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NMETC > Med Emerg Management > Flashcards

Med Emerg Management Flashcards

1
Q

NARCOTIC TOXIDROME Drug Examples (7)

A 
Morphine
Codeine
Heroin
Methadone
Fentanyl
Oxycodone
ASA
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2
Q

NARCOTIC TOXIDROME S/S (8)

A 
Hypoventilation
Respiratory arrest
Constricted pupils
Bradycardia
Hypotension
Track marks
Drowsy/Stupor
Coma
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3
Q

SYMPATHOMIMETIC Drug Examples (7)

A 
Pseudoephedrine
Amphetamine
Meth
Cocaine
Caffeine
Nasal decongestants
Bath salts
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4
Q

SYMPATHOMIMETIC S/S (9)

A 
HTN
Diaphoresis
Tachycardia
Tachypnea
Dilated pupils
Agitation
Seizure
Hyperthermia
Paranoia
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5
Q

SEDATIVE HYPNOTIC Drug Examples (6)

A 
Phenobarbital
Diazepam
Versed
Lorazepam
Propofol
Ethanol
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6
Q

SEDATIVE HYPNOTIC S/S (9)

A 
Hypoventilation 
Respiratory arrest/depression
Drowsy
Uninhibited
Ataxia
Slurred Speech
Confusion
Progressive CNS depression
Hypotension
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7
Q

CHOLINERGIC Drug Examples (3)

A

Organophosphates
Sarin
V agent

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8
Q

CHOLINERGIC S/S- DUMBELS

A 
Diarrhea
Urination
Miosis (constricted pupils)/Muscle Weakness
Bradycardia/Bronchospasm
Emesis
Lacrimation
Seizures/Salivation/Seating

Respiratory depression

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9
Q

ANTICHOLINERGIC Drug Examples (6)

A 
Atropine
Antihistamines
Benadryl
Tricyclic AntiDepressants
AntiPsychotics 
Jimson weed
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10
Q

ANTICHOLINERGIC S/S (9)

A 
Agitation
Dry mucous membranes
Flushed
Hyperthermia
Tachycardia
Dilated pupils
Blurred vision
Mild hallucinations
Delerium
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11
Q

Cranial Nerve 1

A

Olfactory- Smell

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12
Q

Cranial Nerve 2

A

Optic- Vision

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13
Q

Cranial Nerve 3

A

Oculomotor- Movement of Eye/Pupil

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14
Q

Cranial Nerve 4

A

Trochlear- Movement of eye

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15
Q

Cranial Nerve 5

A

Trigeminal- Chewing/Px/Temp/Touch of face and mouth

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16
Q

Cranial Nerve 6

A

Abducens- movement of eye

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17
Q

Cranial Nerve 7

A

Facial- tears/salivation/taste/movement of face

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18
Q

Cranial Nerve 8

A

Auditory- hearing and balance

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19
Q

Cranial Nerve 9

A

Glossopharyngeal- swallow, taste, sensation of pharynx and mouth

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20
Q

Cranial Nerve 10

A

Vagus- sensation and movement of pharynx/larynx/thorax/GI

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21
Q

Cranial Nerve 11

A

Accessory- Movement of head/shoulders

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22
Q

Cranial Nerve 12

A

Hypoglossal- movement of tongue

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23
Q

Cushings Triad

A

Decreased HR
Decreased Respiratory rate
Widened pulse pressures (systolic)

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24
Q

Hallmarks of Increased ICP (5)

A 
Cushing triad
Decorticate/decerebate posturing
Biot/Apneustic/Cheyne Stokes Respirations
Unresponsive
Dilated Pupils
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25
Q

Standard Neuro Tx Plan

A 
Scene Safety
ABC's
Check blood glucose
Consider stroke eval
Assess for ICP
Check for drug use
Assess for seizures
Evaluate temp
Provide support for family
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26
Q

