Flashcards in Emergency Medicine Deck (142)
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1
gastric lavage useful in....
1 hour of ingestion
2
ALL types of gastric emptying are dangerous in
1. caustic ingestion
2. altered mental status
3. acetaminophen overdose
3
ALWAYS WRONG ANSWER GIT emptying...
1. ipecac
2. cathartics
3. diuresis: fluids and diuretics
4. whole bowel irrigation
4
ipecac
prior to coming to hospital
5
cathartic agents=
sorbitol
does NOT eliminate ingestion without absorption
6
diuresis=
pulmonary edema
7
only times whole bowel irrigation is correct
1. massive iron ingestion
2. lithium
3. swallowing drug filled packets
8
not clear what cause of OD is, go with..
acetaminophen or
aspirin
(since mcc death from OD)
9
patient with altered mental status and unknown cause order of steps
1. naloxone and dextrose
2. intubation
3. gastric lavage
10
chronic benzo user given flumazenil
INSTANT WITHDRAWAL--> seizures
11
first time benzo use and TCA
benzos PROTECT from TCA induced seizures
12
first time benzo use and TCA and give flumazenil
flumazenil removes the protection from seizures by benzzos--> SEIZURES
13
opiate OD vs benzo OD
opiate= fatal
benzos= non fatal (DO NOT GIVE FLUMAZENIL)
14
charcoal use
ANYONE with pill OD, not dangerous, and not specific
15
charcoal in comparison
BETTER than lavage and ipecac
16
don't know what to do in toxicology give....
CHARCOAL
17
what scenario when less acetaminophen is needed to cause toxicity
ALCOHOLICS
18
toxic amount of acetaminophen ingested (8-10grams)
N-A-C
19
OD acetaminophen more than 24hrs ago
NO TX
20
amount of ingestion of acetaminophen is unclear
DRUG LEVEL
21
ok to give both NAC and charcoal
YESSS it is
22
PC aspirin OD
- tinnitus
- hyperventilation
- resp alkalosis ---> metabolic acidosis
23
why metabolic acidosis in aspirin OD
aspirin messes with ox phos--> anaerobic--> lactic acidosis
24
blood gases for aspirin OD
low O2
low bicarb
HIGH PH
25
best initial test for someone with TCA ingestion after given antidotes...
EKG
26
what are you looking for on EKG with TCA OD
TdP---> WIDENING of QRS
27
serious consequences of TCA OD
seizures
arrhythmia
28
bicarb use in TCA OD
protects from arrhythmias
DOES NOT increase urinary excretion
29
caustics
acids and alkalis (drain cleaner)
30
