Nose/anaphylaxis/snakes/heat-NP615

Question 1

Epitaxis-Rarely life-threatening

Answer 1

Posterior is seen more in those 40 yrs and up and is more serious than anterior
Anterior is seen more in those younger than 40 and nasal mucosa is the most common cause.

Question 2

Epitaxis

Answer 2

Localize the bleeding
Lean forward and pinch for 5-20 minutes
If abnormal vital signs gain vascular access and administer IV solution.
Attempt to cauterize a 0.5 cm area of mucosa around the bleeding site with a silver nitrate stick.
Observe patient for 30 minutes
Do not send anyone home with COPD or with cardiac problems

Question 3

Peritonsilar abscess

Answer 3

Edema, erythema, exudate
Surgical intervention
Needle asp[iration
Antx
pain meds
Can have stridor, drooling, "hot potato voice"
SOB, lymphadenopathy

Question 4

Epiglottis- Mean age from 3 years to 7 but can happen at any age. Adolescents and adults may just complain of sore throat.

Answer 4

Mechanical obstruction to the flow of air. Stridor. Determine the cause. Triad of drooling, agitation and the absence of cough is useful for differentiating epiglottitis from croup

Question 5

Strep Pharyngitis

Answer 5

10-15% of sore throats in adults. Rare in children under 3 and adults over 50. Onset is acute with difficulty swallowing, exudate 50%, fever >101 and erythema.

Question 6

Anaphylaxis

Answer 6

Clinical syndrome 
1st step is to watch closely for s/s
Get good hx
Any previous reaction to stings
watch for flushing, urticaria, laryngeal edema/stridor, bronchospasm, hypotension, tachy and anxiety
Acute respiratory distress

Question 7

Anaphylaxis-Treat aggressively. Never lose someone due to conservative tx.

Answer 7

Tx with epinephrine
Adults:1:1000 0.2-0.5mg IM in anterolateral aspect of thigh (middle 1/3) q5-15 minutes
PEDS: 1:1000 0.01mg/kg q 5-15 minutes (max single dose 0.3 mg)
EPI pen .15 for children
.3 for adults and children over 25 kg

Question 8

Triad tx for anaphylaxis

Answer 8

Epinephrine, benadryl and steroids

Question 9

Snake bite

Answer 9

If its venomous it is a medical emergency.
Determine whether envenomation has occurred. This is the first step
Know where (clinic) the antivenom is kept.

Question 10

Heat illness

Answer 10

Patient and community education is the first step to preventing a heat-related illness. Core temp of more than 40C and altered mental status, delirium and coma are HEAT STROKE (Emergency)
Remove heat source-Get rectal temp
Elevate limbs
Rest and rehydrate
Cramps-1/2 tsp salt to 1 qt water
Sponge and then fan
Take fluids over the next 24-48 hrs is minor illness. Cool to 38.5C
Know the meds