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PGY4 - MISC Flashcards

1
Q

Post Resus Care

A
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2
Q

Indications for Post-Resus Cooling

A

Adult with ROSC

From VF or VTach Arrest

Hemodynamically Stable

Comatose or not obeying commands

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3
Q

Temperature Goal for ROSC

A

TTM Trial - 36C

Various 32-36

x 24 hours

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4
Q

Post Resus Goal

  • Spo2
  • SBP
  • MAP
A

92-98%

SBP >90

MAP>65

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5
Q

Post Resus Cooling Contraindications

A

“HOLD”

Hemorrhage

OB (Preg)

Ill (Terminally)

DNR or ICU inappropriate

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6
Q

ITP

  • Presentation
  • Labs
  • Tx
A
  • Presentation:
    • Easy Bleeding + Thrombocytopenia
    • Kids:
      • 2-6 yo
      • Prior viral prodrome
      • Self-limited with in few weeks to months
    • Adults :
      • Usually present with platelets < 10,000
  • Txreatment​:
    • Supportive care - usually self resolving
    • Platelet Transfusion Indications:
      • Severe bleeding (platelets < 50,000)
      • Platelet < 20,000
    • RBCs PRN for resuscitation and anemia
    • Corticoteroids
    • IVIG (1 gm/kg): <5,000 platelets and completed steroid course
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7
Q

HIT

Pres

Labs

Treatment

A
  • Presentation
    • Thrombocytopenia + Thrombosis
    • Necrotic skin lesions
  • Labs
    • Platelets either <150 or more than 50% decrease
  • Usually 5-10 days after heparin
  • Treatment;
    • Stop heparin
    • Start alternative
      • Argatroban or Pradaxa
    • Avoid warfarin and platelet transfusion
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8
Q

TTP

  • Presentation
  • Labs
  • Treatment
A
  • Female 10-40yo
  • Classic Pentad
    • Fever
    • Thrombocytopenia
    • Renal Failure
    • Neuro Findings
    • Anemia
      • Hemolytic (schistocytes, frag RBCs)
      • Microangiopathic
  • Management
    • Treat prior to definitive diagnosis
    • Plasmaphoresis
    • Hematology Consult
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9
Q

Platelet Disorders

  • List
  • General Presentation
A

HIT

ITP

TTP

HUS

Epistaxis, menorrhagia, GIB, mucosal petechiae, easy bruising

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10
Q

HUS

Pres

Treatment

A
  • ​​ Presentation
    • Child w E Coli 0157:H7); age 6 mo-4yo
    • Triad
      • Microangiopathic Hemolytic Anemia
      • Renal Insufficiency
      • Thrombocytopenia
  • Treatment:​
    • Supportive care and admit
    • Plasma exchange
    • Abx may worsen
    • Dialysis if renal failure
    • Avoid plts
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11
Q

Coagulation Treatment Disorders

List

Presentation

A

Hemophelia, Coumadin, NOACs, DIC, VWB

Bleed into deep mm/joints, hematuria, intracranial bleed

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12
Q

Causes of Increased PT

A

Coumadin

Liver Failure

Vit K Def

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13
Q

Causes of Increased PTT

A

Heparin

DIC

Hemophilia

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14
Q

Hemophilia A

  • Factor
  • Labs
  • Treatment
A
  • ↓VIII, prolong PTT
  • Tx​:
    • Factor VIII:
      • Mild bleeding - 12.5 units/kg (replace to 50%)
        • Hematuria, early hemarthrosis, laceration
      • Moderate Bleeding - 25 units/kg (replace to 50%)
        • Oral lacerations, dental, late hemarthrosis
      • Severe Bleeding - 50 units/kg (replace to 100%)
        • CCNS, GI, major trauma/surgery
      • Each unit/kg increases plasma factor VIII level by 2%
  • Cryo if no recombinant VIII
  • DDAVP for acute bleeding or prophylaxis (0.3mcg/kg/dose IV)
  • Ice, compression, and splinting
  • Consult Heme
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15
Q

Von Willenbrand Disease

  • Factor
  • Labs
  • Treat
A

Most Common Hereditary Bleeding Disorder

  • Factor:
    • ↓VIII:vwf (
  • Labs
    • ↓VIII)
    • Normal PT/PTT
    • Bleeding time increased
  • Tx​:
    • DDAVP 0.3mcg/kg
    • Humate P- factor VIII conc
  • -Cryo- 10 units/kg
  • -FFP- limited use due to volume overload
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16
Q

