FINALS LEC (w/ antidotes) Flashcards by Renren Dominguez

● Reducing potential disaster damages before a
disaster threatens

MITIGATION

How well did you know this?

Not at all

Perfectly

PHASES OF DISASTER AND EMERGENCY

MPRR

Mitigation, Preparedness, Response, Recovery

How well did you know this?

Not at all

Perfectly

Developing operational capabilities and facilitating an
effective response before an emergency occurs

PREPAREDNESS

How well did you know this?

Not at all

Perfectly

Actions taken immediately before, during, or directly
after an emergency occurs

RESPONSE

How well did you know this?

Not at all

Perfectly

Returns infrastructure systems to minimum operating
standards.
● Most difficult disaster phase

RECOVERY

How well did you know this?

Not at all

Perfectly

A process for sorting injured people into groups based
on their need when resources are insufficient for all to
be treated

TRIAGE

How well did you know this?

Not at all

Perfectly

are used in situations
in which triage is dynamic, occurs over many hours to days,
and only limited, austere, field, advanced life support
equipment is readily available.

START and SAVE triage techniques

How well did you know this?

Not at all

Perfectly

Open fracture of femur with
● unstable V/S
● Severe burns
● Tension pneumothorax
● Open chest wound
● Upper airway obstruction

DISASTER TRIAGE TAGS
RED

How well did you know this?

Not at all

Perfectly

Dislocations
Burns
Blunt trauma with stable v/s
Head injury with no
change in LOC

DISASTER TRIAGE TAGS
YELLOW

How well did you know this?

Not at all

Perfectly

Simple fracture
Minor laceration
Hysterical reaction

DISASTER TRIAGE TAGS
GREEN

How well did you know this?

Not at all

Perfectly

Triage system may have to be adapted to the situation
1. Red:

send to the hospital

How well did you know this?

Not at all

Perfectly

Triage system may have to be adapted to the situation
YELLOW

send to an ambulatory site to either receive
meds or get vaccinated

How well did you know this?

Not at all

Perfectly

Triage system may have to be adapted to the situation
GREEN

send home, are not at risk because are
immune

How well did you know this?

Not at all

Perfectly

Triage system may have to be adapted to the situation
BLACk

susceptible or very ill, but do not
treat – send to where directed

How well did you know this?

Not at all

Perfectly

Quick Circulatory Checks

(5P’s) pain, paresthesia, paralysis, pulses,
pallor
● Capillary Refill
● Obvious External
● Bleeding
● Electrocardiogram

How well did you know this?

Not at all

Perfectly

particularly important in the patient with a
traumatic mechanism of injury where failure to identify
a second or third injury

Exposure

How well did you know this?

Not at all

Perfectly

An intentional or unintentional wound or injury inflicted
on the body from a mechanism against which the
body cannot protect itself.

TRAUMA

How well did you know this?

Not at all

Perfectly

any force that penetrates or fractures
the skull.

Direct Trauma

How well did you know this?

Not at all

Perfectly

severe forces that may shake or
rotate the brain enough to cause permanent brain
damage.

Indirect Trauma

How well did you know this?

Not at all

Perfectly

HISTORY: AMPLE

Allergies
● Medications
● Prior illnesses and operations
● Last meal
● Events and environment surrounding injury

How well did you know this?

Not at all

Perfectly

an object entering the body or head due to an
object striking the body, or the body being placed in
motion and striking an object which then penetrates
the body.

PENETRATING TRAUMA

How well did you know this?

Not at all

Perfectly

Do’s and Dont’s in Chest Impalement

Never try to remove an impaled object.
2. Expose the wound.
3. Control the bleeding.
4. Stabilize the impaled object.

How well did you know this?

Not at all

Perfectly

referred pain at the tip of left shoulder and in left upper quadrant

Kehr’s sign

How well did you know this?

Not at all

Perfectly

Lower abdominal rigidity with spasms
Appearance of blood in NGT

PERFORATED GASTROINTESTINAL TRACT

How well did you know this?

