Critical Care / ED Flashcards
tachypnea, muscle rigidity, incr CO2, acidosis, fever after GA?
Tx?
malignant hyperthermia
tx w/ hypervent, o2, dantrolene
most common vital sign assoc w/ incr ICP?
hyperventilation
Cushing triad?
bradycardia, htn, irreg respiration
3 signs of complete heart block?
HR incr w/ crying
soft vibratory ejection murmur
intermittent brisk jugular venous pulse wave of neck
salt wasting + fatigue, vomiting, HA, muscle weakness, wt loss
adrenal insufficiency
lab findings in adrenal insuff?
low glucose
hi K
low Na
candidiasis with adrenal insufficiency- think of what?
autoimmune polyendocrinopathy
what should ADH be like in adrenal insufficiency?
high, appropriately so.
when can near drowning be observed at home?
< 1 min submerged, no LOC, no resuscitation needed
key prognostic predictor in near drowning?
length of asphyxia
near drowning w/ any of these three features requires observation for risk of ARDS in 6 hrs
- hx apnea and CPR in field
- resp failure from aspiration
- arterial desat / tachypnea –> ARDS
when to intubate (GCS score) after head trauma?
GCS </= 8
ARDS CXR findings
fine reticular infiltrate
6 causes of ARDS
- PNA
- Lung contusion
- smoke inhalation
- blood product trf
- sepsis
- aspiration
SVT tx when adenosine doesn’t work right away or recurs?
try again w/ incr dose, if it recurs tx w/ IV Dilt
poor prognosis after near drowning 3 fx
submersion > 25 min
apnea / coma at admission
pH < 7
< 10 min CPR has good or bad prognosis
good w/o neuro impairment
flail chest w/ resp distress and tachypnea, next step?
decompress hemothorax w/ chest tube
normal cardiac ejection fraction?
55%
EF in acute heart failure?
<25%
infant with grey color, poor cap refill, thready pulses?
cardiogenic shock
tx w/ child with aortic stenosis in heart failure
PGE1 to maintain or reopen ductus arteriosis
FH of sudden death and epilepsy in patient with syncope in pool?
long QT! Familial…
muffled heart sounds and pulsus paradoxus
tamponade
define pulsus paradoxus
decr SBP during inspiration
absence of vertebral and carotid artery blood flow? How to document.
brain death.
radionucleotide scan or angiography
signs of impending liver failure?
high ammonia and change in mental status
chronic tremor, anxiety, high LFTs? Dx and next step?
Likely Wilson’s, get serum ceruloplasmin
TCA (imipramine) ingestion and EKG
QT and QRS prolongation
Do the Primary Survey:
- Airway w/ cervical spine stab
- Breathing / vent
- Circ / hemorrhage control
- Disability: neuro screen
5: environment/exposure
optimal end tidal CO2 for trauma pt w/ head injury
30-35mmHg (mild hypervent)
imaging of choice to look for abd trauma?
Abd CT, most treated conservatory
eye punch, 24-72 hrs later w/ red eye, pain, vision issues, constricted pupil
post traumatic iritis
hyphema 2/2 complication in next week
rebleeding