Medical Emergencies Flashcards
hemophilia types
-hereditary genetic disorder that impairs the body’s ability to control blood clotting
-Males:
>hemophilia A (Classic Factor 8 VIII)
>hemophilia B (Factor 9 IX)
-Both:
>Von Willebrand
signs & treatment of hemophilia
-decreased LOC
-bleeding of soft tissues
-replace clotting factor or administer cryoprecipitate or FFP
-no IMs, hold pressure to venipun
-avoid ASA & NSAIDS
Disseminated Intravascular Coagulation (DIC)
*elevated D-dimer & fibrin degradation products
*prolonged coagulation times (PT, PTT)
-low HgB,hematocrit, platelets, fibrinogen
Tx with TXA and platelet transfusion
Idopathic Thrombocytopenia Purpura (ITP)
an autoimmune disorder seen after a viral infection in children 2-4 that causes low platelet count with normal bone marrow function
Idopathic Thrombocytopenia Purpura (ITP)
an autoimmune disorder seen after a viral infection in children 2-4 that causes low platelet count with normal bone marrow function
epistaxis, bleeding gums, petechiae
polycythemia
excess blood cells
sickle cell disease
-congenital (meaning gene from both parents) sickling of RBCs
- pts take hydroxyurea to decreasing sickling
- triage a level 2
what can SCC cause
-acute chest syndrome: chest pain & dyspnea is the main killer
-sequestration: the cells in the spleen cause abdominal pain
-vaso occlusive crisis: most common
-priapism
triggers- low O2, infection, dehydration, exposure to cold
neutropenia
- low WBC count
- triage level 2
- caused by chemo or radiation, or leukemia
- tx by isolation, avoid invasive procedure, early abx, avoid raw meat, well water, and unwashed produce, & bone marrow stimulants
What causes hyperkalemia?
+K > 5.0
renal failure
burns
crush injuries
ACE inhibitors
rhabdo
What EKG changes happen in hyperkalemia
peaked T waves
widening QRS
loss of P waves
Heat cramps
-Sweat induced electrolyte depletion causes muscle cramps
-TX: rest in a cool environment and fluid electrolyte replacement
Heat exhaustion
-prolonged exposure to heat leads to heat cramps, anorexia and vomiting, headache syncope
-TX: with rest in a cool environment and fluid/electrolyte replacement
Heat stroke
-young and elderly more vulnerable
-medication risk: thyroid meds, Haldol, antihistamines, anticholinergics
-tachycardia, tachypnea, hypotension, hot dry skin, decreased LOC
-rhabdomyolysis from muscle breakdown-dark brown urine
TX: cool patient quickly
Frostbite
-TX: pain medication and quickly rewarm the affected part for 15-30 mins in 40-42 Celsius
-avoid any friction or rubbing
-NSAIDS to limit damage
-administer narcotics
Rabies
-viral disease transmitted through the bite of infected animal
-S/S: delirium, hallucinations, excessive salivation
-TX: early, aggressive wound management, infiltrate rabies immunoglobulin in the wound if possible
-rabies vaccine given 1ml in deltoid
-days 0,3,7 & 14
Lyme Disease
-S/S: nonpruritic, target like circular bulls-eye rash, flulike symptoms (malaise and headache)
-TX: antibiotics (doxycycline)
-risk if untreated: facial paralysis, arthritis, and myocarditis
Rocky Mountain Spotted Fever
S/S: non pruritic, nonblanching macules of the palms wrist, forearms, soles and ankles,
N/V, fever, chills
TX: antibiotics (doxycycline)
Measles (rubeola)
-highly contagious
-incubation periods of 8-12 days
-S/S: conjunctivitis, coryza(rhinitis), cough
-fever, eyelid edema, Koplik spots rash, maculopapular rash from head to trunk to lower extremities
-TX: supportive care, immunization for patient’s family
DKA is what kind of shock?
-hypovolemic shock so priority is isotonic fluid resuscitation
DKA causes what?
-metabolic acidosis
causing Kussmauls respirations to compensate by blowing of CO2
-ketones in urine and BUN elevated due dehydration
-monitor glucose and K level closely
-do not given insulin bolus to avoid risk of cerebral edema
-do not stop insulin infusion gap is closed
Thyroid storm symptoms
tachycardia
restless
pulmonary edema
TSH low
T3 & T4 elevated
How to treat thyroid storm
beta blockers initially
then PTU then iodine an hour after PTU
What happens during an adrenal crisis
-hyponatremia <+Na sodium
-hypoglycemia
-hyperkalemia ^+K potassium
