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332 > Emergency > Flashcards

Emergency Flashcards

1
Q

What does the primary survey consist of?

A

ABCDE

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2
Q

What does the secondary survey consist of?

A

Everything other than ABCDE

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3
Q

What are several causes of airway obstruction (5)?

A

Anaphylaxis, foreign body, tongue, trauma, and inhalation of chemicals/burns.

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4
Q

What might a patient look/sound like if they have an airway obstruction (4)?

A

Can’t speak/breathe/cough, clutching throat/upper chest, restless, and stridor/wheezing.

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5
Q

What are six interventions for airway obstruction?

A

Abdo thrusts, head tilt chin lift, jaw thrust, oral airway, ET tube, suction.

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6
Q

What are some interventions for someone who is having difficulty with breathing/oxygenating?

A

O2, BVM, chest tube.

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7
Q

What might be some reasons a person is having difficulty breathing?

A

Pneumothorax, pleural effusion, pulmonary edema.

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8
Q

What are several interventions for a hemorrhage?

A

Stop the bleed, IV NS or RL. Blood transfusion. CPR/AED.

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9
Q

What type of injury is usually more dangerous… penetrating or blunt? Why?

A

Blunt, because the injuries are often internal and we cannot see the damage from the outside.

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10
Q

What are types of blunt trauma?

A

Acceleration/deceleration, compression, rotational.

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11
Q

If we have a patient with an abdominal injury what are things we are going to be watching for?

A

Shock

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12
Q

What type of organ failure is someone at grave risk for if they’ve gotten a crush injury or a burn? Why?

A

Renal failure. Myoglobin appears in the urine because of rhabdomyolysis.

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13
Q

What do we do if our patient has a fracture and a pulseless extremity?

A

Apply traction and splint the limb.

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14
Q

What are the characteristics of a superficial burn (1st degree)? How long does it usually take to heal?

A

Epidermal layer involvement. Painful, dark pink, dry. 7 days.

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15
Q

What are the characteristics of a superficial partial- thickness burn (2nd degree)? How long to heal?

A

Epidermis and upper layers of dermis destroyed. Dark pink/red, blisters, mild edema, painful. Blanching present. 10-14 days.

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16
Q

What are the characteristics of deep partial-thickness burn (2nd degree)? What will occur? What might need to be done?

A

Epidermis and deeper dermis destroyed. Painful, red, exudate, reduced sensation, delayed blanching. Scarring. Skin grafts.

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17
Q

What are the characteristics of full-thickness burn (3rd degree)? What needs to be done indefinitely?

A

Total destruction of epidermis, dermis and maybe subcut and fascia. Variety of colors. Painless (nerve fibres destroyed). No blanching.

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18
Q

What type of burn is the most dangerous? Why?

A

Electrical. Electricity travels from point of least resistant to most resistant (moves from nerves/BV to bones).

19
Q

What are 5 main problems with burns? Why for each?

A

Hypovolemia (due to extreme edema and fluid shifts), edema (worst at 18-24 hours), hyponatremia/hyperkalemia/hypokalemia, bronchoconstriction, others (renal dysfx d/t myoglobin, inability to regulate temp d/t loss of skin, Curling’s ulcer).

20
Q

What are the main interventions for someone who has suffered a burn?

A

A - intubation if sustpected inhalation of burns/chemicals. B - maintain ventilation, third spacing will affect this dramatically. C - IVF ASAP.

21
Q

In what ways can someone compensate for a brain injury and increasing ICP?

A

Reabsorb CSF, hyperventilate to cause cerebral vasoconstriction, and decrease brain water.

22
Q

Cushing’s triad is a late sign of what? What are the three components of it.

A

Increased ICP. Increased BP, decreased HR, irregular breathing.

23
Q

What are some interventions for increasing ICP?

A

Mandatol and furosemide (diuretics), don’t give too many IVF, low stimulation, treat pain (decrease the metabolic demand of brain).

24
Q

What are some interventions for someone experiencing a spinal cord injury? Where is the most common location for a SCI? Define a complete SCI?

A

Apply traction to the spine. Cervical spine (C4 C6). Posterior ligaments torn in between spinous process.

25
Q

What are interventions for chest trauma?

A

O2 and chest tube.

26
Q

How do we neurally compensate for shock?

A

SNS stimulated which increases HR and cardiac contractility.

27
Q

How do we hormonally compensate for shock?

A

Activation of the RAAS which results in reabsorption of water and sodium, which increases preload and decreases urine output.

28
Q

How do we compensate for shock on a cellular level?

A

Increased chatecholamines and cortisol provide increased glucose for metabolism.

29
Q

How do we chemically compensate for shock?

A

Increased RR to increase O2 sats.

30
Q

How do we treat hypovolemic shock?

A

Determine cause of bleed, fix it, IVF, and blood transfusion.

31
Q

What are coronary causes of cardiogenic shock? Non-coronary causes?

A

Coronary: acute MI, and post-open heart surgery ischemia. Non-coronary: cardiomyopathy, cardiac tamponade, tension pneumothorax.

32
Q

What is the management for cardiogenic shock?

A

Inotrope (dobutamine - increase cardiac contractility), vasodilators (nitro - decreased O2 demand of heart), determine underlying cause/fix it.

33
Q

What lung manifestation occurs with cardiogenic shock? Why?

A

Pulmonary edema. Because of congestion of blood flow.

34
Q

What are 3 forms of distributive shock?

A

Anaphylactic, septic, and neurogenic.

35
Q

Which is the most common cause of distrubutive shock?

A

Septic

36
Q

What happens in septic shock?

A

Bacteria toxins result in vasodilation and increased capillary permeabilty resulting in fluid seeping out of vessels.

37
Q

What are manifestations of septic shock?

A

Evidence of infection, no SNS stimulation (unable to vasoconstrict).

38
Q

How is septic shock treated?

A

Underlying cause, IV abx, IVF, NE (vasoconstriction)

39
Q

What are manifestations of anaphylactic shock? How is it treated?

A

Evidence of exposure, airway reactivity, no SNS compensation (no vasoconstriction). Remove Ag, administer meds that restore vascular tone (epi), anti-histamine (to decrease capillary permeability), maintain airway with bronchodilators.

40
Q

What is neurogenic shock due to? What can cause this type of shock? What the manifestations? How do we manage?

A

Vasodilation due to imbalance between SNS and PNS (PNS overrides). SCI, spinal anesthesia, other NS damage, hypoglycemia. Signs of PNS stimulation (dry, warm skin, dec BP, dec HR), injury above clavicle usually. Restore SNS (position patient properly).

41
Q

What is MODS a complication from? What type of shock does it frequently follow?

A

Shock. Septic shock.

42
Q

In what order do organs begin to fail with MODS?

A

Lungs, heart, liver, GIT, kidneys, immune system, CNS.

43
Q

What are three steps of management of MODS?

A

Control initiating event (ie septic shock), promote adequate organ perfusion, and provide nutritional support.

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