Trauma
You arrive to a 27M who was involved in a MVA. During assessment you notice ecchymosis under the eyes and behind his left ear. What is this sign called and what injury have they sustained?
Battle Signs and Skull Fracture (Basilar skull fracture)
You patient has undergone a Percutaneous Transluminal Coronary Angioplasty over 2 years ago, how does this change our treatment for the patient's chest pain?
It doesnt. We treat this patient the same.
What is the membrane that connects the thyroid cartilage superiorly to the cricoid ring inferiorly?
Cricothyroid membrane
You arrive to a 30F CC unresponsive. Physical exam findings are pinpoint pupils with limited respiratory drive. What is your treatment course?
Airway protections, Provide O2 and BVM, Narcan admin.
You have a 20month old female patient. Parents state there has been something going around the family. The patient is experiencing a 102.6-degree fever that has developed over the last 2 days, with a stridorous cough. You should suspect?
Croup
You have a 11M with epistaxis. His father says he has been bleeding for several hours and that it hasn't stopped or slowed down. What condition is the boy likely suffering from?
Hemophilia
What cardiac rhythms are shock-able?
Vtach and VFib.
your patient has a capnography measuring at 55mmhg. What is the name for this and what does this likely mean for the patients respiration rate?
Hypercarbia and that their rate is slower than normal. Page 438
Your patient jumps into a pool they will lose body heat to the water in what mechanism?
Conduction
What are then fontanelles and when do they close?
The anterior suture closes at 18 months and the posterior suture closes at 6 months
A 23F is found wandering in a park. The pt appears altered and is tachycardic. On physical assessment you find a spider web looking burn on her left shoulder. You should suspect?
Lightning Strike
What is the most detrimental effect that tachycardia can have on a patient with cardiac compromise?
Increase O2 demand
Explain how the body regulates ventilations and the hypoxic drive.
Based upon the acidity of the blood determines the body's need to ventilate. Normally this occurs in relation the buildup of CO2 in the blood.
During Hypoxic drive the patient no longer uses CO2 as regulation and relies on O2 in the blood to determine ventilation rate. This is due to a saturation of CO2 at baseline leading to peripheral chemoreceptors taking over to detect drop in O2 levels thus prompting ventilations.
You arrive to a patient in their 60s the patient has AMS, normal BGL, and is hot to the touch. What vital signs do you suspect and what disease process?
High HR, Low BP.
Sepsis
You assess a newborn and note acrocyanosis, a pulse rate greater than 100, a weak cry, flaccid muscle tone, and slow, irregular respirations. What is the APGAR score?
5
You arrive to a 29M with a steak knife impaled in his left chest and is pulsing with the man's heartbeat. ALS is enroute, initially his vital signs are stable, and limited bleeding is noted. What should your primary goal be when bandaging the injury? If your pt lost pulses, what should you do first?
Stabilize the knife using bulky dressing.
Place pads and remove knife for CPR.
What are the 4 parts of blood and what are their functions?
❖ Red blood cells: are the most numerous and give the blood its color. Bright red when oxygenated and darker red when low on oxygen. Carry oxygen to the bosy’s tissues and remove carbon dioxide
❖ White blood cells: Help fight infection
❖ Platelets: help the blood to clot
❖ Plasma: the fluid in which the cells float. It is a mixture of water, salts, nutrients, and proteins
You arrive to a 67M with a CC of SOB. Pt is on home O2 at 2LPM. Pt states that they have a persistent non-productive cough. Exam reveals 2-5 word sentences with clear lung sounds. What condition is this patient most likely suffering from?
Emphysema
You arrive to a 40M CC dizziness. During assessment patient states you cant take a pressure on their left arm. Pt is is found to have HR 90 irregular, BP 168/96, O2 93. What would you suspect the pt to have a history of?
Renal Failure (dialysis)
You arrive to a 3M CC unresponsive. The pt is unresponsive with heavy deep breathing. The patient is hot to the touch and parents state that the pt has been sick for the last few days. Parents have been giving Tylenol and acetaminophen in rotation for the last few days but may have missed a dose. What is the most likely reason for the patients unresponsive state?
Febrile seizure.
A 22-year-old male was found down after a suspected fall. When you arrive, you observe his eyes are closed. You apply a jaw thrust, and he opens his eyes and groans incomprehensible sounds. When you attempt to move his arm to his side he pulls away from it and groans. What is his GCS?
You find a 75-year-old male lying supine on the floor, who is unresponsive to verbal stimuli but moans and withdraws to painful stimuli. Bystanders state he suddenly collapsed while eating, and his left arm dropped a moment before he fell. Your initial assessment reveals gurgling sounds and shallow, slow respirations. He has a BP of 190/110 mmHg, P 60 strong and irregular, and SpO2 is 88% on room air.
What is the MOST appropriate immediate treatment sequence for this patient?
Roll the patient onto his side, suction the oropharynx to clear the airway, insert an NPA, and begin assisting ventilations with a BVM attached to high-flow oxygen.
You have a 66F CC of Shortness of Breath. Exam shows O2 saturation is 88%, Clear lung sounds, hypotension. What is the most likely cause?
PE
What is the mechanistic difference between missed renal dialysis and CHF that leads to dependant edema, SOB, HTN, irregular heartbeat?
Missed dialysis causes a build up of toxins and excess fluid that the kidneys cant remove.
CHF causes a back up of fluid due to ineffective cardiac output.
While using the PAT for your initial assessment of a pediatric patient, you note low interactiveness and a weak cry. Other signs are adequate. What does this suggest is wrong with the patient?
A CNS/metabolic problem.
Appearance, Work of Breathing, Circulation to the Skin