PEDS/OB/GYN
A 34-week pregnant patient has severe headache, vision changes, and BP 170/110 with facial/hand edema
What is preeclampsia?
Hypertension in pregnancy with possible neurologic symptoms strongly suggests preeclampsia; high risk for seizure (eclampsia) and complications—rapid transport/ALS.
On the adult Rule of 9s chart, the entire head and neck equals this percent of total body surface area (TBSA).
What is 9%?
In adults, head/neck = 9% TBSA on the Rule of 9s
During abdominal assessment, you palpate the right upper quadrant and ask the patient to take a deep breath. They abruptly stop inhaling due to pain
What is Murphy’s sign?
Murphy’s sign is RUQ tenderness with inspiratory arrest caused by the inflamed gallbladder contacting your hand during inhalation—commonly seen in cholecystitis.
Crushing chest pressure with diaphoresis and nausea should be managed as this diagnosis until proven otherwise.
What is acute coronary syndrome (ACS)?
The symptom cluster is classic for myocardial ischemia/infarction; early recognition drives oxygen/aspirin/nitro per protocol and rapid transport.
Common Blood thinners
What is?
Warfarin (Coumadin)
Apixaban (Eliquis)
Rivaroxaban (Xarelto)
A 32-week pregnant patient has sudden, painless, bright-red vaginal bleeding. Abdomen is soft/nontender
What is placenta previa?
Placenta previa is when the placenta is low-lying/over the cervix, which classically causes painless, bright-red bleeding in late pregnancy. The big field clue is painless bleeding (vs. placental abruption = painful bleeding with a tender/rigid uterus).
EMT focus: Treat for shock, no vaginal exam, left lateral tilt if supine, rapid transport/OB alert.
An adult has circumferential partial-thickness burns to both arms. Estimate TBSA burned.
What is 18%?
Each arm is 9% TBSA; both arms together are 18%.
Deep, rapid respirations with a fruity breath odor and signs of dehydration point to this hyperglycemic emergency.
What is diabetic ketoacidosis (DKA)?
Kussmaul respirations are compensation for metabolic acidosis; the overall picture supports DKA—support airway/ventilation and rapid transport.
After blunt chest trauma you see paradoxical movement of a rib segment with severe pain and respiratory distress. Field impression?
What is flail chest (often with pulmonary contusion)?
A free-floating chest wall segment impairs ventilation and often signals underlying contusion; support breathing, stabilize, and transport.
Common antibiotics
Very common outpatient antibiotics
Amoxicillin
Amoxicillin–clavulanate (Augmentin)
Azithromycin (Z-Pak)
Doxycycline
Cephalexin (Keflex)
Cefdinir
Clindamycin
Trimethoprim-sulfamethoxazole (TMP-SMX / Bactrim)
Common UTI antibiotics
Nitrofurantoin (Macrobid)
TMP-SMX (Bactrim)
Cephalexin
Ciprofloxacin (Cipro) (used sometimes; less favored in some cases)
Common hospital/“big gun” names you’ll hear
Ceftriaxone (Rocephin)
Vancomycin (Vanc)
Piperacillin–tazobactam (Zosyn)
Levofloxacin (Levaquin)
An 8-month-old in winter has tachypnea, poor feeding, wheezing and crackles after a few days of runny nose and cough.
What is bronchiolitis (often RSV)?
Lower-airway inflammation in infants commonly causes mixed wheeze/crackles and increased work of breathing after a viral prodrome.
An adult has partial-thickness burns to the entire right leg and the front of the left leg. Estimate TBSA.
What is 27%?
One full leg = 18%; the front of one leg = 9%; total 27%.
You notice bluish-purple bruising around the umbilicus in a patient with severe abdominal pain and vomiting.
What is Cullen’s sign?
Cullen’s sign is periumbilical ecchymosis from intra-abdominal/retroperitoneal bleeding tracking to the umbilicus (classically hemorrhagic pancreatitis, but also other bleeding causes). It’s a red-flag finding.
Severe dyspnea with crackles, orthopnea, and pink frothy sputum in a patient with CHF suggests this complication.
What is acute pulmonary edema from CHF?
Fluid in the alveoli causes crackles and frothy sputum; treat respiratory distress, position upright, consider CPAP if available, and request ALS.
“Water pill” commonly found on med lists for CHF; patients often report peeing a lot and having less leg swelling.
What is furosemide (Lasix)?
Furosemide is a loop diuretic used to reduce fluid overload (edema, CHF).
A 2-year-old has a barking cough, hoarse voice, and inspiratory stridor after a recent cold. Symptoms are worse at night and may improve with cool air?
What is croup
Classic barky cough + stridor after a viral URI points to upper-airway swelling below the cords; keep the child calm and provide oxygen as needed
An adult has partial-thickness burns to the entire back (posterior trunk) and the entire left arm. Estimate TBSA.
What is 27%?
Posterior trunk = 18%; one arm = 9%; total 27%.
Hypotension, jugular venous distention, and muffled heart tones after chest trauma point to this cause of obstructive shock.
What is cardiac tamponade?
Beck’s triad suggests blood in the pericardial sac limiting filling; treat as life-threatening obstructive shock and expedite ALS/transport.
An asthma patient becomes exhausted with minimal air movement (“silent chest”) and altered mental status
What is impending respiratory failure (status asthmaticus)?
A silent chest can mean the patient is no longer moving air; treat as critical and escalate to ALS/ventilation support.
A patient with bradycardia and hypotension says they take a daily heart med that slows the heart rate and lowers blood pressure. They might take it for HTN, angina, atrial fibrillation rate control, or after an MI.
What is metoprolol (Lopressor/Toprol XL)? Will accept beta blocker
Metoprolol is a very common beta blocker. Beta blockers block β-receptors, which decrease heart rate and contractility, so overdose or sensitivity can present as bradycardia/hypotension and can blunt the body’s compensatory tachycardia.
Classic barky cough + stridor after a viral URI points to upper-airway swelling below the cords; keep the child calm and provide oxygen as needed
What is epiglottitis?
Drooling + tripod + fever suggests a critically narrowed upper airway; minimizing agitation reduces the risk of sudden obstruction
An infant has received entire burns to both legs. What is the TBSA?
What is 28%
In infant burns each leg is less total body area than adults at 14%, and their heads count for a larger surface area.
After head trauma you see bradycardia, irregular respirations, and a widening pulse pressure. This triad suggests increased ICP.
What is Cushing’s triad?
These findings are classic for rising intracranial pressure with impending herniation—time-critical.
Sudden shortness of breath with pleuritic chest pain and unexplained tachycardia after recent surgery or long travel suggests this.
What is pulmonary embolism (PE)?
Risk factors + abrupt dyspnea/pleuritic pain make PE likely; oxygenation and rapid transport are priorities.
Common Type 2 diabetes pill; patients may mention GI upset, and you worry about it when someone is very sick with poor perfusion because of lactic acidosis risk.
What is metformin (Glucophage)?
Metformin is a first-line Type 2 DM med; severe illness/hypoxia/dehydration raises concern for lactic acidosis.