What 3 locations are best to apply cold packs for cooling?
Groin, armpit, neck
what part of the brain controls blood temperature and metabolism?
hypothalamus
what size ET tube will be used for needle Cricothyrotomy in a patient less than 5 years old?
2.5
what is the definition of an artery?
any vessel that carries blood away from the heart.
generally as a rule of thumb, how many patients determine it is an MCI?
10
what type of cooling is the most effective and if possible should be done prior transport?
Immersion cooling (pool, high flow cold water)
what is pulsus paradoxus and how does it occur?
Pulsus paradoxus is when the systolic B.P. or heart rate drops upon inhalation. This is seen in a severe asthma attack or pericardial tamponade, where hyperventilation blows up the lungs and puts pressure onto the heart disrupting blood flow.
name 3 of 5 contraindications for CPAP
Respiratory arrest.
2. Suspected pneumothorax.
3. Patient has a tracheostomy.
4. Patient is at risk for aspiration i.e.: vomiting, foreign body airway occlusion.
5. The patient is intubated.
what is the blood flow through the heart?
what do the colors on hazmat placard represent?
yellow- reactivity
red- flammability
blue- health
when the patient reaches what temperature do you stop cooling to prevent overshoot hypothermia?
Double Jeopardy: what is the answer in Celsius
101 degrees F
36 degrees Celsius
Name 2 examples of negative feedback and 1 example of positive feedback?
negative feedback - insulin v.s glucagon, temperature regulation
Positives feedback- child berth and clotting
Identify how to mix TXA and what time it is given over? Does TXA need a dedicated line?
1g in 100ml NSS over 10 minutes
If possible yes, but not necessary
what defines an anaphylactic reaction? per protocol
Two or more body systems involved (e.g., skin/mucosa, cardiovascular, respiratory, GI)
Hemodynamic instability
Respiratory compromise
dose of Glucagon for pt less than 6 years old?
.5mg
Name 5 of the 8 things that characterize heat exhaustion prior to heat stroke?
Volume depletion, Tachycardia, Fatigue, Hyperventilation, Lightheadedness, Hypotension, Headache, Body temperature may be normal
name 10 possible differential diagnoses for AMS.
Anemia
B. Drugs and Alcohol
C. Dysrhythmias
D. Electrolyte Imbalance
E. Head Injury
F. Hypertension
G. Hyperglycemia
H. Hypoglycemia
I. Hypoxia
J. Infection, especially Meningitis
K. Myocardial Ischemia / Infarction
L. Pulmonary Embolism
M. Psychiatric
N. Seizure
O. Shock
P. Stroke, Intracranial Bleeding
Q. Toxic Ingestion
in a crush injury trauma, where extrication is longer than 60 minutes, what medication is most important, how are they mixed and how are they given(time)? Does this need a dedicated line?
1 AMP (50mEq) bicarb in 1L NSS over 1 hour
what are the four properties of cardiac cells?
automaticity, excitability, conductivity, contractility.
Prepare to pace with sedation
Push-dose EPI is highly discouraged.
Name 6 of the 9 symptoms of heat stroke
Syncope, Hallucinations, Coma, Irritability, Hemiplegia, Decorticate/Decerebrate posturing, Combativeness, Seizures, Bizarre behavior
name and describe the RAAS?
Renin-angiotensin-aldosterone-system
Renin - enzyme that splits angiotensin
angiotensin 1- converted to angiotensin 2 via ACE
angiotensin 2 - causes vasoconstriction, triggers the release of aldosterone
aldosterone - causes kidneys to retain sodium, increasing blood volume.
are we able to access a picc line or fistula? if so, what basic steps must be taken prior to administration of meds?
Scrub access port for 15 seconds with alcohol
aspirate 10ml of blood
Flush line, without excessive pressure
secure all tubing
Name 4 types of shock, each smaller subdivision of shock and treatment of each
Distributive - septic, anaphylactic, neurogenic (Fluids, vasopressors)
hypovolemic - hemorrhage/fluid loss (NSS)
obstructive - tension pneumo, tamponade, PE (Fluids, Needle D)
cardiogenic - (vasopressors)
explain how hypoxic drive works?
due to an increase in PaCo2, the body now stimulates ventilations based on a decrease Pao2