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More stuff Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Anaphylaxis is defined by?

A

airway compromise or hypotension

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2
Q

Triggers?

A

(1) Drugs (Antibiotics, NSAIDs; ANY DRUG)
(2) Foods (nuts, shellfish, soy, eggs)
(3) Additives (sulfites)
(4) Toxins (insect stings, venom)
(5) Chemicals (contrast dye, latex)

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3
Q

Classic presentation?

A
  • pruritis
  • flushing
  • urticaria
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4
Q

Progression of anaphylaxis?

A

(a) Throat fullness (lump sensation)
(b) Anxiety
(c) Chest tightness, SOB, Lightheadedness

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5
Q

Severe Reaction of anaphylaxis?

A

(a) Loss of consciousness

(b) Cardiorespiratory arrest

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6
Q

The faster the onset the…

A

severe the reaciton

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7
Q

Within what timeline does anaphylaxis occur?

A

60 min

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8
Q

Tx for anaphylaxis

A
  • ** Rapid admin of EPI 0.5mg IM
  • Remove agent
  • C - A - B
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9
Q

2nd line therapies for anaphylaxis?

A
  • Solumedrol 125mg IM/IV
  • Antihistamine (IV Benadryl preferred)
  • Nebulized albuterol
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10
Q

Initial approach to any toxic inhalation?

A
  • Scene safety
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11
Q

How do Inhaled agents manifest their toxic effects by?

A

1) physical particulates
2) simple asphyxiants
3) chemical irritants
4) chemical asphyxiants.

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12
Q

What may act as a vehicle that carries toxic chemicals thru the respiratory system?

A

Physical particulates

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13
Q

When is physical particulates most commonly encountered?

A

with cases of smoke inhalation.

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14
Q

Tx for particulate inhalation exposure?

A
  • Remove from source
  • O2
  • Albuterol if needed
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15
Q

How do simple asphyxiants works?

A

cause injury by merely being present in an environment and displacing the normal levels of atmospheric oxygen

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16
Q

What are the gases involved in simple asphyxiants

A

1) carbon dioxide (CO2),
2) Nitrogen,
3) Methane,
4) Natural gas.

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17
Q

What do simple asphyxiants effect?

A

Cause hypoxia, no other effects on body’s cells

18
Q

How will patients present if the simple asphyxiant is CO2?

A

narcotic-like sleepiness as the initial effect of exposure.

19
Q

Tx for simple asphyxiants?

A

(b) Administration of High-concentration oxygen

(c) cardiopulmonary support as indicated.

20
Q

What do chemical irritants interact with?

A

chemical reaction with the mucus membranes of the eyes and respiratory system.

21
Q

What are hydrophilic chemical irritants?

A

Chemical irritants that are highly reactive with water

22
Q

What is significant about hydrophilic chemical irritants?

A

react quickly with the moist membranes of the eyes and the upper respiratory tree, causing immediate intense burning and pain.

23
Q

What is significant about non-hydrophilic chemical irritants?

A

can pass more

deeply into the lungs and cause direct lung injury

24
Q

Common non-hydrophilic chemical irritants?

A

phosgene gas, a major chemical used to make plastics and pesticides

25
Q

How do chemical asphyxiants work?

A

cause injury by asphyxiating patients at the cellular level by massively deranging normal cellular utilization of oxygen.

26
Q

Most common example of chemical asphyxiants?

A

carbon monoxide (CO)

27
Q

Other examples of chemical asphyxiants?

A

cyanide gas (HCN) and Hydrogen Sulfide (H2S).

28
Q

What gas comes from Industrial activities that include petroleum/natural gas drilling and refining, wastewater treatment, coke ovens, tanneries, and Kraft paper mills.

A

Hydrogen sulfide

29
Q

How do the symptoms present for H2S and HCN

A

Rapid onset

30
Q

Tx for CO poising?

A

supportive care with high-flow oxygen via a non- rebreather mask or ET tube for the comatose patient

31
Q

candidates for hyperbaric oxygen therapy for CO poisoning?

A

high blood levels of COHgb or those
who are pregnant, have signs of cardiac ischemia or have a loss
consciousness

32
Q

What is characteristic of H2S poisoning?

A

rotten egg smell

33
Q

What is also significant of H2S poisoning

A

possesses both chemical asphyxiant and chemical irritant properties, resulting in eye and
upper airway irritation and burning.

34
Q

How fast does death occur with H2S?

A

Can be as few as a couple breaths

35
Q

Can the patient actually breathe off H2S?

A

Yes, so be careful

36
Q

Tx for H2S?

A

use of the nitrite component of the standard cyanide kit and hyperbaric oxygen therapy.

37
Q

What is the final major chemical asphyxiant?

A

Cyanide posining

38
Q

Classical presentation of cyanide poisoning?

A

unresponsiveness, hyperventilation and hypotension without evident cyanosis.

39
Q

How is cyanide treated?

A

immediately initiate cyanide antidote therapy.

40
Q

What’s in the cyandie kit?

A

(1 inhaled amyl nitrite,
(2 IV sodium nitrite and
(3 IV sodium thiosulfate.

41
Q

Example of hydrophilic chemical irritants?

A

hydrochloric acid

ammonia

Emergency Medicine (13 decks)

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