Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SURG > Chapter 8 > Flashcards

Chapter 8 Flashcards

1
Q

What are some indicators of an emergency situation which should be reported to the surgeon or anesthesiologist right away?

A

-Difficulty breathing
-Chest pain
-Changes in skin color
-Changes in vital signs
-Open bleeding wounds or visible punctures not indicated on the patient’s chart
-Inability to move an extremity
-Misshapen/misaligned body part
-Disorientation or confusion
-Severe cephalagia (headache)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the objective of emergency care/trauma surgery?

A

to preserve life, to prevent further deterioration of patient condition, and then to provide whatever care necessary to restore the patient previous lifestyle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the pattern of priorities in an emergency situation?

A
  1. Provide patent airway/restore breathing
  2. Cardiovascular status/hemostasis should be maintained
  3. Treatment for
    Chest injuries
    -Shock
    -Wound protection/closure
    -Fractures
    -Vital sign monitoring
    -Provision of reassurance and comfort for the patient
    is provided.

(CABDs
C-cardiopulmonary resuscitation
A-airway
B-breathing
D-definitive treatment)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When does clinical death begin?

A

The moment heart action/breathing stops. Pt has 4-6 mins before brain cells deteriorate. Breathing/circulation should be restored in this time frame before biological death.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the warning signs of impending cardiac arrest?

A

-Chest pain (in the awake patient)
-Unstable blood pressure
-Tachycardia
-Cardiac dysrhythmias
-Respiratory changes
-Hypovolemia
-Laryngospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the chain of survival concept applied to cardiac arrests?

A

ABCs—airway, breathing, and circulation—as well as providing the “D,” definitive treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does successful resuscitation require?

A

-Early recognition of cardiac arrest.
-Early activation of trained responders.
-Early CPR.
-Early defibrillation.
-Early advanced cardiac life support (ACLS).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the sequence of BLS

A

C-chest compressions
A-airway
B-breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the chain of survival for BLS?

A

Immediate recognition of cardiac arrest and activation of the emergency response system (ERS).

Early CPR that emphasizes chest compressions.

Rapid defibrillation.

Effective advanced life support.

Integrated post–cardiac arrest care.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How often does the STSR have to renew their CPR/BLS certification?

A

Every 2 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is ventricular fibrillation?

A

Something that many who go into SCA experience. VF demands early CPR and defibrillation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What role does each OR team member have in a code?

A

Anesthesia: provide airway monitoring, IV access, and pressure/gas monitoring

Circulator: get crash cart/supplies/provide support to dr

Surgeon: continue surgery to safe “stopping point”

CST: protect sterile field unless aid needed in resuscitation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is Malignant Hypothermia (MH)?

A

Life-threatening acute pharmacologic disorder developed during/after anesthesia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does MH cause?

A

Potentially fatal hypermetabolic state of muscles bc of defect in calcium transportation in skeletal muscle fibers. muscles are stimulated to contract but can’t bc of buildup of calcium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some triggers of MH?

A

-genetics (usually males)
-halogenated inhalation (curane, succinylcholine)
-strenuous exercise, stress, and trauma
-diagnosed via crisis, biopsy, or family history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the signs of malignant hypothermia?

A

-unexplained tachycardia and tachypnea
-increased levels of CO2
-unstable BP
-perspiration
-muscle contraction
-mottled skin
-high temperature (as high as 107)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the emergency protocol for malignant hypothermia?

A
  1. retrieve the emergency cart
  2. discontinue the triggering agent (administer a non-triggering one)
  3. administer 100% o2
  4. administer dantrolene sodium
  5. introduce chilled IV, ice packing, and chilled saline
  6. administer sodium bicarbonate, dextrose and insulin, furosemide/mannitol, and heparin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are some components of Dantrium/Revanto
(Dantrolene Sodium-muscle relaxant)

A

-36 vials a facility ($3500 total cost)
-3 yr shelf life
-needs to be reconstituted
-load dose of 2.5mg/kg
-1mg/kg every 5 mins
-max dose 10-30 mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the dosing for Dantrium/Revento?

