15-16 Assessment Flashcards
The cause of sx ________________ (does/ doesn’t) change the approach to stabilizing the patient
doesn’t
3 aspects of stabilization (ABCs)
history
physical examination
diagnostic tests
3 things to look for on physical exam for poisonings
efficient tox exam (vitals, pupils, skin/ mucous membranes, bowel sounds, muscle tone, mental status, odors)
look for toxidromes
look for toxic signs (seizures, hypotension, dysrhythmias)
list 2 common problems with getting hx in poisonings
Hx often unreliable or absent (ex- pt found unconscious)
Pt may not know/ able to verbalize what they ingested
Pts may not want to volunteer what they ingested- ask family, friends, paramedics, bystanders if any additional hx available
which of the following is a good way to obtain history in a patient with poisoning
1. ask the patient, even if they’re hesitant after explaining why this is important
2. ask family if anyone else is sick
3. ask paramedics about surroundings and bottles in the area
4. 2 and 3 only
5. all of the above
4
what are the 10 Ps of poison history taking
Check pockets
Ask the pt
Ask parents/ partners/ friends
Prehospital personnel (EMS)
PADIS
Pedestrians (prob low yield)
Police
Personal MD
Past hx (old charts)
Pharmacy
what is the glasgow coma scale
scale to see how impaired consciousness is in a patient
- higher the better
decerebrate positioning results from damage to _________
arms are _______ with wrists _____ and fingers ____
legs are _____________
results from damage to upper brain stem- arms are adducted and extended, with wrists pronated and fingers flexed, legs are stiffly extended with plantar flexion of feet
decoriate positioning results from damage to _____________
arms ______________, with wrists and fingers ____________, legs extended stiffly and internally rotated, with plantar flexion of feet
damage to one or both corticospinal tracts
arms adducted and flexed
wrists and fingers flexed on chest
list some questions/ things to think about for dermal exposure
What does the skin look like? (red, irritated, blistered, swollen, blue or grey)
What does pt describe skin as feeling like? (pain or itch)
Has skin been irrigated? What was the result?
What other tx has pt already done?
creams/ ointments? Attempt to neutralize the agent?
list some things to think about for eye exposure
Can pt open the eye?
Red or swollen?
Tearing or other purulent drainage
pH- if corrosive agent exposure
Eye exam- if burns progress, may need further assessment later
Foreign body sensation
Visual acuity
Photophobia
Has the eye been irrigated? What was the result?
list some things to think about for inhalation exposure
ABCs important
Has the pt had fresh air?
coughing/ choking- audible wheezing or stridor?
Able to speak full sentences?
Was pt wearing any protective equipment like a respirator?
Were rescuers exposed?
which of the following is correct for ordering diagnostic test
1. all poisoning patients should have a full panel done ASAP
2. a drug test may rule in a poisoning
3. there should always be a rational for the test + action plan for results of test
4. it can be used to identify or confirm a toxin
5. 1, 2
6. 3, 4
7. all of the above
6
2 types of drug screens
immunoassay screening test
comprehensive intensive
which drug screen is quick, has many limitations, and a risk of false +
immunoassay screening test
