Brainscape's Knowledge GenomeTM

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


See full index

EM Residency Start > EM Clerkship podcast > Flashcards

EM Clerkship podcast Flashcards

1
Q

Toradol

-dose

A

10,15,30,60mg q6h

therapeutic ceiling of 10mg

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

Syncope: full approach

A

6-6-6

1. Look for 6 high risk EKG: QT-BRIDE
QT
Brugada
Right heart strain
Ischemia
Delta waves (WPW)
Epsilon (ARVD)
  1. 6 HIGH RISK Hx findings (CHESS + FH)
CHF
Hct <30
Elderly
SOB
SBP <90
FH of sudden cardiac death
  1. 6 Deadly syncope mimics:
SAH
PE
GI Perf/Ectopic
AAA
Aortic Dissection
MI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Non-preg vag bleeding:
(Preg test negative)
approach, steps

A
  1. Pelvic exam
  2. Labs: CBC, Coags, TSH
  3. U/S
  4. Tx with NSAIDs (helps vag bleeding and pain)
  5. Tx DUB with hormones–Progesterone OCP. This stabilizes hormone axis, builds endometrium, and when pt stops taking, will bleed and finish cycle.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Vertigo, approach

A
  1. DESCRIPTION typical of Central vertigo?
    central: mild, vague, non-specific
    peripheral: severe, sudden, N/V
  2. SXS typical of Central? (4 DANGEROUS D’s)
    Diplopia, Dysphagia, Dysarthria, Dysmetria
  3. RISK FACTORS for Central?
    - stroke, trauma, etc
  4. NEURO EXAM consistent with Central?
  5. Tx
    - central: MRI, CT Head/neck
    - peripheral: meclizine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Priapism: what are types? and difference

A
  1. High flow ( non ischemic)
    - not painful
    - trauma, malformations, etc
    - Urology c/s
  2. Low flow (ischemic, COMPARTMENT SYNDROME)
    - painful, 50% chance future ED
    - Drugs, Sickle cell
    - Do bedside pressure release
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Chest pain: ACS questions to always ask, specific for ACS

A

4 specific findings

  1. worse with exertion
  2. radiation to right shoulder
  3. vomiting
  4. diaphoresis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Toxicology approach:

  • tox exam?
  • tox labs?
A
  1. airway
  2. hx
  3. FOCUSED TOX EXAM: Vitals, Skin, Pupils
  4. GET MED LIST, and bottles
  5. Tox labs:
    - EKG, LFTs, BMP
    - Blood levels (APAP, aspirin, ETOH)
    - UDS (?)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Procedural sedation meds (5)

  • dose, dose for adult
  • onset, duration
  • pros, cons
A
  1. Versed (combine with Fentanyl)
    0.05 mg/kg, 2mg adult
    3-5min, 30-60min
    no analgesia, resp depress, hypotension
  2. Fentanyl (combine with Versed)
    1 mcg/kg, 70mcg adult
    <1min, 30-60min
    minimal hypotension, low sedation
  3. Propofol
    1mg/kg (0.5 redose q3min), 70 mcg adult and 35mcg
    <1min, 3-5min
    Hypotension (have IVF), resp depress
  4. Etomidate
    0.015 mg/kg, 10mg adult
    30-60 sec, 5-10 min
    No hypotension, myoclonus, N/V
  5. Ketamine
    1-2mg/kg, 70mg adult
    1-3 min, 10-15 min
    Emergency rxn, laryngospasm, hypersalivation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Leg trauma: What not to miss?

A

Maisonneuve fx:

spiral fx of prox 1/3 fibula, and tear of distal tib-fib intraosseous membrane. (often assoc ankle fx)

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

ABCs: BREATHING–Steps to remember

A

Hypoxia kills quickly! Give O2 in 2 ways:

  1. Add FiO2
    If pt breathing: Non-rebreather mask
    If NOT breathing: Bag-Valve mask
  2. Add PEEP
    If pt breathing: BIPAP
    If NOT breathing: Intubation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dental Pain, approach

-dx to know (3)

