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Oral Boards > Life Support + Procedures > Flashcards

Life Support + Procedures Flashcards

1
Q

When intubating using succ in children under X, premedicate with Y at what dose to prevent Z (or use roc)

A

Children <2, premedicate with atropine 0.01 mg/kg to prevent bradycardia

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2
Q

Transtracheal jet ventilation (as opposed to just using BVM) contraindicated age

A

5

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3
Q

Elevated ICP, premedicate with (2 meds + dose) before intubation to blunt rise in ICP

A

lidocaine 1.5 mg/kg, fentanyl 1 ug/kg

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4
Q

Septic shock + chronic steroids or non-responsive to pressors –> give

A

hydrocortisone 100 mg

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5
Q

Adult levophed dosing (not weight based)

A

1-30 ug/min

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6
Q

2nd pressor after levophed for septic shock and dose

A

0.04 U/min

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7
Q

Goal directed therapy in sepsis. What objective measures?

A

SBP >90, MAP > 65, UOP 0.5 cc/kg/hr, CVP 8-12, ScvO2 > 70

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8
Q

Septic pt. What procedures?

A

CVC, aline, foley, low threshold to intubate

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9
Q

Pulse present but insufficient respirations. What do you do?

A

Bag q5-6 sec + q2 min pulse check

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10
Q

Pt codes in front of you. First 2 things to verbalize.

A

Begin compressions. Activate code blue.

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11
Q

Hs and Ts

A

Hypothermia, hypovolemia, hypoxia, H+, hyper/hypokalemia, hypoglycemia, toxins, tension PTX, thrombus (PE/MI), tamponade

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12
Q

Hyperkalemia treatment (ACLS)

A

Calcium, insulin 10U + d50 1 amp, nebulized albuterol. Dialysis if needed.

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13
Q

ACLS acidosis - consider (med + dose)

A

bicarb 1 mEq/kg

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14
Q

PE circling drain –> TPA dosing

A

50 mg immediately, can give 50 more at 15 min

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15
Q

Bradycardia escalating steps

A

atropine 0.5 mg (up to 3). Epinephrine 2-10 ug/min. Transcutaneous –> transvenous pacing

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16
Q

Tachycardias more likely to respond to lower dose cardioversion vs likely require higher

A

Lower (100 J): aflutter, SVT

Higher (200 J): afib, vtach

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17
Q

Stepwise escalation of cardioversion energy e.g. unstable afib

A

200 - 300 - 360 J

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18
Q

Stable tachycardia stepwise approach: narrow complex, regular

A

Vagal maneuvers/treat underlying issue e.g. fluids. Adenosine 6 -12 -12. CCB (dilt 0.25/kg -> 0.35/kg) or BB. Digoxin if EF <40

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19
Q

WPW EKG

A

PR <120 (orthodromic), slurred QRS upstroke, widened QRS, ST/T wave changes

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20
Q

Antidromic WPW treatment options.

A

Procainamide, amiodarone, or cardiovert. Otherwise treat like VT. AVOID AV nodal blockers including adenosine, BB, CCB, digoxin.

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21
Q

Orthodromic WPW

A

Can treat same as SVT; vagal, adenosine, CCB

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22
Q

Tachycardia. Narrow, irregular. Ddx and tx options. Tx if EF <40%

A

Afib, aflutter. Dilt 0.25 mg/kg -> 0.35 mg/kg. Cardioversion if <48 hrs and properly anticoagulated. OR metop. EF < 40% = digoxin.

23
Q

Wide, regular tachycardia. Ddx and stepwise mgmt.

A

Monomorphic VT vs SVT with aberrancy. Cardiovert if unstable/consider for stable right away as well. Otherwise amiodarone 150 mg over 10 min. OR procainamide 10 mg/kg (give 100 mg q5 min til reaching full dose)

24
Q

Wide, irregular tachycardia. Ddx and stepwise mgmt.

A

Polymorphic VT, afib with aberrancy. Synchronized cardioversion if unstable. Correct underlying abnl - electrolytes, magnesium, MI. Torsades: magnesium. Amiodarone vs BB. Consider overdrive pacing.

