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Respiratory Exam 2 > Emergency Medicine > Flashcards

Flashcards in Emergency Medicine Deck (30):
1

First priority in all trauma resuscitations.

secure Airway and ventilation

2

What is suspected if a trauma patient presents with hoarseness, subcutaneous emphysema, and a palpable neck fracture?

Laryngeal Fracture

3

What is the next step in treating a trauma patient if intubation is unsuccessful?

Emergency tracheostomy

4

What is the Mallampati Score?

Assesses the difficulty of intubation. Higher scores mean more difficult.

Scores are based on visibility into the patient's oral cavity while seated. Viewing only hard palate, vs being able to see soft palate or uvula account for the score.

5

What does a pulse oximeter measure?

Measures the amount of bound hemoglobin.
-not necessarily just oxygen bound to Hb
-DOES NOT measure ventilation

6

Airway management technique very useful for handling a bag-valve device.

Jaw Thrust
-digits 3-5 grab the angle of the mandible and pull it forward while the thumb and 2nd digit hold the mask of the bag-valve over the patients airway.

7

How do you measure the correct size for an Oropharyngeal Airway?

Measure from the center of the mouth to the angle of the mandible.

8

What type of airway is preferred in a conscious patient?

Nasopharyngeal Airway.

9

How is a nasopharyngeal airway measured?

Measure from the nostril to the patient's earlobe

10

What is a definitive airway?

A tube present in the trachea with the cuff inflated, the tube connected to oxygen-assisted ventilation, and the airway secured in place.

11

What is RSI and when is it used?

Rapid Sequence Induction
-use of anesthetic and/or sedative medication in a patient that is awake or has an intact gag reflex in order to secure an airway

12

What are the 5 life threatening injuries identified on the primary survey?

1. Tension Pneumothorax
2. Open Pneumothorax
3. Flail Chest
4. Massive Hemothorax
5. Cardiac Tamponade

13

Tx for a patient that presents with unilateral absent breath sounds, tachypnea, cyanosis, and tracheal shift seen in the neck.

Tension Pneumothorax
1. needle decompression 2nd intercostal space midclavicular line
2. chest tube placement 4th or 5th intercostal space ant. to mid-axillary line (only necessary for serious lung injury or penetrating wound that caused the pneumothorax)

14

Treatment for a patient that presents gasping for air, cyanotic, severehypotension, and a large stab wound in the upper thorax.

Open Pneumothorax
Sterile, air-tight dressing over the wound taped on 3 sides to act as a 1-way valve

15

Tx for a patient that presents with difficulty breathing, hypoxia, chest pain, and asymmetric rise and fall of the chest wall with respiration.

Flail Chest
-oxygen to prevent hypoxia
-pain management if necessary
-fluid resuscitation

16

Tx for a patient that presents with absent breath sounds, mediastinal shift, and shock.

Massive Hemothorax (loss of greater than 1500cc in the thoracic cavity)
-fluid resuscitation
-chest tube placement
-transfusion
-send to surgery

17

What is Beck's Triad and what does it indicate?

1. JVD
2. Hypotension
3. Muffled Heart Sounds
Indicates Cardiac Tamponade

18

Tx for cardiac tamponade.

Pericardiocentesis

19

Most common cause of simple pneumothorax.

Lung laceration with air leakage into pleural space

20

Tx for simple pneumothorax

Chest tube placement in 4th or 5th intercostal space ant. to midaxillary line

21

Best treatment for hemothorax.

Large caliber chest tube

22

How does a pulmonary contusion present?

Similar to ARDS or other restrictive diseases. Patient will be in respiratory distress.

23

Tx for Pulmonary contusion.

PEEP: because it is acts like a restrictive disease that prevents the lungs from expanding, positive pressure helps prevent hypoxemia

24

Tx for a patient that presents with dysphagia, hoarseness, dyspnea, pain between the scapulae, mediastinal widening on CXR.

Traumatic Aortic Disruption
-ABCs
-Surgical repair
(most commonly occurs at ligamentum arteriosum after trauma)

25

Tx for a patient that presents with hemoptysis, fractured larynx and fractured 1st rib.

Tracheobraonchial Disruption
-secure airway and ventilate
-large tears require surgical intervention

26

What is suspected if a patient presents with gut contents coming out of a chest tube?

Esophageal Disruption

27

Tx for esophageal disruption.

Early surgical intervention w/ drainage of the pleural space

28

What is suspected if bowel sounds are heard in the lower chest along with hyperresonance to percussion?

Traumatic Diaphragmatic Injury

29

Tx for Diaphragmatic Injury.

Surgery

30

Tx for Myocardial Contusion

-airway management
-work with cardiology: EKG and enzyme monitoring]
-treat arrythmias