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Emergency Medicine > Approach to EM > Flashcards

Approach to EM Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
1
Q

What is EM always looking for?

A

the worst case scenarios

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2
Q

What do we care more about in a EM diagnosis?

A

what it is NOT

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3
Q

What does the EM live for?

A

Acute resuscitations
Airways and procedures
Variety of presentations and etiologies
Making a tangible difference NOW

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4
Q

Who is the sickest of the sick?

A

Acute resuscitations

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5
Q

What are the DDX for EM based on?

A

threat to patient safety, not commonality

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6
Q

What type of patients are seen in the ER now?

A

primary care or chronic illnesses

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7
Q

Why are primary care being seen in the ER?

A

NO access to care, shortage of primary care providers

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8
Q

What is the order of work for EM?

A

Discharge patients
Checking for pending results
See new patients
Review results and prep for discharge or admi

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9
Q

When does preparation start for the EM?

A

day before

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10
Q

What are 3 common courtesies in the EM?

A

Shake their hand
Introduce your self
Don’t interrupt for at least 30 sec

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11
Q

When should the patient not be interrupted for at least 30 secs?

A

after asking why your in the ER

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12
Q

What things are crucial for knowing during the patient turnover?

A 
History
Exam 
Assessment
Labs
Imaging
Necessary orders/results, consults
Tentative Disposition
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13
Q

When picking up a new patient what must be reviewed?

A

age, sex, c/c, vital signs

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14
Q

When should staff be notified about sick patients?

A

early

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15
Q

What type of physical exam should be performed?

A

focused w/ basics

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16
Q

What component of the physical exam should be performed on EVERYONE?

A

HEART AND LUNGS!

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17
Q

Should you adjust doses on pt chronic meds?

A

NO, DO NOTHING!

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18
Q

What guides imaging and labs?

A

differentials

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19
Q

What shouldn’t you be stingy with?

A

EKGs

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20
Q

When it comes to charting what must be performed?

A

mark every box and don’t chart at the bedside

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21
Q

What is flow of clinical decision making?

A

history > physical exam > differential and tentative dispositions > data gathering > diagnosis or differentials + what it’s not

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22
Q

What things make up the ED Safety Net?

A 
Peripheral IV
O2 Supplementation
Vital sign monitor
Chest Xray
CBC, CMP
\+/-Pregnancy, UA, Tox screen
\+/-EKG
\+/-Finger stick glucose
23
Q

What is considered the most dangerous time in the ED?

A

patient turnover

24
Q

When should DNR questions be asked?

A

upfront

25
Q

Who becomes the medical decision maker when a patient is unresponsive w/ unclear wishes?

A

Next of kin

26
Q

What federal law requires that anyone coming into an ED has to be stabilized and treated regardless

A

Emergency Medical Treatment and Labor Act

27
Q

When was EMTALA passed?

A

1986

28
Q

What is termed “Patient Anti-Dumping” statue?

A

EMTALA

29
Q

What words should be used, and what should be used?

A

hot button terms

use: alleged, patient reports, patient decribes

30
Q

What exam has high liability for provider performing the screening?

A

Medical Screening Exam

31
Q

What exam is used to r/o or identify life-threatening problems?

A

Medical Screening Exam

32
Q

Ped patient medications require?

A

weight based dosing

33
Q

Ped patient equipment requires?

A

pedi size

34
Q

What can cause long term harm in a pedi pt?

A

testing

35
Q

What are 3 ways a geri pt can present?

A

stoic presentations, under-selling symptoms, or reduced pain sensation

36
Q

What is a common symptom seen in geri pt?

A

AMS

37
Q

AMS can present in what 4 ways in geri pts?

A 
sepsis
UTI
Pain
Poly-pharmacy
New meds
38
Q

What represents infection in a geri pt?

A

hypothermia

39
Q

What is the #1 step in sexual assault pt?

A

accessing for threatening injuries and asking if they want a forensic exam

40
Q

Who performs the forensic exam?

A

SANE examiner

41
Q

If a pt wants a forensic exam DO NOT:

A

remove clothing, perform GU or rectal exam (UNLESS- required to stabilize life threatening injury)

42
Q

What should be avoided in Geri pt?

A

anti-histamines

43
Q

What does anti-histamines cause in a geri pt?

A

delirium or excitation

44
Q

What is “Pop Drop”

A

when the geri pt is left in the ED by a family member

45
Q

If a pt doesn’t want to forensic exam?

A

treat like any other pt

46
Q

What STI post-exposure prophylaxis (PEP) meds should be used?

A

Rocephin, azithromycin, possible HIV PEP

47
Q

What STI post-exposure prophylaxis (PEP) labs should be used?

A

Acute and chronic Hep panel, Anti-HBs, HCV screening, HIV screening, RPR

48
Q

What is the 1st step when receiving a psych pt?

A

r/o if the pt is a danger and r/o medical causes

49
Q

If a pt has a short term substance induced danger what can be done?

A

metabolization to freedom

50
Q

What is metabolization to freedom

A

letting the patient wear off the drug until they become self-aware

51
Q

Under emergency detention how long is the pt detained?

A

48hrs

52
Q

Cooperative psych pts can be given?

A

oral meds

53
Q

Non- cooperative psych pt can be given?

A

intramuscular: Haldol, Lorazepam, Benadryl

Emergency Medicine (6 decks)

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