emerg foundations-ppt and notesfrom wk 1

Question 1

what is the difference between beta 1 and 2 receptors

Answer 1

Beta receptors-beta 1 inc the heart rate, inc contractility. Beta 1-you have 1 heart
Beta 2-you have two lungs. Causes bronchodilation

Question 2

what function do bound alpha receptors have

Answer 2

Alpha your bodys organ triage system. It decides which organs are most imp or least imp. They will draw blood away to most imp organs. Alpha receptors withdraw in order from extrem, GI, kidneys,

Question 3

how long can the cells in extremities metb anaerobically

• GI
• kidneys

Answer 3

The cells in extremities can metb anaerobically for 1.5hrs.
Gi tract can last an hr before cell death
Kidneys can last approx 45min without oxygenated blood.

Question 4

pt has compartment syndrome and pulseless limb what CTAS triage level might they be
how soon should they be seen

Answer 4

Level II- see in 15min

Question 5

which triage levels are focused upon in a disaster

Answer 5

focus on levels II and III as the interventions will make the biggest difference for them. Level Is will die and IVs can wait..
greatest good for most # of people

Question 6

inflm peaks at __hrs and genrally subsides by ___

Answer 6

12

36 or 48?

Question 7

pt has inspiratory stridor what might be the problem in adult

Answer 7

foreign body is stuck in a/w

Question 8

why does inspiratory stridor often happen in kids? what is occuring physiologically

Answer 8

Classically peds sound. Gen from croup. From pulling diaphragm down their trachea is soft and closes off
Pay most attention to tongue and inflm.

Question 9

pt has C spine injury and is unconscious and making snoring noise what can you not do
what should you do instead

Answer 9

head tilt chin lift. DONT

jaw thrust

Question 10

your pts a/w is in trouble but you put in oropharyngeal a/w are they safe now?

Answer 10

no, all this does is keep the tongue from back of throat

they need intubation for definitive a/w mgmt

Question 11

your pt is breathing very quickly and struggling to get air but their lungs sound fine and Sp02 is 98% what could be the problem

Answer 11

low Hgb

Question 12

what 3 parts of breathing are there

Answer 12

Ventilation
Diffusion
Perfusion

Question 13

pt doesnt have reg pulse and pulse is thready what intervention (not assessment) do you do

Answer 13

Generally first approach is to give them volume.

Question 14

if your pt needs _liters fast then gen you should use blood products instead as they need Hgb to transport 02

Answer 14

3l

Question 15

what does AVPU stand for

Answer 15

alert

A=awake and alert
V=respond only to verbal stimulus
P=responds to pain
U=unresponsive

Question 16

what is CTAS

Answer 16

canadian triage acuity scale

Question 17

what order of things do you treat and assess eg starting with airway

Answer 17

airway; then ventilation but c spine must be protected and chest injuries ruled out first, immed after a/w; eval and restore CO by control of hemorrhage, prevent or treat shock, manage hypothermia, examine periph pulses and any immed closed reductions of fractures are performed if extremity is pulseless, GCS, motor and sensory eval of spine.)

Question 18

how many mins before you have permanent brain injury or death from cerebral hypoxia

Answer 18

3-5mins

Question 19

you find a pt unconscious other than listening for breathing what do you assess

Answer 19

assess oropharynx in case they have something in mouth

Question 20

your pt comes into ER bleeding what test do you want what do you want put in

Answer 20

blood typing will be done

put in two large gauge Ivs one for replacement and the other for blood

Question 21

would it be better to use O negative or O positive blood for woman age 27

Answer 21

O neg as she is childbearing age and she might be Rh negative and positive blood could sensitize her to a future Rh pos baby–>hemolytic disease of the newborn

Question 22

is a tourniquet applied early to bleeding wounds

Answer 22

no it is last resort

Question 23

why are ABGs taken during internal hemmorhage

Answer 23

• ABG’s are obtained to evaluate pulmonary function and tissue perfusion and to establish hemodynamic parameters and then used as an index for determining the amount of fluid replacement the patient can tolerate and the response to therapy.

Question 24

why does a grand mal seizure stop

Answer 24

there is no longer enough oxygen

Question 25

You are walking down the hallway of your unit when a visitor comes out of a room calling for help. You go into the room and find another visitor on the floor seizuring.
what will you do first?

Answer 25

check room is safe

turn on 02 and suction

Question 26

what kind of a/w doesnt stim the gag reflex

Answer 26

nasopharyngeal

Question 27

why get 02 ready for seizure pt

Answer 27

their seizure will use a lot of oxygen and they may come out of it breathing irregularly

Question 28

how does vagal stimulation affect the heart

Answer 28

it slows it. this is part of parasympathetic system

Question 29

wat kind of things can cause vagal stimulation

Answer 29

eating too much, things that inc intrathoracic pressure

many things can cause vasovagal syncope like seeing blood

Question 30

how is someones BP after seizure

Answer 30

very high