In ppl 18 yrs or older, what is the most useful sign for appendicitis?
Fever
Quick facts about Class I hemorrhagic shock
BP is fine
Quick facts about Class II hemorrhagic shock
Tachycardic, narrowed pulse pressure
Quick facts about Class III hemorrhagic shock
New onset hypotension
Quick facts about Class IV hemorrhagic shock
Letheragic/comatose + hypotension
Most likely organisms in acute diabetic foot infxn
Staph aureus
Streptococci
Most common herniation of the brain
Subfalcine
What is the most common sign of a subfalcine herniation?
Gait abnormalities
Formula important in brain injuries?
CPP = MAP - ICP
Cushing reflex sings
HTN
Bradycardia
Irregular breathing
Basilar Skull fracture signs
Temporal bone fx
Raccoon eyes
Hematotympanum
Battle sign
CSF
Hearing probs
Vertigo
MC skull bone of the basilar skull fracture
Temporal bone
Le Fort Type Classifications
Type 1 = Mobile Palate
Type 2 = Mobile Nose
Type 3 = Mobile Face
Le Fort Type I fracture pattern
Below nose
Le Fort Type II fracture pattern
Thru inferior orbits
Le Fort Type III fracture pattern
Thru zygomatic arch
MC mandibular fracture
Condylar
Nasal bridge tenderness
Septal hematoma
A common sign for Le Fort Type III fractures
CSF Rhinorrhea
Which zone of the neck is the MC penetrating neck injury?
Zone II
Borders of Zone II of neck
Cricoid and Angle of mandible
Hard signs of a penetrating neck injury
HARD Bruit
- HypoTN
- Arterial bleed
- Rapid expanding hematoma
- Deficit (pulse/neuro)
- Bruit
What is Wellen's syndrome?
Occlusion of LAD
EKG pattern of Wellen's syndrome
Deeply inverted or biphasic T waves in V2-3
What are the compartments of the leg?
Anterior
Lateral
Superficial posterior
Deep posterior
What is the formula for delta pressure?
deltaP = Diastolic BP - compartment pressure
Calcium for hyperkalemia lasts...
1 hr
Discharge characterization of Nec Fasc
Dirty dishwater
Tx for Nec Fasc
Vanc + Zosyn + Clinda
Signs of flexor tenosynovitis
BEST
Bend finger
Extension pain
Sausage digits
Tender tendon
CXR for Aortic Dissection
Mediastinal Widening
Obscure Aortic Knob
Pulmonary contusion tx
Repeat CXR 6 hr
Supportive
MC complication of pulmonary contusion
PNX
Flail chest tx
Intubate
Sternal fractures are associated with...
Myocardial Contusion
Mediastinal hematoma
Indications for doing ED thoracotomies?
Penetrating trauma + Witnessed loss of vitals
When do you do a thoracotomy for hemothorax?
Unstable
Chest tube > 1500cc
Chest tube > 200c/h
Air leak
MC organ injury in GSW
Small bowel
MC organ injury in stab wound
Liver
Mechanism of injury of Diaphragmatic injury
MVA
Stab wound
Bike handle bar MC organ injury
...
When do you do DPL
Unstable and have no US
Bike handlebar injury, what organs are inured?
Duodenum
Pancreas
How long does it take for meconium to pass a baby?
6 days
How much should infants eat?
Months Age in Ounces q2hrs
How long does it take for babies to get their weight back after birth?
2 wks
How long does it take for the umbilical cord to fall out?
2 wks
Posterior urethral injuries are cause by
Pelvic fracture
Bladder rupture is associated with what kind of injury?
Pelvic fracture
Nexus criteria
Cervical midline
Pain, distracting
Altered
Intoxicated
Deficits in neuro
C Spine
Jefferson Bit Off A Hangman's Tit
Jefferson (C1),
Bilat facet dislocation,
Odontoid,
Atlantoaxial dislocation,
Hangmans,
Teardrop
Lap belt injuries are associated with what kind of fractures?
Chance fracture
If patient has blast injury and has tympanic membrane perforation, what is the next best step?
CXR to look for blast lng
White woman with chest pain at night
Prinzmetal's angina
Which EKG leads represent the LAD artery?
V1-V4
ST Elevation in V1-V4 represents infarction in what region of the heart?
Anterior
What EKG leads represents the left circumflex artery?
I, aVL, V5, V6
ST Elevation of I, aVL, V5, V6 represents an infarct in which region of heart?
Left lateral
Posterior MI have ST depressions in
V1-V3
Succinylcholine dose
2 mg/kg
LEMON mnemonic
Look
Evaluate 3-3-2
Mallampati
Obstruction
Neck
Don't give WPW patients...
Adenosine
What are the most rightward leads on the EKG?
III and V1
What is the most common complication of inferior MIs?
Blocks
Complications of Right ventricular MIs
Hypotension
Mobitz I