Hemophilia B

  • Factor
  • Labs
  • Treatment
A
  • ↓IX,
  • Labs
    • Inc PTT
    • Normal PT
  • Tx:​
    • Recomb IX or IX conc :
      • Minor 25 units/kg
      • Moderate 50 units/kg,
      • Severe 100 units/kg.
      • Increases activity by 1%
    • FFP if no recomb IX
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17
Q

DIC

  • Labs
  • Treatment
A
  • Lab findings:
    • Thrombocytopenia (Most common)
    • Prolonged PT
    • Low fibrinogen
    • Increased Fibrin Split Products
  • Treatment:
    • Treat underlying cause (infx, obstetric pathology, trauma, malignancy, drugs, transfusion) and predominant sx
    • Platelets for Plt <50K AND active bleed
    • FFP for increased PT or low fibrinogen
    • Vit K for long PT
    • LMWH if thrombosis
    • TXA for trauma-related DIC
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18
Q

Supratherapeutic INR Tx

A
  • OPtions
    • Hold Dose
    • Vit K
      • PO or IV for all bleeding
      • Watch for anyphylaxis
    • FFP
    • PCC4
  • INR <5, No bleed
    • Lower or omit dose
  • INR 5-10, No bleed
    • Omit doses
    • +/- Vitamin K
  • INR > 10, No bleed
    • Hold dose
    • Vitamin K at high dose (2.5-5 mg PO)
  • Any INR, Serious Bleed
    • Hold Dose
    • Vit K 10mg IV
  • Life-Threatening Bleed
    • Hold Dose
    • Vit K 10 mg IV
    • FFP or PCCC
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19
Q

Heparin Reversal

A

Protamine Sulfate - 1mg/100u of heparin

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20
Q

NOAC Reversal

A

Idaricuzimab for Pradaza (Dabigatran)

Endexanet alfa for Apixaban (Eliquis) and Rivaroxaban (Xarelto)

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21
Q

Clopidogrel Reversal

A

Platelets

DDAVP

rIIIa

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22
Q

Thyroid Storm Presentation

A
  • Palpitations/afib
  • N/V/D
  • Agitated/Anxious/Psychosis/Delerium
  • AMS
  • Cardiovascular collapse,
  • Goiter
  • Proptosis,
  • Tachycardia
  • Diaphoresis
  • Tremor
  • CNS depression (late)
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23
Q

Hyperthyroidism Treatment

A
  • General
    • Supportive IVF (use D5NS)
    • Cool
    • Treat dysrhythmias
    • Replace lytes PRN
    • Treat fever w/ APAP (no ASA!/NSAIDs)
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24
Q

Thyroid Storm Specific Treatment

A
  • Supportive - Cooling, IVF, etx
  • Treat Cause
    • Infection, Infarction (PE/MI/CVA), Insulin lack (DKA), IUP, Iodine therapy/dye/amiodarone, Injury/surgery
  • Block peripheral effects:
    • Propranolol 1 mg IV q 15 m up to 10 mg-
    • OR Esmolol 500 mcg/kg, then 20-50 mcg/kg/min - used when concerns over B blockers
      • Majority of CHF in storm is high output- will respond to B blockers (fluid down)
  • Inhibit thyroid hormone synthesis:
    • PTU 600-1000 mg PO
    • OR Methimazole 90-120 mg PO
  • Inhibit thyroid hormone release: ​1 hr after PTU
    • SSKI (Potassium iodide) 5 drops PO
    • OR Lugol’s sol (K iodide) 20 drops PO
  • Steroid
    • Decadron 2mg q6h
    • OR Hydrocortisone 300mg load
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25
Q

Unknown Wide Complex Tachycardia

Differential

A

QRS>120, HR>100

  • Ventricular tachycardia
  • SVT with aberrancy (BBB, WPW) Paced rhythms
  • A fib with WPW
  • Torsade de pointes
  • Drug overdose
  • Na channel blockers Hyperkalemia
  • Post-resuscitation
  • Artifact
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26
Q

Painful Vision Loss DDx

A
  1. Trauma
    1. Hyphema
    2. Open Globe
    3. Iritis
  2. Optic Neuritis
  3. Acute Closed Angle Glaucoma
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27
Q

Painless Vision Loss DDx

A
  • CRAO
  • CRVO
  • Temporal Arteritis
  • Retinal Detachment
  • Vitreous Hem
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28
Q

Optic Neuritis

  • Pres
  • Treatment
A
  1. Hx
    1. Women > Men
    2. Unilateral
    3. Loss of Central Vision
    4. Rapid Progression
  2. Exam
    1. Normal Slit Lamp
  3. Tx
    1. Solumedrol
    2. Ophtho consult
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29
Q

Closed Angle Glaucoma

  • Pres
A
  • Pres
    • Decreased VA
    • Redness
    • Fixed, mid-dilated pupil
    • IOP > 40
    • Firm Globe
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30
Q

Acute Closed Angle Glaucoma

Treatment

A
  • Pilocarpine
    • 1 gtt q15 min until pupil constricts
    • One drop in C/L eye (ppx)
  • Timolol
    • 1 drop q 30 min
  • Acetazolamide
    • 500 mg IV/IM/PO
  • Mannitol
    • 1 g/kg IV
  • Stat ophtho consult
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31
Q

Central Retinal Artery Occlusion

  • Presentation
  • Exam
  • Tx
A
  • Presentation
    • Sudden
    • Monocular
  • Exam
    • Afferent pupillary defect
    • Cherry red spot at fovea
  • Tx
    • Ocular massage - 5 sec on, 5 sec off
    • Decrease IOP
    • Hyperbaric Oxygen Therapy
    • Stat Ophtho Consult
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32
Q

Afferent Pupillary Defect

A

Normal pupillary constriction when light shined in unaffected eye

No constriction when light shined in affected eye

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33
Q

Central Retinal Vein Occlusion

  • Pres
  • Exam
  • Treatment
A
  • Pres
    • Monocular
  • Exam
    • Blood and Thunder Retina
  • Treatment
    • Call ophtho
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34
Q

Temporal Arteritis

  • Pres
  • Tx
A
  • Pres
    • HA
    • Age >50
    • Assoc with Polymyalgia Rheumatica
    • Increased ESR
  • Tx
    • Prednisone 1mg/kg PO
    • NSAIDs
    • Call ophtho
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35
Q

Retinal Detachment

  • Pres
  • Tx
A
  • Pres
    • Flashing lights
    • Floaters
    • Cloudy/Curtain-Like vision loss
  • Look with US
  • Tx = Call ophtho
36
Q

Vitreous Hemorrhage

  • Pres
  • Tx
A
  • Pres
    • Floaters or webs
    • Monocular
  • Exam
    • Decreased red reflex
  • Tx
    • Elevate head of bed
    • No anti-caog/reverse
    • Call ophtho
37
Q

Pre-E/Ecclampsia

Presentation

Labs

A
  • Pres
    • HA, vision changes, abd pain, edema, pulm edema,
    • HTN systolic >140 or diastolic >90,
    • hyperreflexia, tachycardia, clonus
  • Labs: CBC, BUN/Cr, lytes, gluc, Ca/Mg/Phos, LFTs, UA, coags, D-dimer, fibrinogen, uric acid
38
Q

Pre-E/Ecclampsia DDX and Criteria

A
  • Starts at 20 weeks
  • Pre-E
    • HTN
      • > 140 sys or >90 dia twice (sep by 4 hrs)
      • > 160 sys or > 110 dia once
    • Proteinuria
  • Severe preeclampsia:
    • ≥ 160 systolic or ≥ 110 diastolic +
    • End Organ Dysfunction
      • Thrombocytopenia, renal insufficiency, impaired liver function, pulmonary edema, cerebral or visual disturbances
  • Ecclampsia
    • Pre-E + Seizure
  • HELLP
    • Hemolysis
    • Elevated Liver Enzymes
    • Low Platelets
39
Q

Pre-E/Ecclampsia Tx

A
  • IVF
  • Decrease BP if > 160/105
    • Hydralazine 5mg IV q20
    • Labetalol 0.25 mg/kg double q 10 min (300mg max)
  • Severe Pre-E
    • Mg 4-6 gm IV over 30 min (sz ppx)
  • Ecclampsia
    • Mg as above
    • Benzos
    • Delivery
40
Q

Considerations when giving Mag for Pre-E/Ecclampsia

A
  • Hold for:
    • Bradycardia
    • Loss of DTRs
    • Resp depression
  • Antidote for Mg toxicity is Ca
41
Q

PE Types

A
  • Non massive:
    • No signs of clinical instability, hemodynamic compromise or RV strain
  • Submassive PE:
    • Acute PE without hypotension but with any of the following:
      • RV dysfunction or RV dilation on POCUS,
      • Elevated BNP
      • Elevated troponin
      • New ECG changes (RBBB, ST changes, anterolateral T wave inversions)
  • Massive PE:
    • Sustained hypotension
    • Pulselessness
    • Persistent bradycardia
    • Signs of shock
42
Q