Not at all

Perfectly

abnormal sound or murmur along middle or lower back

Bruit:

fixes area of dullness when left upper abdominal quadrant is percussed

Ballance’s

bluish color on blank

Turner’s

purplish color around umbilicus

Turner’s:

ecchymosis on scrotum and labia

Coopernail:

BITES AND STINGS NURSING MANAGEMENT

1. Wash the wound gently with soap and water. 2. Apply pressure if bleeding continuously. 3. Apply sterile bandage to the wound.

SNAKE VENOM Snake venom is highly modified saliva MECHANISM OF TOXICITY

Cytotoxic effects on tissues ● Hemotoxic ● Neurotoxic ● Systemic effects

Local envenoming (swelling etc) with bleeding/clotting disturbances - VIPERIDAE

SYNDROME 1

Ptosis, external ophthalmoplegia, facial paralysis etc and dark brown urine - =Russell's viper, Sri Lanka and South India

SYNDROME 2

Local envenoming (swelling etc) with paralysis - =Cobra or king cobra

SYNDROME 3

Paralysis with minimal or no local envenoming - Krait, Sea snake

SYNDROME 4

Paralysis with dark brown urine and renal failure: Russle viper

SYNDROME 5

No evidence of envenomation ● Suspected snake bite ● Fang mark may be present

GRADE 0

Moderate envenomation ● Severe pain ● Edema spreading towards trunk

GRADE 2

Severe envenomation ● Within 12 hours edema spreads to the extremities and part of the trunk

GRADE 3

Minimal envenomation ● Fang wound & moderate pain present ● 1-5 inches of edema or erythema

GRADE 1

Envenomation very severe ● Sudden pain rapidly ● Progressive swelling which leads to ecchymosis all over trunk

GRADE 4 ● Env

Blow up a blood pressure cuff to 80 mm Hg and leave it on for 5 minutes. ● If a crop of purpuric spots appears below the cuff, the test is positive.

HESS’ TEST

DON’TS in bites

● No Tourniquet ● No Suction apparatus to be used(Sawyers) ● Do not run ● No role of Ice application

begins at the time of injury and concludes with restoration of capillary permeability

Emergent Phase/Resuscitative Phase

when the person is hemodynamically stable, capillary permeability has been restored and diuresis has begun

Acute Phase

begins during the acute hospital stay, after the patient is stable.

Rehabilitative Phase

individual fascicles of the heart beat independently rather than the usual coordinated, synchronized manner that produces rhythmic heartbeat.

Ventricular Fibrillation

the heart has stopped beating

Cardiac Standstil

enters the body by passing through the skin or membranes. No cut or tear is required for them to enter a body

Absorbed Class

they are generally in the form of a liquid, powder or syrup that has either no taste or a pleasant taste

Ingestive Class

are airborne toxins that must be introduced into the respiratory system in order for them to work

Inhaled Class

these poisons have color, once applied to a surface, they tend to fade into the material they're applied to, making them hard to notice.

Insinuative/injective Class

the treatment of choice to prevent absorption of the poison.

Activated charcoa

Within minutes of injury - Due to major neurological or vascular injury - Medical treatment can rarely improve outcome

FIRST PEAK

Occurs during the “golden hour” - Due to intracranial hematoma, major thoracic or abdominal injury

SECOND PEAK

Occurs after days or weeks - Due to sepsis and multiple organ failure

THIRD PEAK

- No. of patients and the severity of their injuries do not exceed the ability of the facility to provide care.

Multiple Casualties

- The no. of patients and the severity of their injuries exceed the ability of the facility to provide care.

Mass Casualties

Segmental separation of chest wall causing inability to breath and ventilate the lungs

SEVERE FLAIL CHEST

Does not begin until the primary survey is completed, resuscitative efforts are established and patient is demonstrating normalization of vital functions.

