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21 Cards in this Set
- Front
- Back
What is the earliest intervention for "A" in trauma patients?
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All trauma patients must receive supplemental O2
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What are 2 key reasons to assure a trauma patient has a patent airway?
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1. Prevent hypercarbia
2. Maintain oxygenation |
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What are the objective signs of airway obstruction? (4)
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1. Observe patient: agitation (hypoxemia) vs obtunded (hypercarbia); cyanosis? (hypoxemia); retractions/acc. muscle use? (airway compromise)
2. Abnormal breath sounds: snoring, gurgling, stridor are all abnormal 3. Position of trachea: midline? 4. Patient's behavior: abusive/belligerent may be HYPOXIC and not intoxicated |
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3 signs of laryngeal trauma?
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1. Hoarseness
2. SubQ emphysema 3. palpable fracture |
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High concentrations of O2 can mask breathing problems, what are 2 ways to more accurately measure ventilatory efforts?
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1. Arterial CO2
2. End tidal CO2 |
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Name 3 objective signs of inadequate ventilation.
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1. Asymmetric chest rise/chest wall excursion - splinting of rib cage or flail chest
2. Asymmetric breath sounds - presence of thoracic injury 3. Pulse oximeter - O2 saturation (NOT adequacy of vent) |
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During "B" in the ABCDEs, what precaution is of utmost importance?
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Maintaining C-spine protection
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What is a contraindication to a nasopharyngeal airway?
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Suspected cribiform plate fracture
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A patient arrives with a LMA in place, what must be done?
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Plan for a definitive airway -- LMAs are NOT definitive airway options
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What are the 3 types of definitive airways?
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1. Orotracheal
2. Nasotracheal 3. Surgical airways (cricothyroidotomy/tracheostomy) |
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When is an orotracheal intubation indicated over a nasotracheal route?
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If the patient has apnea
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What are 3 contraindications to use of succinylcholine?
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Can precipitate severe hyperkalemia in:
1. Burn victims 2. Crush injuries 3. electrical injuries |
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What is the normal RSI dose of etomidate?
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0.3mg/kg for induction, typically 30mg
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What is the normal RSI dose of succinylcholine?
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1-2mg/kg for paralysis, typically 100mg
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What is the DOC to reverse benzo action in trauma patients?
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Flumazenil
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Why are some induction agents (e.g. thiopental) and sedatives particularly dangerous in trauma patients?
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If hypovolemia is present, can exacerbate
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What is preferred in the ED for a surgical airway?
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cricothyroidotomy (over a tracheostomy)
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What does the pulse oximetry NOT measure?
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PaO2 levels -- which can vary greatly based upon the position of the oxyhemoglobin curve
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What O2 sat typically signifies adequate periph arterial oxygenation?
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O2 Sat > 95% (usually indicates PaO2 > 70mmHg)
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What scenario limits the usefulness of pulse oximetry?
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CO poisoning -- the pulse oximeter cannot distinguish between oxyhemoglobin and carboxy-/met-hemoglobin
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Bag-mask ventilation can result in gastric distention, what are 2 complications associated with this?
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1. Vomiting and aspiration
2. Stomach distention placing pressure on the IVC resulting in hypotension and bradycardia |