drowning

Question 1

Because respiratory arrest is the most common cause of cardiac arrest in drowning victims, _______ approach should be used for drowning victims

Answer 1

the traditional A-B-C

instead of the AHA’s new C-A-B approach

Question 2

Cardiac arrest from drowning - arrythmia??

Answer 2

The initial rhythm in the arrest is PEA followed by asystole.

Question 3

abx in drowning

Answer 3

no evidence that empiric prophylactic treatment with antibiotics is efficacious for pulm or cns infection

Question 4

MONA is for?

Answer 4

(Morphine, Oxygen, Nitroglycerin, Aspirin) greets chest pain patients at the door

Question 5

Relative contraindications to the use of β-blockers include

Answer 5

asthma
COPD
decomped CHF
third-trimester pregnancy

Question 6

The most common ECG abnormalities in PE are

Answer 6

tachycardia and nonspecific ST-T– wave abnormalities

Question 7

S1Q3T3 pattern is seen in

Answer 7

“right heart strain pattern”- manifestation of acute pressure and volume overload of the right ventricle

S1Q3T3 is a sign of acute cor pulmonale

Question 8

S1Q3T3 is?

Answer 8

lead I S wave= complete/ incomplete RBBB

lead III= Q wave, slight ST elevation, and an inverted T wave*

*These findings are due to the pressure and volume overload over the right ventricle which causes repolarization abnormalities.

Question 9

The main ED treatment for atrial fibrillation is _________

Answer 9

rate control- agent most commonly used= diltiazem

Question 10

If the patient is in atrial fibrillation for greater than 48 hours, then needs to be ____________ prior to cardioversion.

Answer 10

anticoagulated

stable atrial fibrillation –> echocardiogram

clot= Coumadin 2-3 wks w/ cardioversion when INR therapeutic.

no clot= heparin and cardioversion

Question 11

ECG manifestations of hypokalemia include

Answer 11

flattening of T waves, ST-segment depression, and U waves.

Question 12

Anticipatory guidance.

_____________ must be avoided until PTX completely resolves

Answer 12

Air travel and underwater diving (changes in atmospheric pressure)

Question 13

what drug do you never use in cocaine coronary vasospasm

Answer 13

b- blocker

leaves alpha overwhelmed, makes things worse

Lorazepam is a great choice instead

Question 14

Inferior wall MIs are characterized by ST elevation in at least two of the inferior leads __________

Answer 14

II, III, aVF

Question 15

Neuroleptic malignant syndrome (NMS) is an idiosyncratic, life-threatening reaction to antipsychotic medications, with ___________ being the most common cause.

Answer 15

haloperidol

Question 16

any patients with temperatures greater than ____ most likely have non-infectious etiologies for temperature elevation.

Answer 16

105

Question 17

Dystonic reactions tpo anti-psych should be treated with____________

Answer 17

IM or IV

• benztropine (Cogentin®)- 1 to 2 mg
• diphenhydramine (Benadryl®)- 25 to 50 mg

Question 18

Potential side effects of haloperidol include

Answer 18

acute dystonia, prolonged QT interval, Parkinsonism, and akathisia

Question 19

The following mnemonic can be used to recall the common causes of an increased anion gap metabolic acidosis: CAT MUDPILES

Answer 19

C - cyanide
A - alcoholic ketoacidosis
T - toluene

M - methanol
U - uremia
D - diabetic ketoacidosis

P - paraldehyde
I - isoniazid/iron
L - lactate
E - ethylene glycol
S - salicylates

Question 20

__________ is the most effective and most

rapid means of reducing preload in a patient with CHF.

Answer 20

Nitroglycerin

Question 21

first-degree heart block

Answer 21

PR interval greater than 200 ms with a narrow QRS complex (less than 120 msec).