PE Treatment - Massive

A
  • Massive
    • Thrombolytics
      • rt-PA 10mg then 90mg over 2 hours
      • 50mg bolus for code dose
        • Must code for 45 minutes
    • Surgery second line
43
Q

PE Treatment - Submassive

A
  • Thrombolytics remain contreversial
    • Full Dose vs. Half Dose vs. Cath Directed
  • Anticoagulation
    • Heparin 80 u/kg then 18 u/kg/hr
    • OR Lovenox 1mg/kg SQ
44
Q

PE Treatment - Non-Massive

A

PO: Xarelto or Elliquis

45
Q

PE Dispo

A

Calculate PESI Score

46
Q

DVT Treatment

A
  • Lovenox 1 mg/kg SC BID
  • OR NOACs
    • Xarelto
    • Elliquis
47
Q

Cardiogenic Shock DDx

A
  • RV infarct
  • LV infarct
  • Acute valvular insufficiency
  • Wall Rupture
  • Papillary Rupture
  • Tamponade
  • Thoracic Aortic Dissection
48
Q

Cardiogenic Shock Treatment

A
  • Treat underlying causes (bradycardia, tachycardia, ischemic, valve problem, ect)
  • If suspecting i​nfarct​…
    • Stat Cards consult for cath/​IABP/ECMO
    • ASA and Heparin after CXR reviewed. Do not give BB
    • If no cath lab or contraindications consider thrombolytics
  • If ​TAD.​ .. stat CT surgery consult
  • Oxygenation/pulm edema:
    • Can trial BIPAP but may not tolerate well
    • Early intubation
      • Challenging due to hypotension, hypoxia and acidosis.
      • Maximize pre-intubation hemodynamics (small bolus, push dose pressors, preoxygenation, oxygenation during intubation.
      • Etomidate may be best choice for induction
  • If ↓BP / shock…​
    • 250-500ml IVF bolus: eval response (need to be cautious).
      • Especially if dehydrated or RV infarction
      • BP >90
        • Consider dobutamine or milrinone (if patient on BB)
        • Dobutamine will need vasopressor (NE)
      • BP < 90
        • Consider NE. Can add on dobutamine
  • Optimize electrolytes (especially Ca)
  • Optimize H/H (higher threshold for transfusion, 10)
49
Q

ANC

  • Nadir after chemo
  • How to calculate
  • Neutropenia definition
  • Neutropenic Fever Definition
A
  • Nadir Time
    • 10-14 d s/p chemo
  • ANC Calc
    • = WBC X ((PMN/100) +(Bands/100))
  • Neutropenia
    • ANC < 1500
    • < 500 = Severe
  • Neutropenic Fever
    • Temp > 38.3 single or >38 x 1 hr
      • ANC < 1500
50
Q

Cancer Patient DDx

A
  • Tumor Lysis Syndrome
  • PE
  • Neutropenic Fever
  • Spinal Cord Compression
  • Hyperviscosity Syndrome
  • SVC Syndrome
  • Pericardial Disease
  • SIADH
  • Hypercalcemia
51
Q

Neutropenic Fever - High Risk

  • Features
  • Tx
A
  • High Risk Definition:
    • Shock
    • ANC < 500,
    • ANC levels low for > 7 days
    • Other organ dysfunction
    • MASCC Score < 20
  • Treatment
    • Empiric
      • One of:
        • Zosyn 4.5 gm IV
        • or Cefepime 2 gm IV
        • or Ticar/Clv or Imipenem/Cilastin
      • +/- Vanc 1gm IV
      • +/- Acyclovir 10 mg/kg IV
52
Q

Neutropenic Fever - Low Risk

  • Features
  • Tx
A
  • Low Risk Definition:
    • No hypotension
    • No COPD
    • Age < 60
    • No dehydration
    • Solid tumor or hematologic malignancy
    • Minimal symptoms
    • MASCC > 21 low risk
  • Empiric Treatment
    • Cipro 500mg q8
      • Augmentin 500mg q8 x7.
  • Talk with Onc - May d/c.
53
Q

