Emergency Medicine

Question 1

compression ventilation for lone rescuer for children and adults

Answer 1

30 compressions to 2 breaths

push chest fast at a rate of 100 compressions/min

Question 2

how to open airway for breaths

Answer 2

head tilt chin lift with one hand one forehead and two fingers under chin of lower jaw

• don’t use thumb
• don’t press into soft tissue under chin

Question 3

when do you use jaw thrust

Answer 3

if head or neck injury is suspected
*need two people
place fingers under angles of jaw on both sides and lift

Question 4

Complete secondary survey (SAMPLE)

Answer 4

Signs and sx
Allergies
Meds
PMHx
Last meal
Events related to injury

Question 5

differences between adult and child CPR

Answer 5

tap bottom of childs foot
compression vent ration for 2 rescuers is 15:2
one hand on chest, other on forehead for compressions

Question 6

if adult, child, or infant has a pulse but is not breathing, you

Answer 6

give rescue breaths only at a rate of 1 breath every 5-6 seconds (10-12 breaths/min)
*check pulse every 2 minutes

Question 7

if a choking victim becomes unresponsive

Answer 7

activate EMS
lie on ground and begin CPR 30:2
Do not check pulse
*if object can be visualized and easliy removed, go ahead, but if not visible, continue CPR

Question 8

relief of choking infants

Answer 8

infant on lap
facedown with head lower than chest
5 back slaps between shoulder blade
Turn over and 5 quick downward chest thrusts in middel of chest over lower half of breastbone

Question 9

Do you perfrom finger sweeps in infants and chidlren?

Answer 9

DO not perform blind finger sweeps

Question 10

heat stroke (temp s/sx)

Answer 10

Temp over 104.9f
dry hot skin
altered mental status
muscle cramps, nausea, vomitting
rapid pulse

Question 11

transport hypothermia pt with head and feet where

Answer 11

head lower than feet

Question 12

rule of 9s for burns

Answer 12

arm = 9% each
legs = 18% each
torso = 18% front and 18% back
head = 9%

Question 13

second degree burns involve what skin layers

Answer 13

superficial dermis, hair follicles, sweat glands

Question 14

tx 3rd degree burns

Answer 14

o2
Ringers lactate IV
clean with mild soap, water, sterile dressing
topical and systemic antibiotics

Question 15

when do you refer burns to ER

Answer 15

1st degree >75% body
2nd degree >10%
3rd degree >10% or >2-3% in children or elderly

Question 16

what suggests CO poisoinging

Answer 16

normal PO2 with low o2 saturation

Question 17

tx for CO poisoning

Answer 17

100% o2 by mask

ER

Question 18

Activated charcoal dose for poison tx

Answer 18

3-5 tbsp in children less than 5 years
10-20 tbsp >5 years
Do not use if cyanide, corrosives, ethanol, methanol, organic solvents, or iron

Question 19

what gauge needle for infant or elderly with poor veins

Answer 19

24

Question 20

when would you adminster normal saline 0.9%

Answer 20

hyperacute dehydration, severe diarrhea, vomiting, shock, post anaphylaxis

Question 21

when would you administer lactated ringer

Answer 21

2-3 days of dehydration, elecrolyte replacement, burns, trauma, metabolic acidosis.

Question 22

what IV solutions are isotonic

Answer 22

normal saline and lactated ringers

Question 23

when would you use half normal saline 0.45%

Answer 23

intracellular dehydration - hypernatremia

*do not give for burns or liver disease

Question 24

When would you give D5W 5% dextrose

Answer 24

dehydration, fluid loss, hypernatremia

*not for use in rescusitation

Question 25

when would you give sterile water

Answer 25

diluting or dissolving drugs for IV, IM, or SubQ

Question 26

3% or 5% saline - hyertonic when to use?

