Emerg Med Flashcards Preview

NPLEX 2 > Emerg Med > Flashcards

Flashcards in Emerg Med Deck (32):
1

What type of fluid is isotonic with blood and used after blood loss due to trauma, surgery, or burns? What is the usual administration dosage?

Ringer's lactate
20-30 ml/kg/hour

2

What type of fluid is used after post-op?

D5-W
5% dextrose in water, achieves balance between starvation reactions and hyperglycemia.

3

What are the signs that birth is imminent?

Contractions < 3min apart (beg to beg)
Mother feels urge to push
Crowning

4

T/F: Fundal massage is indicated in placental delivery and is done passively.

T

5

What is the first lab you should do in an acute abdomen in a female in child-bearing years?

Hcg

6

What are uterotonic medications?

Oxytocine, Methergine, Hemabate, misoprostol

7

What are the four T's of post partum hemorrhage management?

Tone - uterine massage, bimanual massage between vagina and uterine fudus, empty bladder (promote oxytocin - infant suckling)
Trauma - laceration, inversion
Tissue - retained placenta
Thrombin - clotting disorder

8

Two primary causes of neonatal encephalitis/meningitis. How is it prevented?

Grp B Strep (more pathogenic) E.coli

Prophylactic antibiotics - Penicillin

9

What's the first thing you do in an emergency scene?

Survey the scene

10

If you HAVE to move a victim (for safety), what are you most careful not to move or move minimally?

Head/neck

11

What does RAP mean?

Responsiveness
Activate EMS
Position - for compression, unless suspected head/neck trauma.

12

Difference in CPR for infants.

Total coverage of nose/mouth infant.
Use two fingers to perform shallow compressions.

13

For hydration or emergency purposes, what would you select as far as size for infusion catheter?

18-20 gauge (bigger, infuses more quickly)

Use an isotonic solution

14

What should an IV solution pH be?

6.6-7.6

15

What should IV solution osmolarity be?

150-450 low risk phlebitis
450-600 moderate risk
600 + 100% risk of some phlebitis

16

What are some IV changes that can help reduce risk of phlebitis?

Slow the IV
Increase solution/dilution
Buffer (Bicarb or HCl)
Use largest vein
Watch catheter tip placement

17

Who is at increased risk for fluid overload with IV infusion? How is it avoided?

Elderly with impaired heart or kidney function.

Slow infusion, heat to dilate peripheral circulation, O2 administration

18

How big of an air embolism does it take to cause death in a human?

10-60cc

19

What is the antidote to Mg overdose or speed shock?

1 gram of calcium
Give additional grams depending on how they respond.

20

What is the treatment for a hypoglycemic emergency?

Administer high dose Vit C IV with food. EDTA can also cause.

Infuse D5W or slow push D50.

21

What is the treatment for hyperglycemic emergency?

Steroid injection
Administer NS or 1/2NS
Insulin (SQ or IV)

22

What is the minimal pulse and correlating peripheral BP for radial, femoral, carotid?

Radial = 80 systolic
Femoral = 70 systolic
Carotid = 60 systolic

23

What is the IM/SQ epinephrine concentration and dose?
What is the IV epinephrine concentration and dose?

1:1000, 0.3-1 cc immediately

1:10000, 3cc and wait May give 10cc

24

What is the dose of benadryl for anaphylaxis?

50mg IV stat

25

What other medications would you include in treatment anaphylaxis?

Steroids - dexamethasone, prednisone, hydrocortisone
Ca Gluconate
Mg Sulfate
Albuterol

26

What fluid do you never give to hydrate a patient?

Sterile water - will kill the pt.

27

What is CI in a toxic child with epiglottitis?

Moving the neck or opening mouth.

28

When is oxygen required in an adult? In a child? An infant?

An adult breathing fewer than 12 rpm or more than 20 rpm.

A child is breathing fewer than 15 rpm or more than 30 rpm.

A infant is breathing fewer than 25 rpm or more than 50 rpm.

29

T/F: Always go beyond 2-3L per minute of oxygen with a COPD pt.

F. Never, use nasal cannula.

30

What is something all head injury pts require?

100% oxygen

31

What is important to consider in facial/eye trauma?

Small bone fractures

32

Dosages for epi:
Subcut
IV
IM
Subling

0.5-1 ml IV
0.3-0.5 ml for the rest