Trauma Flashcards
Intubate patients with
Apnea, significantly depressed mental status (GCS <8), impending airway compromise
Suspect .. or … injury to the airway in patients with singed nasal hair, facial burns, hoarseness, wheezing, soot in the posterior oropharynx, or carbonaceous sputum
Thermal or inhalational
Massive hemothorax is diagnosed trough … and is defined as … of immediate blood return
Chest tube placement
> 1500 cc
If a previously stable chest trauma patient suddenly dies, suspect
Air embolism
A new diastolic murmur after chest trauma suggest
Aortic dissection
… , syphillis and Ehlers Danlos syndrome all predispose to a weak aortic wall
Marfan’s syndrome
Bleeds from … cannot cross the suture lines vs bleeds from subdural hematoma that can cross suture lines
Epidural hematomas
… is the gold standard for evaluation of aortic disruption
Aortography
Possible cause of pulseless electrical activity
5 H 5 T Hypovolemia Hypoxia Hydrogen ion : acidosis Hyper / Hypo : K+ , other Hypothermia Tablets : drug OD ingestion Tamponnade :cardiac Tension pneumothorax Thrombosis : coronary Thrombosis : pulmonary embolism
A positive B HCG in the setting of shock is a … until proven otherwise
Ruptured ectopic pregnancy
Abdominal pain plus syncope or shock in an older patient is a … until proven otherwise
Ruptured abdominal aortic aneurysm
Nearly all female patients with an acure abdomen require a … and a … to look for PID, ectopic pregnancy and ovarian torsion
Pelvic exam Pregnancy test
Parkland formula
Fluids for the first 24 hours = 4 x patient’s weight in kg x % BSA. Give 50 % of fluids over the first 8 hours and the remaining 50 % over the following 16 hours
The 6’s “W” of postoperative fever
Wind : atelectasis, pneumonia Water : UTI Wounds : wound infection, abcess Walking : DVT Wonder drugs: drug reaction Womb : endometritis
Fevers before post operative day 3 are unlikely to be infectious unless … or B hemolytic streptococci are involved
Clostridium
… is the first vital sign to change in hemorrhagic shock. BP falls only after the loss of … of blood volume
Heart rate
30 to 40 %
… and neuroleptic malignant syndrome should be ruled out in any case of hyperthermia.
Malignant hyperthermia
Malignant hyperthermia would be seen after … exposure and NMS after a …
Halothane
Neuroleptic
Orogastric lavage is generally recommended only for life threatening toxins < or = … after ingestion
1 hour
Activated charcoal is indicated for cases of recent isolated ingestion ( < 2 hours ) of substance known to adsorb to it, not used for
Lithium, iron, lead, hydrocarbons or toxic alcohols
Drug reactions :
- Stevens-Johnson syndrome :
- Competition for albumin binding site :
- Induction of P-450 enzymes:
1: anticonvulsants, sulfonamides, penicillins
2: warfarin, ASA, phenytoin
3: quinidine, barbiturates, St Jonh’s wort, phenytoin, rifampin, griseofulvine, carbamazepine
Specific antidotes:
1- acetaminophen 2- B blocker 3- benzodiazepines
4- heparine 5-INH 6-methemoglobine 7- opiods
8- streptokinase 9- warfarin
1- n-acetyl cysteine 2- glucagon 3- flumazenil
4- protamine sulfate 5- pyridoxine 6- methylene blue
7-naloxone 8- aminocaproic acid 9- vitamin k
Major drug side effects:
1- ACEIs. 2- Amantadine. 3- antipsychotics
4- Carbamazepine. 5- Chloramphenicol
6- clonidine. 7- cyclophosphamide. 8- digoxin
9- doxorubicin 10- halothane 11- INH. 12- MAOis
13- niacin. 14- phenytoin. 15- quinidine 16- vancomycin
1- cough. 2- livedo reticularis. 3- neuroleptic malignant syndrome. 4- agranulocytosis. 5- gray baby syndrome
6- severe rebound headache and hypertension
7- hemorrhagic cystitis. 8- yellow visual changes, arrhytmias
9- cardiotoxicity (cardiomyopathy). 10- malignant hyperthermia
11- peripheral neuropathy. 12- hypertensive thyramine reaction, serotonin syndrome. 13- cutaneous flushing 14- gingival hyperplasia. 15- torsades de pointe 16- red man syndrome
