Ch.12 Pharmacology
What is the difference between enteral and parenteral medications routes?
Enteral = absorbed through the GI tract
Parenteral = routes outside the GI tract
What is the difference between compensated shock and decompensated shock? Give symptoms of both.
Compensated shock: body maintains perfusion. symptoms include anxiety, weak rapid pulse, pale cool skin, rapid breathing.
Decompensated shock: body can no longer maintain perfusion. symptoms include low BP, labored breathing, cyanosis, dull eyes, and weak/absent pulses.
What is the goal of BLS and when should it be initiated?
The goal is to maintain circulation and breathing artificially until normal function returns. Initiate BLS when the patient is unresponsive, not breathing normally, and has no pulse.
What is the index of suspicion and why is it important?
Index of suspicion helps determine what injuries are possible or likely based on the MOI, guides assessment and treatment.
How do you distinguish arterial, venous, and capillary bleeding?
Arterial: bright red, spurting blood, oxygenated
Venous: dark red, steady flow, deoxygenated
Capillary: slow oozing, may mix with clear fluid
Right patient, right drug, right dose, right route, right time, right form, right reason, right response, and right documentation.
What are three universal treatments for any patient in shock?
maintain airway and provide oxygen, lay supine, keep warm/blankets
How do you handle a choking victim in a adult vs infant?
Adults/children: Abdominal thrusts (Heimlich maneuver)
Infants: 5 back slaps + 5 chest thrusts
Give a example of a low, medium, and high velocity penetrating traumas and why they are in each category
BONUS 50 POINTS: What three factors help assess fall injuries
Low-velocity: knife, pencil; injury along projectile path
Medium-velocity: handguns, some rifles; injury less predictable due to ricochet
High-velocity: assault rifles; injury path much larger due to cavitation
Fall assessment: distance fallen, surface struck, body part landed on
What are the steps for controlling external bleeding, and when should a tourniquet be used and not used?
Apply direct pressure with a dry sterile dressing
If bleeding persists, apply a tourniquet proximal to the wound
A tourniquet cannot be applied to anything other than extremities.
What is the difference between indications, contraindications, unintended effects, and untoward effects?
Indications: reasons to give the drug.
Contraindications: reasons not to give the drug.
Unintended effects: side effects that are not harmful.
Untoward effects: harmful, unexpected reactions.
What are the three basic requirements for adequate perfusion in the body, what happens if one fails?
A working pump (heart),
Intact pipes (blood vessels),
Adequate fluid volume (blood).
If one fails → shock (hypoperfusion) occurs, leading to organ failure and death if untreated.
A bystander finds an unresponsive adult who is not breathing and has no pulse. What are the first three critical actions they should take according to the AHA Chain of Survival?
Recognize cardiac arrest and activate EMS (call 911)
Start immediate CPR
Use an AED / rapid defibrillation
Describe the four types of blast injuries (primary, secondary, tertiary, quaternary)
Primary: pressure wave of the blast
Secondary: injuries from flying debris
Tertiary: body thrown against stationary object
Quaternary: burns or inhalation injuries
Describe each soft tissue injury:
Abrasion
Laceration
Penetrating wound
Contusion
Hematoma
avulsion
Abrasion: scrape due to friction
Laceration: jagged cut
Penetrating wound: puncture wound
Contusion: bleeding beneath the skin
Hematoma: collection of blood in tissue
Avulsion: skin flap
Explain these routes of administration/absorption
Intravenous, Subcutaneous, Intramuscular, Intranasal, Inhalation, Sublingual, Transcutaneous
BONUS 50: which of these routes is the fastest and slowest?
through IV fastest and immediate effect, injection into the fat layer, directly into muscle tissue, rapid via mucous membranes, rapid absorption into lungs, under the tongue, skin patch
fastest: intravenous, slowest: transcutaneous
Explain each type of shock:
Cariogenic
Obstructive
Distributive
Hypovolemic
BONUS 50 POINTS: Give an example of what could cause each
Cardiogenic → pump failure (heart attack).
Obstructive → physical obstruction (tension pneumothorax, tamponade, PE).
Distributive → vessel dilation (septic, neurogenic, anaphylactic, psychogenic).
Hypovolemic → loss of fluids (arterial bleed)
What are the differences between single-rescuer and two-rescuer adult CPR? What is the differences between single-rescuer and two-rescuer infant CPR?
Adults:
Single-rescuer: 30 compressions : 2 breaths, compress 2–2.4 inches deep. 1 breath every 5-6 seconds.
Two-rescuer: One rescuer performs compressions while the other manages airway/breathing; switch roles every 2 minutes.
Infant:
Single-rescuer: 30:2, depth about 1.5 inches (1/3 chest)
Two-rescuer: 15:2, same depth
Match the type of collision with the common injuries:
Head-on, Rear-end, Lateral (T-bone), Rollover
A. unpredictable injuries, high risk of ejection
B. injuries along the side of impact
C. head, spine, chest, abdomen, hip, lower extremities; ejection if unrestrained
D. cervical spine (whiplash), hyperextension injuries
A. Rollover
B. Lateral (T-bone)
C. Head-on
D. rear-end
What are the three types of burns and what do they look like?
BONUS 50: What are the two ways you can determine amount of body surface area burned?
Superficial (1st degree): epidermal only, red, painful, no blisters
Partial-thickness (2nd degree): epidermal + partial dermal, blisters, painful
Full-thickness (3rd degree): through dermis, dry, leathery, not painful
Palm method or rule of nine
What is each drugs primary indication:
1. Epinephrine
2. Albuterol
3. Naloxone
4. Nitroglycerin
5. Oral Glucose
1. anaphylaxis
2. difficulty breathing with wheezing and chest tightness from lung disease
3. opioid overdose
4. chest pain of cardiac origin
5. hypoglycemia
Two patients arrive at the scene:
Patient A: Low blood pressure, hives, swelling of lips and tongue, difficulty breathing after eating peanuts.
Patient B: Low blood pressure, warm skin, rapid pulse, fever, and confusion after a severe infection.
Question: Identify the type of shock for each patient and explain how you would treat both
Patient A: Anaphylactic shock
Patient B: Septic shock
treatments:
Maintain airway and provide oxygen, Keep the patient warm, Rapid transport. Administer epinephrine to patient A.
Which airway-opening techniques are used for patients with and without suspected spinal trauma? When should the recovery position be used?
Head tilt–chin lift: patients without suspected spinal trauma.
Jaw thrust: patients with possible spinal trauma.
Recovery position: unresponsive patients breathing adequately with no trauma.
A patient has eye opening to speech, inappropriate verbal response, and withdraws from pain. What is their GCS score and what does it indicate?
A patient has eye opening to speech (3), inappropriate verbal response (3), and withdraws from pain (4) = 10, the lower the score the higher likelihood of brain injury
A patient has a crush injury, a full-thickness circumferential burn, and an evisceration. What are the key complications to monitor, and how do you manage these injuries differently?
Crush injury: risk of compartment syndrome; do not move patient, call physician
Full-thickness circumferential burn: risk of hypovolemic shock, airway compromise; cover, keep warm, rapid transport
Evisceration: external organs protruding; cover with moist sterile dressing, treat for shock, immediate transport
Key complications: sepsis, hypothermia, hypovolemic shock, airway compromise