CNS Injuires
Which scale is used to determine CNS function?
What is the Glascow Coma Scale.
Used to treat conditions that disrupt the pleural space?
What are chest tubes.
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How do we calculate what percentage of a patient's body is burned?
What is the Rule of Nine's
What is the name of the eye anesthetic we use in the ER and where can we find it?
What is Proparacaine, which is found in the pharmacy fridge.
What is our goal in obtaining an EKG for a patient c/o chest pain?
What is 10 minutes.
The most common cause of CNS injuries in children are?
What are Falls.
What equipment is needed to assist with chest tube placement? Where is this equipment located?
What is thoracotomy tray, chest tube of correct size and CDU.
Location: Bay 1
(Pull the chest tube box)
What is the rate of chest compression's during CPR on an non-intubated patient.
What is at least 100 compression's per minute. A ratio of 30 compression's to 2 ventilations. (30:2)
You have a patient who has held his nose, leaning slightly forward for 10 minutes as instructed. What other nose bleeding interventions might we anticipate?
What is Silver Nitrate, gauze saturated with afrin or vaseline, Rhino rocket placement, Merocel placement, nasal balloon or use of cocaine.
What fibrinolytic medication is preferred for a patient suffering an ischemic stroke? What is the dose?
What is Activase. It is a weight based medication, use enclosed dosing chart, always have an additional license verify dose with you.
Assessment findings indicating basilar skull fracture include?
What is: * Raccoon eyes * Battle sign (after 8-12 h) * CSF rhinorrhea or otorrhea * Hemotympanum
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What is the preferred drug and dose for a patient experiencing anaphylaxis?
What is Epinephrine 1: 1000 0.2 to 0.5 ml (.2 -.5 mg) every 10 to 15 minutes as needed.
True or false: the Eye spud we use in the Emergency room is a disposable, one time use instrument?
What is false. Please do not throw it away.
What is our goal time for door to CT completion for a patient having stroke like symptoms?
What is 25 minutes.
Under traumatic conditions, Cerebral autoregulation is lost, resulting in a linear relationship of BP to cerebral blood flow. Therefore, maintenance of adequate _____ is of vital importance for brain survival.
What is Blood pressure.
Can you name 5 different types of airway's we have available in the ER?
What is OA, NPA, ET tube, LMA, tracheotomy
What fluid is recommended for fluid resuscitation in burn patient's
What is LR.
-LR contains physiologic concentrations of major electrolytes, and lactate may reduce the incidence of hyperchloremic acidosis that can occur with administration of large volumes of isotonic saline
You anticipate prolonged eye irrigation to a patient who has had chemical splashed in both eyes, what would be appropriate to use for prolonged irrigation of the eyes?
What is the Morgan lens.
With any significant ocular exposure to alkali or acid, ophthalmologists generally recommend continuous irrigation until a neutral pH is achieved in the eye (intially 30 minutes). Water or isotonic saline may be used. Irrigation initiated at the scene is continued at the emergency department.
The Poison Control Center called and said that they have had the wife of a 50 y/o man call them reporting that he took a whole bottle of regular strength Tylenol. Poison Control asks if you have the antidote. What is the antidote?
What is ACETYLCYSTEINE
The approved 20-hour IV dosing regime is complicated and is performed as follows:
●Administer an initial loading dose of 150 mg/kg IV over 15 to 60 minutes (we recommend 60 minutes).
●Next, administer a four-hour infusion at 12.5 mg/kg per hour IV (ie, total of 50 mg/kg over four hours).
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What simple measures can we as nurses implement to help lower ICP?
What is: 1- The head should be elevated (30-35°). Keep the neck straight, do not flex hips.
2- Maintain normovolemia and normal BP (mean BP >90 mm Hg, < 150 mm Hg).
3- Ventilate to normocapnia and avoid hypocapnia.
4- Use light sedation and analgesia.
5- Consider administration of mannitol (0.25-1 g/kg IV immediately), but contact the neurosurgery.
6- Prevent hyperthermia
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Where are the Co2 adapters located?
What is in the bottom compartment of the crash cart.
One time use, do not throw away the cord.
What is the formula for fluid resuscitation for a patient who has sustained a burn.
What is (4 mL x weight in kg x % TBSA = 24 hour fluid total). Give 1/2 this amount in the first 8 hours.
How would you treat a 50 yr. old who arrives to the ER unresponsive but breathing after intentional ingestion of his entire bottle of 60 tablets of verapamil approx 45 minutes PTA?
What is placement of OG tube for EZ lavage.
-Commercial break.....Dr. Inouye wants you to assist him in administering conscious sedation to reduce a radial fracture on a 10 year old boy. In order to administer sedation medications, who else is required to be present, what equipment do you need?
What is another RN, CRNA.