Critical Care/ Emergency

Question 1

Risk Factors for Poor Prognosis s/p Near Drowning

Answer 1

1. Age Less than 3 years
2. Submersion longer than 10 min
3. Resuscitation longer than 25 min
4. Need for continued Resuscitation in the ED
5. Water temp >10 min

Question 2

Carbon Monoxide poisoning Signs and symptoms

Answer 2

20%(mild) HA, dyspnea, visual changes, confusion
30% (moderate) drowsiness, faintness, n/v, tachycardia
40-60% (mod-severe) Memory loss impending cardiovascular and neurologic collapse
>60% coma, convulsion, and death

Question 3

Substances not absorbed by Activated Charcoal

Answer 3

Alcohols
Heavy Metals 
Iron
Caustics Hydrocarbons 
Ethylene Glycol 
Lithium

Question 4

Clinical Picture of Acetaminophen Toxicity

Answer 4

Toxic Dose 150mg/kg

Stages 1-4:

1. 0-24hrs - Nausea, anorexia, vomiting
2. 12-48hrs -Assymptomatic
3. 2-7 days -Fulminant Hepatic failure
4. 1-2weeks - recovery

Question 5

Clinical Picture of Alcohol Intoxication

Answer 5

Inebriation 
CNS Depressant 
Seizures 
Hypoglycemia 
BLINDNESS -(METHANOL) 
GASTRITIS -(ISOPROPANOL)
FIXED DILATED PUPILS (METHANOL) 
RENAL FAILURE -(ETHYLENE GLYCOL)
PANCREATITIS (METHANOL)

Question 6

Treatment for Ethylene Glycol or Methanol

Answer 6

ethanol infusion

DOC Fomepizole -inhibits alcohol dehydrogenase