Critical Actions

Question 1

Simple Febrile Seizure

Answer 1

Detailed H/P
Rule out things like MEningititis
Tylenol/ibuprofen
counsel parents and secure follow up

Question 2

Cocaine Chest Pain

Answer 2

EKG
O2
BEnzos
Nitrates
Trop
CXR
Obs admit

Question 3

Iron OD

Answer 3

Large bore IV access
EKG
WBI
Deforxamine
ASA/Tylenol levels

Question 4

Pyloric stenosis

Answer 4

IV access and adequate rehydration
abd exam
NGT
NPO
Abd US

Question 5

ICH

Answer 5

Airway
LArge bore access and fluids
Serum glucose level
LAbs, coags
heat ct
reverse anticoagualtion
NSGY and ICU consult

Question 6

TENSION PTX

Answer 6

needle thoracostomy
tube thoracostmy
upright CXR
pain
diligent search for other injuries
surgical consult

Question 7

Acute Chole

Answer 7

IV
RUQ US
Pain
Surgery
Abx

Question 8

Sepsis

Answer 8

IV or IO
Multiple fluid bolus
early abx
ICU conuslt

Question 9

Boerhaave sundrome

Answer 9

Crepitus on exam
esophogeal tear on ddx
CXR to evaluate lungs/mediastinum
emergent GI,ENT,CT surgery consultastions
fluids
abx

Question 10

Epidural abscess

Answer 10

On DDX
rectal temp!
obtain stat imaging
NSGY conuslt
Determine the cause! From UTI

Question 11

Nec Fasc

Answer 11

Early recognition
IVF
ABx
surgical consult
do nto delay definitive management- surgery

Question 12

HyperK

Answer 12

EKG
DDX
Calcium gluconate
Insulin, dextrose, albuterol, kayelcoate, lasix, bicarb drip, stat lytes,

Question 13

Glaucoma

Answer 13

VA, EOM, IOP, Pupils,
SLIT LAMP!
optho consult
early meds:
Brimodidnie
timolol
mannitol
pilocarpine
steroids
Acetazolamide

Question 14

incarcerated hernia

Answer 14

DDX
IV
CXR upright
Obstuctive series
NGT
Pain
Surgery

Question 15

ASA OD

Answer 15

IV
Preggo test
Hx of ASA use
Soidum Bicarb
Repeat ASA levels
ICU admission

Question 16

HSP

Answer 16

Fluids
Abd X ray
Pain
Labs for kidney and liver
surgery consult

Question 17

Snake Bite

Answer 17

ABCs
Assess wound
ID the snake fir venom exposure
Labs for snake bit enmovation CBC, CMP, Coags, Fibrinogen, Dimer, Type and Cross

Question 18

CRVO

Answer 18

Ocular exam
Optho consult

Other: DC with follow up, CT head, still get labs

Question 19

Torsades in a kid

Answer 19

EKG and Dx
Dx torsades
PALS
cards consult, ICU consult

—- Family, lidocaine drip, EPi, Mag, defibrillate mutl times

Question 20

RPO

Answer 20

Prepare for intubation
Abx
Soft tissue neck x ray
ENT ocnuslt
ICU admission

Question 21

SCFE

Answer 21

phys exam bilaterally
ortho
bilat x rays w/ lateral!
pain meds- ibuprofen

Question 22

3 year old test torsion

Answer 22

test exam
immediate urolgoy/ped surg consult
US doppler
pain- morphine
menaul deotrsion attempt )procedural sedation, elevate, 540 medial to lateral)
OR
NPO

Question 23

Gastric Perf

Answer 23

IV access
upright cxr
pain
surgery

Question 24

pertussis kid

Answer 24

O2
IVF if tachy
CXR
Abx
Admit resp isolatio

Question 25

AAA

Answer 25

IVF and access bedside US!!!! (CT will be down) surgery consult Blood trasfusion (call BB to make sure MTF is ready) Grey turner sign- gflank ecchymosis signs of retroperitoenal hematoma

Question 26

CO Posioning

Answer 26

100% NRB Glucow HX COHb elvel Transfer for hyperbaircs

Question 27

LeFort 2 Fx

Answer 27

Early advanceed airway - Awake intubation, cric at thebedside hemorrhage control - stop epistaxis! C spine immobilization CT head, face, c spine CXR for aspirated teeth assess for csf rhinorrhea Epistaxis, direct compression first

Question 28

Circumfenertial burn

Answer 28

Large bore IV access Pain Tube Escharotomy tdap burn unit transfer CO level Tdap Intubate for sedation parkland forumla!

Question 29

varicela bleed

Answer 29

IVF Hemodynamic monitring Platelt/FFP ransfusion Abx ICU GI consult

Question 30

Bradycardia

Answer 30

EKG O2 Atropine .5 up to 3 mg pace - tracsQ to tansV

Question 31

Status Ashtmaticus

Answer 31

Pulse ox cardiac monitoring O2 Duonebs, steroids frequent reassessment Mag, Epi, terbutaline Bipap Admit to ICU

Question 32

SJS

Answer 32

Hx of abx usage skin exam DDX stop the offending agent Derm and OPTHO consult ICU admit

Question 33

GBS

Answer 33

FSG Neuro exam GBS Dx Neuro consult intubate- decom from NIF ICU admit Plasma exacnhe LP too

Question 34

SBO

Answer 34

IVF Upriught CXR obsutricve series pain surgery NGT