Tx Plan for Pt with increased ICP

A 
Ensure BP of 110-120
Give fluids as needed
Elevate head by 30 degrees if no trauma
Support ventilation
Maintain EtCO2 high 20's and low 30's
Clear Airway

Do not aggressively suction–>vagus nerve stimulation increases ICP

If bradycardia due to increased ICP, no atropine or TCP is indicated

Prompt txp

DO NOT use solutions with dextrose

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27
Q

Normal Cerebral perfusion pressure

A

70-90

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28
Q

Hemorrhagic stroke S/S

A

Severe HA- worst ever
difficult to arouse
s/s increased ICP
cannot speak

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29
Q

Normal ICP

A

1-20

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30
Q

CPP Equation

A

CPP= MAP-ICP

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31
Q

A-EIOUTIPS (2)

A

Alcohol- 02, glucose, temp, thiamine

Acidosis- bicarb

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32
Q

AE-IOUTIPS (3)

A

Epilepsy- 02, versed
Endocrine- supportive
Electrolytes- EKG, ABC’s

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33
Q

AEI-OUTIPS

A

Insulin- dextrose, glucagon

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34
Q

AEIO-UTIPS

A

Opiates- narcan, ABCs

Other drugs

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35
Q

AEIOU-TIPS

A

Uremia (kidney failure)- 02, glucose, temp

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36
Q

AEIOUT-IPS

A

Trauma- c spine, adequate BP

Temperature- cool or warm pt

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37
Q

AEIOUTI-PS

A

Infection- ensure adequate BP

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38
Q

AEIOUTIP-S

A

Poisoning- care based on agent

Psychogenic causes- 02, glucose, temp, restraints

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39
Q

AEIOUTIPS-

A

Shock- ABC’s and adequate circulation/vasopressors
Stroke- 02, glucose, temp, ABC’s
Syncope- ABC’s, EKG, trauma if fell
Space occupying lesion- tx seizure or stroke
Subarachnoid hemorrhage- tx seizure or stroke

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40
Q

ALOC Medical Rapid Onset

A 
Insulin
Stroke
Epilepsy
ETOH
OD
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41
Q

ALOC Medical Gradual Onset

A 
Acidosis
Uremia
Psychosis
Infection
OD
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42
Q

ALOC Trauma

A

Head injury

Hypotension

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43
Q

Seizure types

A

Tonic clonic
Pseudoseizures
Absence seizures

Partial seizures- either shaking of one limb, or subtle changes in LOC

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44
Q

Seizure tx

A 
ABC's
Protect from injury
If still seizing, give Versed/Ativan
Check blood glucose
Give 02- consider NPA and high flow 02
45
Q

Cardiac causes of Syncope (10)

A 
Bradycardia
Sick Sinus
SVT
Pacemaker malfunction
TdP
Transient Asystole
Transient VF
VT
MI
Medication problem
46
Q

NonCardiac Causes of Syncope (5)

A 
Dehydration
Hypoglycemia
Vasovagal
PE
Other medications
47
Q

Syncope tx

A 
ABC's
Sit/Lay down if needed
Orthostatics
Drugs/ETOH
EKG
Blood glucose check

Consider fluids or vasopressor

48
Q

Migraine tx

A

Consider px management

Zofran 4mg

49
Q

Dystonia tx

A

Benadryl 25-50mg

50
Q

Encephalitis s/s (8)

A 
Fever
HA
N/V
Malaise
ALOC
Stiff neck
Photophobia
Seizure
51
Q

Meningitis S/S

A

Runny nose
Cough
Malaise

HA
Fever
Neck rigidity
Chills
Photophobia
N/V
Seizure
ALOC
Inc ICP

Kernig sign-px with hips flexed and straightening knee

Brudzinski sign- px when neck flexed to chest while lying down

52
Q

Polio Tx

A

Watch Airway and Breathing

53
Q

Brain Abscess consideration

A

watch for seizures

54
Q

S/S Hemorrhagic Stroke

A 
decreased HR
Cheyne Stokes breathing
HTN
Unequal pupils
posturing
55
Q

Target EtCO2 for Stroke Pt

A

30-35

56
Q

Multiple Sclerosis

A

Autoimmune disorder–> body attacks myelin sheath surrounding the axons of neurons. Causes scarring and decreased neural function.