SIADH

Pres

Treatment

A

HypoNA with Euvolemia

Water Restriction

54
Q

Tumor Lysis Syndrome

Timing

Labs

Complications

A
  • Timing
    • 2-3 d post chemo;
  • Labs
    • Increased
      • K
      • Phos
      • Uric Acid
    • Decreased
      • Calcium
  • Complicatons
    • ARF (from uric acid and calcium phos crystals),
    • Dysrhythmias
    • Neuromuscular problems
55
Q

TLS Treatment

A
  1. IVFs
  2. Correct electrolytes
  3. +/- Dialysis
  4. Allopurinol- decrease uric acid production
  5. Rasburicase- decrease uric acid levels (conversion to allantoin)
    1. C/I in G6PD deficiency
56
Q

Tx of acute spinal cord compression in cx

A
  • Steroids
    • Decadron 25mg
  • NS consult
  • Stat MRI
57
Q

Hypercalcemia Treatment

A
  • Mild (<12, no sx)
    • PO fluids
  • Mild (12-14, no sx)
    • IVF
    • Find Cause
  • Severe (>14, severe sx)
    • IVF 200-300 mL/hr
    • Calcitonin 4 units/kg
    • Bisphosphonates after hydration
    • Dialysis
    • +/- Steroids
      • If due to calcitriol overproduction
    • Loop diuretics not recommended
      • Unless renal or heart failure,
58
Q

Hyperviscosity Snydrome

Presentation

Tx

A
  • Sludging from ↑ proteins –>
    • Fatigue
    • Neuro
      • HA, Sz, AMS,
    • Cardiac
      • MI, CHF.
  • Tx:
    • IVF,
    • Phlebotomy w/ PRBC replacement.
59
Q

SVC Syndrome

Cause

Pres

Work Up

Tx

A
  • Obstruction of blood through SVC due to internal intravascular invasion or external compression.
    • Lung cancer MCC.
  • Pres
    • Neck veins distended
    • SOB
    • ↑RR
    • Facial swelling
  • Work Up: CT chest w/ IV contrast
  • Tx:
    • Solu Medrol 250 mg IV
    • +/- Lasix 40 mg
      • If respiratory compromise,
        • most literature does not support
    • IV anticoagulation if due to thrombus
    • Definitive:
      • Chemo
      • Possible stent placement
60
Q

CD4 Count = AIDS

61
Q

Absolute Lymphocyte Count

A

WBC x Lymph%

<1000 –> 91% probability CD4 < 200

62
Q

HIV Encephalopathy

A

Dx of Exclusion

CD4 ~200

63
Q

Cryptococcus Neoformans

A
  • CD4 <100
  • CSF:
    • Inc opening pressure
    • Inc mono
    • +Crypto Ag
64
Q

T. Gondii

A

Ring enhancing lesions (with contrast)

65
Q

HIV Pulm Infection

A
  • Local –> Likely bacterial
  • Diffuse interstitial/granular –> Likely PCP
  • Hilar –> Crypto, histo, mycobac
  • Upper Lobe with Cavitation –> TB
66
Q

PCP PNA

  • Pres
  • Tx
A

Pres

  • Unexplained Hypoxia
  • Inc LDH

Tx

  • Steroids if PaO2 < 70, A-a Grad > 35
67
Q

AIDS Fungal Infec

A
  • Histo - Central/East US
  • Blasto - Central US
  • SW - Coccidio
68
Q

AIDS GI Issues

A
  • Candidadal Esophagitis - White plaque, scrapes away
  • Hairy Leukoplasia - White, corrugated lesions on edge of tongue
  • Diarrheal Infec
    • Salmonella - Recurrent bacteremia
    • C Dif
    • MAC/Cryptosporidium/Isospora
69
Q

AIDS Skin Issues

A
  • Kaposis Sarcoma
    • HHV 8
    • Pink/Purple papules/nodules
70
Q

Sickle Cell Complications

A
  • Vaso Occlusive Crises
    • Pain Crisis
      • Consider cause - cold, trauma, dehydration
    • Dactylitis - painful swelling hands/feet
    • Stroke
      • Consider exchange transfusion
    • Priaprism
      • IVF, transfusion, drainage
    • Acute Chest
      • # 1 Killer
      • Pulm Sx + New Infiltrate on CXR
      • Gets ABx
  • Hematologic Crisis
    • Splenic Sequestration
      • Enlarged spleen + decreased Hgb
    • Aplastic Crisis
      • Rapid decrease in Hgb and Retic
      • Causes - Folate def, infec
      • Transfuse
  • Infectious Issues
    • Functionally asplenic by 5 yo
    • Encapsulated org
      • S Pneumo, N Mening, Kleb, H Flu, Salmonella, Crypto, Pseudomonas
    • Osteomyelitis
      • Staph, Salmonella, E Coli
71
Q

