Emerg Med Flashcards
What type of fluid is isotonic with blood and used after blood loss due to trauma, surgery, or burns? What is the usual administration dosage?
Ringer’s lactate
20-30 ml/kg/hour
What type of fluid is used after post-op?
D5-W
5% dextrose in water, achieves balance between starvation reactions and hyperglycemia.
What are the signs that birth is imminent?
Contractions < 3min apart (beg to beg)
Mother feels urge to push
Crowning
T/F: Fundal massage is indicated in placental delivery and is done passively.
T
What is the first lab you should do in an acute abdomen in a female in child-bearing years?
Hcg
What are uterotonic medications?
Oxytocine, Methergine, Hemabate, misoprostol
What are the four T’s of post partum hemorrhage management?
Tone - uterine massage, bimanual massage between vagina and uterine fudus, empty bladder (promote oxytocin - infant suckling)
Trauma - laceration, inversion
Tissue - retained placenta
Thrombin - clotting disorder
Two primary causes of neonatal encephalitis/meningitis. How is it prevented?
Grp B Strep (more pathogenic) E.coli
Prophylactic antibiotics - Penicillin
What’s the first thing you do in an emergency scene?
Survey the scene
If you HAVE to move a victim (for safety), what are you most careful not to move or move minimally?
Head/neck
What does RAP mean?
Responsiveness
Activate EMS
Position - for compression, unless suspected head/neck trauma.
Difference in CPR for infants.
Total coverage of nose/mouth infant.
Use two fingers to perform shallow compressions.
For hydration or emergency purposes, what would you select as far as size for infusion catheter?
18-20 gauge (bigger, infuses more quickly)
Use an isotonic solution
What should an IV solution pH be?
6.6-7.6
What should IV solution osmolarity be?
150-450 low risk phlebitis
450-600 moderate risk
600 + 100% risk of some phlebitis
What are some IV changes that can help reduce risk of phlebitis?
Slow the IV Increase solution/dilution Buffer (Bicarb or HCl) Use largest vein Watch catheter tip placement
Who is at increased risk for fluid overload with IV infusion? How is it avoided?
Elderly with impaired heart or kidney function.
Slow infusion, heat to dilate peripheral circulation, O2 administration
How big of an air embolism does it take to cause death in a human?
10-60cc
What is the antidote to Mg overdose or speed shock?
1 gram of calcium
Give additional grams depending on how they respond.
What is the treatment for a hypoglycemic emergency?
Administer high dose Vit C IV with food. EDTA can also cause.
Infuse D5W or slow push D50.
What is the treatment for hyperglycemic emergency?
Steroid injection
Administer NS or 1/2NS
Insulin (SQ or IV)
What is the minimal pulse and correlating peripheral BP for radial, femoral, carotid?
Radial = 80 systolic Femoral = 70 systolic Carotid = 60 systolic
What is the IM/SQ epinephrine concentration and dose?
What is the IV epinephrine concentration and dose?
1: 1000, 0.3-1 cc immediately
1: 10000, 3cc and wait May give 10cc
What is the dose of benadryl for anaphylaxis?
50mg IV stat
What other medications would you include in treatment anaphylaxis?
Steroids - dexamethasone, prednisone, hydrocortisone
Ca Gluconate
Mg Sulfate
Albuterol
What fluid do you never give to hydrate a patient?
Sterile water - will kill the pt.
What is CI in a toxic child with epiglottitis?
Moving the neck or opening mouth.
When is oxygen required in an adult? In a child? An infant?
An adult breathing fewer than 12 rpm or more than 20 rpm.
A child is breathing fewer than 15 rpm or more than 30 rpm.
A infant is breathing fewer than 25 rpm or more than 50 rpm.
T/F: Always go beyond 2-3L per minute of oxygen with a COPD pt.
F. Never, use nasal cannula.
What is something all head injury pts require?
100% oxygen
What is important to consider in facial/eye trauma?
Small bone fractures
Dosages for epi: Subcut IV IM Subling
- 5-1 ml IV
0. 3-0.5 ml for the rest
