membranes, confusion/drowsy | TCA OD, watch for widened QRS and arrhyth, give bicarb and furosemide to help flush out |
| dilated reactive pupils w incrsd HR, F, agitation | sympathomimetric OD (ie decongestant, amphethamines, cocaine) |
| pinpoint pupils, low HR, BP | opiate OD, give naloxone |
| cramping abd pain, emesis, confusion, sweating | organophosphate poisoning, give atropine followed by pralidoxime |
| N/V, F, incrsd RR, agitation w metabolic acidosis, tinnitus | ASA OD, give Na bicard and acetazolamide |
| how does Bengay or oil of wintergreen OD present? | same as ASA OD, w metabolic acid and respir alk |
| what does Fe OD cause (in stages) | first F, abd (abd pain, vomit, diarrhea, GI bldg), then metabolic acidosis and circ collapse (DIC, renal and liver failure) |
| tx of Fe OD | can do gastric lavage if <1hr, deferox (charcoal won't bind) |
| antidote for benzos | flumanezil |
| which are caustic acids? Caustic bases? | acids=toilet cleaner, bases=bleach, drain cleaner, luandry detergent |
| what toxin causes pt to see a snow storm | MetOH and windshield wiper fluid |
| what's in antifreeze? What does ingestion cause? | CNS depression, ketones in serum and urine, metabolic acidosis and AG |
| what's the antidote for CCB or BB OD | glucagon |
| what's the antidote for sulfonyl urea OD | octreotide or glucagon |
| nystagmus, ataxia, hypersalivation--what OD? | PCP |
| how does heroine OD typically present | pin point pupils, low HR BP and somnolent |
| what can't you use charcoal for | Fe, Li, alcohols (incl EtGlycol, MetOH), K+, arsenic…and don't use for caustic ingestions |
| what is the mech of acetaminophen OD damage | depletion of glutathione |
| how tx digitalis OD | special Ig |
| very red skin, confusion, N/V, retinal hemorr, incrsd RR and HR | CO poison (even though PaO2 may appear nml) |
| what 3 sets of Rx present w dilated pupils | stimulants (cocaine, amphet), antichol (anti-His, TCA), hallucin (LSD, PCP) |
| what are 2 exs of Rx classes that present with pinpoint pupils OD | opioids, incl heroin, and cholinergic (sedatives, |
Created by:
ehstephns
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