Emergency Medicine Flashcards
Antomical differences between infants an older children
large head, short neck
large tongue
floor of mouth is compressible
loose teeth
airway narrowest at cricoid cartilage
ET intubation in infants
larynx anterior is C2/C3
Epiglottis is horse shoe shaped
Straight larnyngoscope is used
ET intubation in older infants
larynx anterior C5/6
Curved laryngoscope is used
Causes of shock
Hypovolaemia
cariogenic
distributive
obstructive
Features of Neurogenic shock
Sympathetic tone has been lost – heart rate stays normal
Lack of vasoconstriction – limbs stay warm
Hypotensive
Features of Digoxin overdose
Bradycardia
Hypotension
Hypoglyceamia
Flattened t waves
short QT interval
Benzodiazepine overdose antidote
Flumenazil
What can iron overdose cause
scarring of gut tissue
Most commonly leads to pyloric stenosis
Iron overdose antidote
Desferioxamine
Effects of MDMA
Cardiac arrythmias
Hyponatremaia
Hypertension
Hyperthermia
What part of nervous system dose MDMA stimulate?
Stimulates sympathetic nervous system
Shifts in oxygen-heamaglobin curve to left
rise in pH = alkalosis = shift in curve to left
Decrease in body temperature
Shifts in oxygen-heamaglobin curve to right
decrease in pH = acidotic
Blood becomes more acidotic at times of stress (infection or exercise)
Blood needs to be more able to bind to oxygen
Curve moves right
Most common nerve injury in supracondylar fracture
Median nerve - branch called anterior interosseous nerve
Assess - can’t make OK sign
Signs and symptoms of aspirin overdose
headache
tinnitus
confusion
fever
pH levels in aspirin overdose
initially respiratory alkalosis - salicylate acid stimulates respiratory centre
Changes to metabolic acidosis - reduction in ATP production and increase in lactate acidosis
Treatment for aspirin overdose
harm-dialysis and difiltration
urinary alkalisation with IV sodium bicarbonate
Treatment of beta-blocker overdose
Glucagon
If symptomatic bradycardia - atropine
If bradycardia and hypotension - dobutamine or isoprenaline
Most common types of burns
Scald burns <4 years old
Flame burns in older children
First degree burns classification
No blisters
Only epidermis
minimal damage
Second degree burn classification
Involves epidermis, and parts of dermis
Vesicles and blistering
Metobolic derangements and fluid loss
Extremely painful - exposed nerve endings
Third degree burns
All epidermis and dermis - can involve muscles/ bones - full thickness burns
Not painful - no nerve endings
No capillaries - no CRT
Pathophysiology of full thickness burns
0-72 hours - massive capillary leak -> shock
1-7 days - hyper dynamic and catabolic state - high risk of wound infection
1 - 7 weeks - continued catabolic state with high risk of non-wound septic events
6 weeks - recovery
Pathophysiology of inhalation injury
Sloughing of mucosa - pulmonary oedema and airway obstruction -> atelectasis