SECONDARY SURVEY

Rapid assessment of neurologic status to identify life-threatening injury ● Pupil size and response ● Mental status (GCS) ● Motor and Sensory exam

DISABILITY OR DYSFUNCTION OF THE CNS

Head to toe examination of the patient for injury ● Pitfalls - Maintenance of spine precautions - Prevention of heat loss

EXPOSURE

RUQ PAIN SIGNS OF HYPOVOLEMIC SHOCK HX OF BLUNT OR PENETRATING ABDOMINAL TRAUMA

LACERATED OR FRACTURED LIVER

MUSCLE SPASM & RIGIDITY IN LUQ KEHR’S SIGN COMPLAINTS OF ABDOMINAL TENDERNESS, IF CONSCIOUS S/SX OF HYPOVOLEMIC SHOCK ENLARGED SPLEEN WITH MEDIAL DISPLACEMENT

RUPTURED SPLEEN

Signs of hypovolemic shock Mild epigastric tenderness Absence of bowel sounds Involuntary abdominal muscle spasm Possible elevated serum amylase

LACERATED OR FRACTURED PANCREAS

Lower abdominal rigidity with spasms Appearance of blood in NGT Epigastric tenderness Hx of penetrating trauma to upper abdomen or lower thorax

PERFORATED GASTROINTESTINAL TRACT

Signs of hypovolemic shock but if pt has retroperitoneal hematoma, he may not have signs of shock Hx of penetrating abdominal wound

LACERATED INFERIOR VENA CAVA

Abdominal tenderness and rigidity Signs of hypovolemic shock Hx of penetrating abdominal wound

LACERATED ABDOMINAL AORTA

Gross bleeding or dried blood at urethral orifice Perineal ecchymosis Suprapubic pain Difficult urination, accompanied by distended bladder; urge to urinate

URETHRAL TRANSECTION

Signs of hypovolemic shock Pain in abdomen and back, paralytic ileus Absent or diminished bowel sounds, vomiting hematuria Hx of blunt abdominal/pelvic trauma

FRACTURED PELVIS

Pain in midback or flank abdominal pain Hematuria, oliguria or anuria Local ecchymosis Tenderness to touch

RENAL TRAUMA

Pain Signs of hypovolemic shock Difficulty with bowel movement Hematuria Ecchymosis Large suprapubic mass

PERFORATED BLADDER

Radiograph Chest

Pneumothorax, Hemothorax, Fractured Ribs, Pulmonary Contusion, Tracheobronchial Injury, Great Vessel Injury

Pelvis Extremeties Angiogram

Fracture Great vessel injury, renal injury, vascular injury of the extremities

Abdominal Injury, Retroperitoneal Injury, Thoracic Injury, Renal Injury, Pelvic Fracture

Computed Tomography

Duodenal Hematoma or Laceration

Upper GI Series

Intarvenous Pyelogram (IVP)

Renal Injury

Urethral Injury

Retrograde Urethrogram

Bladder Injury

Retrograde Cystogram

Paracetamol/Acetaminophen

Acetylcysteine or Mucomyst

Benzodiazepine

Flumazenil

Coumadin

Vitamin K

Curare

Endrophonium

Cyanide Poisoning

Methylene Blue

Digitalis

Digibind

Ethylene Glycol/ Methanol

Ethanol/Fomepizol

Heparin

Protamine Sulfate

Iron

Deferoxamine Mesylate (Desferal)

Lead

Edetate Disodium (EDTA), Dimercaprol (BAL), Succimer

Lovenox

Protamine Sulfate

Magnesium Sulfate

– Calcium Gluconate

Morphine Sulfate

Naloxone Hydrochloride

Methotrexate

Leucovorine

Mestinon

Atropine Sulfate

Neostigmine

Pralidoxime Chloride (PAM

Penicillin

Epinephrine

Isoniazid

Pyridoxine

Atropine

Physostigmine

Organophosphates

Atropine & Pralidoxime