For sure on test Flashcards
How to position yourself in death disclosure?
- Always be seated
2. Maximize Eye contact
What to say in death disclosure?
- Always say “died” or “dead”
Classic signs thyroid storm?
- Extreme Fever (often >104F)
- Tachycardia (can be accompanied with AFib, widened pulse pressure)
- AMS
What is picture of leg maneuver showing?
Anterior drawer test for ACL injury
How does NAC work?
Sulfhydryl group donor: Substitutes for natural sulfhydryl group donor, glutathione
How is the anion gap calculated?
= ([Na] + [K]) − ([Cl] + [HCO−)
Which bone is most likely fractured with pain in snuff box?
Scaphoid
Want can not examining snuff box cause?
Avascular necrosis of scaphoid
Proper rate of ventilations and compressions if no bag?
30:2
Most common animal transmitting rabies in US?
- Bats
Also: skunks, foxes, raccoons
Most common presentation compartment syndrome?
Pain that is hard to control
People at highest risk for suicide?
Depression, Rational thinking loss, serious attempt, and future attempt = highest risk
S = Sex (male)
A = Age (<19 or >45)
D = Depressive symptoms and hopelessness*
P = Previous suicide attempt or psychiatric illness
E= Excessive alcohol or drug use
R= Rational thinking loss*
S = Single, separated, divorced or widowed
O = Organized or serious suicide attempt*
N = No social support
S = Stated future intent*
How to stop thyroid hormone production?
PTU: stops peripheral conversion from T4-T3 as well as release of these hormones
Presentation HYPERkalemia?
- 2nd or 3rd degree heart block, wide complex tachy, ventricular fib and asystole
- Weakness
- Cramps, paresthesias
- N/V/D
Definition Hyperkalemia?
K above 5.5
EKG changes in Hyper K?
K 6.5-7.5 mEq/L Peaked T waves
K 7.5-8.0 mEq/L Widening of QRS, decreased amplitude of P waves
K 10-12mEq/L Sine wave, ventricular fibrillation, asystole
First step in treating Hyper K?
- Stabilize cardiac membrane:
Calcium gluconate 10ml (1 ampule) IV over 2-5 minutes. This dose may be repeated after 5 minutes if no improvement
How to redistribute K in Hyper K?
Regular insulin 10-20 units IV
- Combined with Dextrose (D50 50 ml) if serum glucose is less than 250. Onset 15 minutes, duration 4-6 hours
How to reduce total body K?
- Kayexalate – binding resin that exchanges sodium for potassium in the colon, onset 1-2 hours, duration 4-12 hours.
- Furosemide 20-40mg IV, onset 15 minutes to 1 hour, duration approximately 4 hours. May enhance renal excretion of potassium in patients with preserved renal function.
Which drugs can be given via NT tube?
"Navel" Naloxone Atropine Vasopressin Epinephrine Lidocaine
What to do if a problem encountered during survey?
Any problem should be addressed before moving on
How to intubate in trauma?
Maintain C spine and jaw thrust
Nexus criteria for C spine imaging?
- No tenderness posterior midlines
- No neurologic deficit
- Normal alertness
- No intoxication
- No distracting injury
How to posterior mold foot / ankle?
- Distal to MTP (MT heads)
- Proximally to proximal calf
- Positioning:
- Prone
- Knee flexed and ankle at 90 degrees
How to posterior mold elbow?
1. Distal along ulnar side of hand at the level of the palmar crease 2. Extending along ulnar forearm 3. Proximally to the proximal humerus 4. Positioning: • Elbow 90 degrees • Wrist and hand neutral • Wrist extends to 20 degrees • Abduct the thumb
Indication sugar tong?
- Distal ulnar fracture
2. Distal radius fracture
How to sugar tong?
- MCP palmar around the elbow to MCP dorsally
- Elbow flexed to 90 degrees
- Wrist and hand neutral
- Extend wrist to 20 degrees
- Abduct thumb and flex MCP to 70 degrees
Indication posterior mold elbow?
- Fracture or soft tissue injuries of the elbow
- Fracture or soft tissue injuries of the proximal
radius or ulna
Indication posterior mold ankle?
- High-grade ligamentous sprain of ankle
- Metatarsal or tarsal fracture
- Distal tibia or fibula fracture
How to thumb spica?
- Distal to IP joint of thumb
- Proximal along distal 2/3 of radial forearm
- Positioning
- Hand neutral
- Extend wrist 20 degrees
- Abduct thumb (as if holding a wine glass)
When does TPA need to be given for stroke?
Door to drug administration: 60 minutes (and less than 3 hours from onset)
IM or SQ epi better for asthma?
IM
How to examine flexor digitorum superficialis?
- Hold 2,4, and 5 digit straight do immobilize profundus
2. Ask patient to flex 3 at PIP
How to examine flexor digitorum Profundus?
- Immobilize 2,4,5
- Immobilize PIP of 3
- See if they can flex DIP of 3
Most common cause OM?
- Strep Pneumo
- H Flu
- RSV
Most common cause OE?
- Pseudomonas
2. Staph
What is emtala?
Federal law that requiring ED to screen every seeking care and to stabilize or transfer those with medical emergencies, regardless of health insurance status or ability to pay
Who needs tetanus?
- Adults 5 years in prone wound
- Adults 10 years non prone wound
- IF never have gotten - Give Ig
- Give Tdap
