Emergency Department Flashcards
WBC count high
infection
Hgb(Hemoglobin) low
anemia
Hgb high
dehydration
Hct(Hematocrit) low
anemia
Plt(Platelets) low
prone to bleeding
Band cells high
serious infection
Segmented neutrophils(Segs) high
acute infection
Lymphs high
viral infection
Monos low
bacterial infection
Eos (eosinophils) low
parasitic infection
Sodium high (hypernatremia) or low (hyponatremia)
dehydration
Potassium high (hyperkalemia)
poor kidney function
Potassium low (hypokalemia)
may cause arrhythmia
BUN(blood urea nitrogen) high
renal insufficiency or failure
Creatinine high
renal insufficiency or failure
Glucose high (hyperglycemia)
high blood sugar
Glucose low (hypoglycemia)
low blood sugar
Bicarbonate high (hypercarbia)
possible respiratory disease
Bicarbonate low
hyperventilation; possible DKA
Chloride high (hyperchloremia)
possible dehydration
Liver Function Tests (LFT’s) include
T Prot/Alb, T bili, AST, ALT, Alk Phos
T Prot/Alb low
poor nutrition
T bili high
jaundice/liver failure
AST, ALT, or Alk Phos high
liver damage
Troponin high
specific to heart damage
CK(creatine kinase) high
heart damage or rhabdomyolysis
CK-MB (creatine kinase-muscle breakdown) high
heart damage
CK-RI (creatine-kinase relative index) high
heart damage
Myoglobin high
heart damage
D-dimer high
must rule out PE by running a CTA or VQ exam
BNP(B-type Natriuretic Peptide) high
congestive heart failure
ABG (arterial blood gas) low pH
acidosis
ABG high/low HCO3
metabolic problem
ABG high/low pCO2
respiratory problems
ABG low pO2
hypoxia
VBG (venous blood gas) low pH
acidosis
VBG high pH
alkalosis
Sputum Cx positive
respiratory infection
Cardiac Order
CBC, BMP, CK CK-MB CK-RI, Troponin, EKG, CXR
CSF Gluc low
possible bacterial meningitis
CSF Prot high
possible meningitis
CSF RBC >0 in Tube 4
subarachnoid hemorrhage
CSF WBC >3 in Tube 4
possible meningitis
CSF gram stain positive bacteria
likely bacterial meningitis
PT(prothrombin time) high
blood is too thin
INR(international normalized ratio) >3
too much coumadin
INR <2
not enough coumadin
Normal INR when not on coumadin
1.0
PTT(partial thromboplastin time) high
blood is too thin
Rapid Strep test postive
Strep throat
Mononucleosis test positive
mononucleosis
influenza A and B positive
the flu
Respiratory syncytial virus positive
likely bronchiolitis
Lipase or Amylase high
pancreatitis
Thyroid Stimulating Hormone (TSH) high
possible hypothyroidism
TSH low
possible hyperthyroidism
T3 or T4 low
hypothyroidism
CRP(C-reactive protein) high
active inflammation in the body
ESR(erythrocyte sedimentation rate) high
active inflammation in the body
HCG positive
pregnant
Serum HCG quantitative higher
further along in the pregnancy
Serum HCG quantitative lower
possible failure of pregnancy
ABORh Rh negative
needs RhoGAM shot if pregnant
T+S (type and screen) positive growth
possible blood transfusion
Wet Prep many clue cells
bacterial vaginosis
Wet Prep many trichomonas
STD
Wet Prep many yeast
Vaginal yeast infection
GC (gonococcus) positive
gonorrhea
CT (chlamydia trachomatis) positive
chlamydia
Genital Cx positive growth
pending results;ED will call pt if Cx is positive
Leukocyte Esterase positive (Urine dip)
possible UTI
Nitrite positive (Urine dip)
UTI
Glucose positive (Urine dip)
high blood sugar DM
Blood positive (Urine dip)
kidney stone vs. UTI
WBC in urine >6
UTI
RBC in urine >6
UTI vs Kidney stone
Bacteria in urine
UTI
Complete Blood Count high WBC or high Bands
possible sepsis
Lactic acid high
sepsis or cell death in the body
Blood Cx positive growth
definitive sepsis
Since cultures will never result the same day they are ordered…
Results pending
ASA(serum acetasalicylic acid) high
toxic ASA level
Tylenol high
toxic Tylenol level
EtOH high
alcohol intoxication
UTox (urine drug screen) positive
drug abuse
Ketones large
likely DKA
Low Dilantin, Tegretol, Keppra, Depakote, Neurontin
subtherapeutic; at risk for sz
Digoxin low
subtherapeutic; at risk for A-fib
CXR potential findings
PNA, PTX widened mediastinum, pleural effusion, CHF
AAS/KUB potential findings
free air, SBO, constipation, large kidney stones
all other x-rays potential findings
