PEARLS

Question 1

high heart rate, low blood pressure

Answer 1

bleed-dehydration

Question 2

flat jugular veins when supine

Answer 2

bleed-dehydration

Question 3

hot skin in a shocky pt

Answer 3

septic shock (look for source)

Question 4

female patients on birth control & or smoking with shortness of breath

Answer 4

pulmonary embolism (PE)

Question 5

hives, laryngeal edema

Answer 5

allergic or anaphylactic

Question 6

cool, clammy skin

Answer 6

shock (sympathetic response)

Question 7

sudden onset after eating of vomiting/diarrhea

Answer 7

allergic or anaphylactic shock

Question 8

cool, clammy skin above, warm dry skin below, low BP, how HR

Answer 8

neurogenic shock (does not have to be trauma)

Question 9

getting PT to the hospital isn’t good enough

Answer 9

make sure you are treating it (could be MI, shock)

Question 10

person on ace inhibitor with laryngeal edema & stridor

Answer 10

allergic response, anaphylactoid reaction (ace inhibitor, ends in -pril)

Question 11

hives

Answer 11

allergic or anaphylactic shock

Question 12

if it is wet and sticky and isn’t yours…

Answer 12

don’t touch it

Question 13

black tarry stools

Answer 13

GI bleed

Question 14

PT states “I feel like my heart is beating out of my chest”

Answer 14

supraventricular tachycardia (SVT), treated with bear down, adenosine - follow with bolus to condense, electrical shock

Question 15

crushing sub sternal chest pain

Answer 15

MI

Question 16

sudden onset shortness of breath

Answer 16

pulmonary embolism (PE)

Question 17

jugular vein distention (JVD)

Answer 17

ride side failure, PE, tension pneumothorax, cardiac tamponade, COPD

Question 18

COPD patients are…

Answer 18

hypercarbic

Question 19

any female of child bearing age with belly pain has…

Answer 19

ectopic pregnancy until proven otherwise

Question 20

tall skinny males with sudden onset shortness of breath

Answer 20

spontaneous pneumothorax

Question 21

if PT has Hx of hypertension (HTN)

Answer 21

think MI, stroke, aneurysm

Question 22

number one cause of PE is left sided failure, number one cause of left sided failure is MI, number one cause of right sided failure is left side failure. number two cause of right side failure is COPD. this means if you hear wet lungs…

Answer 22

ask yourself if the PT is having a MI

Question 23

belly insults can refer pain to shoulders

Answer 23

ie. ruptured spleen, liver, ectopic pregnancy

Question 24

never trust a diabetic

Answer 24

just don’t

Question 25

if necessary to disrobe a trauma PT, the only concern is…

Answer 25

environmental

Question 26

if you see JVD…

Answer 26

look to heart or lungs for problem

Question 27

remember, kids go from respiratory arrest to…

Answer 27

asystole

Question 28

chest pain radiating between shoulder blades

Answer 28

rule out thoracic aneurysm

Question 29

if you suspect PT is having an inferior wall MI

Answer 29

check right side (V4R)

Question 30

right side MI treat with ________, left side MI treat with ________

Answer 30

fluid, nitro

Question 31

in cardiac resuscitation, the most important factors for success are…

Answer 31

electric and great CPR

Question 32

trauma PTs must be kept…

Answer 32

warm

Question 33

pain between chin and public bone could be…

Answer 33

cardiac

Question 34

PT deteriorating enroute to hospital

Answer 34

check your interventions

Question 35

hypertensive unresponsive PTs

Answer 35

stroke or head injury

Question 36

trauma is…

Answer 36

surgical problem

Question 37

belly pain after eating fast food or fatty food

Answer 37

rule out cholecystectomy disease

Question 38

dislocations of the elbow or knee are a

Answer 38

medical emergency

Question 39

BP of 90 systolic is…

Answer 39

fine

Question 40

too much oxygen is bad for

Answer 40

STEMI’s

Question 41

the finding of an ETCO2 25 and under, think

Answer 41

sepsis