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36 Cards in this Set

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List the steps involved in the primary survey of a trauma patient.
"ABCDEFG"
-Airway - assure clear, unobstructed airway
-Breathing - assess chest wall motion
-Circulation - check pulses, note hemorrhages
-Disability - neurologic assessment
-Exposure - remove clothing to unmask injuries
-Foley - asssess need (CI if blood at urethral meatus)
-Gastric tube - assess need for nasogastric (NG) or oral gastric (OG) tube
Name four situations that preclude patients with C-spine collars from being cleared clinically (without radiographic imaging)
1. Intoxication (or any altered level of consciousness)
2. Focal neurologic impairments
3. Midline cervical spine ternderness
4. Distracting injury
What method is useful in the evalutation of blunt abdominal trauma?
Focused assessment with sonography for trauma "FAST" (evaluates pericardium, perirhepatic, perisplenic, and pelvis)
What substance supplements gastric lavage in the process of GI decontamination?
Activated charcoal (plus sorbitol for catharsis)
Ethylene glycol (antifreeze)
Anion gap metaolic acidosis with increased serum osmolality, calcium oxalate crystals in urine

Tx: Ethanol, fomepizole, dialysis
Mercury
Erethism (insomnia, delirium, decreased memory)

Tx: Dimercaprol, succimer
Acetaminophen
N/v early, increased LFTs, and PT at 24-48 hours

Tx: N-acetylcysteine (w/i 8-10 h)
Warfarin
Bleeding (increasd INR/PT)

Tx: FFP (acutely, vitamin K)
Antimuscarinics (atropine, scopolamine, ipratropium bromide), anticholinergics
"Dry as a bone, red as a beet, blind as a bat, mad as a hatter"

Tx: physostigmine
Digoxin
n/v, dysrhythmias, increased K+, color vision changes

Tx: Manage K+, lidocaine, and antidigoxin Fab
Theophylline
Hematemesis, seizures/coma, dysrhythmias, decreased BP

Tx: Activated charcoal, cardiac monitoring
Arsenic
Fatigue, seizures; Mees lines in fingernails (chronic)

Tx: Dimercaprol, succimer
Methanol
Anion gap metabolic acidosis with increased serum osmolality, blindness, optic disc hyperemia

Tx: Ethanol, fomepizole, dialysiss
Aspirin (salicylates)
Anion gap metabolic acidosis (normal serum osmolality), respiratory alkalosis, tinnitus, garlic odor

Tx: Alkalinization, hemodialysis
Cyanide
Lethargy, LOC, dysrhythmias

Tx: Sodium thiosulfate and amyl nitrite
tPA, streptokinase
Bleeding

Tx: Aminocaproic acid
Isoniazid (INH)
Peripheral neuropathy, confusion

Tx: Pyridoxine (vit B6)
Benzodiazepines
Drowsiness, weakness, ataxia

Tx: Flumazenil (caution in patients on chroic benzos)
Lead
Ataxia, peripheral neuropathy, microcytic anemia (w/ basophilic stippling), lead lines on gums

Tx: CaEDTA, penicillamine, dimercaprol
Tricyclic antidepressants
"Three Cs": Cardiac arrhythmias, Convulsions, Coma

Tx: Sodium bicarbonate (if QRS >100ms), benzos for seizures, cardiac monitoring
Alkali agents (drain cleaner, dishwasher detergent)
Mucosal burns, dysphagia, drooling

Tx: Milk/water, then NPO
B-blockers
Decreased HR, confusion, possible hypoglycemia or increased K+

Tx: Glucagon, Ca2+ (stabilize cardiac membranes)
Heparin
Bleeding (increased PTT), thrombocytopenia

Tx: Protamine sulfate
Opioids
Respiratory and CNS depression, miosis

Tx: Naloxone (Narcan)
Carbon Monoxide
Headache, confusion, dyspnea, cherry-red skin (later)

Tx: 100% O2 or hyperbaric O2 (if pregnant or CNS dysfunction)
Quinidine
V-tach, torsades de pointes, cinchonism

Tx: Mg2+(IV)
Iron
Erosive gastritis, vomiting, lactic acidosis

Tx: Deferoxamine
Organophosphates (anticholinesterases)
"SLUDGE"(Salivation, Lacrimation, Urination, Defacation, Gastric Emptying) +wheeezing, miosis

Tx: Atropine, pralidoxime
Isopropyl alcohol (rubbing alcohol)
Intoxication, decreased RR, osm gap (no acidosis)

Tx: CV/resp support, dialysis
Osborne (J) wave on EKG
Hypothermia
Envenomation may cause local, generalized, or anaphylactic rxn
Hymenoptera (e.g. bee stings)
Type of burn initially causing painless, dry, white, cracked, and insensate skin
Full-thickness 3rd -degree and 4th - degree burns
Loss of thermoregulatory mechanisms, causing CNS dysfunction and dry skin
Heat stroke
Extensive deep-tissue injury under nl skin plus cardiac dysrhytmias
Electrical injury (AC->V-fib; DC -> asystole)
Type of burn causing red, blistered, edematous, and painful skin
Partial-thickness ( 1st-degree and 2nd -degree) burns
How is percent of body surface area affected by burns calculated/
Rule of nines: 9% (each arm and head), 18% (each side of torso and each leg), 1% (groin)