11/10 Flashcards
If there is high suspicion for a pelvic fracture in a patient with signs of hemorrhagic shock, place a ____________
pelvic binder or sheet if a binder is not available.
interventional radiology
activation- stroke or trauma team
As a first step, give __________ to any patient with significant hyperkalemia-associated ECG changes
calcium
Digoxin Toxicity on ECG
Sagging ST segments- aka Salvador Dali’s moustache
TCA OD ecg
Intraventricular conduction delay: QRS > 100 ms
THYROID STORM MEDICATIONS
Administer medications in order
1- Propranolol / esmolol
2- Propylthiouracil / Methimazole
3- Iodine
4- Hydrocortisone
Mistakenly giving iodine prior to the anti-thyroid medication will
intensify the thyroid storm by increasing hormone synthesis and release worsening symptoms.
________________ is the most common vital sign abnormality and is present in ~90% of patients with decompensated hypothyroidism.
Hypothermia at lower than 94°F
Early ophthalmology consultation to look for______________ is an important component of the inpatient non-accidental trauma evaluation.
retinal hemorrhage
Five diagnoses related to thrombocytopenia of which the emergency physician should be aware
1- immune thrombocytopenia (ITP)
2- thrombotic thrombocytopenic purpura (TTP)
3- disseminated intravascular coagulation (DIC)
4- hemolytic uremic syndrome (HUS)
5- heparin-induced thrombocytopenia (HIT)
With the exception of patients with ______________, thrombocytopenic patients with life-threatening bleeding should be transfused to a platelet count of 50
Thrombotic thrombocytopenic purpura (TTP)
DIC is a clinical syndrome with a wide array of presentations/etiologies caused by:
Intravascular coagulation cascade activation, with a subsequent loss of inhibitory control mechanisms
Diagnosis of DIC involves a combination of laboratory tests and clinical evaluation. Laboratory findings suggestive of DIC include
low platelets
elevated D-dimer
decreased fibrinogen
prolongation of clotting times ie PT
HUS shares some clinical features with TTP. Both manifest as
Shares: microangiopathic hemolytic anemia and thrombocytopenia
HUS emphasizes renal injury
TTP instead causes neurologic dysfunction
Outcomes are best if N-acetylcysteine is started within ______ time of APAP overdose
8 hours
If ingestion occurred more than 8 hours ago, an initial dose of N-acetylcysteine can be administered while awaiting acetaminophen concentration and comparison to Rumack Matthew nomogram to determine need for continuation.
