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Cardiology > Emergencies > Flashcards

Emergencies Flashcards

1
Q

How is hemothorax treated?

A
  1. Drain blood from pleural space using chest tube

2. Control bleeding: may need to do thoracotomy if bleeding is from a systemic source

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2
Q

What is flail chest?

A
  1. Paradoxically motion of a portion of the chest wall as a result of rib or sternal fractures
  2. Diagnosed with movement plus negative intrapleural pressure
  3. CXR: more than 3 rib fractures in 2 locations
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3
Q

How is flail chest treated?

A
  1. Supportive
  2. Pain control
  3. Physiotherapy
  4. Oxygen
  5. Mechanical ventilation
  6. Usually takes 6-8 weeks to heal
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4
Q

How is a sucking chest wound treated?

A
  1. 3-sided occlusive dressing
  2. Chest tube away from injury
  3. Surgical debridement
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5
Q

What causes diaphragm injuries?

A

Most common is blunt trauma

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6
Q

How are diaphragm injuries diagnosed?

A
  1. CXR: elevated or in distinct hemidiaphragm

2. CT scan: best test- coronal scans

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7
Q

How is a tension pneumothorax treated?

A
  1. ABCs (give oxygen, fluids)
  2. Needle thoracostomy (2nd-4th mid clavicular line)
  3. ***Chest tube in 5th intercostal space mid axillary line
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8
Q

What are the indications for intubation?

A
  1. Hypoxemia despite noninvasive ventilation
  2. Inadequate ventilation
  3. Remove pulmonary secretions
  4. Provide airway protection
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9
Q

What is the cardiac arrest protocol?

A
  1. Immediate high quality CPR for 2 minutes
  2. Defibrillate if shockable rhythm ( start at biphasic 120-200, mono 200-360)
  3. Immediately resume CPR!
  4. Reassess ABCs
  5. Repeat, or administer epinephrine/vasopressin if not shockable
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10
Q

What it the treatment for torsades?

A

Magnesium (attempt to stop degeneration into ventricular fibrillation)

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11
Q

Ventricular fibrillation

A
  1. No QRS, no P, rate=0, rhythm=0, uncoordinated activity
  2. This is a non perfusing rhythm
  3. Shockable
  4. May also give amiodarone refractory
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12
Q

Ventricular tachycardia

A
  1. Rate over 100, wide complex QRS, no or dissociated P waves. May be mono or polymorphic
  2. Primary cause is MI
  3. Immediate synchronized cardioversion-start with low biphasic
  4. Only give analgesia if will not delay tx or impact hemodynamics
  5. If from MI, proceed with MI treatment: morphine, oxygen, nitro, aspirin
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13
Q

Pulseless electrical activity

A
  1. ECG rhythm but no palpable pulse or measurable BP
  2. Causes: hypoxia, hypothermia, hypovolemia, acidosis, hyper/hypokalemia, toxins/drugs, cardiac tamponade, coronary thrombosis, pulmonary thrombosis, tension pneumothorax
  3. Not shockable
  4. Give epinephrine bolus 1mg, q 3-5 minutes
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14
Q

Asystole

A
  1. Lack of electrical activity/ heart motion
  2. Very poor prognostic sign
  3. Not shockable
  4. Use epinephrine
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15
Q

What is the treatment for symptomatic bradycardia?

A
  1. Serious symptoms= any cardiovascular compromise
  2. Atropine (0.5mg IV, q 3-5 min)
  3. Dopamine or epinephrine infusion (2-10 mcg/min)
    4 . Transcutaneous pacing if refractory, start at low mA work up
  4. Transvenous pacing
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16
Q

ARDS

A
  1. Syndrome of low pressure pulmonary edema
  2. Characterized by acute onset, bilateral infiltrates, absent left atrial HTN, hypoxemia
  3. Can be causes by pneumonia, sepsis, aspiration, trauma, transfusion
  4. Treat underlying chase, ppv, anti-inflammatory,
  5. PFTs return to normal but profound psych effects
17
Q

Type 1 respiratory failure

A

Hypoxemia- result of increased shunt

18
Q

Type 2 respiratory failure

A

Hypercapnic- decreased ventilation from decreased drive or increased load

19
Q

Cardiogenic shock

A
  1. Caused by valves, vascular, electrical, pericardial
  2. Decrease in forward stroke volume
  3. Cool extremities, elevated JVP
  4. Compensation= increase in heart rate and SVR
  5. Sx= bilateral basal crackles, s3, new murmurs, dysarrhythmias
20
Q

Obstructive Shock

A
  1. Caused by vascular or extravascular block of flow
  2. Decrease in preload to heart
  3. Compensation= increase in heart rate, SVR
  4. Sx: peripheral edema, dyspnea, tachyons, muffled heart sounds
21
Q

Hypovolemic shock

A
  1. Caused by fluid or blood loss
  2. Decreased volume means decreased pre load
  3. Compensation is increased hr and SVR
  4. SX= signs of dehydration, bleeding, cool extremities, low JVP
  5. Watch urine output!
22
Q

Distributive shock

A
  1. Caused by anaphylaxis, neurogenic, infection, hepatic failure, or adrenal insufficiency
  2. Vasodilation decreases after load
  3. Compensation is increase in hr, contractility
  4. SX= warm extremities, bounding pulse
  5. Further labs for cause
23
Q

What are the features of life threatening respiratory failure?

A
  1. Silent chest
  2. Paradoxical breathing
  3. Hypotension, Bradycardia
  4. Exhaustion, confusion, coma,
  5. Peak expiratory flow rate

Cardiology (20 decks)

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