intro Flashcards
What qualities are needed to be considered a level 1 hospital
- 24 hour surgeons in all specialties
- 24hr neuroradiology
- 24hr hemodialysis
- trauma research program
What is Emtala
- 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.
Can a woman in labor be transferred to another hospital
They are considered unstable and cannot be transferred unless patient requests it
What things are considered apropriate for transfer
- 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
If an accepting hospital has capability & capacity to receive a patient… can they deny the transfer
No!
Breaks EMTALA
When does EMTALA no longer apply
- After evaluation the patient is found not to have an emergency medical condition
- After admission
Which patients get providers attention no matter their complaint
-extremes of age
- other high risk features
What does SAMPLE stand for
S- signs/ symptoms
A- Allergies
M- Meds
P- pertinent PMH
L- Last oral intake
E- events leading up to episode
What are the reversible causes for cardiac arrest
- Hypovolemia, hypoxia, hydrogen ion (acidosis), hypo/hyperkalemia, hypothermia
- Tension pneumo, Tamponade, Toxins, Pulm/coronary thrombosis
What are the posible disposition from the ER
Admission
observation
AMA
Discharge
What is the number 1 cause of death in age group 1-44
Trauma
Head/chest/vascular
What is the most common cause of preventable death
Hemorrhage
What is included in a primary neurologic survey
Opening eyes
Best verbal response
best motor response
Why is preventing hypothermia so important in trauma patients
prevent further coagulopathy
What is the massive transfusion protocol
> 10 units w/n 24 hours
When do you give pRBC outside of trauma
transfuse when Hgb <7 w/o cardiopulmonary or PVD
What GCS score indicates the need to intubate
less than 8 –> intubate
What angle do you keep the head of the bed at with head trauma
30 degrees
What intervention is required when someone has a blown pupil
burr holes
What is the target SBP and what do you give someone who is hypertensive
<180
IV nicardipine or labetolol
What are some signs of elevated ICP
posturing
Siezure
N/V
agonal respirations
What is cushings triad
Hypertension
Agonal breathing
bradycardia
What views are included on an EFAST exam
- 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
Where will bruising be seen first with pelvic fractures
perianal
Where is the proper placement of a pelvic binder
over the greater trochanters
What is a REBOA and what is it used for
Balloon catheter used for tamponade when there is an aortic bleed
