Emergency Part 1/ part 2

Question 1

what is the role of beta1?

Answer 1

inc HR and contractility

Question 2

what is the role of beta 2?

Answer 2

Inc HR and causes bronchodilation to maximize oxygenation

Question 3

What is the role of alpha blockers?

Answer 3

bodys organ triage system. they vasoconstrict the vessels surrounding the least important organs during SNS flight or fight

Question 4

What is the order of organs that the body shunts blood away from during SNS response (least important to most)

Answer 4

first is peripheries, GI tract, kidneys (dec urine output), liver, pancreas, etc.

Question 5

what are the levels of triage?

Answer 5

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)

Question 6

what are some causes of airway obstruction?

Answer 6

tongue
inflm
foreign bodies
masses (malignant and benign)
trauma (obstr or inflm)
disease

Question 7

if your pt has a snoring sound what is the most likely cause?

Answer 7

tongue obstr

Question 8

what can cause inflm in the airway?

Answer 8

heat and chemical burns, smoke inhalation, trauma, allergic reactions

Question 9

what are the 3 different ways hypoxia could occur?

Answer 9

problem with:
ventilation
diffusion
perfusion

Question 10

what is the first approach to shock (intervention)

Answer 10

give them volume (IV, blood)

Question 11

what are the 3 causes of a circulation problem?

Answer 11

problem with:
heart
vessels
volume

Question 12

what does AVPU stand for? when is this used?

Answer 12

for D- disability.
A- awake and alert
V- respond to verbal stimulus 
P- only physical
U- unresponsive to deep pain

Question 13

what is trauma?

Answer 13

• Unintentional or intentional wound or injury inflicted on the body from a mechanism against which the body cannot protect itself

Question 14

when there is multiple injuries should we assume there is a spinal injury?

Answer 14

yes, unless indicated otherwise.

Question 15

what is priority management with multiple injuries? other than ABC

Answer 15

1. Establish airway and ventilation
2. Control hemorrhage
3. Prevent and treat hypovolemic shock
4. Assess for head and neck injuries
5. Evaluate for other injuries (reassess head and neck, chest, assess abdomen, back and extremities)
6. Splint fractures
7. Perform a more thorough assessment and ongoing examination.

Question 16

whats the difference between a penetrating or blunt trauma?

Answer 16

penetrating- gun, stab wounds

blunt- MVCs, falls, explosions

Question 17

whats an early sign of intraperitoneal or intra-abdominal injury?

Answer 17

absence of BS

Question 18

how is peritoneal irritation presented?

Answer 18

abdominal distention, involuntary guarding, tenderness, pain muscular rigidity, or rebound tenderness

Question 19

what labs might you do for an intra-abdominal injury?

Answer 19

urinalysis to detect hematuria, Hgb, hct, wbc, serum amylase to detect inc level (pancreas injury)

Question 20

what is a common occurrence when there is pain in the L shoulder?

Answer 20

ruptured spleen?

Question 21

what is a common occurrence when there is pain in the right shoulder?

Answer 21

injury to liver

Question 22

what is a patient at risk of after a trauma?

how can we treat this?

Answer 22

infection because of disruption of technical barriers, exposure to exogenous bacteria, and aspiration of vomitus material

tetanus prophylaxis and broad spectrum abx

Question 23

what is a crush injury?

Answer 23

occurs when a person is caught between opposing forces.

Question 24

what would you observe following a crush injury?

Answer 24

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)

Question 25

what is rhabdomyolysis?

Answer 25

muscular damage that signifies a release of myoglobin from ischemic skeletal muscle which can result in acute tubular necrosis

Question 26

how can you assess for compartment syndrome?

Answer 26

pain- severe, pallor of skin (pale or mottled), pulselessness, poikilothermic (or polar) sensation (cold to the touch), parathesia (burning, tingling), and paralysis.

Question 27

what happens if pulselessness occurs in a fracture?

Answer 27

reposition the extremity to proper alignment if required.

check for coolness, blanching and dec sensation nd motor function

Question 28

how do you apply a splint?

what if the fracture is open?

Answer 28

distal and proximal to the fracture to relieve pain and restore circulation

if open: apply a moist dressing

Question 29

what can partial obstruction of an airway lead to?

Answer 29

hypoxia, hypercapnia, and resp and cardiac arrest

Question 30

what can complete obstruction lead to?

Answer 30

permanent brain injury or death- which can occur 3-5 min secondary to hypoxia.

Question 31

what are some common signs of upper airway obstruction?

Answer 31

choking, apprehensive appearance, refusing to lie flat, inspiratory and expiratory stridor, labored breating, use of accessory muscles, flaring nostrils, increasing anxiety, restlessness, and confusion.

Question 32

what develops as hypoxia worsens? (airway obstr)

Answer 32

cyanosis and LOC (late signs)

Question 33

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?

Answer 33

treat as complete

Question 34

what are some interventions of airway obstruction?

Answer 34

abdominal thrusts
head-tilt-chin lift
jaw thrust 
oropharyhngeal airway insertion
endotracheal intubation
intubation with a  combitube or laryngeal mask airway
cricothyroidotomy

Question 35

which manoeuvre would you use if you don’t know if the person has a spinal injury?

Answer 35

jaw-thrust

Question 36

what are the signs of shock?

Answer 36

cold, moist skin, dec bp, inc hr, delayed cap refill, dec output

Question 37

what are the goals of hemorrhage?

Answer 37

control the bleeding,maintain adequate circulating blood vol for tissue oxygenation, prevent shock
Management

Question 38

what are some interventions for hemorrhage?

Answer 38

fluid replacement- IV, packed RBC, control of hemorrhage with pressure or tourniquet

Question 39

why do you apply a tourniquet to a bleed?

Answer 39

to control arterial blood flow

Question 40

when is internal hemorrhage suspected?

Answer 40

exhibits tachycardia, falling BP, thirst, apprehension, cool and moist skin or delayed cap refill