Emergencies Flashcards
(189 cards)
1
Q
an event independent of human willpower, caused by an external force, acts rapidly and results in bodily or mental damage
A
Accident
2
Q
“the physical damage that results when a human body is suddenly subjected to energy (mechanical, thermal, chemical or radiated) in amounts exceeding threshold of physiological tolerance or the result of a lack of one or more vital elements, such as oxygen”
A
Injury
3
Q
implies random event that cannot be prevented
A
Accident
4
Q
a medical condition with defined risk and protective factors, hence, can be controlled and prevented
A
Injury
5
Q
the term accident prevention has been replaced by
A
injury control
6
Q
CHILDHOOD ACCIDENTS AND INJURIES
A
ppt
7
Q
most commonly injured sites, with deep 2nd degree friction injury sometimes associated with fractures of __
A
Hands
fingers
8
Q
major cause of morbidity and mortality in house fires
A
smoke inhalation
9
Q
approximately 18% of burns are the result of child abuse, usually ___.
A
scalds
10
Q
flame burns accound for ___%
A
13
11
Q
classification of burn injury according to degree of severity
A
1st degree
2nd degree
3rd degree
4th degree
12
Q
classification of burn injury according to depth of injury
A
Partial thickness
Full thickness
13
Q
zone of tissue injury. center of burn wound and represents actual tissue damage
A
zone of coagulation
14
Q
zone of tissue injury. the surrounding area and represents areas of potential tissue loss
A
zone of stasis
15
Q
zone of tissue injury. outer ring. unburned tissue that is inflamed
A
zone of hyperemia
16
Q
burn wound pathophysiology
A
changes in capillary permeability allow plasma to seep into interstitial spaces.
the sodium pump fails and sodium remains in the cell.
there is a corresponding increase in serum potassium.
17
Q
pag may blisters, anong degree?
A
2nd degree burn
18
Q
depth of burn wounds. 1st degree
A
epidermis
19
Q
depth of burn wounds. 2nd degree
A
corium
20
Q
depth of burn wounds. 3rd degree
A
fat
21
Q
classification of burn injury according to depth of injury.
epidermis remains intact and without blisters.
erythema; skin blanches with pressure. pain. epidermis (sweat duct, capillary)
A
1st degree
22
Q
classification of burn injury according to depth of injury. wet, shiny, weeping surface. blisters. wound blanches with pressure. painful. sensitive to touch, air currents. dermis. subQ, nerve endings, hair follicle.
A
2nd degree
23
Q
classification of burn injury according to depth of injury. color variable (deep red, white, black, brown). surface dry, thrombosed vessels visible, no blanching. insensate (decreased pinprick sensation). sweat gland, fat, blood vessel. autografting.
A
3rd degree
24
Q
classification of burn injury according to depth of injury. color variable, charring visible in deepest areas, extremity movement limited. insensate. bone. amputation, autografting
A
4th degree
25
burns involving the face, eyes, ears, hands, feet, and perineum likely to result in functional or cosmetic disability
major burn injury
26
first aid for pain
analgesics
27
high voltage electrical burn injury
major burn injury
28
all burn injuries with concomitant inhalation injury or major trauma
major burn injury
29
less than 10% TBSA full-thickness burn without cosmetic or functional risk of face, eyes, ears, hands, feet, or perineum
moderate burn injury
30
less than 2% TBSA full-thickness burn without cosmetic or functional risk of face, eyes, ears, hands, feet, or perineum
minor burn injury
31
burn initial assessment should first include
airway, breathing, circulation
32
RMR x Activity Factor x Injury Factor
Modified Harris-Benedict
33
strongest determinant of mortality from burns, mostly from fires in the home
smoke inhalation
34
highest death rates in burns
infants
35
lowest death rates in burns
10-14 yo
36
The death rate climbs again at which age.
15-19 yo
37
important cause in overall morbidity from burns, and a significant cause of disability
scalds and contact burns
38
Unawareness of risks
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
a
39
Lack of experience
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
a
40
Need to explore and innovate
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
a
41
Role models (motorcyclist as hero)
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
a
42
Risk-taking behavior
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
a
43
Use of a motor vehicle to build up self-esteem
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
a
44
Psychological maladjustments (extreme personality traits, unbalanced personality)
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
a
45
Sociopathic behavior (aggressiveness, deviance)
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
a
46
Family dysfunctions (chronic family syndrome)
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
a
47
Habitual use of a two-wheeled vehicle without due protection
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
b
48
Lack of body protection (helmet, gloves, etc.)
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
b
49
Increased commercial advertising promoting vehicles that are dangerous
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
b
50
Inadequate age-specific driving regulations
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
b
51
Inadequate enforcement of existing laws
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
b
52
Increasing need to make long trips to and from work, school, etc.
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
b
53
Inadequately or excessively expensive public transport
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
b
54
Heightened emotional tension (endocrinological and psychological)
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
c
55
Alcoholic condition
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
c
56
Driving under influence of medicines or drugs (especially hallucinogenic)
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
c
57
Special traffic conditions
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
c
58
Social pressure to “perform” in a certain way (traveling in groups)
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
c
59
Use of poorly maintained vehicles
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
c
60
Use of stolen vehicles
a. Psychosocial (endogenous) Predisposing Factors
b. Environmental (exogenous) Predisposing Factors
c. Precipitating Factors
c
61
age with highest % of death due to injuries
15-19 yo in us
| 10-14 in ph
62
top 2 causes of child injury deaths
1. road traffic injuries
| 2. drowning
63
3rd leading cause of injury death in children 1–4 yr of age (infantile) and 2nd leading cause in 15–19 yr old (adolescent)
homicide
64
Injuries most common cause of death when
beyond 1st few mo of life
65
3rd leading cause of death for 15–19 yr old
suicide
66
most common injury (in PH) for children to miss school
sharp objects
67
a child’s behavioral style
Temperament
68
irregular rhythm, high energy, negative mood, low adaptability
Difficult child:
69
opposite of child with irregular rhythm, high energy, negative mood, low adaptability
easy child
70
low activity, positive approach, highly adaptable, mild energy
Slow to warm up child
71
interest in accomplishing a task
motivation
72
Motivation
Normal drive for autonomy
Interest in imitating behavior
Risk-taking or self-destructive behaviors
73
level of functioning
Competencies
74
sometimes lose touch with reality combined with innate need for experimentation and tendency to imitate older persons
adolescents
75
Two major causes of death
Airway compromise
| Unrecognized hemorrhage
76
Traumatic injuries that may affect successful resuscitation:
Cervical spine injury
Hemorrhage
Chest trauma
77
Three DELAYS that KILL!
DELAY in decision-making
DELAY in transporting patient
DELAY in managing patient
78
Principles of Injury Control
Education or persuasion
Changes in product design
Modification of social (laws) or physical environment
79
Control external hemorrhage immediately by
direct pressure over the wound
80
CARDIOPULMONARY RESUSCITATION
PPT
81
respiratory alkalosis with an anion gap
salicylates
82
late sequelae includes pyloric and intestinal scarring with stenosis
iron poisoning
83
peripheral blood smear may show microcytic anemia, basophilic stippling, and RBC precursors
lead poisoning
84
classic PE findings, although uncommon inc cherry red skin
carbon monoxide poisoning
85
antidote is N-acetylcysteine
acetaminophen
86
inhalation injury is the most important predictor of mortality
burn injury
87
major damage concealed, visible areas are necrotic tissues
electrical injury
88
produce a coagulative necrosis and liquefactive necrosis of tissues
chemical injury
89
leads the list of injuries beyond infancy
vehicular accidents
90
most common in infants
fall injury
91
head tilted back with mouth open
near drowning
92
may result in pulmonary edema
near drowning
93
commonly occurs in children less than 3 yo
foreign body aspiration
94
Heimlich maneuver
foreign body aspiration
95
head tilt chin maneuver
cardiopulmonary resuscitation
96
bolus fluid resuscitation therapy: 20mL/kg isotonic crystalloid solution administered ASAP
cardiopulmonary resuscitation and shock
97
inotropes for poor perfusion or hypotension with adequate volume and stable rhythm
shock and CPR
98
treat acid base imbalance
shock and CPR
99
cricothyrotomy
cardiopulmonary resuscitation
100
60% of poisoning occurs in this age group
0-5 yo
101
age group where suicide is the 3rd leading cause of death
15-19 yo
102
suffocation occurs in about 50% of all intestinal(?) deaths
0-5 yo
103
age group where burn injuries rank lowest
11-14 yo
104
peak of foreign body aspiration
0-5 yo
105
eythema
1st degree burn
106
thrombosed veins visible
3rd degree burn
107
very sensitive to touch or currents
2nd degree burn
108
desquamation in 3-7 days
1st degree burn
109
extremity movement limited
4th degree burn
110
preferred gastric decontamination is WBI
iron poisoning
111
directly related to glutathione during its metab by CYP 450
acetaminophen
112
o2 is displaced from hemoglobin molecure
CO poisoning
113
Tinnitus
salicylate poisoning
114
dialysis may be required in life threatening situation
salicylate poisoning
115
hypertension is manifested when blood loss is about 25%
trauma/ hypovolemic shok
116
52% occurs in the right main bronchus
foreign body aspiration
117
pulmonary edema and atelectasis are expected complications
near drowning
118
using 2 fingers in chest compression
BLS
119
presence of congenital heart disease may be an etiological factor
cardiogenic shock
120
center of burn wound and actual tissue damage
zone of coagulation
121
wet, weeping surface of the skin
2nd degree burn
122
more than or = to 25% volume loss
shock
123
inadequate ventilation of oxygenation
respiratory failure
124
insufficient ventilation, oxygenation and perfusion
cardiopulmonary failure
125
with generalized seizures, metabolic acidosis and coma
isoniazid poisoning
126
has 200x more affinity to Hgb than O2
carbon monoxide
127
induces parasympathetic effects
organophosphate poisoning
128
pattie had a seizure 30mins after ingetsing the toxic dose of
isoniazid poisoning
129
uses Rumack-Matthew Normogram
Acetaminophen Poisoning
130
hemodialysis is indicated
salycilate poisoning
131
most common lower airway object
peanut
132
maneuver in older children and adults
Heimlich maneuver
133
most common cause of accidents in toddlers and children
motor vehicle accident
134
salt water drowning is associated with
Pulmonary edema
135
bradycardia is most common in
cold water drowning
136
15 mo old child suffering 2nd degree burn is best assessed using
Lund and browder Chart
137
secondary gram positive infections in burn patients is caused by
S. aureus
138
Fracture of distal radius and ulna
Colle's fracture
139
Low-energy forces
toddler's fracture
140
supination and flexion of elbow is used in
Pulled elbow
141
air passes in and out, no radiographic changes and S/Sx
bypass valve
142
most corrosive componen of coins
Zinc
143
Most corrosive component of button batteries
Mercury
144
concentration used in isopropyl alcohol
70-90%
145
urine coproporphyrin is during Pb toxicity. what is the unusual normal level?
<120ug/L
146
during Hyperbaric Tx, CO is decreased within how many mins?
20-30 mins
147
max dose of Vit B6 in children and adult, respectively
child 20g
| adult 40g
148
ratio of vitB6 to INH ingestion
1:1
149
atropin sulfate is given how many dosage? route?
0.03-0.04mg/kg IV
150
isoniazid toxicity level in adult and child respectively
child 10-20 mg/kg/day
| adult 300mg
151
plumbism occurs in 3 ways.
inhalation, ingestion, cutaneous contamination
152
triad in INH toxicity
generalized edema,
metabolic acidosis,
coma
153
NaHCO3 for acidosis what dose and route during INH toxicity
1-2 meQ/kg IV
154
clinical symptoms of Plumbism in blood is
>70ug/dL
155
lethal dose in Ethanol alcohol in children and adult respectively
child 3g/kg
| adult 5-8 g/kg
156
use of containers for drugs and other dangerous household products.
active or passive intervention?
passive
157
use of proper labeling in household products
active or passive intervention?
active
158
change of behavior by parents or caretakers to prevent untoward incidents of drugs or household toxicity
active
159
abnormal ABG and ECG is noted
carbon monoxide
160
hemodialysis can be assessed as tx
isopropyl alcohol
161
lab findings are acetonia, acetonuria and metabolic acidosis
isopropyl alcohol
162
immediately absorbed in GIT (30mins)
isopropyl alcohol
163
2 agents said to be rapidly absorbed
INH
| Ethanol
164
metallic taste
lead toxicity
165
prescribed as cough medication
INH toxicity
166
requires chelation therapy
lead toxicity
167
peroxynitrate is known as the toxic metabolite seen in what condition
CO poisoning
168
Increase in ICP, edema, and more likely will lead to death is
lead
169
fastric decontaminantion where ativated charcoal can be used is the mgt of
INH toxicity
170
motor incoordination, dizziness and slurred speech
ethanol
171
hypotonia, hypothermia, hemolytic anemia
isopropyl alcohol
172
patient is given Naloxone which is the tx for CNS depression. identify the type of toxicity or chemical agents in the said ondition
ethanol?
173
oxygenation and hyperbaric therpay as tx
carbon monoxide
174
most toxic agents have nausea and vomitting. however, hematemesis is seen in
isopropyl alcohol
175
lavage or emesis is tx for
ethanol
176
tissue hypoxia is seen in
CO poisoning
177
dense metaphyseal line in xray
lead toxicity
178
normal RR for premature
40-70 cpm
179
normal RR for 0-3 months
35-55 cpm
180
normal RR for 3-6 months
30-45 cpm
181
normal RR for 6 to 12 mos
25-40 cpm
182
normal RR for 1-3 yo
20-30 cpm
183
normal RR for 3-6 yo
20-25 cpm
184
normal RR for 6-12 yo
14-22 cpm
185
normal RR for 12 yo and above
12-18 cpm
186
normal HR for newborn to 3 mo
85-200 bpm
187
normal HR for 3mo-2yo
100-190 bpm
188
normal HR for >2 yo
80-140 bpm
189
bradycardia for all ages
< or = 60 bpm
