Topics in EM Flashcards
Massive hemothorax: dx and tx
chest tube >1500cc immediate return
tx: volume resuscitation and chest decompression; operative management
Open pneumothorax tx
occlusive dressing
secure 3 sides only, place thoracostomy tube
JVD, hypotension, muffled heart sounds: dx and tx
cardiac tamponade
immediate pericardiocentesis
Trauma fluidresuscitation
Isotonic (LR or NS) repletion in 3:1 ration (fluids to blood loss)
1-2L bolus, reassess
Consider PRBCs if continue to be unstable
Immediate tx penetrating chest wound
- intubate
- empiric bilat chest tubes
- open thoracotomy if cardiac arrest
New diastolic murmur after chest trauma
aortic dissection
Reasons for ex lap in abd trauma pts
below 4th intercostal
peritoneal signs, hemodynamically unstable
trauma penetrating platysma
admit + surgical exploration
upper extremit hypertension, hoarse voice
CXR: widented mediastinum, loss aortic knob: dx + workup
Aortic dissection (ligamentum arteriosum for rabid-decel injury) CT/TEE Aortography= gold standard
Subdural vs epidural hematoma
Subdural: can cross suture lines, crescentic (bridging veins)
Epidural: biconvex, middle meningeal
Fever, tachypnea, rash on upper extremities, conjunctival hemorrhage after trauma
fat embolism
Retroperitoneal air in trauma pt
duodenum perf
confirm with CT
bood urethral meatus, ballotable or nonpalpable prostate
suspect urethral injury
retrograde urethrogram before foley placement
Tx: asystole or PEA
epinephrine or vasopressine
5Hs 5Ts
Tx: Vfib, pulseless vtach
Defib 200J x2->epi->defib->ami->defib->epi
Afib/aflutter tx
synchronized cardiversion (120-200J) diltiazem or bblock
SVT: tx
vagal maneuver
adenosine
AV-nodal blocker (bblock, cachblock)
J wave
classic sign of hypothermia
cranial nerve dysfunction, excessive motor acitivity, resp compromise after hiking: tx and dx
scorpion bite
benzodiazepine and analgiesic
atropine for hypersalivation and resp distress
IV scorpion-specific ab
spider bite side effects
necrosis, hypocalcemia
Angular stomatitis, cheliosis, corneal vascularization
B2 (riboflavin deficiencey)
diarrhea, dementia, dermatitis
B2 (niacin)
Convulsion, hyperirritability, INH
B6 (pyridoxine)
Dermatitis, enteritis, alopecia, adrenal insufficiency
B5 (pantothenate)
Dermatitis, enteritis, raw egg consumption/abx use
biotin def
Keshan cardiomyopathy
selenium def
weakness, muscle cramps, CNS hyperritiability, choreoathetoid mvmt
Mg def
What avoid with cocaine/ amphetamine withdrawal
bblock- unopposed a activity, HTN
