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36 Cards in this Set
- Front
- Back
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List the steps involved in the primary survey of a trauma patient.
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"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 |
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Name four situations that preclude patients with C-spine collars from being cleared clinically (without radiographic imaging)
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1. Intoxication (or any altered level of consciousness)
2. Focal neurologic impairments 3. Midline cervical spine ternderness 4. Distracting injury |
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What method is useful in the evalutation of blunt abdominal trauma?
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Focused assessment with sonography for trauma "FAST" (evaluates pericardium, perirhepatic, perisplenic, and pelvis)
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What substance supplements gastric lavage in the process of GI decontamination?
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Activated charcoal (plus sorbitol for catharsis)
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Ethylene glycol (antifreeze)
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Anion gap metaolic acidosis with increased serum osmolality, calcium oxalate crystals in urine
Tx: Ethanol, fomepizole, dialysis |
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Mercury
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Erethism (insomnia, delirium, decreased memory)
Tx: Dimercaprol, succimer |
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Acetaminophen
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N/v early, increased LFTs, and PT at 24-48 hours
Tx: N-acetylcysteine (w/i 8-10 h) |
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Warfarin
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Bleeding (increasd INR/PT)
Tx: FFP (acutely, vitamin K) |
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Antimuscarinics (atropine, scopolamine, ipratropium bromide), anticholinergics
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"Dry as a bone, red as a beet, blind as a bat, mad as a hatter"
Tx: physostigmine |
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Digoxin
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n/v, dysrhythmias, increased K+, color vision changes
Tx: Manage K+, lidocaine, and antidigoxin Fab |
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Theophylline
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Hematemesis, seizures/coma, dysrhythmias, decreased BP
Tx: Activated charcoal, cardiac monitoring |
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Arsenic
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Fatigue, seizures; Mees lines in fingernails (chronic)
Tx: Dimercaprol, succimer |
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Methanol
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Anion gap metabolic acidosis with increased serum osmolality, blindness, optic disc hyperemia
Tx: Ethanol, fomepizole, dialysiss |
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Aspirin (salicylates)
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Anion gap metabolic acidosis (normal serum osmolality), respiratory alkalosis, tinnitus, garlic odor
Tx: Alkalinization, hemodialysis |
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Cyanide
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Lethargy, LOC, dysrhythmias
Tx: Sodium thiosulfate and amyl nitrite |
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tPA, streptokinase
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Bleeding
Tx: Aminocaproic acid |
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Isoniazid (INH)
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Peripheral neuropathy, confusion
Tx: Pyridoxine (vit B6) |
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Benzodiazepines
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Drowsiness, weakness, ataxia
Tx: Flumazenil (caution in patients on chroic benzos) |
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Lead
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Ataxia, peripheral neuropathy, microcytic anemia (w/ basophilic stippling), lead lines on gums
Tx: CaEDTA, penicillamine, dimercaprol |
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Tricyclic antidepressants
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"Three Cs": Cardiac arrhythmias, Convulsions, Coma
Tx: Sodium bicarbonate (if QRS >100ms), benzos for seizures, cardiac monitoring |
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Alkali agents (drain cleaner, dishwasher detergent)
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Mucosal burns, dysphagia, drooling
Tx: Milk/water, then NPO |
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B-blockers
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Decreased HR, confusion, possible hypoglycemia or increased K+
Tx: Glucagon, Ca2+ (stabilize cardiac membranes) |
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Heparin
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Bleeding (increased PTT), thrombocytopenia
Tx: Protamine sulfate |
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Opioids
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Respiratory and CNS depression, miosis
Tx: Naloxone (Narcan) |
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Carbon Monoxide
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Headache, confusion, dyspnea, cherry-red skin (later)
Tx: 100% O2 or hyperbaric O2 (if pregnant or CNS dysfunction) |
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Quinidine
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V-tach, torsades de pointes, cinchonism
Tx: Mg2+(IV) |
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Iron
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Erosive gastritis, vomiting, lactic acidosis
Tx: Deferoxamine |
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Organophosphates (anticholinesterases)
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"SLUDGE"(Salivation, Lacrimation, Urination, Defacation, Gastric Emptying) +wheeezing, miosis
Tx: Atropine, pralidoxime |
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Isopropyl alcohol (rubbing alcohol)
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Intoxication, decreased RR, osm gap (no acidosis)
Tx: CV/resp support, dialysis |
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Osborne (J) wave on EKG
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Hypothermia
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Envenomation may cause local, generalized, or anaphylactic rxn
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Hymenoptera (e.g. bee stings)
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Type of burn initially causing painless, dry, white, cracked, and insensate skin
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Full-thickness 3rd -degree and 4th - degree burns
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Loss of thermoregulatory mechanisms, causing CNS dysfunction and dry skin
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Heat stroke
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Extensive deep-tissue injury under nl skin plus cardiac dysrhytmias
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Electrical injury (AC->V-fib; DC -> asystole)
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Type of burn causing red, blistered, edematous, and painful skin
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Partial-thickness ( 1st-degree and 2nd -degree) burns
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How is percent of body surface area affected by burns calculated/
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Rule of nines: 9% (each arm and head), 18% (each side of torso and each leg), 1% (groin)
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