A

-2.5 mg/kg (68 kg/20 mg)= # of vials needed
-2.5 (68/20)= 8.5 vials
-Max dose: 68 kg x 30mg/1kg= 102 vials

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are some components of Ryanodex? (dantrolene sodium-muscle relaxant)

A

-3 vials a facility (total cost $7000)
-2 yr shelf life
-needs to be reconstituted
-vials at 250 mg
-1 load dose
-4-12 max

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is Disseminated Intravascular Coagulation? (DIC)

A

Pathological process in the body that occurs when blood begins to coagulate within the body.
-body’s blood clotting mechanisms are activated throughout the body
-leads to the consumption of all coagulation factors and platelets
-leads to the overstimulation of fibrinolytic degradation which acts as anticoagulants
-initial hypercoagulation is replaced with hypocoagubility and hemorrhaging.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the factors that stimulate disseminated vascular coagulation?

A

-infection of blood (bacteria or fungus)
-severe tissue trauma
-leukemia/cancer
-severe liver disease
-recent blood transfusion reaction
-obstetric complication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How do you treat DIC

A

-determine and treat the underlying cause
-fresh, frozen plasma to replace coagulation factors
-cryoprecipitate
-heparin may be administered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is an anaphylactic reaction?

A

An exaggerated allergic reaction to a protein or substance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the first line drug used to treat an anaphylactic reaction?

A

Epinephrine
-creates bronchodilatation
-reduces laryngeal spasm
-raises bp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the common causes of anaphylactic reactions in the OR?

A

-local anesthesia
-codeine
-antibiotics
-animal-derived drugs
-contrast media
-latex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the signs and symptoms of an anaphylactic reaction?

A

-mild inflammatory symptoms (hives, itching)
-progresses into bronchospasm and laryngeal edema.
-vascular collapse (hypotension, tachycardia, diminished urine output)
-finally becomes anaphylactic reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How is an anaphylactic reaction treated?

A

-supplemental O2 is provided to prevent respiratory arrest
-epi is administered
-steroids are administered (stabilize mast cells and stop chain of events)
-IV and plasma to restore fluids
-vasopressive agents (increase bp)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How do you prevent anaphylactic reaction in clinical settings?

A

Known allergies should be identified and available to entire surgical team.
-identified in chart
-pt id band
-prior history of reaction in chart
-skin test prior to surgery to something that is suspicious
-maintain airway or O2

30
Q

What is all hazards preparation?

A

-system in place to respond to all emergencies
-procedures for communication and evacuation
-response for special needs pts
-local, regional need policies
-duties and roles to accommodate influx
-emergency action plan is a broad response plans available to all area of a county.

31
Q

Where is epinephrine contraindicated?

A

Eyes, ears, fingers, penis, toes, nose

32
Q

What are some natural disasters to watch out for?

A

Most commonly occurring that can affect large populations.
- Avalanche
- Rockslide
- Winter storms
- Heat waves
- Wildfires
- Earthquakes categorized 1-5 on Richter scale
- Tsunamis
-Volcanos
- Tropical storm
- Hurricanes
- Floods
- Tornados

33
Q

How can infectious disease result from natural disaster?

A

Large gathering of people in shelters with poor infrastructure and no access to healthcare. This can turn into epidemic/pandemics and overwhelm the healthcare system as equipment may not be available for secondary illness.

34
Q

How are chemical or radiation release accidents dangerous?

A

Chemicals can be flammable, toxic, and caustic causing permanent damage to the resp tract, eyes, and burn the victim. Radiation injuries are usually from a blast causing thermal/flash burns, ionizing radiation injuries, and flash blindness. Cancer can be caused from long term exposure.

35
Q

What are the zones of triage for nuclear/radiation release patients?

A

Hot zone: central area where disaster occurred. Pt is assessed for severe hemorrhaging and airway patency

Warm zone: 300 plus ft from accident. pt’s are triaged into four categories

Cold zone: near warm zone. pts are assessed for secondary injury and transported to facilities.

36
Q

What are the four categories that radiation/nuclear release patients are triaged into?

