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49 Cards in this Set
- Front
- Back
s/s horseness and drooling
altered abgs, HBCO2 20-60%, DO NOT use spo2 monitors to monitor 02 saturation |
INHALATION INJURY
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TX: early intubation, avoid tracheostomy
early mechanical ventilation with FI02 100%, then adjjust ABGS, Early use of high frequnecy ventilators is severe |
inhalation injury treatment
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Complications: v-fib and other dysrhytmias, tetany of repsitaroty muscles
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electrical burns
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debride, wound care. Cardiac monitor and treat dysrhytmias, and intubation/ventilation PRN
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electrical burns treatment
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topical care (except if cause is sodium metal) remove agent and shower with cool tap water
EYES irrigate with tap water Ist aid, or sterila saline, do not use irrigation lenses inhalation mustard gas: 100% o2 at hi pressure/frequency SODIUM METAL EXPLODES IN WATER AND AIR, REMOVE THIS SURGICALLY UNDER OIL |
CHEMICAL BURNS TREATMENT
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24-72 hrs
priority: fluids death by incineration or fluid and electrolyte imbalances |
resuscitation phase of care
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days to months
priority is wound care, cause of death is infection |
acute phase of care
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up to 2 yrs: priority return/preserve function
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rehab phase of care
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erythimic, mild inflamation, mild pain, usually resolves in 2-3 days, sunburn usually goes away in 2-7 days
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Epidermis burn, partial thickness, superficial 1ST DEGREE
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treatment aloe vera, noxema to cool skin and treat pain, moisturize but dont use butter oil porducts. Drink lots of fluid,
Use moisturizer thats water based bc oil traps heat |
treament of epidermis superficial burns, sunburns 1ST DEGREE, partial thickness
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very painful, erythemic (bright-light red), mottled, blotchy appearance, weapy/oozy, moist, bullae (blisters), sensitive to air currents.
Takes 7 days to 6 weeks to heal, usually minimal scarring ONCE you get blisters, your in the dermal area |
2ND DEGREE, MODERATE, EPIDERMIS AND 1/3 OF DERMIS TOP, SUPERFICIAL, partial thickneses
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erythemic w white areas where there are deeper parts of the burn, weepy, DO NOT DEVELOP BULLAE/BLISTERS, delayed cap refill in burned area, long time to heal, usually requires debridement, requires skin grafting, have scarring
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deep dermal, second degree burn, epidermis and deep dermis., partial thickness
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White in color, charred looking leather, red brown leathery looking areas with full thickness, nerves killed in this area so USUALLY not painful. may require debridement, grafting. will have scars
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full thickness 3rd degree burn, involves subq tissue
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age + % burn =
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mortality
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age+ % burn x 2=
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inhalation injury mortality
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always use large IV on unburned area, IV SUTURED, always give LR
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fluid resuscitation in burns
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LR 2-4 ml/kg/%burn
half fluid given in first 8hrs since time of burn, remaining half over nest 16 hrs USE big tubing, 10drops/min |
parkland formula to treat burns
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maintain urinary output,
if rhabdo give more fluids, double urinary output slow fluids down after 24 hrs if developing fluid overload |
30-50mls
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Early intubation, hi pressure support vent, high frequency,
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facial burn, suspect inhalation injury
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hi vent pressure to provide adequate tidal volume, escharotomy bilaterally to prevent compartment problems, will demostrate increase in vent peak pressure
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circumferential burn of the torso (chest)
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morphine or fentanyl, does not interfere with bleeding
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pain control in burn
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arterial bleed, fast onset,
brief LOC, wake up lucid, confused, then LOC again |
epidural hematoma
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decrease: supply, extraction,
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microemboli
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decreases extraction
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inter edema
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decreases supply
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pulm edema
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decreases supply, increases demand
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decreases CO
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decreases extraction
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respiratory acidosis
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increases 02 demand
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seizures
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increases 02 demand, decreases supply
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V-FIB
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decreases supply
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apnea
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carbon monoxide poisoning
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decreases supply, decreases extraction
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increases 02 demand, decreases supply
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fever
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increases 02 tissue demand, decreases extraction
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anemia
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decreases supply, extraction and increases demand
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pneumonia
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decreases extraction
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leaky capillaries
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increases 02 tissue demand, decreases extraction
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anemia
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decreases supply, extraction and increases demand
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pneumonia
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decreases supply, decreases extraction
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leaky capillaries
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treat increased afterload
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dilators/Nitro, labetalol, hydrolazine,
AUGMENT IABP |
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treat decreased afterload
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pressors, epi, norepi, dopaminel evophed, not vassopressin
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treat decreased contractility
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postive inotropes: doapmine (2-10mcg.kg.min) dobutamine, digoxin
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treat increased preload
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diuretic, dilators like nitro, nitroprusside, ca channel blockers
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treat decreased preload
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give volume, antidysrhytmic, amiodarone
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increased heart rate treatment
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beta blockers metropolol, atenolol,
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treat decreased HR
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dopamine 2-10 mcg/kg/min, dobutamine, atropine, epinenephrine
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subarachnoid hemorrhage, cough up blood, pee blood, abdominal distention, GI Bleed, bleeding gums, nose bleeds, bruises
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initial stage of DIC
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LOC, CVA, dysrhytmias, chest pain, embolus, resp, failure, oliguria, ATN, renal failure, diarrhea, constipation, bowel infarction, peripheral cyanosis, gangrene
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second stage of DIC
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ABCS,
SHOCK at 120 biphasic, CPR, SHOCK AGAIN, higher joules EPI, VASSPRESSIN, SHOCK LIDOCAINE, SHOCK AMIODARONE, SHOCK MAGNESIUM, SHOCK |
V-FIB treatments
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atropine or pacemaker
dopamine if low bp epinephrine |
sinus bradycardia treatments
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