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