A

-Flammable
-Toxic
-Caustic
-Nuclear: includes blast injuries, thermal/flash burns, ionizing radiation injuries, flash blindness, retinal burns, cancer, bacteria/viral infection, skin burns and damage to resp tract.

37
Q

What reduces 90% of contamination for patients exposed to radiation?

A

Taking off clothes

38
Q

What injuries are common for explosions (includes bombs, factory explosions, gas tank explosions, and mine explosions)

A

Penetrating wounds, blast soft tissue, fractures, and burns

39
Q

Which type of explosion results in most variety of physical trauma needing surgery

A

Factory explosion

40
Q

What injuries are most common for infrastructure accidents (collapse of roads, bridges, and structures)

A

Crush injuries and severe lacerations

41
Q

What type of injuries are most common for transportation accidents?

A

lacerations, fx, crush injuries, burns, eye injuries

42
Q

What is terrorism and what type of weapons do they usually use?

A

Unlawful use of violence to instill fear and coerce governments and societies. Usually use chemical, biological, radiological, and nuclear weapons.

43
Q

What is bioterrorism?

A

The intentional use of infectious agents to cause illness. HCP must become familiar w facility’s bioterrorism readiness plan (BRP). First indicator is that many people are coming in w the same s&s. Anthrax and smallpox are most likely used.

44
Q

What is an emergency action plan? (EAP)

A

Broad response plan in any area of country or any category in disaster

45
Q

What does the National Incident Management System do? (NIMS)

A

Provides a national model for coordinating an emergency response, provides access to federal money, and develop LEMA.

46
Q

What is the Local Emergency Management Agency (LEMA) and what do they do?

A

Community agency that has the lead responsibility for managing and coordinating local agencies. Reports to city. Develops EOP.

47
Q

What is an Emergency Operations Plan (EOP)?

A

Predetermines the location of the emergency operation center (EOC). Contains info including supplies, training, first responder plan, organizes the ICS

48
Q

What is an Incident Command System? (ICS)

A

Ensures that responders know their roles and who to report to. (Person in charge is incident command- IC) May also establish a unified command (UC) to direct a response as a group effort. Includes operations, planning, logistics, and finance/administration.

49
Q

What does each Unified Command (UC) group do?

A

Operations: carries out orders (workers)

Planning: gather/documents, updates information, and provides report

Logistics: takes care of infrastructure, transportation, supplies, food, communications, and equipment

Finance/Administration: Record costs

50
Q

How is a federal emergency response initiated?

A

LEMA requests federal assistance through the state, governor forwards to president, president declares a federal disaster.
-May take up to 3 days

51
Q

Who is the Federal Emergency Management Agency and what do they do?

A

A division of the US Department of Homeland Security (DHS). They coordinate providing treatment, food, and shelter at scene. Can make assistance help decisions prior to anticipated disaster. Coordinate NRF and NDMS.

52
Q

What is the National Response Framework? (NRF)

A

Developed by the Department of Homeland Security. It is a basic guide used for coordinating disaster relief activities. Enacted by the NDMS.

53
Q

What is the National Disaster Medical System (NDMS)?

A

sends medical equipment, supplies and teams to disaster scene, provide medical transportation.
-over 100 med teams and 1000 hospitals

54
Q

What are some medical teams that are part of the NDMS?

A

DMATs: Disaster Medical Assistance Teams. specialized teams that can be rapidly deployed to emergency scene, can be ST

DMORT: Disaster Mortuary Operations Response Team. Includes ME’s, pathologists, radiographers, etc. Recording the identification of victims

NPRTs: National Pharmacy Response Teams. Include pharmacists and pharmacy techs. dispense drugs and provide vaccinations.

55
Q

What is an Emergency Action Plan?

A

Similar to EOP but in health care facilities. They are required by the joint commission, OSHA, and Medicare.

-must be practiced two times a year
-scalable (small incident to large community disaster)

56
Q

What are the four components of an Emergency Action Plan?

A

-Mitigation (id of hazards and how to reduce hazards)
-Preparedness (developed EAP with an EOC)
-Response (responsibilities)
-Recover (plan for rebuilding and restoring function to community)

57
Q

What is the Health Care Incident Command System (HICS)?