Answer 26

severe Na depletion

Question 27

when would you give nasal cannula and what flow rate and o2 concentration

Answer 27

- indicated for breathing, COPD, pt with low O2 concentration - flow rate: 1-6 L per min - 02 concentration: 24-45%

Question 28

when would you give pocket mask without o2 and what flow rate and o2 concentration

Answer 28

- breathing or non-breathing trauma victim - manual/CPR use - 16% o2

Question 29

when would you give simple face mask and what flow rate and o2 concentration

Answer 29

breathign, mild or moderate respiratory distress 6-10 L/min -40-60% o2

Question 30

when would you give Venturi mask and what flow rate and o2 concentration

Answer 30

Breathing, COPD, asthma, stable - 4-15 L/min - 20-40%

Question 31

when would you give bag-valve mask with O2 and what flow rate and o2 concentration

Answer 31

apnea or inadequate respiratirons 10-15L/min 90-100% o2 unconscious or conscious

Question 32

when would you give partial rebreather mask and what flow rate and o2 concentration

Answer 32

breathing or non-breathing 8-15L/min 60-80%

Question 33

when would you give non-rebreather mask and what flow rate and o2 concentration

Answer 33

COPD, smoke inhalation, CO2 poisoning 10-15L/min 90-100%

Question 34

when do you administer o2 in an adult, child, and infant

Answer 34

adult: <12 breaths or > 20 child: <15 or >30 infant <25 or >50

Question 35

signs of upper airway obstruction

Answer 35

``` cyanosis drooling LOC retraction insp or exp stridor ```

Question 36

early compensated shock signs vs late decompensated shock signs

Answer 36

compensated: tachycardia, anxiety, diaphoreses, wide pulse pressure decompensated: hypotension, confusion, LOC, oliguria, acidemia

Question 37

radial, femoral, carotid pulses = BP

Answer 37

radial: 80 Femoral: 70 carotid: 60

Question 38

Epi dosing IM, IV Diphenhydramine dosing steroids

Answer 38

IM: 1:1000 0.3 - 0.5ml IV: 1:10,000 0.1-0.2mg repeat every 3-5 min Diphenhydramine: 50mg IV steroid dosing depends on form

Question 39

how do you rehydrate a burn victim?

Answer 39

ringer lactate

Question 40

lab for burns

Answer 40

see myoglobinemia with renal damage and severe tissue breakdown

Question 41

If no urination for > 12 hours how do you cath

Answer 41

darain 300-400ml and let bladder relax for 30-60 min

Question 42

which is worse hyphema or subconjunctival hem

Answer 42

hyphema can lead ot acute glaucoma

Question 43

if suspected corneal abrasion

Answer 43

send to emergenct eye doc to rule out corneal ulceration

Question 44

RAPCAB

Answer 44

``` R Activated EMS P compression airway breathing ```

Question 45

pH level for IV | human blood

Answer 45

human blood 7.35-7.45 | patient comfort 6.6-7.6

Question 46

osmolarity

Answer 46

isotonic 250-375 hypo <250 hyerp >375 human body fluids 280-295

Question 47

ca ch blockers can interact with what in IV

Answer 47

EDTA and Mg

Question 48

Rauwolfia can interact with what in IV

Answer 48

Mg, Ca, EDTA

Question 49

Beta blockers can interact with what in IV

Answer 49

Mg

Question 50

when do you see hypoglycemic emergency and what do you do?

Answer 50

high dose vit C or EDTA chelation | D5W infusion

Question 51

when do you see fluid overload

Answer 51

``` isotonic solution too quickly edema, hypertension, , pulm edema tx: slow fluid infusion heat to dilate 02 ```

Question 52

when do you see dehydration in IV therapy

Answer 52

with hypertonic solutions

Question 53

rehydration needle size type of fluid

Answer 53

largest needle 20 or 24 | use isotonic normal 0.9% soaline, ringer lactate, or D5W

Question 54

main tx goal for AAA

Answer 54

decrease BP with propranolol

Question 55

what position do put someone in shock in

Answer 55

supine with leg raised 8-12 inches

Question 56

tx anthrax

Answer 56

cipro or doxy

Question 57

important protective gear for anthrax

Answer 57

mask

Question 58

what part of secondary survey is most important

Answer 58

watch face

Question 59

most common complication of tibial fracture

Answer 59

compartment syndrome

Question 60

sign of femoral neck hip injry

Answer 60

shortened, externally rotated

Question 61

complication of hip fracture

Answer 61

DVT