A
  1. number the tooth
  2. choose dx (pulpitis, gingivitis, periapical abscess)
  3. pain meds
  4. consider abx (Pen VK for periapical abcess and bad gingivitis, none for pulpitis)

can do inf alveolar nerve block

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

Stroke: approach

A
  1. last known well?
  2. fingerstick glucose!!!
  3. CT Head
  4. NIHSS
  5. give TPA if no contraindications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

C-Spine injury, approach, steps, decision rule

A
  1. Airway+C-spine (put cervical collar)
2. Apply NEXUS: "SPINE" CT if any positive
Spinal midline tenderness
Painful distracting injury
Intoxication
Neuro deficit
Encephalopathy
  1. If NEXUS negative: move head 45 left/right, and touch chin to chest. Can clear C-Spine. Otherwise leave on C-Collar
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Neck soft tissue injury: approach

  • blunt
  • penetrating
  • what are Hard signs
A

blunt: get CTA if:
- neuro deficit
- forceful impact to neck
- Fx of basilar skull, facial bone, or c-spine

penetrating (of platysma):

  • if unstable–> OR
  • if stable, Hard signs –> OR
  • stable, no Hard signs –> CTA
Hard signs: "HARD Bruit"
Hemoptysis/hematemesis/hypotension
Art bleeding
Rapidly expanding hematoma
Deficit (neuro
Bruit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Fingertip injuries:

  • approach, steps?
  • what kinds of repair scenarios?
A

If any 5 injury criteria met, needs Hand consult. Otherwise:

  1. Tetanus needed?
  2. XR finger (Fx or foreign body?)
  3. Digital block, clean wound
  4. Repair scenarios (3)
    - partial amputation–sew back on
    - full amputation, tip good–sew back on
    - full amputation, tip not good–put abx ointment, then wrap it up
  5. F/u with hand surgeon in few days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

First 5 minutes of crashing pt

5 steps per podcast

A
  1. Vitals
  2. ABCs, rapid
  3. 3 stat RN orders: IV, monitor, draw blood (hold it for now)
  4. 3 stat meds to consider:
    naloxone, ativan, epi
  5. 3 stat tests, bedside:
    EKG, preg, fingerstick glucose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

PERC

A

Think Wells, very similar. 8 total, 3 different.

  • Unilateral leg swelling (ie Clinical signs/sxs DVT)
  • HR >100
  • Age >50
  • O2 <95%
  • Hx of DVT/PE
  • Recent surgery/trauma
  • Hemoptysis
  • Estrogen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Chest pain: PE questions to always ask

A

5 questions to cover Wells and PERC:

  1. Hx blood clot?
  2. Recent surgery/trauma?
  3. Hemoptysis?
  4. Cancer?
  5. Estrogen?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pre-eclampsia

-what labs to always order?

A
  1. LFTs (HELLP)
  2. CBC (low platelets, hemolysis)
  3. UA (look for protein)
  4. BMP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Urethral injury:
posterior is usu caused by?
ant usu caused by?

A

post: pelvic fx, rapid decel trauma
ant: straddle injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Dilaudid IV/IM

-dose

A

0.015 mg/kg

1mg in adults q2h PRN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

GU injury, trauma: approach, steps

-Injury types to know

A
  1. get Pelvic Xray first
  2. Look for blood in perineum
  3. UA, looking for hematuria (amount does not correlate with severity)

1) kidney injury–CT w/ con
2) ureter–CT w/con
3) bladder–retro cystogram
4) urethra (post/ant)–retro urethrogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

PE:

approach

A
  1. everyone with possible signs/sxs enters “pathway”
  2. exclude everyone with OBVIOUS other cause
  3. Wells to risk stratify.

If low risk, PERC.
If med, D-dimer or CT now
If high, CT now, consider empiric anticoag

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Tylenol OD

  • phases
  • what shows on labs and sxs?
A
  1. Day 1–ingestion
    high APAP level, nl LFTs, asx maybe nausea
  2. Day 2–Valley
    mild elevation APAP, mild elevation LFTs
    -RUQ pain, jaundice
  3. Day 3–Sever
    low APAP level (absorbed), high LFTs
    -symptomatic
  4. death (70% survive)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Aspirin OD:

  • what labs abnormal?
  • how to tx? mild vs severe
A
  • mixed met acid and resp alk on Blood gas
    mild: alkalinize urine (Na HCO3)
    severe: dialysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

AMS Differential:

-and, what labs/imaging/tx based on it?

A

AEIOU TIPS

Alcohol--BAL, thiamine
Electrolytes/Endocrine--BMP, TSH
Ischemia (Cardiac)--EKG, Trops
Opiates--naloxone
Uremia

Trauma–CT Head
Infxn–CBC, LP, CXR, UA
Poisoning–tox labs
Stroke/seizure–CT Head, full neuro exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

HyperCa+ sxs

A

Bones, stone, groans, psychiatric overtones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is most common factor with missing PE dx?

What % of pts admitted for COPD actually have PE?

What % of pts admitted for syncope, unknown cause, have PE?

A

Infiltrate on CXR (infarcted lung can look like PNA)

1 in 4!

1 in 6!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Fingertip injuries:

hand surgeon c/s criteria (5)

A
  1. infection
  2. contaminated
  3. fx
  4. if you can see bone
  5. extends past cuticle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Hyperkalemia, tx

A

C BIG K Di/Di

Calcium chloride 1 amp (can use Ca gluconate if have time)
Beta agonist (and Bicarb)
Insulin+Glucose (D50)

Kayexalate

Diuresis
Dialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Pre-eclampsia tx and meds

A

Magnesium (beware low reflexes)

reduce BP with labetalol or hydralazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

contraindications to NSAIDs: (5)

A
  1. pregnant
  2. GI ulcer
  3. elderly
  4. cardiac
  5. Renal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Norco

  • dose
  • max
A

q4-6h

5,7.5,10-325

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Wells score

and points? what is low and high risk

A

7 things: 3 exam, 4 history

  1. Clinical signs/sxs of DVT–3
  2. PE is #1 dx or equally likely–3
  3. HR>100–1.5
  4. Hx of DVT/PE–1.5
  5. Recent surgery/immobilization–1.5
  6. Hemoptysis–1
  7. Cancer–1

Low: <2
High >6

35
Q

Lac (eval)

-approach, steps

A

4 steps:

  1. Hx–5 things, thinking about infection risk
    - Chronic dz
    - Age of wound
    - location
    - mech
    - foreign body/contamination?
  2. Tetanus?
  3. Exam:
    - include motor/sensory/cap refill distal to wound
  4. Xray? (search for foreign bodies)
36
Q

Face injury: Dangerous thing for each facial area (6)

A

Forehead: Sinus wall fx (internal frontal sinus wall)

Eyes/Orbits: Orbital blowout fx with trapped extraocular muscles

Nose: Septal hematoma

Zygoma (cheekbone): Tripod fx

Maxilla: Le Fort fx

Mandible: Lac inside mouth

37
Q

Face injury, basic approach

A
  1. airway of course
  2. CT maxillofacial w/o contrast
  3. supportive care (that’s it)
    - pain meds, ice, stop bleeding
  4. Abx, consider in sinus and open fx
  5. consult
38
Q

Epistaxis:

Do what? in what order of steps? (4)

A
  1. clear nose, visualize bleed
  2. spray Afrin (can repeat)
  3. Cauterize with Silver Nitrate (can provide local anesthesia by soaking gauze in 4% lido or cocaine, leave in nose 10 min)
  4. Pack nose with gauze
39
Q

Non-pregnant vag bleeding:

-think what DDX categories?

A
  1. Structural
    - esp MALIGNANCY in post menopausal
    - also fibroids, polyps, adenomyosis
  2. Coagulopathy (20%)
  3. Hormonal (DUB, anovulatory bleeding)
40
Q

Severe sepsis criteria:

  • big 2
  • others (6)

Septic shock criteria

A

Sepsis with organ dysfunction:

BP<90 or -40 below baseline
Lactate >2

Cr>2
Bili >4
Plt <100k
INR >1.5
UOP <0.5ml/kg/h for 2h despite adequate resus

Acute lung injury (paO2/FiO2 ratios)

Septic shock:

  1. lactate >4, OR
  2. Hypotension not responsive to IVF
41
Q

1st trimester vag bleeding:

after pregnancy test positive,
-what tests need to get everytime?

A

5 tests:

  1. CBC
  2. T+S (both for transfuse and Rhogam)
  3. Quant HCG (1500 discrim)
  4. UA (if asx UTI, must tx in preg)
  5. U/S, Pelvic
42
Q

Epistaxis: locations of bleed and cause (2)
which is MCC
which is most severe

A
  1. Anterior: kiesselbach’s plexus, MCC

2. post: sphenopalatine artery (most severe)

43
Q

Chest pain life-threatening differential (6 cardiopulmonary)

A

heart: ACS, tamponade
lungs: PNA, PTX
vascular: PE, aortic dissection

also esophageal rupture

44
Q

Ibuprofen

  • dose
  • max
A

400-800mg q6-8h

-max 3200mg

45
Q

Narcotics:

what are the 5 Rx rules?

A
  1. Check database!
  2. Never for chronic non-CA pain
  3. Never for acute flares of Chronic pain
  4. Unless acute pain now, do not rx in pts who are already Rx’ed narcotics or sedatives (eg BZDs)
  5. 3 days max!
46
Q

STEMI: what steps to do?

-include drugs and their doses

A
  1. call STEMI alert
  2. stop Platelets
    - Aspirin 325mg
    - Plavix 600mg
  3. stop Coag cascade
    - Heparin 60U/kg (max 4000 U)
  4. Cath lab

Other drugs:

  • Nitro 0.4mg SL q5min (x3 doses)
  • Nitro gtt 10mcg/min (titrate UP)
  • morphine 4mg IV q5min PRN pain
47
Q

HA: Differential?

A

King, Queen, 3/3/3

KING: SAH
QUEEN: Meningitis

3 Killers in BRAIN:

  • Stroke
  • Hematoma
  • Tumors/elevated ICP

3 Killers in VESSELS

  • Arterial dissection
  • Brain DVT
  • Temporal arteritis

3 Killers in MISCELLANEOUS

  • Glaucoma
  • Preeclampsia
  • CO poisoning
48
Q

Laceration eval:

-what to know about when doing XR for foreign body?

A

Wood does not show up on XR

49
Q

Aspirin OD:
when to suspect?
what are sxs?

A

“great mimicker of EM,” can look like sepsis with abd pain

ASA does 2 things: stim brain, and stim GI

Brain:
tachypnea (most classic), fever, AMS

GI:
Abd pain, N/V

50
Q 
Head injury: approach
DDx?
important Hx
important Exam
next step
A
  1. Big 5
    - skull fx
    - epidural, subdural hematoma
    - SAH
    - parenchymal injury (concussion)
  2. important Hx
    - mechanism
    - LOC?
    - blood thinners?
  3. Exam
    - GCS
    - pupils
    - basilar skull fx signs (battle’s sign, raccoon eyes, CSF rhino/otorrhea, hemotympanum)
  4. Canadian Head CT rule
51
Q

Sore throat:

  • approach:
  • life threatening ddx?
A
  1. CENTOR criteria
  2. if GAS, amox/pen
  3. steroids
  4. consider Mono
Big 4 life-threatening:
Ludwig's
PTA
RPA
Epiglottitis
52
Q

Pre-eclampsia: what’s def?

who to check?

A

BP >135/85, plus proteinuria

Check BP on every pregnant female >20 weeks

53
Q

Canadian Head CT rule (7)

A
  • GCS <15, 2h post injury
  • Suspected open or depressed skull fx
  • Basilar skull fx signs
  • vomiting x2
  • Age >65
  • Amnesia, >30 min retrograde prior to event
  • “dangerous” mech (auto v ped, fall >3ft, ejected from car)
54
Q

Tylenol:

  • dose
  • max
A

650mg q4-6h

max 3-4g/day

55
Q

CENTOR criteria

-how scoring works

A
  1. Fever >38
  2. No cough
  3. Tender LAD
  4. Tonsillar exudate
  5. Age <15 (>45 is -1 point))

1 point: no further testing

2: optional
3: do rapid strep/culture

56
Q

Leg trauma, Ottawa rules:
Foot
Ankle
Knee

A

Foot:

  • unable to bear weight after injury/in ED
  • TTP navicular
  • TTP 5th metatarsal

Ankle:

  • unable to bear weight after injury/ED
  • TTP 6cm post lat malleolus
  • TTP 6cm post med malleolus

Knee:

  • unable to bear weight after injury/ED
  • TTP patella
  • TTP prox head of fibula
  • unable to flex knee 90 degrees
57
Q

C-spine fractures

A

Jefferson Bit Off A Hangman’s Tit

Jefferson fx
Bilateral facet d/l
Odontoid fx
Atlantooccipital d/l
Hangman's fx
Teardrop fx
58
Q

Pregnancy injury, trauma:

approach, steps

A
  1. Left lateral decubitus (pressure off vessels)
  2. Palpate fundus.
    if you can feel fundus above umbilicus, >20weeks. beware Abruption
  3. OB U/S
    - look for abruption/free fluid
  4. T+S (assess Rh status)
  5. FHR monitoring for all >20weeks. Help f/o Abruption
59
Q

Sgarbossa’s criteria

A

LBBB plus:

  1. Concordant ST elevation >1mm in leads with positive QRS

or

  1. Concordant ST depression >1mm in leads with negative QRS in V1-3

or

  1. Discordant ST elevation (>5mm) in leads with negative QRS
60
Q

Pre-eclampsia

-Sxs to know and ask?

A

Big 4:

  1. HA
  2. vision change
  3. abd pain
  4. swelling
61
Q

Priapism: approach (5 main steps)

A
  1. Prepare
    - 19 and 21G needles, Penile nerve block
  2. Drain
    - 19G needle at 3/9 o’clock, aspirate
  3. Send VBG
  4. Irrigate
    - 21G more proximal (stil 3/9 o clock), inject NS, aspirate from 19G
  5. Phenyl
    - Inject
62
Q

Dangerous mechs of Canadian Head CT

A
  1. auto v ped
  2. ejected from car
  3. Fall, >3 ft
63
Q

Morphine IV/IM

-dose

A

0.1mg/kg, q3-4h

approx 7mg in adults

64
Q

Heart injury, trauma:

3 critical dx, how to dx and what tx?

A

Tamponade–U/S, pericardiocentesis, then thoracotomy if doesn’t work

Dissection–(CXR widening, unequal pulses), CTA, esmolol, then nitroprusside. then surg c/s

Cardiac contusion–(check EKG, trops, admit for monitoring for arrhythmias)

65
Q

Lung injury, trauma:

3 critical dx

A

Tension PTX
open PTX
hemothorax

all chest tube

66
Q

ABCs: CIRCULATION–Steps to remember

A

Think: Tank, Clogged pipes, Broken pipes, Pump

  1. Fill Tank
    - IVF
  2. Consider Clogged pipes
    1) tamponade (U/S, pericardiocentesis)
    2) tension PTX (clinical or U/S, needle decompress+chest tube)
    3) PE (clinical or CT or U/S, TPA)
  3. Squeeze Broken pipes
    - Pressors
  4. Check Pump
    - EKG
    - ischemia: cath lab
    - arrythmia: shock
67
Q

AMS approach steps:

A
  1. airway
  2. POC labs: Fingerstick glucose, EKG, Pregnancy
  3. consider Naloxone (0.4mg)
  4. AEIOU TIPS
68
Q

SIRS, qSOFA

A

T 36-38
HR >90
RR>20
WBC 4-12

SBP <100
AMS (GCS<15)
RR >22

69
Q

Sepsis steps:

A
  1. Sepsis? (SIRS vs qSOFA, with source)
  2. Severe sepsis? Give 3 hour bundle (3h, 3 things)
    - Lactate, Blood cx, Abx.
    - admit ICU
  3. Septic shock? (hypotensive or lactate>4)
    GIVE 30ml/kg IVF
  4. Still hypotensive:
    PRESSORS
70
Q

Hemoptysis

-approach

A

Think 3 types:

  1. super mild, streaky
  2. scary, but stable
  3. tons of blood, crashing
  4. probably bronchitis. Almost NTD. Do CXR to screen for other causes. D/C home with f/u
  5. Workup: Labs + CT
    - CBC, coags, BMP, UA
  6. INTUBATE, BRONCH, CONSULT (Ct surg or IR)
71
Q

Back pain:

  • Approach, what to ask, ddx
  • what meds for pain
A

Simple: Red flags, then XR and MRI. Otherwise, no imaging and outpt.

Big 5!

  1. Aorta (AAA, dissection)–tearing pain, abnormal pulses
  2. Infxn–F/C, IVDU, immunosuppress–HIV, DM
  3. Cord compress–full neuro exam, esp post void residual rectal tone
  4. Fx–trauma?
  5. CA–CA questions

MSK Pain: no opiates. naproxen or Flexeril. Tell pt to keep walking

72
Q

SOB: approach to thinking DDx

A

Go by anatomy (not complete ddx):

Upper airway: obstruction, anaphylaxis–stridor
Lower airway: asthma, COPD
Alveoli: PNA, pulm edema
Blood: anemia, acidosis (sepsis, DKA), Toxins (eg aspirin)
Vessels: PE
Heart: MI/ACS, CHF

73
Q

Abd pain:

  • general approach, things to be aware of per podcast
  • core 8 labs
  • dispo
A
  1. Risk stratify (elderly, immunocompromised, diabetic are high risk)
  2. Consider GU causes (do GU exam!)
3. Core 8 labs:
CBC, BMP
LFT, Lipase
EKG, Troponins
UA, UPreg
(Lactate, blood cx, and Urine cx as necessary)
  1. Imaging
  2. Dispo: f/u in 12-24h, in ED if necessary!
74
Q

Hemoptysis

-ddx

A

Bronchitis–mcc
TB–mcc world
PNA

PE
CA

Vasculitis (eg wegeners, goodpasture)

75
Q

ABC’s: AIRWAY–Steps to remember

A
  1. SUCTION!!
  2. move tongue
    - head tilt, jaw thrust, chin lift
    - NP, OP airways
76
Q

Upper GI bleed

  • ddx?
  • hx
  • labs, workup
A

king/queen: varices, PUD
HISTORY! for risk factors:
Varices: liver dz, alcohol use
PUD: NSAID use, steroids

2 IVs
CBC, CMP (look for high BUN), Coags, T+S,
Protonix
If varices suspected: abx and octreotide

77
Q

COPD/Asthma

-all txs

A

10 things in order:
1,2,3: duonebs, steroids
4,5 for COPD: BIPAP and abx

6 mag sulfate (relaxes stuff, think OD no reflexes)
7 ketamine (helps calm pt, reduce spasm)
8 epi (think as systemic albuterol)
9 heliox
10 intubate
78
Q

Seizure: how to take hx

A

be as detailed as you can. include TIME:

Tongue biting
incontinence
med change
ETOH

79
Q

status epilepticus

-what order of meds

A
  1. BZD
  2. AED. can try up to 3. fospheny, keppra, depakote
  3. If 30 min no result, then start drip to sedate. Versed, propofol, or phenobarb. Pt now sedated
  4. do continuous EEG
80
Q

What rhythm assoc with WPW that is dangerous?

A

Irregular wide complex tachycardia.
WPW with Afib
Don’t use AV blockers.

81
Q

Crystalloids vs Colloid:
how much fluid stays intravascular?
ECF: how much intravascular?

A

Crystalloid: 1/4. so 1L is 250cc
Colloid: 3/4. so 0750cc

ECF: 1/4 intravascular, 3/4 interstitial

82
Q

anaphylaxis:

  • criteria?
  • dose adult/peds Epi
  • what home med to be aware in anaphylaxis? and what to know
  • other meds
A

2 organ systems:
skin, pulm, CV (hypotension), GI

1: 1000 0.3-0.5 ml Epi (0.3 in epipen)
0. 01mg/kg for peds (0.15 in pedipen)

BB can cancel out Epi. If Epi no response, give antidote to BB (glucagon 1-3mg q5min)

benadryl 50, famotidine 20/ranitidine 50, solumedrol 125

83
Q

Bradycardia

  • ddx
  • tx
A 
'HE DIES'
hypoT
elevated ICP
DRUGS
ISCHEMIA
ELECTROLYTES
sick sinus

0.5mg atropine, up to 3mg
Epi gtt
Transcut pacing

EM Residency Start (3 decks)

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