A

Similar to ICS. provides a chain of command that specifies roles and written responsibilities. CEO is usually IC. HCP should be familiar with roles

58
Q

How does evacuation work in a health care facility?

A

There is a shelter in place where everything is moved to (most secure place in the hospital)
-logistics to consider are transportation of pts, meds, blood, and chilled products.
-gas powered generators should be available
- medical records should be backed up and laptops/ipads should be available
-MOU: memorandums of understanding should be in place (agreement w other facilities to receive patients)
-a plan to account for all staff and patients should be available.

59
Q

What is triage?

A
60
Q

How should standard precautions and PPE be used in an all hazards situation?

A

-use standard precautions to best of ability to prevent cross contamination (hand sanitizer if no wash station)
-PPE levels are determined by IC
(4 levels: A, B, C, D)
-level A is highest w space suits
-level D is lowest w medical masks, eye protection, and gloves

61
Q

What are decontamination areas?

A

For those who come in contact w the disaster scene. Separate male and female.

Radiological: clothing should be removed and put into waterproof/vapor-resistant bag. wounds are irrigated w normal saline. skin and hair w warm water and soap.

Chemical: clothing is disposed of. skin and wounds are decontaminated w .5% hypochlorite and irrigated w saline. contraindicated for brain, spinal cord, eyes, and peritoneal cavity.

-Disposable items should be used
-Supplies for preventing hypothermia should be available.

62
Q

What is triage?

A

A process of sorting through victims according to injuries. The goal is to provide treatment to as many patients as possible while spreading out and making the most of medical resources.

-Personnel are usually EMT/ER physicians and most experienced and best suited. ST can complete training in triage or help w BLS/CPR, first aid, and transport

63
Q

What are some components of triage?

A

-separate area should be established for triage
-pt should be tagged
-separate ambulance loading area w IC of transport to what facilities.

64
Q

What is the DIME Triage System?

A

Delayed- yellow tag. life threatening but intervention may be delayed for several hours w reassessment

Immediate- red tag. immediate attention required to prevent death

Minimal- green tag. ambulatory. minor injuries like lacerations or burns. can wait for action

Expectant- black tag. survival unlikely such as extensive burns or severe head injuries.

65
Q

What are some guidelines for individuals doing triage?

A

-no care. only assess.
-quickly (no more than 1 minute a person)
-patients should be reassessed
-basic first aid and transportation ASAP
-START: Start triage and rapid treatment
-remember chemical and nuclear disaster triage.

66
Q

What is the triage system for chemical and nuclear disasters?

A

Pt is triaged 3 times.
Hot zone: triaged for airway and hemorrhage
Warm zone: Pts are triaged into the four categories
Cold zone: Evaluated for secondary injuries and transport

67
Q

What is the point of distribution? (POD)

A

temporary site for providing vaccines and medicines to a large population, called mass prophylaxis.

68
Q

What is the strategic national stockpile? (SNS)

A

The CDC’s storage of meds and vaccines that are divided into push packs that can be shipped to disaster scenes.

Two phases:
1st mass is antibiotics. 2nd is for individualized needs and chronic illnesses.

-NPRT (national pharmacy response team) who repackage and distribute

69
Q

How should risk communication with the public happen?

A

Should happen in a timely and accurate manner. Questions from media are referred to public information officers (PIOs). Language barriers should be addressed.

70
Q

What are some moral, ethical, and legal issues associated with disaster treatment?

A

-HCP’s are faced w quick decisions.
-limited supplies and resources
-decisions made prior: age, health status, economic status.
-out of state responders
-first scene responders
-regular treatments go on in a disaster.

71
Q

Who are the ESAR-VHP?

A

Emergency System for the Advanced Registration of Volunteer Health Professionals. system to preregister health professional volunteers who can respond to an emergency within their state and out of state. The volunteers are deployed through the Emergency Management Assistance Compact (EMAC), an interstate agreement to coordinate the deployment of medical supplies and equipment, and health care volunteers.

72
Q

What is the Community Emergency Response Team? (CERT)

A

A team of community members who are trained in basic response such as fire safety, basic first aid, and search/rescue.

SURG (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions