EM POD Flashcards
defines national goals, 15 elements
1973 public law 93-154
IVs, epi, glucagon, albuterol, dual lumen airway
AEMT
cardiac meds, etc
paramedics
off line, develops protocols, quality check, education
medical control
direct communication in the field
on line
anyone coming to an ED must be stabilized and treated regardless of their ability to pay/insurance
Emergency Medical Tx and Labor Act (EMTALA)
30:2 compression to ventilation for?
one or two rescuers for adults
one rescuer for child or infant
15:2 chest compressions to ventilations
for two rescuers for an infant or child till puberty
2nd most common cause of hospitalization
2nd most common infectious cause of death
acquired outside the hospital
*RFs include comorbidities, smoking, EtOH impaired airways
community acquired pneumonia
overwhelming majority are anterior from kiessalbach plexus
apply direct pressure while sitting up, vasoconstrictive agents, cautery with silver nitrate, packing
commercial nasal packs
epistaxis
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
vulvovaginitis
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
genital herpes
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
renal colic
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
acute alcohol intoxication
certain toxins or meds cause a specific grouping of signs and symptoms
know anticholinergic, cholinergic, extrapyramidal, narcotics, sympathomimetics as examples
CO poisoing
toxidromes
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
anticholinergics
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)
cholinergic
dysphonia, dysphagia, oculogyric crisis, rigidity, torticollis, trismus, laryngospasms
phenothiazines and other neuroleptics
Rx: antihistamines: i.e. Benadryl
try to prevent with meds
extrapyramidal
CNS depression, pinpoint pupils, resp depression, hypotension
need to assist respirations
responds quickly to parenteral narcan
due to morphine, heroin, oxycontin
narcotics
CNS excitement or agitation, seizures, hypertension, hyperthermia, tachycardia, MI, diaphoresis, mydriasis
amphetamines, cocaine, PCP, ephedrine, aminophylline,
tx is cooling, sedation with benzos, hydration
sympathomimetics
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
CO
