intro

Question 1

What qualities are needed to be considered a level 1 hospital

Answer 1

• 24 hour surgeons in all specialties
• 24hr neuroradiology
• 24hr hemodialysis
• trauma research program

Question 2

What is Emtala

Answer 2

• It is a federal law stating that all patients have the right to a medical screening exam
• States that you must screen and stabilize before transferring or discharging a pt.

Question 3

Can a woman in labor be transferred to another hospital

Answer 3

They are considered unstable and cannot be transferred unless patient requests it

Question 4

What things are considered apropriate for transfer

Answer 4

• pt stabilized to best of current facility abilities
• Accepting facility has to have capability & capacity
• Accepting facility agrees to take pt.
• Medical info sent with patient
• transfer occurs w/ qualified personnel

Question 4

If an accepting hospital has capability & capacity to receive a patient… can they deny the transfer

Answer 4

No!

Breaks EMTALA

Question 5

When does EMTALA no longer apply

Answer 5

• After evaluation the patient is found not to have an emergency medical condition
• After admission

Question 6

Which patients get providers attention no matter their complaint

Answer 6

-extremes of age
- other high risk features

Question 7

What does SAMPLE stand for

Answer 7

S- signs/ symptoms
A- Allergies
M- Meds
P- pertinent PMH
L- Last oral intake
E- events leading up to episode

Question 8

What are the reversible causes for cardiac arrest

Answer 8

• Hypovolemia, hypoxia, hydrogen ion (acidosis), hypo/hyperkalemia, hypothermia
• Tension pneumo, Tamponade, Toxins, Pulm/coronary thrombosis

Question 9

What are the posible disposition from the ER

Answer 9

Admission
observation
AMA
Discharge

Question 10

What is the number 1 cause of death in age group 1-44

Answer 10

Trauma

Head/chest/vascular

Question 11

What is the most common cause of preventable death

Answer 11

Hemorrhage

Question 12

What is included in a primary neurologic survey

Answer 12

Opening eyes
Best verbal response
best motor response

Question 13

Why is preventing hypothermia so important in trauma patients

Answer 13

prevent further coagulopathy

Question 14

What is the massive transfusion protocol

Answer 14

> 10 units w/n 24 hours

Question 15

When do you give pRBC outside of trauma

Answer 15

transfuse when Hgb <7 w/o cardiopulmonary or PVD

Question 16

What GCS score indicates the need to intubate

Answer 16

less than 8 –> intubate

Question 17

What angle do you keep the head of the bed at with head trauma

Answer 17

30 degrees

Question 18

What intervention is required when someone has a blown pupil

Answer 18

burr holes

Question 19

What is the target SBP and what do you give someone who is hypertensive

Answer 19

<180
IV nicardipine or labetolol

Question 20

What are some signs of elevated ICP

Answer 20

posturing
Siezure
N/V
agonal respirations

Question 21

What is cushings triad

Answer 21

Hypertension
Agonal breathing
bradycardia

Question 22

What views are included on an EFAST exam

Answer 22

• Upper chest (R/L quadrants)
• RUQ abdomen (b/n Kidney and liver)
• LUQ abdomen (b/n kidney and spleen)
• Subxyphoid (look at the heart)
• Suprapubic

Question 23

Where will bruising be seen first with pelvic fractures

Answer 23

perianal

Question 24

Where is the proper placement of a pelvic binder

Answer 24

over the greater trochanters

Question 25

What is a REBOA and what is it used for

Answer 25

Balloon catheter used for tamponade when there is an aortic bleed