EM POD

Question 1

defines national goals, 15 elements

Answer 1

1973 public law 93-154

Question 2

IVs, epi, glucagon, albuterol, dual lumen airway

Answer 2

AEMT

Question 3

cardiac meds, etc

Answer 3

paramedics

Question 4

off line, develops protocols, quality check, education

Answer 4

medical control

Question 5

direct communication in the field

Answer 5

on line

Question 6

anyone coming to an ED must be stabilized and treated regardless of their ability to pay/insurance

Answer 6

Emergency Medical Tx and Labor Act (EMTALA)

Question 7

30:2 compression to ventilation for?

Answer 7

one or two rescuers for adults

one rescuer for child or infant

Question 8

15:2 chest compressions to ventilations

Answer 8

for two rescuers for an infant or child till puberty

Question 9

2nd most common cause of hospitalization

2nd most common infectious cause of death

acquired outside the hospital

*RFs include comorbidities, smoking, EtOH impaired airways

Answer 9

community acquired pneumonia

Question 10

overwhelming majority are anterior from kiessalbach plexus

apply direct pressure while sitting up, vasoconstrictive agents, cautery with silver nitrate, packing

commercial nasal packs

Answer 10

epistaxis

Question 11

pruritic, discharge, irritation, malodorous discharge

trichomoniasis detected on wet mount

asymptotic in men, 90% of time

yellow green, frothy D/C, pear shaped, motile flagellated, one or multiple dose metronidazole

Answer 11

vulvovaginitis

Question 12

pain, pruritis, days to weeks after exposure

initially, tiny papules on white blisters

ulcerations, scabs

antiviral meds shorten course

in ED, script given for future

Answer 12

genital herpes

Question 13

severe pain in flank, radiating to groin with N,V, hematuria

absence of blood doesn’t rule it out

can’t sit still

<3 mm usually pass, >5 mm usually not

pain meds, IV hydration, flomax

pain is not from AAA

Answer 13

renal colic

Question 14

extremely common ED patient

level does not correlate with degree of intoxication for chronic abusers

slurred speech, CNS depression, loss of coordination

elimination varies between people

Answer 14

acute alcohol intoxication

Question 15

certain toxins or meds cause a specific grouping of signs and symptoms

know anticholinergic, cholinergic, extrapyramidal, narcotics, sympathomimetics as examples

CO poisoing

Answer 15

toxidromes

Question 16

dry as bone, red as a beet, crazy as a loon, blind as a bat, hot as a tamale, urinary retention, decreased bowel sounds

causes: atropine like, belladonna, scopolamine, certain plants, TCAs, anti histamines

Answer 16

anticholinergics

Question 17

muscurinic effects: salivation, secretions, lacrimation, urination, defecation, GI upset, bradycardia, bronchospasm, miosis

nicotinic effects: muscle cramps, tachycardia, weakness, hypertension, fasciculations

causes: organophosphate or carbamate insecticides, maybe amanita mushrooms
tx: airway protection, atropine, and pralidoxime (2 pam)

Answer 17

cholinergic

Question 18

dysphonia, dysphagia, oculogyric crisis, rigidity, torticollis, trismus, laryngospasms

phenothiazines and other neuroleptics

Rx: antihistamines: i.e. Benadryl

try to prevent with meds

Answer 18

extrapyramidal

Question 19

CNS depression, pinpoint pupils, resp depression, hypotension

need to assist respirations

responds quickly to parenteral narcan

due to morphine, heroin, oxycontin

Answer 19

narcotics

Question 20

CNS excitement or agitation, seizures, hypertension, hyperthermia, tachycardia, MI, diaphoresis, mydriasis

amphetamines, cocaine, PCP, ephedrine, aminophylline,

tx is cooling, sedation with benzos, hydration

Answer 20

sympathomimetics

Question 21

increases in winter, space heaters

headaches, N/V

baseline CO level on everyone can be several percentage points, higher in smokers

high flow O2, hyperbaric chamber if severe neurons symptoms

Answer 21

CO