UNIT 2 - Select Emergencies Flashcards
Ischemic Stroke Symptoms
- RIGHT/LEFT SIDED WEAKNESS
- TWISTING OF MOUTH OR FACE
- DYSPHAGIA
- SLURRED SPEECH
- DROOLING
- INABILITY TO MAINTAIN GAIT AND WALK
Hemorrhagic Stroke symptoms
- DIZZINESS
- VERTIGO
- ATAXIA- Poor muscle control
- OCCIPITAL HEADACHES
- NYTASGMUS, IPSILATERAL GAZE DEFICIT
- DYSARTHRIA
Mangement of Ischemic Stroke
Dosage: 0.9 mg/kg to max 90 mg
10% in 1st minute and rest in an hour via infusion pump
Management of Hemorrhagic stroke
Monitor for increased intracranial pressure
Nurse @ 30-degree angle
Maintain pressure 150 - 170 mmHg
Labetalol IV
Common spinal injury sites
C1-2
C4-6
C11-L2
Management of spinal cord injury
Medical
Methylprednisolone is less than 8 hours
Bolus 30mg/kg over 1 hour then 5.4mg/kg for 23 hours
Cullen’s sign
Discoloration of peri-umbilical
Turner’s sign
Discoloration of the flanks
Coopernails
Bruising of scrotum or labia
Management of GI hemorrhage
approx 3 days hospital stay
Ngt free drainage ugib
Bowel prep for colonoscopy
Normal troponium level
0 - 0.04 ng/ml
A patient with the following symptoms is under your management, what do you do in the first hour?
Fruity breath
Polyuria
Nausea & vomiting
Weight loss
15-20 ml/kg Isotonic 0.9% NaCL/LR
What is done in the second hour for pt with DKA?
Continue fluids at 15ml/kg
Give 0.45% for pt with hyponatremia, HF or is a child
In the third hour of DKA, you should…
Reduce fluids to 7.5ml/kg
Hyperkalemia effects
ST elevation, V- fib,
bradycardia, hypotension
Diarrhea, hyperactive bowel sounds
Paralysis in extremities, Increased deep tendon reflexes (DTR)
Hypokalemia effects
ST inversion, prolong QT complex, present u wave
Decreased DTR, Muscle cramping, Flaccid paralysis
Decreased motility, hypoactive bowel sounds, constipation, paralytic ileus
Cushing’s triad
Increased SBP with widened pulse pressure & bradycardia
Cheyne-stokes
Neurogenic hyperventilation -> Apneustic breathing -> Ataxia breathing
For ICP, you would want to maintain PaO2 at
90 - 100 mmHg
medical management of cardiac arrest
Streptokinase given within 3-6 hours of onset of chest
Epinephrine/ Adrenaline: 1mg every 3-5 mins
Three infusions for DKA
Infusion A - 0.9% NS with Humulin R
Infusion B - Only saline
Infusion C - Dextrose
monitor BS
All three IV would be titrated based on sliding scale.