25
Q

Wide, irregular tachycardia >200 bpm. What is it (most likely) and how to treat?

A

WPW + afib. Use ONLY cardioversion and/or procainamide. No adenosine, BB, CCB, or digoxin.

26
Q

Versed status epilepticus dose

A

0.2 mg/kg

27
Q

Consider ketamine for induction for RSI with which specific condistions

A

hypotension/sepsis, asthma, bronchospasm

28
Q

Pediatric fluid resuscitation dose. When to start pressors (how much given in fluids)

A

20 cc/kg boluses then reassess. Add pressors if 60 cc/kg given w/o adequate response.

29
Q

Cardioversion, defibrillation, defibrillation subsequent dose energy settings for PEDS

A

Cardiovert 1J/kg. Defib 2J/kg -> 4 J/kg

30
Q

Cardioversion/defibrillation paddle sizes for peds

A

Infant: 4.5 cm paddles. Older child: 8 cm paddles. can use AP OR right ant + left lateral placement.

31
Q

Meds that can be given through ETT

A

LEAN: lidocaine, epi, atropine, narcan

32
Q

Peds Dosing: adenosine

A

0.1 mg/kg -> 0.2 on subsequent

33
Q

Peds Dosing: amiodarone (pulseless VT/VF). Maximum?

A

5 mg/kg bolus. Max 15 mg/kg/d. (Give 5 mg /kg over 20 min if perfusing rhythm)

34
Q

Peds Dosing: atropine

A

0.02 mg/kg IV (same or double ETT). Min: 0.1 mg. Max: 1 mg.

35
Q

Peds Dosing: epi for cardiac arrest bolus dosing

A

0.01 mg/kg (=1 mL for every 10 kg 1:10,000). Dose x10 if using via ETT (no access, use 1:1000 epi)

36
Q

Peds Dosing: epi infusion

A

0.1-0.2 ug/kg/min

37
Q

Peds Dosing: magnesium (polymorphic VT)

A

25-50 mg/kg over 10-20 min

38
Q

Pediatric bradycardia drug of choice

A

epinephrine (can consider atropine, but epi first unlike adults)

39
Q

Procedure on a pt: steps to verbalize

A

Consent, time out, antiseptic prep

40
Q

Critical action: joint injury

A

evaluate joint above and below. evaluated CMS.

41
Q

When to reduce a dislocated joint prior to imaging (2)

A

neurovascular compromise, skin tenting

42
Q

Posterior shoulder dislocation critical action

A

pinprick sensory discrimination over axillary nerve territory

43
Q

Posterior shoulder dislocation reduction technique +1 thing to avoid

A

Supine, in line traction. Avoid forced external rotation.

44
Q

Distal radius fx: do not reduce in ED if ______

A

intraarticular extension

45
Q

Distal radius fx critical actions

A

Test median, ulnar, and radial nerve. Check for snuffbox tenderness.

46
Q

Hip reduction textbook approach

A

Anterior traction and slight external rotation

47
Q

Knee dislocation critical actions

A

Neurovascular check before and after reduction. Reduce asap (no imaging prior). CTA afterward. Orthopedics consult.

48
Q

Ankle dislocation stepwise mgmt

A

Neurovasc assmt. Reduce before imaging if clear. Posterior slab. Ortho consult.

49
Q

LP reasons to delay

A

Anticoagulated (consider), elevated ICP, thrombocytopenia

50
Q

LP procedural specifics to verbalize

A

Mark L4-L5 space. Decubitus. Cleanse, drape. Bevel up.

51
Q

Pericardial effusion predisposing conditions

A

Lupus, cancer, TB

52
Q

Pericardial effusion with tamponade beck’s triad

A

muffled heart sounds, JVD, hypotension. Likely has narrow pulse pressure.

53
Q

Perimortem c-section indicated at how many weeks if known? Decide to initiate w/in how long?

A

23 weeks. 3-4 min (could consider up to 20 but that’d be weird)

Oral Boards (4 decks)

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