Encapsulated Bacteria

A

Some Nasty Killers Have Serious Capsule Protection

  • S Pneumo
  • Neisseria Menin
  • Klebsiella
  • H. Flu
  • Salmonella
  • Cryptococcus
  • Pseudomonas
72
Q

Sick Newborn DDx

A

THE MISFITS

  • Trauma (NAT), Tumor, Thermal
  • Heart/Lung: Bronchiolitis, pertussis, congenital heart
  • Endocrine: CAH, DM, Thyroid
  • Met Acidosis
  • Inborn Errors of Metabolism
  • Seizures
  • Feeding Abnormalities
  • Intestinal Disorders
  • Sepsis
73
Q

Neonatal Seizure Treatment

A
  • ​If ↓ glucose​… D10 5 ml/kg IV/IO
  • ​If ↓ calcium​… Ca Gluconate 100 mg/kg (up to 1 gm) IV over 10 min​
  • If still seizing.
    • Phenobarbital 20 mg/kg IV (drug of choice in neonates - intubate!)
    • and/or Ativan 0.1mg/kg IV (may repeat in 10 min w 1/2 dose)
  • If still seizing​… pyridoxine 100 mg q 5-15 min (max 500 mg)
  • If hyponatremic.​ ..4-6m L/kg 3%NacL
74
Q

Neonatal Tx of Intracranial Infection

A
  • Ampicillin 100 mg/kg IV
  • Cefotaxime 100 mg/kg IV or gentamycin 2.5 mg/kg IV
  • Acyclovir 10 mg/kg IV
75
Q

Neonatal Shock Treatment

A
  • 20 ml/kg IVF
  • Pressors
    • Cold Shock - Dopamine or Epi
    • Warm Shock - Levo
  • Shock not improving - Hydrocortisone
76
Q

Neonatal Cardiovascular Distress

A
  • Likely respiratory etiology if…
    • Better w/ crying
    • No murmur
    • Normal EKG
    • ↑ O2 sat w O2.
  • Likely cardiac etiology if…
    • Worse w/ crying
    • Pos murmur
    • Abnormal EKG
    • No change in O2 sat w O2.
    • Tx for CHF/cyanosis
  • If hypercyanotic/Tet spell…
    • Calm child
    • Knee to chest position
    • Phenylephrine
    • Morphine 0.1 mg/kg IV or Ketamine
    • ± Propranolol 0.01-0.1 mg/kg IV
77
Q

Gray Baby in Resp Arrest at less than 2 weeks

A
  • C/f ductal dependent lesion
    • Consider PGE1 0.01-0.1 mcg/kg/min IV
    • Intubate.
      • Side effects-hypoTN, apnea, hyperpyrexia)
      • Use Atropine prior to intubation
  • Pressors
    • Non-cyanotic = Milrinone
    • Cyanotic = Levophed
  • Oxygen for most (except hypoplastic heart)
78
Q

BURN Thickness

A
  • Superficial - Epidermis
  • Superficial Partial - Dermis (Blisters)
  • Superficial Deep - White
  • Full - Underlying structures, no pain
79
Q

Rule of 9s

A

18% - Front, Back, Legs

9% - Arms, Head

1% - Genitals

Peds:

Head is also 18%, legs are 14%

80
Q

Parkland Formula

A

LR 2-4 ml x kg x % BSA

(1/2 in First 8h, rest in 16hr)

81
Q

Indication for Fluid Resus in Burns

A

15% in kids

20% in adults

82
Q

Goal UOP in Burns

A

30-50cc/hr

Kids 1cc/kg/hr

83
Q

Escharotomy Sites

84
Q

Burn Center Criteria:

A
  • >20% adults, >10% kids/elderly
  • >5% full thickness
  • Face/eyes/hand/feet/genital/perineum burns
  • Electrical (incl lightning)
  • Chemical burns
  • Inhalation injury
  • Circumferential Full thickness to chest or extremity
  • Concern for pt with preexist dz
  • No hospital capability for child burn
85
Q

Rule of 10s

A

LR

%TBSA x 10 - Initial wt in mL/hr (for 40-80Kg)

For every 10kg over 80, increase rate by 100

86
Q

Cyanotic Heart Lesions

A

5 Ts

Tetralogy of Fallot

Truncus Arteriosus

Transposition of the Great Vessels

Tricuspid Atresia

TAPVR4-7

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