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petechiae differential; labs? - Answer-low plts,
meninococcemia, emesis, ITP, HTP, HSP, DRESS
Rocky Mountain spotted fever,
Labs: CBC with diff, retic count, smear, Ig levels, HIV, Hep
C, H. pylori, LFTs, antiphospholipid Abs, SLE serology,
Diagnostic testing to consider for AMS - Answer-No
shotgun orders unless absolutely necessary:
- Met/Endo - fingerstick glucose, BMP (Na, Ca, BUN, Cr),
ABG/VGB, TSH, T4, ammonia, cortisol
- Meds/toxins - serum osmolality, ETOH, drug screen, drug
levels (i.e. antiepileptics)
- CBC w/ diff, UA, UC, BC, LP
- CXR, CT head/spine, MRI, EEG
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- Cardiac: ECG, trops, cardiac echo, carotid/vertebral US
vasogenic edema from CNS lesions. give - Answer-
glucocorticoids
what are the goals of BLS primary survey? - Answer-
support or restore early oxygenation, ventilation, and
circulation until you get a return of spontaneous circulation
or until ACLS can be initiated
T/F patients with shockable rhythm and in desperate need
for intubation should be intubated first - Answer-F: pts with
shockable rhythm should be defibrillated without delay
What consists ABC of ACLS? - Answer-Airway - jaw thrust,
oropharyngeal or nasopharyngeal airways, or intubation
Breathing - auscultation of lung sounds, ETCO2, CZR, etc.
Circulation - IV/IO access
What drugs are safe for ET administration? What dosage
shuold be used? - Answer-NAVEL
Naloxone, atropine, vasopressin, epinephrine, lidocaine
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2-2.5 times the IV route dosage
ACLS recommends that compressions should be
interrupted for... - Answer-ventilation, rhythm checks, and
shock delivery
after how many minutes of resuscitation with BLS and
ACLS is it okay to cesate? - Answer-20 minutes of
unsuccessful rescucustation - studies have shown that
resuscitation efforts are unlikely to be successful
what are the two shockable rhythms? - Answer-V fib and
V-tach
you see a patient with cardiac arrest. what should you do
first? - Answer-1) shout for help, activate emergency
response
2) start CPR
3) give O2, attack monitors and defibrillator
4) determine whether rhythm is shockable (VF/VT) or not
(asystole or PEA)
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you see a patient with cardiac arrest, initiate CPR, and
determine has shockable rhythm. What are the next few
steps? - Answer-1) shock immediately w/o delay
2) Give CPR 2 minutes while you obtain IO/IV access
3) determine rhythm again
4) repeat if still shockable rhythm starting epinephrine 1
mg q3-5m IV/IO, consider advanced airway
5)continue algorithm until develops ROSC or non-
shockable rhythm
you see patient with shockable rhythm, received CPR, 3x
defibrillations, and epinephrine q2-q5m, and got LMA and
continues to have a shockable rhythm. What additional
step do you take? - Answer-- Continue CPR, shocks, and
epineprhine q2-5m
- Add antiarrhythmics: amiodarone 300 mg bolus, 150
every 2 shocks until no longer has shockable rhythm, or
lidocaine 1-1.5 mg/kg bolus, then 0.5-0.75 mg/kg q5-10m
you see a pt in cardiac arrest, obtain help, start CPR and
determine they have a non-shockable rhythm. What are
your next steps? - Answer-- Continue CPR
- Establish IV/IO access