Accidents and Injuries

Question 1

Rule of 9’s

Answer 1

Head is 9, front of torso is 2 9’s, front of each leg is 9, arm is 9, back of each leg is 9, back of torso is 2 9’s

Question 2

What do you do for electrical burns?

Answer 2

EXTRA FLUIDS to prevent myoglobinurea, then watch for COMPARTMENT syndrome b/c that could happen, and EKG for arrhythmia

Question 3

Inpatient for burn if:

Answer 3

second degree taking up more than 10%

3rd degree more than 2%

Burn of ace, hands, genitalia or major skin crease

Question 4

Parkland formula for burns?

GIVE LRs

Answer 4

4 X wt in kg X Body surface area burned (%).

Half of it given in first 8 hours,second half in next 16 hours

Question 5

Burn antibiotics?

Answer 5

Use bacitracin or silver sulfadiazine

Question 6

Child with sudden gagging, wheezing, stridor you do what?

Answer 6

Suspect Choking

Supplemental O2, measure O2, CXR, Bronchoscopy may be definitive DX and treatment.

ENCOURAGE COUGHING

Heimlich if not breathing

IV corticosteroids may reduce inflammation

Question 7

Lung damage from salt water drowning?

From fresh water?

Answer 7

Salt water: High electrolytes causing pulm edema

Fresh water? Hypovotonic water is in, so RBC lysis

Question 8

heat stroke vs heat exhaustion

Answer 8

Stroke is like a stroke! you are confused with possible vision changes. Might not be sweating. COOL THE PATIENT and bentos to relax muscles

(heat exhaustion you just gotta give fluids)

Question 9

What causes a J wave? (positive deflection after QRS)

Answer 9

Hypothermia!!! Like Jeff wave! Like i’m cold right now

Question 10

EKG in hypothermia?

Answer 10

Can have ventricular tachycardia and J WAVES!!!!

Question 11

Snake bite tx?

Answer 11

Mobilize joint, clean the wound and antivenin

Complicaiton is it can cause anticoag

Question 12

Scorpion sting symptoms?

Answer 12

Pain and swelling at bite

CHOLINERGIC: sweating, vomiting, diarrhea

Atropine and antivenin is tx

Question 13

Black widow symptoms and tx?

Answer 13

ALL ACETYLCHOLINE OUT

Muscle pain and spasm, diaphoresis

Give benzos and antivenin

Question 14

Brown recluse symptoms and tx?

Answer 14

Incerasing pain at site and necrosis. Give dapsone to prevent necrosis

GIVE erythromycin if sign of infection

Question 15

Rule out G6PD deficiency before giving dapsone after brown recluse

Answer 15

OK

Question 16

Cat bites should be left open b/c more likely to be infected than dog. Dog bites you can close face b/c well perfused

Answer 16

oh ok

STILL antibiotics and tetanus

Question 17

Td shot if dirty wound and been 5 years.

When do you give immunoglobulin?

Answer 17

If dirty tetanus risk wound and uncertain vaccination

Question 18

timetable for antivenin in black widow?

Answer 18

30 minutes