Clinical care for Emergencies Flashcards

1
Q

Defined by airway compromise or hypotension, is obviously a true medical emergency and must be rapidly assessed and treated

A

Anaphylaxis

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2
Q

Systemic hypersensitivity reaction with multisystem involvement of cardiovascular & respiratory

A

Anaphylaxis

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3
Q

Triggers for anaphylaxis

A
  • Drugs (Antibiotics, NSAIDs, ANY DRUG)
  • Food (nuts, shellfish, soy, eggs)
  • Additives (sulfites)
  • Toxins (insect stings, venom)
  • Chemicals (contrast dye, latex)
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4
Q

Pruritis, flushing, urticaria

Throat fullness, anxiety, chest tightness, SOB, lightheadedness

A

Anaphylaxis

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5
Q

Anaphylaxis

Signs and symptoms begin within ____ mins of exposure

A

60 minutes

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6
Q

Anaphylaxis

____% will have a reoccurrence within 12 hours after resolution of the first episode

A

21%

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7
Q

With suspected anaphylaxis, the single most important step in treatment is the rapid administration of:

A

Epinephrine

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8
Q

2nd line therapies for anaphylaxis

A

Corticosteroids

Antihistamines

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9
Q

Allergic bronchospasm is treated with:

A

Albuterol

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10
Q

Drug allergy usually occurs within:

A

First or second week

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11
Q

Smoke inhalation can be caused by:

A

Heat

Smoke

Chemicals

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12
Q

Leading cause of smoke inhalation injuries

A

Fire

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13
Q

Smoke inhalation

Upper airway is usually due to:

A

Thermal injury

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14
Q

Smoke inhalation

Tracheobronchial tree is usually caused by:

A

Chemicals in the smoke

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15
Q

Smoke inhalation

Injury to the lung tissue, usually a delayed process.

  • Results in alveolar collapse and impaired oxygenation.
  • Risk for pneumonia
A

Parenchymal injury

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16
Q

Caused by breathing toxic substances

A

Systemic toxicity

17
Q

Two most relevant gases for systemic toxicity are:

A

Carbon monoxide

Hydrogen cyanide

18
Q

Frequent cause of death and most common complication after inhalation injury

Colorless and odorless gas

Affinity for hemoglobin 260 times greater than oxygen

A

Carbon Monoxide (CO)

19
Q

Gaseous form of cyanide, colorless and odor of bitter almonds

Difficult to screen for and treatment should be considered in all inhalation injuries

Treatment should be initiated patients who are at risk and who display altered mental status, cardiac arrest or signs of heart failure

A

Hydrogen cyanide

20
Q

Gas that can lead to myocardial ischemia

A

CO poisoning

21
Q

First step in the treatment of smoke inhalation

A

Rescue from the source and limit exposure time

22
Q

Significant burns (>40%) even with an airway that seems intact might require ________ if capability exist due to impending edema and airway compromise

A

Prophylactic intubation

23
Q

Therapy used for significant CO toxicity

A

Hyperbaric oxygen

24
Q

Sarcomere

A

Muscle fiber

25
Q

Rhabdo

Intracellular components

A

Potassium

Creatine Kinase (CK)

Myoglobin

26
Q

Striated muscle breakdown

Occurs with injury/necrosis to the muscle fiber

A

Rhabdomyolysis

27
Q

Rhabdo

Leakage of extracellular calcium ions into the intracellular space leads to:

A

Interaction of actin and myosin that ends in muscle destruction

28
Q

Rhabdo

If large amount of muscle is damaged the myoglobin released can precipitate in:

A

Kidneys, cause renal damage and obstruction

29
Q

Causes of rhabdomyolysis

A

Trauma or muscle compression

Exertional rhabdomyolysis

Non-exertional rhabdomyolysis

30
Q

Rhabdo caused by:

Trauma, crush injury, prolonged restraints or immobilization, compartment syndrome, electrical injuries

A

Trauma or muscle compression

31
Q

Rhabdo caused by:

Individual is not conditioned, hot humid conditions, impaired sweating, seizures and delirium tremens, methamphetamine and cocaine use

A

Exertional rhabdomyolysis

32
Q

Rhabdo caused by:

Coma induced by drugs
Medications (statins)
Toxins (snake venom & CO)

A

Non-exertional rhabdomyolysis

33
Q
  • Muscle tenderness
  • Edema
  • Muscle weakness
  • Dark urine (*Coca Cola urine)
  • Altered mental status may occur from underlying etiology
A

Rhabdomyolysis

34
Q

Lab hallmark in rhabdomyolysis

A

Elevation in CK (typically fivefold increase)

35
Q

Elevation in CK (Hallmark) typically fivefold increase from normal

Urinalysis dipstick positive for blood however no red blood cells on microscopic exam

Electrolyte abnormalities (*Hyperkalemia)

EKG to evaluate electrolyte abnormalities (Hyperkalemia (causes peaked T waves))

A

Rhabdomyolysis

36
Q

Treatment for rhabdomyolysis

A

Large volume IV fluid resuscitation (1.5L/hr)

2ml/kg/hr urine output

37
Q

When to MEDEVAC a rhabdomyolysis patient?

A

Altered mental status, temp > 105, or unresponsive to IV fluids

38
Q

Complications of rhabdomyolysis

A
Acute renal failure, acute kidney injury
Compartment syndrome
Electrolyte abnormalities
Cardiac arrhythmias
Death