Lisa Crit Care 2/poisoing Medstudy

Front 1

what drug/toxin causes dystonic rxn, acute spasm of facial M, can’t swallow, clenched teeth, torticollis, facial grimace, posturing, dysarthria, dysphagia?
-what's treatment?

Back 1

due to promethazine; class of phenothiazine;
tx: diphenhydramine

Front 2

Kid drank gas, no coughing, what’s next step?

Back 2

Close observation for development of resp sx.
-avoid charcoal, lavage, emesis b/c risk of further aspiration

Front 3

worst object to aspirate?

Back 3

balloon

Front 4

What med overdose causes : coma, cardiac, seizure; tacky, lethargy; Prolonged QT, wide QRS, flat T wave, ST depression, complete heart block?
-tx?

Back 4

TCA--> Na Bicarb

Front 5

what drug can work w/ charcoal?

Back 5

salicylates

Front 6

next step after black widow bite?

Back 6

opiate and benzo before antivenin: take care of pain, and benzo for M. rigidity

Front 7

Which meds cause Miosis?

Back 7

CCOOPPS (COPS x2) : cholinergics, clonidine, opiates, organophosphates, phenothiazine, pilocarpine, sedatives (barbs)

Front 8

what kind of shock: sx: diarrhea, v, low UOP;
-decreased preload ~ fluid loss -tachy, poor perfusion
- what's Tx ?

Back 8

Hypovolemic
-Tx: 1): Dopamine, 2) Epi – cold shock
3) NE: warm shock
-steroids for adrenal insuff

Front 9

what kind of shock? -poor feeding, tachypnea, mottled, arrythmias; obstructive: coarc/tamponade
Sx: cardiomeg, gallop, M, HPM, JVD
-don’t respond to fluid boluses**

Back 9

-cardiogenic;
Tx: milrinone

Front 10

Name most common causes of septic shock in Neonate; Kids, immunocomp ; and what are sx?

Back 10

Neo: GBS, enterobacter, listeria, mono; Staph, arueus;
-Kids: s. pneumoniae, N. menigitidis, staph aures, enterobacter,
-Immunocomp: enterobacter, staph aureus, PSA, candida
SX: warm ext, bounding pusles, grunting, tachypnea

Front 11

How do you manage a pt w/ bradycardia, poor pulse perfusion?

Back 11

HR < 60;
-ABC, O2, CPR
-EPi IV/IO: 0.01 mg/kg/ (1:10,000)
-ETT: epi: 0.1 mg/kg/ (1:1000)
-Atropine 0.02 mg/kg

Front 12

How manage pt w/ taccy w/ poor perfusion?
-sinus tacch?
vs
-SVT?

Back 12

ABC, O2 -Narrow QRS: (< 0.08 second) QRS
a) sinus tachy: P waves, variable rate;
-tx: underlying cause
b) SVT; NO or abnl P waves; rate > 220 bpm in infants;
-rate > 180 bpm in kids
Tx: vagal: ice, carotid massage; valsalva;
-adenosine: rapidly; -synch shock: unstable: 0.5-1 J/kg
-amiodorone or procainmide

Front 13

-how manage puseless arrest: asystole?

Back 13

epi

Front 14

-how manage puseless arrest: PEA?
-name causes.

Back 14

2 ) PEA: puelseless electrical activity: slow wide QRS
- Epi; ? cz: H/T:
(hypovolemia, hypoxia, H (acidosis) hypo/hyper K, hypo/hyperglycemia, hypothermia, toxins, tamponade, tensions Pneumo, thrombosis, trauma

Front 15

-how manage VF/VT:

Back 15

- VF/VT: shock: defibrillate w/ 2-4 J/kg
-Epi, amiodarone, lidocaine, Mg for torsades de pointes;

Front 16

how manage wide QRS (>0.08)?

Back 16

c) Wide QRS (>0.08)
-? Vtacc;
tx: shock: 0.5-1 J/kg; increase to 2 J/kg if not effective;
-consider adenosine

Front 17

Death in near drowning, due to what?

Back 17

1) - SX: hypoxemia, reflex laryngospasm; pulm: ARDS, Pulm edema -cerbral edema, hi ICP, cerebral herniation;
-asystole, arrythmias (VF/VT);
2)

Front 18

-what are risks for poor prognosis ** (BOARDS) for near drowning?

Back 18

B) RISKS poor prognosis: *** Boards
-age < 3 yo
-submersion > 10 min
resusuication > 25 min; need for continued resus in ER
-water > 10 degrees Celcius:

Front 19

how do you calculate fluid management for burns?

Back 19

2000 mL/m2 BSA + 5000 mL/m2 TBSA
- ½ over first 8 hrs, remainder x next 16 hours;
target UOP: 1 mL /kg /h

Front 20

what toxin causes altered skills, A, dyspena, confusion; faintness; neuro collaps; coma convulsion, death; Cherr red lips; -how dx and tx?

Back 20

-carbon monoxide poisoing;
DX: venous carboxyhemoglobin level !!! must do co-oximetery
TX: 100 % O2 via non-rebreather mask or ETT;

Front 21

what bug causes dog bites; and tx?

Back 21

Pastuerlla canis: most common organism; most common; can suture
- Can be sutured wounds; TX: amox-clavulanate

Front 22

what bug ~ cat bites; tx?

Back 22

-cx: pastuerlla mulitcoida; Deep puncture wounds can inoculate; wound care; no suture
- need antbx: amox-clavulanate or clinda

Front 23

what animals cause rabies?

Back 23

Cz: bats, skunks, foxes, racoons; rabbits, ferrets, woodchucks, beavers, opposums, coyotes, groundhogs, cats, dogs, wolves

Front 24

how do you treat rabies? and what do you do if found a bat in room of a child?

Back 24

Tx: Human Rabies IG + 5 doses of rabies vaccine ; treat as if it was a bite...

Front 25

what bite causes local necrosis; perioral numbness; and what's tx?

Back 25

-snake bite;
-Tx: antivenom; Loose fitting contriction band (NOT TIGHT fitting tournique!!)

Front 26

what kind of bite causes? Brown recluse: Violin on back:
-local rxn: redness w/ central blister or pustule, necrosis (if > 2 cm in 48 hr, iv antbx), F, V, hemolysis;
-what's tx?

Back 26

brown recluse;
--local wound care

Front 27

what kind of bite is worse!!: 2 red markings underside
- swelling, puncture marks, - M. spasm/aches: abd, lower back, chest, ext, coma, HTN-leading cause of death from spider bites;
-tx?

Back 27

Tx: antivenom, antihypertensives, nefidpine

Front 28

what causes core body temp > 40 degrees C w/ CNS dysfxn
-neuro dysfxn, ARDS, hypotn; -DIC;
-tx?

Back 28

-heat stroke;
tx: wet, windy

Front 29

whate GCS do you intubate?

Back 29

< or = 8

Front 30

what's dx of rib fx > loss of stability of chest wall; flail retracts w/ inspiration and bulges w/ expiration: paradoxical movement?

Back 30

flail chest

Front 31

what's dx: w/ decreased BS and shifting of mediastinum?

Back 31

PTX