exam 1 Flashcards
3 tiers of TRIAGE SYSTEM
Emergent
Urgent
Non urgent
Triage tier level for life threatening
emergent
examples of emergent triage tier
chest pain w diaphoresis
hemorrhage
resp distress
stroke
vital sign instability
examples of urgent level triage
severe abdominal pain
displaced or multiple fractures
renal colic
resp infection
soft tissue injuries
what triage tier would a chest pain pt w diaphoresis be
emergent
what triage tier would a pt w resp distress be
emergent
what triage tier would a pt w severe abdominal pain be
urgent
what triage tier would a pt with displaced or multiple fx be
urgent
what triage tier would a pt with renal colic be
urgent
what triage tier would an older adult pt w resp infection be
urgent
what triage tier would a pt w a simple fracture be
non urgent
what triage tier would a pt with a rash be
non urgent
what triage tier would a pt with soft tissue injuries be
urgent
what is disposition
providers decision of where pt should go after discharge from ED
what should you do with IV lines and indwelling tubes when a pt dies in bed from trauma, suspected homicide or abuse?
leave them in place
what level is a trauma center that provides care from prevention through rehabilitation
level 1
what lvl trauma center is a community hospital that can provide care to vast majority of injured pts
level 2
what lvl trauma center is a rural hospital that focuses on initial injury stabalization & pt transfer
level 3
what lvl trauma center is located in a rural/remote setting
level 4
What to check during primary survey
Airway/cervical spine
Breathing
Circulation
Disability
Exposure
*ABCDE
If there is excessive bleeding what should be checked during primary survey
Circulation
Airway/cervical spine
Breathing
*If a pt is bleeding hella, call a CAB
What should be checked during secondary survey
comprehensive head to toe
identify other injuries
what should be anticipated during 2nd survey
gastric tube & urinary catheter
prep for diagnostic studies
application o f splints & temp dressings
what should be done before disposition is determined
assess psychological needs
consult w social services and rehab team
coordinate w other support services as needed
be alert for human trafficking signs
implement SBIRT
what is SBIRT
screening, brief intervention and referral to treatment
should you give a pt w heat exhaustion a salt tablet
no
can you give a pt with heat exhaustion plain water
no it’ll worsen sodium deficit
what should you rehydrate a heat exhaustion pt with in a clinical setting
IV 0.9% saline
what labs should be done on heat exhaustion pt
serum electrolyte analysis
what can happen if heat stroke is untreated
organ dysfunction or death
how does exertional heat stroke happen
strenuous activity in hot, humid conditions
how does classic non exertional heat stroke occur
chronic exposure to hot humid environment over time
body temp over 104 degrees F indicates
heat stroke
signs of a heat stroke
temp over 104
altered mental status
hypotension
tachycardia
tachypnea
elevated cardiac troponin
how would a heat stroke pts heart rate be
tachy
how would a heat stroke pts breathing be
tachy
how would heat stroke pts cardiac troponin be
elevated
what kind of IV should be inserted in heat stroke pt
IV with large bore needle or cannula
How should core temperature be measured in heat stoke pt
rectal probe
what kind of snake has depression or pit between each eye and nostril
pit viper
rattlesnakes, copperheads and coppermouths are what kind of snakes
pit vipers
snakes with red, black rings separated by yellow cream rings are
coral snakes
what is the most significant risk of snake bite
airway compromise and resp failure
what to do with snake bite pt
ensure IV lines
have resuscitation equipment available
contact poison control
how would you treat a bee sting allergic rxn
epi pen
what imaging would be done for pt struck by lightning and where
CT of head
what lab should be done for pt struck by lightning
CK
what do CK labs diagnose
skeletal muscle damage
what should be given prophylactically to pt struck by lightning
tetanus
where should pt struck by lightning follow up
burn center
what should lightning burns be covered with in community setting
sterile dressing
what material should be avoided in cold weather
cotton
what clothing material should be worn in cold weather
synthetic clothing
a body temperature of 90-95 indicates
mild hypothermia
a body temp of 82.4 to 90 indicates what
moderate hypothermia
body temp below 82.4 indicates
severe hypothermia
body temp below 95 indicates
hypothermia
what position should hypothermia pt be placed in
supine
how should hypothermia pt be internally rewarmed
warm IV fluids
heated oxygen
heated lavage (peritoneal, pleural, gastric)
what is a lavage
the washing out of a body cavity with water or medicated solution
what frostbite grade is hyperemia and edema
grade 1
what frostbite grade has large, clear to milky, fluid filled blisters with partial thickness skin necrosis
grade 2
what frostbite grade has small blisters containing dark fluid, body part that is cool, numb, blue or red and doesnt blanch
grade 3
what frostbite grade has a blister over carpal or tarsal that is numb, cold, bloodness and has necrosis that extends to muscle and bone
grade 4
how should frost bite affected area be rapidly rewarmed
swirled in water without touching side of container
why should you not let frost bite affected area touch side of container during rapid rewarming
to prevent tissue damage
how should frost bite affected area be elevated
above heart level
what should you assess frost bite for
compartment syndrome
what is compartment syndrome
when pressure increases and restricts blood flow
what immunization should be given for frostbite
tetanus
how should frostbite dressings be
loose ,non-adherent and sterile
disaster that occurs inside hospital
internal disaster
disaster that occurs outside hospital
external
what color triage is emergent class 1
red
what color triage can wait for care and is class 2
yellow
what color triage is non urgent/ walking wounded class 3
green
what color triage allows pt to die and is class 4
black
what color triage is class 4
black
what color triage is class 2
yellow
what color triage is class 3
green
what color triage is class 1
red
total arterial blood flow is called
perfusion
blood flow through tissues is
peripheral perfusion
blood flow through heart is
central perfusion
functional site of blood formation
bone marrow
spleen tissue that is filled w WBCS, a major site of antibody production and filters out bacteria and old RBCs
white pulp
what spleen tissue is storage site for RBCs
red pulp
what spleen tissue contains ends of many blood vessels
marginal pulp
process of controlled blood clotting
hemostasis
process that prevents over enlargement of fibrin clot
fibrinolysis
anti-clotting deficiency increases risk for
venous thromboembolism, myocardial infarction, strokes
pallor or cyanosis indicates
reduced perfusion
thin/absent hair can indicate
poor perfusion
most common symptom of sickle cell disease crisis
pain
labs for sickle cell
hemoglobin S (HbS) percentage on electrophoresis
hematocrit
reticulocyte count
how will hematocrit be during sickle cell crisis
low
how will WBC be during sickle cell crisis
high
imaging for sickle cell
xray
CT
PET
MRI
sickle cell pain management uses
morphine & hydromorphone
PCA
Hydroxyurea
Endari
Crizanlizumab
Hydration
combination hormone drugs for contraceptive may increase what in sickle cell pts
clotting
hemoblobin less than 13.5 in men indicaress
anemia
hemoglobin less than 12 in women indicates
anemia
how would heart rate be after meal and activity in pt with anemia
continuous and rapid
most common type of anemia
lack of iron
pernicious anemia is a deficiency of
vitamin b12
rare life threatening anemia from not enough RBCs
aplastic anemia
how to treat iron deficiency anemia
increase oral intake of iron
how to treat pernicious anemia
increase vitamin b12 intake
aplastic anemia treatment
blood transfusions
immunosuppressive therapy
