D-P Flashcards
What causes death in shock?
Acidosis
Abnormal distribution and return of the blood as seen in anaphylaxis, sepsis, neurogenic shock.
Distributive shock
Inadequate cellular perfusion.
Shock
Shock causes what
Metabolic acidosis.
20% Blood loss
Drop in BP
15% Blood loss
Narrowing pulse pressure
Cushings reflex
Slowing pulse, Rising blood pressure, Erratic Respirations. Sign of head trauma.
Radius is on which side of forearm
Thumb side
Subluxation
A partial or complete dislocation
Crushing traumatic chest injury
Traumatic asphyxia
Rhabdomyolosis
Excessive myoglobin release due to the destruction of muscle tissue.
Parkland burn formula
4ml x weight in kg x BSA
How many liters of blood does the body have
6L
Slow release into a coma, alcoholics and elderly more prone.
Subdural hematoma
Occurs rapidly, often associated with damage to the middle meningeal artery
Epidural Hematoma
Brown sequard syndrome
Condition associated with penetrating trauma-hemisection of spinal cord and complete damage to all spinal tracts on involved side.
GSW to parietal (top) region of the head
Direct pressure around the wound.
Normal human PH scale
7.35-7.45
Acidic level in humans (when in shock)
Anything lower than 7
Pt. has been vommiting/diarrhea or has OD on sodium bicarb
Metabolic alkalosis
Aerobic metabolism
Metabolism that can proceed only in the presence of O2
Anaerobic Metabolism
Metabolism that takes place in absence of O2
Increase in HR during pregnancy’s
15-20
Blood volume during pregnancy
30% increase
BP during pregnancy
decrease by 10-15 mmHg by 2nd trimester
Normal weight gain
approx. 20 Pounds
Umbilical cord makeup
AVA (2 arteries 1 vein)
Endometritis
Infection / inflammation of uterus
High fever in child
Always think meningitis first
Pt. Injured and cannot feel anything below umbilics
What vertebrate
T-10
decrease in cell size
atrophy
increase in number of cells
Hyperplasia
Cell replaced by another cell
Metaplasia
How is histamine released
Mast cells
T-10
Umbilicus
T-4
Nipple line
T-3,4,5
Keep diaphragm alive
Coup
same side as injury
Contre coup
Opposite side of injury
Most commonly fractured bone in body
Clavicle
Pathogen
any disease producing agent >a virus, bacterium, or other microorganisms
Viruses
Obligate intracellular paracites > Kill by invading host
Minor (green)
Move the walking wounded
Delayed (yellow)
All others (pulse with good mental status)
Immediate (red)
Resps over 30/ no radial pulse/ AMS
Dead/ dying (Black)
No respirations after head tilt/ OPA
If a Red (immediate)Pt. goes into cardiac arrest
Tag as black (dead)
Pediatric assessment triangle
Appearance
circulation to skin
Work of breathing
(WAC)
Drug of choice for eclampsia
Mag sulfate 1-2 grams
Which way does flail chest segment move
Moves in not out
Seal bark cough
croup
S1 sound
Mitral and tricuspid valve closing (Lub)
S2 sound
Aortic and pulmonic valves closing (Dub)
D.O.P.E
Intubated patient problem
Displacement
Obstruction
Pneumothorax
Equipment failure
P Wave
Atrial Depolarization
QRS
Ventricular depolarization
T wave
Repolarization of the ventricles
Anterior
V3, V4
Septal
V1, V2
Inferior
II, III, AVF
Lateral
I, AVL, V5, V6
Symptomatic bradycardia
Pace first, if BP is still low also give dopamine
Master endocrine gland
Pituitary gland. (controlled by the hypothalamus)
Insulin does what
Facilitates the entry of glucose into the cells.
Type 1 diabetes
Autoimmune disease that results in destruction of insulin producing beta cells in the pancreas.
Type 2 diabetes
Disorder characterized by high glucose in the context of insulin resistance.
Fastest way to deliver meds
IV
Slowest way to deliver meds
PO (by mouth)
Belly insults can refer pain to shoulders ( ruptured spleen/liver/ectopic pregnancy)
Kehr’s sign
Birth normal vital signs
R-30-60
HR-100-180
Sys. BP- 60-90
Preschool 3-5
R-22-34
HR-70-110
Sys. BP-95-110
Adolescence 13-18
R-12-26
HR-60-90
Sys. BP-112-128
Best sign of MI
Crushing substernal chest pain
Levines sign
Puts their hands across their chest
Nitro and morphine when used to treat MI are used to
Decrease preload
Positive P wave (upright)
Lead II
Average volume of gas inhaled and exhaled in one respiratory cycle
500ml
Cardiogenic shock
Impaired pumping power of the heart, either too fast or too slow. Lack of contractility.
Hypovolemic shock
Decrease of blood/water volume.
Anaphylactic shock
Allergic reaction, quick onset. Stridor is ominous sign.
Septic shock
Infection that enters the blood stream and is carried throughout the body.
1st organ affected by lack of O2
Brain
Blood loss needs replaced by crystalloids at what rate
3:1
Lefort 1
Slight instability involving the maxilla
Lefort 2
Fractures of both the maxilla and nasal bones
LeFort 3
Fracture to entire face below eyebrows. Zygoma, nasal, maxilla.
Biggest concern for facial fractures
Protecting the airway.
Cullens sign
Umbilicus bruising, sign of internal bleeding of belly
Grey turner sign
Bruising of the flanks. 24-48 hours to appear and predicts a severe acute pancreatitis.
How much blood can be lost to a pelvic fracture
2000-4000 ML
Ipsilateral
same side
When to never perform heimlich maneuver
On a drowning victim
Best airway movement for C-Spine injury
Modified jaw thrust.
Eviscerated bowel treatment
Cover with moist dressing, then cover with occlusive dressing.
1st step with sucking chest wound
Cover with gloved hand
Suctioning newborn
Mouth first then nose. 10 Seconds or less
1st stage of labor
Begins with contractions-ends when cervix is fully dilated
2nd stage of labor
begins when cervix is fully dilated-ends with birth of baby
3rd stage of labor
begins right after birth of baby-ends with delivery of placenta.
Petechiae (symptom associated with meningitis)
red/purple rash-spots
1 indicator of hypoxia in a child
bradycardia
Hematoma
Blood pooling under skin. (bruise)
Abrasion
Thin layer of skin removed. (scrape)
Laceration
Deep cut or tear
Avulsion
Deep break in skin tearing away
Needle decompression location
2nd intercostal space midcovicular
4th/5th intercostal space ant axillary
Vessels that carry oxygenated blood
arteries
Vessels that carry de-oxygenated blood
veins