1- PA's Role and Airway EM's Flashcards
Sudden onset of sx, cardiopulmonary sx, IMC, and frequent/ recent ER visits should alert you to what?
Have a heightened awareness (all are examples of warning signs in pt’s hx)
What is the most important 1st impression in the ED?
General appearance (respiratory rate also important)
What is the role of PAs in ED triage?
Can examine and discharge patients with minor conditions
EMTALA determines if an emergency medical condition exists or not and requires what?
Medical Screening Examination (MSE)
What is required for a PA to order a hospital transfer under EMTALA?
Consult w/ SP first, SP must co-sign order, w/in time frame specified by hospital policy (some hospitals do require Doc to Doc interaction)
Temperature and O2 saturation of what are defined as high acuity care?
Temp > 103F, O2 sat < 90% on room air
What roles can a PA have in EM?
Pre hospital (as part of EMS team/military), fast track, high acuity, trauma, rural, administration, teaching
What should be the focus of an ED chart/documentation?
Ruling out worst possible scenario, with thorough documentation to prove or disprove
What is the most important part of the ED note with respect to patient management?
Disposition (discharge, AMA, OR, obs, admit, transfer)
For a pt admitted to observation, what is the typical length of time?
24 hours, 72 hours max
What are the 4 exceptions to informed consent?
Unconscious, incapable of consenting, imminent harm from non-treatment, no surrogate available
What is required for a procedure note?
Pt Name & DOB, Date/time, indication, consent, description of procedure, estimated blood loss (EBL), complications (if any)
What does “ADC VANDISMAL” stand for and in what type of note is it utilized?
Used in admission note; admit, diagnosis, condition, vitals, allergies, nursing, diet, IV fluids, specials, meds (pre-hospital AND new meds), activity, labs
What 5 things are included in a discharge note?
Discharge dx, secondary dx, discharge meds, discharge instructions (ER precuations), follow up (appointment information if scheduled)
How will a patient in respiratory failure typically present clinically? (5)
Hypoxemia, hypercapnia, respiratory exhaustion, accessory muscle use, retractions
What is the timeframe of complete airway obstruction to onset of brain damage?
~4 minutes (varies)
What is the most common cause of airway obstruction?
The tongue (falls to the back of the throat and occludes airway)
What are the low-flow oxygen delivery devices? (2-8 L)
Nasal cannula (simple, partial rebreathing, non-rebreathing masks, tracheostomy collar)
What are the high-flow oxygen delivery devices? (up to 40 L)
Aerosol masks, T-pieces, venturi masks
What is the max oxygen flow rate for oxygen cannula (flow rate of 6L/min?)
~ 44%
What is the max oxygen flow rate for a simple face mask (flow rate of 7-8L/min?)
~ 60%
What is the max oxygen flow rate for a mask w/ reservoir bag (flow rate of 10L/min?)
>80%
What form of external oxygen support is used for resuscitation and manual ventilation?
Manual resuscitation bag (AMBU)
What is the max oxygen flow rate for a manual resuscitation bag/AMBU (flow rate of 10L/min?)
> 90% w/ tidal volumes up to 800 mL (oxygen flow into bag must be high flow)