57
Q

Multiple Sclerosis S/S

A

Muscle weakness
Speech changes
depression
light touch causing px

58
Q

Guillan Barre Tx

A

Largely supportive–> may need to be aggressive with intubation, ventilation, and fluid infusion

59
Q

ALS

A

attacks motor neurons causing death and thereby muscle atrophy

60
Q

ALS (Lou Gehrigs) Tx

A

May need aggressive airway intervention

61
Q

Graves Disease

A

Hyperthyroidism

Risk of thyroid storm

62
Q

Thyroid storm s/s

A 
extreme high fever
diaphoresis
tachycardia 
N/V
agitated delerium
seizures
unconscious
hypoglycemia
63
Q

Thyroid storm tx

A 
tx hypoglycemia if needed
may require very high benzo amounts
aggressive fluids if normo-hypotensive
beta blocker medication if tachycardic
active cooling
64
Q

Hypothyroidism/Myxedema coma

A

Occurs when ALOC, and hypothermic

65
Q

Myxedema coma tx

A

maintain 02
maintain temp/passive rewarming
intubation if no gag reflex or inadequate breathing
monitor ECG and blood glucose

66
Q

Adrenal insufficiency s/s

A 
ALOC
hypotension
weakness
weakness
N/V
diarrhea
67
Q

Adrenal insufficiency tx

A

aggressive fluid management
treat hypoglycemia if present
treat hyperkalemia if present

68
Q

Cushings s/s

A 
weakness
fatigue
depression
mood swings
buffalo hump
facial hair
moon face
69
Q

Cushing tx

A

treat symptoms

treat hypoglycemia if present

70
Q

Congenital adrenal hyperplasia

A

inadequate production of cortisol and aldosterone

71
Q

Extreme episode in Type I Diabetes

A

Diabetic ketoacidosis

72
Q

Extreme episode in Type II Diabetes

A

Hyperosmolar Hyperglycemic State

–> or Hyperosmolar hyperglycemic nonketotic coma, hyperosmolar nonketotic coma

73
Q

Hypoglycemia tx

A

25g-50g D50 and flush

250mL D10 soln

74
Q

Hyperglycemia tx

A

at least 1L NS in first 30mins
evaluate lung sounds
watch cardiac function
watch for hyperkalemia—> calcium chloride 1g

75
Q

Anaphylaxis tx

A 
remove offending agent
cardiac monitoring
0.3mg 1:1000 epi IM 
at least 1 large bore IV
fluid run wide open
benadryl 25-50mg
solumedrol 125mg

consider albuterol neb if wheezing, or epi neb 3mg 1:000

if pt’s on beta blocker, consider glucagon IVP q 5mins

may need epi infusion —> 1mg 1:1000 epi in 1L NS and run mix at 0.1mcg/kg/min

or push dose epi —> 0.1mg in 0.9mL NS

76
Q

Systemic Lupus Erythematosus

A

multisystem autoimmune disorder effecting whole body

common in women in child bearing age with joint pain, fever, rash

77
Q

Pneumonia S/S

A

Fever
Chills
productive cough- colored
chest px

78
Q

Hepatitis S/S

A

jaundice
low grade fever
malaise
grey feces

79
Q

Lyme S/S

A

bulls eye mark
fever
chills
muscle and joint px

80
Q

Rabies S/S

A 
flu like symptoms
numb bite
seizures
hyperactive delerium
bizarre behavior
81
Q

Anticholinergic Phrase

A 
Blind as a bat- dilated pupils
Red as a beet- vasodilation/flushed
Hot as a hare- hyperthermia
Dry as a bone- dry skin
Mad as a hatter- hallucinations/agitated
82
Q

