Week 1 Flashcards
Iron Overdose Treatment
-Decontamination
——Whole bowel irrigation facilitates removal of iron from the (GI) tract prior to absorption.
-Chelation
——Early treatment with IV deferoxamine:
———Symptomatic patients (intractable vomitus, metabolic acidosis, lethargy, hypotension, or signs of shock/end-organ injury)
———Serum iron concentration >500 μg/dL (>89.5 μmol/L)
Key Meds in penetrating trauma
TDAP
Antibiotics (ancef)
Pain control
TXA
Often missed exam
Neuro
Rectal
Post intubation steps
Vent
Foley
Sedation
If acute cholangitis is suspected, ______________ is the preferred imaging modality.
CT with IV contrast
Cholangitis vs Cholecystitis consults
Cholangitis:
Consult GI for urgent ERCP
Cholecystitis:
Consult general surgery or interventional radiology for either a cholecystectomy or temporizing percutaneous cholecystostomy.
Severe cholecystitis antibiotics
piperacillin-tazobactam 3.375 g IV q6h
plus
vancomycin loading dose of 25-30 mg/kg IV
All potential surgical cases need these labs
Type and screen
Co-ags
Trauma chest tube size
28-32
Hypotension parameters are as follows:
Term neonates (0-28 days old)
Systolic BP (SBP) < _______ mm Hg
Systolic BP (SBP) <60 mm Hg
Hypotension parameters are as follows:
Infants (1-12 months old)
SBP < ________mm Hg
SBP <70 mm Hg
Neonatal Sepsis Meds
-10-20 mL/kg rapid 0.9% NS
- ampicillin
plus - cefotaxime or gentamicin
consider
- acyclovir for suspected neonatal herpes
- adding vancomycin (Some use vancomycin for all cases of late-onset neonatal sepsis)
Hypotension parameters are as follows:
Children 1-10 years old
SBP <______ mm Hg
SBP <70 + (2 age) mm Hg
The rule of 50- Hypoglycemia
D10- 5 mL/kg
D25- 2 mL/kg
D50- 1 mL/kg
Note that all three, when multiplied, equal 50 (e.g. 5ml/kg x 10 = 50)
Hypotension parameters are as follows:
- in term neonates (0-28 days old)
- in infants (1-12 months old)
- in children 1-10 years old
- in children ≥10 years old
Systolic BP (SBP) <60 mm Hg in term neonates (0-28 days old)
SBP <70 mm Hg in infants (1-12 months old)
SBP <70 + (2 age) mm Hg in children 1-10 years old
SBP <90 mm Hg in children ≥10 years old
Hypotension parameters are as follows:
Systolic BP (SBP) <60 mm Hg in ____________
term neonates (0-28 days old)
Boerhaave’s Syndrome Management should include
Pain control
PPI
Broad-spectrum abx (vanc/ zosyn)
NPO
Early consultation with specialists (GI, ENT, or CT surg)
ICU admit
Acute-angle closure glaucoma treatment
Timolol - 1 drop every 30 minutes × 2 in the affected eye only
Apraclonidine 0.5% 1 drop every 30 minutes × 2 in the affected eye only
Acetazolamide 500 mg
Mannitol 1-2 g/kg if no response to other medications
*Mannitol is contraindicated in renal failure or pulmonary edema, and caution with CHF.
Measure IOP q60 min to determine the response to treatment.
Once the IOP has decreased, apply to affected eye only:
Prednisolone acetate 1% 1 drop every 15 minutes × 4
If medical therapy is unsuccessful–> emergency surgery or laser iridotomy.
Parkland Formula
Fluid requirement in 24 hours is as follows:
= 4ml x TBSA (%) x body weight (kg)
50% given in first eight hours
50% given in next 16 hours.
_____ is the preferred paralytic for RSI in GBS.
Roc
