Burns

Question 1

Burns

Answer 1

Chem/electrical/thermal
Stop Burning process w/ saline
Remove Jewelry & Constrictive clothing
Rule of 9’s & MAP
Life Threats Consider Tube if mouth/throat/lips have char/burn
Bronchospasm/Wheezes Albuterol 5mg HR>160 Base
Peds 2.5mg HR>180 Base PRN 3 x 10 minutes
Morph-2-5mg IV/IO 20mg Max Peds .1mg/kg 5mg Max
Peds10% Dry sterile dressing or sheet

Question 2

Burn Center Criteria

Answer 2

BSA>10% 2/3 degree
BSA>2? 3 degree
Evidence of respiratory burns 
Circumferential burns
Burns that cross joints
significant electrical burns 
Burns involving face, hands, feet, perineum

Question 3

Snake Bites

Answer 3

Life Threats
Constrictive jewelry
Bite below heart level in neutral position
Reduce physical activity
Accurate description of snake 
Morphine 3-5mg IV/IM Max 10mg
Peds .1mg/kg IV/IM/IO Max 5mg
Legal sellers of exotic snakes often have anti venom kit.  Bring it with you to hospital

Question 4

OD Organophosphate

Answer 4

Atropine 2mg IVP/IO PRN 5 min
Peds .05mg/kg never less than .1mg b/c paradoxical bradycardia effect
Treat seizures
BG<70 treat
Versed .1mg/kg IV/IO .2mg IM Max 2x
Peds Max is 3mg
SLUDGE- Salivation lacrimation, urination, defication, gastro cramping, emesis, miosis

Question 5

Cyclic Anti-Depressants

Answer 5

Bicard 1mEq IV/Io only for widening QRS hypotx, seizure, tachycardia, heart block

Question 6

Beta or Calcium Blocker OD

Answer 6

BB atropine 1mg no response glucagon

CC
Symptomatic hypotx - fluid
No response give glucagon

Question 7

Dystonic Reactions

Answer 7

1mg/kg IV/IO/IM max 50mg

Question 8

Acute Allergic Reactions Mild

Answer 8

Mild- Benadryl 1mg/kg 50mg max

Peds No Benadryl when mild

Question 9

Acute Allergic Reactions Moderate/Severe

Answer 9

Epi (1:1000) .3mg IM PRN 5 minutes
Peds .01mg/kg IM Max .3mg
Benadryl-1mg/kg IVP/IM/IO Max of 50 adult and Peds
Wheezes bronchospasm Albuterol 5mg peds 2.5mg

Question 10

Anaphylaxis

Answer 10

MUST MAKE BASE FIRST
Epi: (1:10,000) .2-.5mg slow IVP/IO no more than .1mg minute
PEDS .01mg/kg must make base
Hypotension persistent- Dope-5-10 mikes/kg titrated max 20mcg/kg
#1 killer in anaphylaxis is upper airway ubstruction Aggressive airway management

Question 11

Nausea Vomiting

Answer 11

Zophran 5mg IV/IO/IM/ODT PRN 5-10 minutes 16mg max
Contra alergy/5-HT3 antagonist Kytril, Anzemet, Aloxi
Peds-.1mg/kg IV/IO/IM
ODT 2-3y/o-2mg 4y/o + 4mg 40KG>8mg Max

Question 12

Excited Delirium

Answer 12

Base Contact not practical 5-10mg. Larger doses MUST HAVE PHYSICIAN ORDER

Question 13

ALOC

Answer 13

BG<70 DEXTROSE(5ml/kg peds) or Glucagon
Narcan .5mg IVP/IN or 1mg IM
Peds .01mg/kg .5 max first dose 2mg max
2 max
Repeat BG
do not discontinue insulin pumps
Glucagon causes N/V

Question 14

IO

Answer 14

Lido 40mg

Peds .5mg Max of 40mg

Question 15

Trissmus

Answer 15

5mg IV
Peds .1mg/kg
IM 2x