CO poisoning S/S

A 
N/V
Confusion
HA
Weakness
Cherry red face **usually unsurvivable at this point

**check blood sugar to be sure not hypoglycemic

83
Q

Cyanide poisoning S/S

A

Lethargy
weakness
breathing will be rapid–>to slow–>arrest
bitter almond smell

84
Q

Cyanide poisoning tx

A

Use of antidote
Benzos for seizures
**rapid transport

85
Q

Esophageal Varices S/S

A

copious hematemesis

due to portal HTN from EtOH

86
Q

Esophageal Varices Tx

A

02
Saline lock
Fluid if hypotensive
**Zofran usually doesn’t work

87
Q

Mallory Weiss Tx

A 
Bleeding less severe than varices
Common from protracted vomiting
O2
IV access
Fluids for dehydration
Zofran to limit vomiting
88
Q

Appendicitis S/S

A

Fever
N/V
LRQ px
rebound tenderness

89
Q

Appendicitis Tx

A

Position of comfort
IV
Fluids if shock present

90
Q

Cholecystitis S/S

A

jaundice
px after eating fatty meal
N/V
RUQ px

91
Q

Cholecystitis Tx

A

morphine makes px worse- tightens sphincter

92
Q

Diverticulitis S/S

A 
n/v 
Fever
malaise
LLQ px
**easy to turn septic
**be prepared for lots of fluids
93
Q

RAAS

A

renin (kidney) converts angiotensinogen (liver)–> angiotensin I which is converted by ACE in lungs to angtiotensin II

angtiotensin II promotes release of aldosterone in adrenals—>promotes water retention to increase BP

94
Q

Dialysis emergencies

A

Air Embolism
Disequilibrium syndrome
HypoK/HyperK
Hypotension/Shock

95
Q

Disequilibrium syndrome

A

Acute haemodialysis is associated with this syndrome due to the reduction of plasma solute level over a limited time. Plasma becomes hypotonic compared to brain cells and water shifts from the plasma into the brain tissue

Systemic and neurological symptoms are associated with disequilibrium syndrome.

Early signs include nausea, headache, vomiting, and restlessness. More serious symptoms can result in seizures and coma.

96
Q

Heat Stroke Tx

A

Cool aggressively
Fluids
Cardiac montior
IV

97
Q

Heat exhaustion Tx

A 
Cool 
Cardiac monitor 
IV 
Fluids 1L over 1 hour
Zofran is N/V
98
Q

Mild Hypothermia

A

95-90 degrees

99
Q

Mild Hypothermia tx

A 
remove wet clothes
warm
warmed fluids
cardiac monitor 
treat hypoglycemia if present **check!!
manage seizures
IV
100
Q

Moderate Hypothermia

A

90-82.4 degrees

101
Q

Moderate Hypothermia Tx

A 
remove wet clothes
warm
warm fluids/IV
cardiac monitor 
check hypoglycemia
watch for bradycardic rhythms
102
Q

Severe Hypothermia

A

82.3 and under

103
Q

Severe hypothermia Tx

A 
remove wet clothes
warm
warm fluids and IV
cardiac monitor 
expect V Tach and no pulse
CPR until warm and dead
104
Q

Cold water drowning temps

A

under 68 degrees

105
Q

Drowning tx

A 
watch for pulmonary edema
EtCO2
SpO2
EKG
Albuterol for wheezing
be prepared to intubate
106
Q

Snake bite- pit viper and coral snake

A

pit viper- immobilize extremity and rapid txp

coral snake- constricting band to slow spread. be prepared to aggressively manage airway

107
Q

Spider bite tx

A

benzos for px and paralysis

narcotics for px

108
Q

Scorpion tx

A 
ABCs
intubate if necessary
treat cardiac dysrhythmias
constricting band to slow lymph return to heart
rapid tx
109
Q

DT S/S

A 
high BP
shakes
chills
irregular HR
hallucinations
sweating

NMETC (11 decks)

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