fracture, dislocation, joint effusion
CT w/o in head potential findings
large hemorrhagic or ischemic CVA
CT w/o in C-spine potential findings
cervical spine fracture or subluxation
CT w/o in chest potential findings
PNA, PTX, pleural effusion, rib fracture
CT w/o in Abd/Pel potential findings
kidney stones, pyelonephritis
CTA Chest potential findings
PE, aortic dissection
CTA Head potential findings
Hemorrhagic CVA, Ischemic CVA
CTA Neck potential findings
carotid dissection, carotid occlusion
CT A/P w/ PO potential findings
appendicitis, SBO, Diverticulitis, Ischemic Gut
US Doppler LE potential findings
DVT
US RUQ potential findings
cholelithiasis, cholecystitis, bile sludge, gallbladder wall thickening, bile duct obstruction
US OB/Transvag potential findings
IUP, ectopic pregnancy, ovarian cyst, ovarian torsion
US Scrotum potential findings
testicular torsion or mass
Spint Application
Preparation: none
indication: joint injury
results: distal CSM intact (ex)
Joint Reduction
Preparation: pain control of anesthesia
indication: dislocation of___
results: good alignment, distal CSM intact
Arthrocentesis
Preparation: sterile field
Indication: joint effusion
Results: fluid obtained, sent to lab
Laceration repair
Preparation: wound cleansed and explored. local anesthesia with 1% lidocaine
Indication: laceration length in cm
Results: good closure and hemostasis
Incision and Drainage
Preparation: local anesthesia with 1% lidocaine
Indication: Abscess (simple or complex)
Results: improved, less fluctuant
Lumbar Puncture
Preparation: sterile field, betadine prep. local anesthesia 1% lidocaine
Indication: rule out meningitis or Sub-Arachnoid Hemorrhage
Results: Pt tolerated procedure well, there was no complications
Endotracheal Intubation
Preparation: suction at bedside. consent precluded by clinical urgency
Indication: respiratory failure, airway control
Confirmation: positive CO2 color change, equal breath sounds, rising SaO2, CXR shows good position above carnia
Central Line Placement
Preparation: sterile field, chlorhexidine prep. local anesthesia 1% lidocaine
indication: need for intravenous access for Abx or fluid resuscitation
Confirmation: good patency and drawback through all three lumens
3 major sites for Central Line Placement
Internal jugular, subclavian, femoral
3 Labs to monitor closely for efficiency
Creatinine, D-dimer, Troponin
Conscious Sedation
Preparation: suction at bedside, pt on cardiac monitor and continuous pulse oximetry, RT at bedside
Indication: obtain sedation to allow for joint reduction
Post-Procedure: The procedure lasted 6 minutes, vital signs remained stable. Pt tolerated procedure well, there were no complications. Pt returned to baseline
Chest Tube Placement
Preparation: Sterile field, betadine prep, consent precluded by clinical urgency
Indication: PTX or hemothorax
Confirmation: CXR shows PTX to be improved. Tube in good position. Vital signs stable
Bedside Ultrasound
Preparation: US to bedside, pt positioned
Indication: Trauma, suspected acute disease, or US-guided procedure
Confirmation: image documentation recorded
Critical Care Dx
Respiratory failure, sepsis, pneumothorax, MI, severe dehydration, ect
Critical Care procedures
central line, intubation, CPR, CPAP/BiPAP, cardiversion, chest tube
NSR
normal sinus rhythm
SB
sinus bradycardia
ST
sinus tachycardia
A flutter
atrial flutter
PAV
premature atrial contraction
PVC
premature ventricular contraction
LBBB
left bundle branch block
RBBB
right bundle branch block
1 AVB
first degree AV block
LAD
left axis deviation
LVH
left ventricular hypertrophy
RAE
right atrial enlargement
LAE
left atrial enlargement
PRWP
poor R wave progression
SVT
supraventricular tachycardia
T-invr.
T wave inversion
T-flat
T wave flattening
NS ST/T
non-specific ST changes
Re-evaluations
Define Reasons for a re-eval before admission or discharge recheck abnl vital signs Recheck abd, neuro, lungs Symptoms improved after treatment
Cardioversion
Preparation: conscious sedation, attached to cardiac monitor and pulse oximetry
Indication: atrial fibrillation or abnormal rhythm
Confirmation: repeated EKG ordered, patient remains in NSR, vital signs stable