Clinical Care For Emergencies

Question 1

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

Answer 1

Anaphylaxis

Question 2

What are the common triggers for anaphylaxis? (5)

Answer 2

1. Drugs
2. Food
3. Additives
4. Toxins
5. Chemicals

Question 3

What are these classic symptoms indications of:

A. Prurtitis
B. Flushing
C. Urticaria

Answer 3

Anaphylaxis

Question 4

Signs and symptoms of anaphylaxis begin usually with in what time frame?

Answer 4

With in 60 minutes

Question 5

What is the initial treatment for member with anaphylaxis?

Answer 5

Epinephrine

Question 6

What are the secondary line treatments for anaphylaxis?

Answer 6

1.) Corticosteroids:
a.) Methylprednisolone ( solumedrol) 125 mg IM/IV daily x 2 days.

2.) Antihistamines:
a.) diphenhydramine ( preferred)

3. Allergic Bronchospasm:
   a.) Nebulizing albuterol: 5 mg 15-30 mins.

Question 7

What is the leading cause for smoke inhalation injuries?

Answer 7

Fire

Question 8

Systemic Toxicity- caused by breathing toxic substances, what are the two most relevant gases?

Answer 8

1. Carbon Monoxide
2. Hydrogen cyanide

Question 9

What has the affinity for hemoglobin 260 time greater than oxygen?

Answer 9

Carbon monoxide CO

Question 10

What are symptoms and physical findings on an upper airway inhalation patient?

Answer 10

Dyspnea
Soot around nares
Barbonaceous sputum
Burns on neck and face
Strifor
Drooling
Dysphonia

Question 11

What are symptoms and physical findings on an lower airway inhalation patient?

Answer 11

Dyspnea
Productive Cough

Question 12

What are the clinical findings of smoking inhalation?

Answer 12

Tachycardia
Decreased breath sounds
Adventitous lung sounds
Accessory muscle use

Question 13

What are laboratory Studies good for smoke inhalation patients?

Answer 13

CBC
Chemistry panel
Lactate
Co/ABG/VBG
CXR
EKG

Question 14

What is the first step of treatment for smoke inhalation patients?

Answer 14

Rescue from the source

Question 15

If there is signs of themal injury i.e. burns on face or other places what is indicated?

Answer 15

Intubation

Question 16

If member has > 40 % of burns what is the treatment to be rendered?

Answer 16

Remove from source
Intubation
100% O2 via fitting mask or ET tube
Iv fluids

Question 17

What other medication used for broncospasms?

Answer 17

Albuterol
- 1-2 puffs q 2 hrs for the first 4 hrs.
Additional q4-6hrs if needed.
- maintenance: 1-2 puffs q 4-6 hrs max of 8 per day.

Question 18

What id defined as striated muscle break down?

Answer 18

Rhabdomyolysis

Question 19

What causes Rhabdomyolysis?

Answer 19

Trauma
Crush injury
Prolonged restraints or immobilization
Compartment syndrome
Electrical injuries

Question 20

What are symptoms of Rhabdomyolysis?

Answer 20

Muscle tenderness
Edema
Muscular weakness
*Dark urine ( coca cola uurine)
Altered mental status

Question 21

What are labs for Rhabdomyolysis?

Answer 21

Elevated CK
Urine dipstick + with blood
Electrolyte abnormalities ( hyperkalemia)
Ekg (Peaked T waves)

Question 22

Whats the treatment for Rhabdomyolysis?

Answer 22

Large volume of IV fluids ( 2ml/kg/hr urine output

If AMS, temp > 105 f, none responsive to fluids= MEDEVAC