Emergency Stabilization Exam 1

Question 1

What changes the outcome of acutely poisoned patients?

Answer 1

• Triage
• ABCT
• Avoid foulups
• Antidotes

Question 2

What is the role of the poison control center in the triage process?

Answer 2

• have board certified med tox person
• have applied toxicology person
• always on call
• fill in the blanks
• assume the worse
• assists in using kits and makes recommendations

Question 3

ABCT

Answer 3

• Airway
• Breathing
• Circulation
• Temperature

Question 4

Airway

Answer 4

• Assessment – check gag reflex
• Position patient and optimize airway:
  • Sniffing position, jaw thrust, head down, left-sided position
  • Remove obstruction or secretions
  • Endotracheal intubation?
• Prepare for barfing

Question 5

Breathing

Answer 5

• Ventilate pt to make sure there is air coming in and out (make sure you hear breathing sounds); assist with bag/mask
• Assess for hypoxia or cellular inhibitors causing it
• Complications of respiratory failure: hypoxia, hypercarbia
• Hypercarbia not dangerous unless pH drops
• Obtain ABG
• Give supplemental oxygen

Question 6

Hbg’s role in oxygenation

Answer 6

• holds four O2 molecules; carries O2 to cells
• center iron MUST be FERROUS; if not, it cannot bind to oxygen; nitrates can interact with ferrous and turn it into ferric; methylene blue is the antidote to this
• CO bind to Hbg with greater affinity than O2; CO will still make your blood look red

Question 7

Circulation

Answer 7

• Check BP, HR, rhythm
• ECG monitoring
• Perfusion

Question 8

What is the most common cause of bradycardia?

Answer 8

hypoxia

Question 9

How does TCA’s affect conduction?

Answer 9

• causes failure in conduction
• bradycardia
• prolongs the QRS complex (>0.12)
• give bicarb when this happens
• causes ventricular arrhythmias

Question 10

What happens when you lose regulation of heat loss?

Answer 10

• hypothermia

- loss of vascular control

Question 11

Hyperthermia

Answer 11

• if temp > 105F, medical emergency; when temp is too high, muscles break down -> rhabdo
• cool pt immediately
• administer glucose
• control seizures, agitation, muscle rigidity
• use BZD

Question 12

Treating Malignant hyperthermia

Answer 12

Dantrolene

Question 13

Treating Neuroleptic malignant syndrome

Answer 13

Bromocriptine

Question 14

Treating Serotonin syndrome hyperthermia

Answer 14

Cyproheptadine