Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NSER 7410 (ER Theory 3) > Module 3 > Flashcards

Module 3 Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
1
Q

Parkland formula

A

4ml x KG x % of TBSA = fluid over 24h
First half over first 8 hours

titrate for urine output 30-50 cc/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Vent settings that impact ventilation

A

RR

TV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Vent settings that impact oxygenation

A

FiO2

Peep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

TV setting

A

6-8ml/KG IBW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Assessments of burns

A
  1. Depth of burns
  2. Determine extent of burn
  3. Weight of pt
  4. Determine concomitant injuries
  5. Comorbities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Depths of burns

A

Superficial
Partial thickness
Full thickness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Superficial thickness

A 
simple erythema
without blistering (rapid healing)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Partial thickness

A

Skin loss
blistering
pain from exposed nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Full thickness

A

Skin loss penetrating deep layers of dermis

leathery, waxy, in elastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Basic first aid of burns

A 
Remove jewelry
Remove clothes and debris
Active cooling x20-30mins for small burns
Don't cool in extensive burns >10% TBSA
Cool burns warm core
Dress burns
Control pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why are burns worse in children

A

Children have thinner skin and larger body surface area

Greater fluid loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why are burns worse in old people

A

Old peeps thin dermis, reduced microcirculation and poor capacity for tissue regeneration results in deeper more complex burns and prolonged healing time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Flames cause

A

mixed depth burns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

contact burns always cause

A

deep burns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

cold/frostbite

A

severe drop in temp
causes formation of ice crystals and consequent intra cellular freezing leading to severe cellular damage and cell death

formation of micro clots cut off circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Chemical burns

A

cause progressive damage to the skin

remove irritant and irrigate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Acid chemical exposure

A

coagulative necrosis with swift formation limiting further tissue penetration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Alkalotic chemical exposure

A

results in liquefactive necrosis which allows deeper penetration of the chemical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Palmar estimation for burns

A

used for small or patchy burns

palm with fingers is 1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Rule of Nines

A

moderate to severe burns in adults
not useful in kids unless its modified

each area of the body represents 9% TBSA
front of legs- 9%
Back of legs- 9%
whole arm front and back - 9%
entire head 9%
abd 9%
chest 9%
upper back 9, lower back 9
groin 1%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Lund and Browder chart

A

accurate for use in adults and kids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

vascular changes in thermal injury

A

Capillary leakage and massive fluid shifts

leads to decreased tissue perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

at what percentage of TBSA do people become hypotensive

A

> 15-20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Burns Acute phase

A

hypovolemia
increased capillary permeability
fluid shifts

25
Q

Hypermetabolic phase

A

hypoproteinaemia—- edema

cardiac dysfunction

26
Q

Pulm complications with burns

A 
inhalation injuries
Airway burns/mucosal burns
subglottic injury
pneumonia
infection
ARD
27
Q

Signs and symptoms of inhalation injury (5)

A 
carbonaceous sputum
facial burns
singed facial hair
wheezes/ stridor
Resp changes
28
Q

Fire with synthetic material increases the risk of…

A

cyanide poisoning

antidote is Hydroxocobalamin

29
Q

Burns assessment Airway

A

Prevent hypoxia and treat smoke inhalation
Cspine
Early administration of O2
Inhalation injury = supreglottic edema

30
Q

Burns assessment Breathing

A

smoke inhalation
high risk of ARDS
Circumfrentail burns prevent expansion
assume carbon monoxide poisoning (carboxyhemoglobin >30%)

31
Q

Burns assessment Disability

A

consider noxious exposure
blood glucose due to hypermetabolic state
PAIN CONTROL (multimodal)

32
Q

Burns assessment Circulation

A

parkland formula
smoke inhalation means increased fluid requirements
Vit C infusion reduces fluid requirements

33
Q

What type of fluid should be used for burn pts

A

crystalloids and blood

albumin to decrease compartment syndrome

34
Q

fluid creep

A

need to balance fluids to prevent shock but we can’t over resuscitate or we cause compartment syndrome via extra vascular fluid loss

35
Q

Burns assessment expose

A

rapid heat loss
need invasive temp monitoring
prevent hypothermia

36
Q

Assist control VOLUME

A

Healthy lung mode
SET: VOLUME
Can breath above the set RR but always get a set VOLUME

Need to monitor pressure

37
Q

Assist control PRESSURE

A

Sick lung mode- needed with decreased lung compliance
SET: PRESSURE
Can breath above the set RR but always get a set PRESSURE

Need to monitor volumes

38
Q

Pressure support

A

Weaning mode
Pt only gets pressure with a spontaneous breath (5-20)
No set RR or VT
Similar to BiPAP but with an ETT

39
Q

SIMV

A

used to bridge or wean
combo of AC and PC each breath gets pressure support
set RR and AC

40
Q

Min Ventilation

A

TV xRR ( how much gas in exchanging in a minute)

41
Q

Ventilation effects of Hemodynamics

A

Increased intrathoracic pressure causes decrease in venous return

42
Q

Ventilation effects of Hemodynamics

A

Increased intrathoracic pressure causes decrease in venous return to rt side of heart
decreased preload causes decrease in cardiac output

Positive pressure impairs venous outflow from the brain and increases the ICP

43
Q

What do we assess in its that are deteriorating while ventilated (DOPE)

A

Displacement/Dislodgement
Obstruction
Pneumothorax
Equipment

44
Q

Pt safety checks on vent (8)

A 
Tube position
securement
position of circuit
cuff
suction
BVM
end tidal 
sedation
45
Q

Ideal end tidal Co2

A

35-45

46
Q

High pressure vent alarm

A

tube obstruction
asynchrony with vent
Bronchospasm
decreased lung compliance

47
Q

Low pressure alarm

A

Disconect

48
Q

High RR alarm

A

pt tiring while in weaning mode
Hypoxia
anxiety or pain

49
Q

Apnea

A

no breath x20 sec

50
Q

Low minute volume/ ventilation

A

cuff leak
tiring while in weaning mode
Pressure limit being reached ( worsening lung compliance)

51
Q

Low exhaled Tidal volume

A

leak in circuit
tiring pt
inappropriate alarm settings
pressure limit reached

52
Q

Rnhabdomylosis

A

destruction of a significant amount of muscle
increase CK and Potassium and phosphate
myoglobin
AKI

decreased renal function

53
Q

Lab marker for Rhabdo

A

High CK
high potassium
high phosphate

54
Q

Complications of positive pressure ventilation

A 
Barotrauma
Decreased CO2/Increased ICP
O2 toxicity
Decreased nitrogen ( keeps alveoli open)
Diaphragm weakend
VAP
55
Q

The mechanism of thermal injury most likely to be under resuscitated with fluids based on %TBSA calculations is?

A

Electrical

56
Q

The information needed to calculate fluid requirements based on the Parkland formula on a patient with a superficial erythema thermal burn is:

A

We don’t include superficial erythema thermal burns

57
Q

A patient is unconscious from a house fire and has not regained consciousness with high flow oxygen. The patient has severe metabolic acidosis. The most likely cause is?

A

cyanide toxicity.

58
Q

The cardiac arrhythmia most likely in a lightning strike is:

A

asystole.

59
Q

Your patient has a high voltage electrical burn. Which diagnostic test will be elevated indicating massive muscle tissue damage

A

CK

NSER 7410 (ER Theory 3) (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions