Emergency Part 1/ part 2 Flashcards
what is the role of beta1?
inc HR and contractility
what is the role of beta 2?
Inc HR and causes bronchodilation to maximize oxygenation
What is the role of alpha blockers?
bodys organ triage system. they vasoconstrict the vessels surrounding the least important organs during SNS flight or fight
What is the order of organs that the body shunts blood away from during SNS response (least important to most)
first is peripheries, GI tract, kidneys (dec urine output), liver, pancreas, etc.
what are the levels of triage?
level 1: rescucitation (see immediately) level 2: emergency (within 15 min) level 3: Urgency (30 min) level 4: less urgency (60 min) Level 5: non urgency (120 min)
what are some causes of airway obstruction?
tongue inflm foreign bodies masses (malignant and benign) trauma (obstr or inflm) disease
if your pt has a snoring sound what is the most likely cause?
tongue obstr
what can cause inflm in the airway?
heat and chemical burns, smoke inhalation, trauma, allergic reactions
what are the 3 different ways hypoxia could occur?
problem with:
ventilation
diffusion
perfusion
what is the first approach to shock (intervention)
give them volume (IV, blood)
what are the 3 causes of a circulation problem?
problem with:
heart
vessels
volume
what does AVPU stand for? when is this used?
for D- disability. A- awake and alert V- respond to verbal stimulus P- only physical U- unresponsive to deep pain
what is trauma?
• Unintentional or intentional wound or injury inflicted on the body from a mechanism against which the body cannot protect itself
when there is multiple injuries should we assume there is a spinal injury?
yes, unless indicated otherwise.
what is priority management with multiple injuries? other than ABC
- Establish airway and ventilation
- Control hemorrhage
- Prevent and treat hypovolemic shock
- Assess for head and neck injuries
- Evaluate for other injuries (reassess head and neck, chest, assess abdomen, back and extremities)
- Splint fractures
- Perform a more thorough assessment and ongoing examination.
whats the difference between a penetrating or blunt trauma?
penetrating- gun, stab wounds
blunt- MVCs, falls, explosions
whats an early sign of intraperitoneal or intra-abdominal injury?
absence of BS
how is peritoneal irritation presented?
abdominal distention, involuntary guarding, tenderness, pain muscular rigidity, or rebound tenderness
what labs might you do for an intra-abdominal injury?
urinalysis to detect hematuria, Hgb, hct, wbc, serum amylase to detect inc level (pancreas injury)
what is a common occurrence when there is pain in the L shoulder?
ruptured spleen?
what is a common occurrence when there is pain in the right shoulder?
injury to liver
what is a patient at risk of after a trauma?
how can we treat this?
infection because of disruption of technical barriers, exposure to exogenous bacteria, and aspiration of vomitus material
tetanus prophylaxis and broad spectrum abx
what is a crush injury?
occurs when a person is caught between opposing forces.
what would you observe following a crush injury?
o Hypovolemic shock resulting from extravasation of blood and plasma into injured tissues after compression has been released
o Paralysis of a body part
o Erthyema and blistering of skin
o Damaged body part appearing sweollen, tense and hard
o Reneal dysfunction (prolonged hypotension)
what is rhabdomyolysis?
muscular damage that signifies a release of myoglobin from ischemic skeletal muscle which can result in acute tubular necrosis
how can you assess for compartment syndrome?
pain- severe, pallor of skin (pale or mottled), pulselessness, poikilothermic (or polar) sensation (cold to the touch), parathesia (burning, tingling), and paralysis.
what happens if pulselessness occurs in a fracture?
reposition the extremity to proper alignment if required.
check for coolness, blanching and dec sensation nd motor function
how do you apply a splint?
what if the fracture is open?
distal and proximal to the fracture to relieve pain and restore circulation
if open: apply a moist dressing
what can partial obstruction of an airway lead to?
hypoxia, hypercapnia, and resp and cardiac arrest
what can complete obstruction lead to?
permanent brain injury or death- which can occur 3-5 min secondary to hypoxia.
what are some common signs of upper airway obstruction?
choking, apprehensive appearance, refusing to lie flat, inspiratory and expiratory stridor, labored breating, use of accessory muscles, flaring nostrils, increasing anxiety, restlessness, and confusion.
what develops as hypoxia worsens? (airway obstr)
cyanosis and LOC (late signs)
if the patient is weak has an ineffective cough, high pitched noise when inhaling, inc resp difficulty or cyanosis is this partial or complete obstr?
treat as complete
what are some interventions of airway obstruction?
abdominal thrusts head-tilt-chin lift jaw thrust oropharyhngeal airway insertion endotracheal intubation intubation with a combitube or laryngeal mask airway cricothyroidotomy
which manoeuvre would you use if you don’t know if the person has a spinal injury?
jaw-thrust
what are the signs of shock?
cold, moist skin, dec bp, inc hr, delayed cap refill, dec output
what are the goals of hemorrhage?
control the bleeding,maintain adequate circulating blood vol for tissue oxygenation, prevent shock
Management
what are some interventions for hemorrhage?
fluid replacement- IV, packed RBC, control of hemorrhage with pressure or tourniquet
why do you apply a tourniquet to a bleed?
to control arterial blood flow
when is internal hemorrhage suspected?
exhibits tachycardia, falling BP, thirst, apprehension, cool and moist skin or delayed cap refill
