Brainscape's Knowledge GenomeTM

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


See full index

ED/Surgery > Crawford - Ill-Appearing > Flashcards

Crawford - Ill-Appearing Flashcards

1
Q

What is done in primary survey?

A

ABCDE = airway, breathing, circulation, disability, expose

Address only what’s going to kill them in the next 5 minutes?

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

What is Sellick’s maneuver in airway treatment?

A

pinch cricoid cartilage to decrease gastric insufflation

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

Two components of breathing that need to be assessed in primary survey?

A

oxygenation: O2 sat
ventilation: end tidal CO2

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

How to optimize oxygen content in hypoxic patient?

A
  • supplemental oxygen
  • increase PEEP with mechanical ventilation or needle decompression
  • increase hemoglobin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What treatments can keep BP low even if circulation needs to increase?

A

beta blockers

pacemaker

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

Hypotension following injury is due to _________ until proven otherwise.

A

hypovolemia

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

CO = ____ x _____

A

SV x HR

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

What medications will increase heart rate? (chronotropy)

A

Non-selective adrenergic agonists - epinephrine

Anticholinergics - atropine

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

What medications will increase stroke volume? (inotropy)?

A

Adrenergic agonists – epinephrine, dobutamine

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

What medications will increase stroke volume without increasing heart rate? (pure inotropy)

A

Digoxin

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

What medications will constrict blood vessels?

A

Adrenergic agonists
Epinephrine
Norepinephrine
Vasopressin

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

What medications will dilate blood vessels?

A

Nitroglycerin
Nitroprusside
Calcium channel blockers

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

What is assessed in the D (disability) of the primary survey?

A

LOC: determine cause (hypoxia, cerebral injury, med/drug), GCS

Neurologically intact?: sensation and movement along dermatomes

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

What is important during E (exposure) step of primary survey?

A

Keep patient warm to prevent hypothermia (trauma triad)

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

Normal urine output that indicates adequate renal perfusion?

A

0.5 - 1 mL/kg/hr

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

End organ signs of shock

A 
Altered mental status
High HR and RR
Low urine output
Low arterial pH
Low BP (specifically MAP)
17
Q

Basic pathophysiology of shock and why it occurs

A

inadequate tissue perfusion; not enough oxygen

3 components: blood (fluid), heart (pump), blood vessels (pipes)

18
Q

“warm” vs “cold” shock

A

early/compensated shock is warm - sympathetic activation (vasoconstriction, high HR and RR)

later decompensated shock patient becomes cold/clammy and hypotensive

19
Q

Different classifications of shock

A

Distributive
Hypovolemic
Obstructive
Cardiogenic

20
Q

Causes of obstructive shock

A

Massive PE
Tension pneumothorax
Cardiac tamponade
Constrictive pericarditis

21
Q

BP = _____ x ______

A

BP = SVR x CO

22
Q

Pathophysiology of Low SVR

A

things that cause vasodilation - septic, neurogenic, and anaphylactic shock

BVs are big and leaky, so blood sits in periphery and heart overworks to compensate

23
Q

Signs of low SVR

A

WARM
pink
bounding pulses
hyper dynamic heart (fast and pounding)

24
Q

Signs of high SVR

A

Cool extremities
Pale
Poor cap refill
Thready pulses (narrow pulse pressure due to high diastolic BP)

25
Q

Stroke volume depends on what 3 factors? How do they cause shock?

A

preload = hypovolemic shock if too low
afterload (aortic resistance) = obstructive shock if too high
contractility = cardiogenic shock

26
Q

Management priorities in hypoperfused states

A

1) Volume: Fluids to get to CVP 10
2) BP: Vasopressors to get to MAP 60 and SBP 90
3) Flow: inotropes for improved signs of perfusion

27
Q

Why must you improve circulating volume before adding a vasopressor?

A

Vasopressors risk tachycardia and increased myocardial oxygen consumption if used too soon

28
Q

Signs of 15-35% blood loss

A

Increased HR and DBP (narrow pp), prolonged cap refill, flat neck veins

29
Q

Symptoms of cardiogenic shock

A
  • Skin: cool, moist, pale with mottling
  • CHF signs: JVD, HJR, APE, pedal edema
  • Heart: murmurs, S3 or S4
  • Pulse: rapid and thready/weak
  • Decreased BP
  • Decreased urine output
30
Q

Treatment of cariogenic shock

A

Increase oxygen: mechanical ventilation, reperfusion

Maximize cardiac output: dysrhythmics, pacing, cardioversion, vasopressors, inotropes

Decrease afterload: intra-aortic balloon pump

31
Q

Vascular changes in anaphylactic shock

A
  • Diffuse vasodilation from histamine and bradykinin release

- Bronchoconstriction

32
Q

Treatment of anaphylactic shock

A

1) ABCs
2) Epinephrine
3) Steroids, H2 blockers, Albuterol, etc.

33
Q

What is septic shock?

A

multiple organ system inflammation causing hypoperfusion

SIRS -> sepsis -> severe sepsis -> septic shock

SIRS criteria + source of infection + hypotension

34
Q

Septic shock treatment

A

Prompt volume replacement
Early antibiotic administration
If MAP

ED/Surgery (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions