Respiratory
BRUE/ALTE what does this describe?
Brief, unresolved, unexplained, event
apparent life threatening event
Absent, decreased, or irregular breathing b. Cyanosis or pallor c. Altered level of responsiveness. d. Marked change in muscle tone
Should you do a rhythm check on a patient that you are deciding whether or not to begin resuscitation and why?
No, because if there was any debate you should be working them immediately.
for a hospital what is the difference between at capacity and limited operations?
At Capacity: the hospital has determined the ED and supporting resources are fully committed (see routing decisions for exceptions). C. Limited Operations: the hospital has normal capacity, but an area or resource is not available. (no CT or MRI, Cath Lab shut down, etc.).
are you able to dilute d50 with NSS
yes
Contraindication for warm Normal Saline
Hyperthermia
your patient has overdosed on midazolam, what medication may be administered to them at the hospital?
More than likely nothing, because giving Flumazenil (the antidote for benzodiazepines) can lead to a seizure that is no longer treatable via benzodiazepines.
what are some things you should avoid doing for a patient with suspected sexual assault?
Avoid letting the patient use the restroom, wash anything, eat, drink, use chewing gum, brush teeth, or use mouthwash as these actions may contaminate or wash away evidence
Avoid performing any medical treatment, including invasive procedures (such as FSBG, IV access) unless necessary. Avoid contact with the patient to avoid disturbing possible evidence. You may take vital signs but note which arm you performed a BP and which finger for pulse ox.
Avoid going into detail about the assault. This will be done by the SANE nurse and law enforcement. The patient may omit important information if they tell the story repeatedly. Always document patient statements in quotation marks.
. Have the patient remain in their current clothing. If the patient has changed since the assault, have the patient bring the prior clothes.
what is the difference between last known well and time of symptom discovery?
The Last Known Well time is the time that the patient, or others, confirm that they were completely normal (or normal for them) prior to the onset of symptoms. This is NOT the time that the patient or bystanders first noted symptoms. If a patient woke up with symptoms present, then establish the last time the patient was noted to be at their baseline prior to going to sleep. (For example, the patient may have woken up in the middle of the night to go to the bathroom. This is the last known normal time.) If possible, bring a witness of last known normal time to the ED with the patient, and/or gather their contact information for the Stroke Team. D. Time of Symptom Discovery refers to the time at which the symptoms were first noticed by a reliable witness. These terms are often mistakenly used interchangeably, and so explicit capture of both ensures accuracy. Among patients with a witnessed stroke onset, these two times will be the same.
cramps - early
exhaustion, and vital sign changes - middle
stroke, AMS - late
what is the preferred concentration of dextrose?
Your patient has a history of asthma and is currently experiencing severe trouble breathing. The patient is tachycardic (160) and has experienced no relief from multiple breathing treatments. What is the next medication to be administered?
1:1000 Epinephrine
what 3 things should be present to consider administration of 3% hypertonic saline during head or spinal trauma?
If patient has signs of cerebral herniation which include coma and unilateral or bilateral blown pupil, posturing, or decline in GCS during transport >2 points then consider administration of 500 mL 3% saline solution if available.
Who can place a 72 hour hold on a patient? (3 needed)
psychiatrist
physician
psychologist
Police officer
sheriff
tricyclic antidepressants end is what suffix
-ine
how many drugs do we carry that have to have their own dedicated line?
2 (Cyanokit, TXA)
Draw wave form capnography of a shark fin, Describe your drawing, and explain in what type of patients this occurs?
The shark fin waveform demonstrates a bronchospasm causing the patient to have difficulty exhaling.
This mainly occurs in asthmatic patients.
what is brugada syndrome?
a genetic disorder that can cause a dangerous irregular heartbeat
(incomplete RBBB pattern in V1/V2 with ST segment elevation, ST elevation with saddle back shape following)
Explain the steps of jumpstart triage
Quick mnemonic flowchart for kids:
what sort of reaction is a possible side effect of zofran administration
dystonic
What drugs are administered in a traumatic arrest?
0
Draw and explain oxyhemoglobin disassociation curve
The oxyhemoglobin dissociation curve illustrates the relationship between the oxygen saturation of hemoglobin and the partial pressure of oxygen (PO2) in the blood. It has a sigmoidal shape, indicating that at low PO2 levels, hemoglobin has a strong affinity for oxygen, allowing it to bind effectively. As PO2 increases, the curve levels off, showing that hemoglobin's affinity for oxygen decreases at higher PO2 levels, which facilitates oxygen release to tissues. The curve can shift due to various factors, such as pH, temperature, and levels of carbon dioxide, affecting hemoglobin's oxygen-binding capacity.
Describe the cardiac rhythm monitoring chart for traumatic arrest?
asystole or PEA < 40 BPM - contact medical control regarding TOR
PEA > 40 BPM - fluid resuscitation, consider repeat needle decompression, Transport to nearest trauma center
VFib/VTach - defibrillate per protocol, fluid resuscitation, consider repeat needle decompression, Transport to nearest trauma center
Name 7 of the 10 predesignated landings zones for SFD
temple baptist
Cinema
Avon
Heritage hill elementary
tri-county mall
Dave and busters
soul-winning church of god
sheakley
vineyard
nazarene
Name the differential diagnoses for psychiatric emergencies? Need 10 of 15
Anemia, Cerebrovascular accident, Drug / Alcohol intoxication, Dysrhythmias, Electrolyte imbalance, Head Trauma, Hypertension, Hypoglycemia, Hypoxia, Infection (especially meningitis / encephalitis), Metabolic disorders, Myocardial ischemia / infarction, Pulmonary Embolism, Seizure,Shock
Blood glucose can be measured in two ways. How do you convert mmol/l to mg/dl?
mmol/l x 18 = mg/dl