Emergency Medicine

Coma: conditions to exclude as cause

MIDAS: Meningitis Intoxication Diabetes Air (respiratory failure) Subdural/ Subarachnoid hemorrhage Show Details / Rate It ---Anonymous Contributor

Resuscitation: basic steps

ABCDE: Airway Breathing Circulation Drugs Environment Show Details / Rate It ---Mohamed Azim, MD Pediatric Surgeon, Alexandria University, Egypt

Malignant hyperthermia treatment

"Some Hot Dude Better Give Iced Fluids Fast!" (Hot dude = hypothermia): Stop triggering agents Hyperventilate/ Hundred percent oxygen Dantrolene (2.5mg/kg) Bicarbonate Glucose and insulin IV Fluids and cooling blanket Fluid output monitoring/ Furosemide/ Fast heart [tachycardia] Show Details / Rate It ---Anonymous Contributor

Vfib/Vtach drugs used according to ACLS

"Every Little Boy Must Pray": Epinephrine Lidocaine Bretylium Magsulfate Procainamide Show Details / Rate It ---Midnight Medic Paramedic in Texas

Coma causes checklist

AEIOU TIPS: Acidosis/ Alcohol Epilepsy Infection Overdosed Uremia Trauma to head Insulin: too little or or too much Pyschosis episode Stroke occurred Show Details / Rate It ---Midnight Medic Paramedic in Texas

Shock: types

RN CHAMPS: Respiratory Neurogenic Cardiogenic Hemorrhagic Anaphylactic Metabolic Psychogenic Septic · Alternatively: "MR. C.H. SNAP", or "NH CRAMPS". Show Details / Rate It ---Anonymous Contributor

Shock: signs and symptoms

TV SPARC CUBE: Thirst Vomiting Sweating Pulse weak Anxious Respirations shallow/rapid Cool Cyanotic Unconscious BP low Eyes blank Show Details / Rate It ---Anonymous Contributor

Fall: potential causes

CLADE SPADE: Cardiovascular/ Cerebrovascular Locomotor (skeletal, muscular, neurological) Ageing (increased body sway, decreased reaction time) Drugs (esp. antihypertensives, antipsychotics) Environmental Sensory deficits (eg. visual problems) Psychological/ Psychiatric (depression) Acute illness Dementia Epilepsy Show Details / Rate It ---Harris-Davies-Tamblyn Adelaide Medical School

Diabetic ketoacidosis management

F*¢KING: Fluids (crytalloids) Urea (check it) Creatinine (check it)/ Catheterize K+ (potassium) Insulin (5u/hour. Note: sliding scale no longer recommended in the UK) Nasogastic tube (if patient comatose) Glucose (once serum levels drop to 12) Show Details / Rate It ---Graeme Little University College London

Asthma: management of acute severe

"O S#!T": Oxygen (high dose: >60%) Salbutamol (5mg via oxygen-driven nebuliser) Hydrocortisone (or prednisolone) Ipratropium bromide (if life threatening) Theophylline (or preferably aminophylline-if life threatening)

 

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Chest pain: differential

CHEST PAIN: Costochondritis/ Cocaine abuse Herpes zoster/ Hyperventilation Esophagitis/ Esophageal spasm Stenosis (AS) Trauma PE/ Pneumonia/ Pneumothorax/ Pericarditis/ Pancreatitis Angina/ Aortic dissection/ Aortic anerusym Infarction/ IV disk disease Neuropsychiatric disorders (e.g. depression, Da Costa's) Show Details / Rate It ---Fahed Al-Daour

Ventricular fibrillation: treatment

"Shock, Shock, Shock, Everybody Shock, Little Shock, Big Shock, Momma Shock, Poppa Shock": Shock= Defibrillate Everybody= Epinephine Little= Lidocaine Big= Bretylium Momma= MgSO4 Poppa= Pocainamide Show Details / Rate It ---Anonymous Contributor

Fall: potential causes

I'VE FALLEN: Illness Vestibular Environmental Feet/ Footwear Alcohol and drugs Low blood pressure Low O2 states Ears/ Eyes Neuropathy Show Details / Rate It ---Muhammad Asif Iqbal Resident, SLU, MO

RLQ pain: differential

APPENDICITIS: Appendicitis/ Abscess PID/ Period Pancreatitis Ectopic/ Endometriosis Neoplasia Diverticulitis Intussusception Crohns Disease/ Cyst (ovarian) IBD Torsion (ovary) Irritable Bowel Syndrome Stones Show Details / Rate It ---Anonymous Contributor

Decompression sickness

Boyle's law: volume of gas is inversely proportionate to its pressure. · Therefore, BOYLE: Breathe (as you ascend) Or Your Lung Explodes · Breathe as you ascend after scuba diving, since the pressure decreases on surfacing, so the gas volume in lungs increases. Show Details / Rate It ---Mohamed Azim, MD Assistant lecturer, Pediatric surgery, Alexandria University, Egypt

Unconciousness: differential

FISH SHAPED: Fainted Illness/ Infantile febrile convulsions Shock Head injuries Stroke (CVE) Heart problems Asphxia Poisons Epilepsy Diabetes Show Details / Rate It ---B Sylvester Surrey Ambulance Service (UK)

Endotracheal tube: troubleshooting

DOPEY: Displaced: esophagus, right mainstem, back of throat, etc Obstructed: secretions, blood, mucus plug, kink, etc Pneumothorax Equipment: malfunctions, O2, ETT, BVM, ventilator, monitor You: your approach, technique: missing something? Show Details / Rate It ---Brenda L. Snyder, RN, CEN, PHRN George Washington University Hospital, Washington, D.C.

Organophosphates poisoning symptoms

MILES: Miosis Increased urinary frequency Lacrimation Enuresis Salivation Show Details / Rate It ---Anonymous Contributor

Chest pain treatment, for nurses

"MOVE your patient!": Monitor: put patient on cardiac monitor Oxygen: put patient on O2 Venous: gain large bore venous access EKG: 12 lead EKG Show Details / Rate It ---R. Stilts, S.N. Senior Nursing Student

ICU confusion causes

ICU CONFUSION: ICU psychosis Cardiac output low [hypotension, post cardiac arrest] Uncontrolled temperature [hypo/hyperthermia] Convulsion [post ictal] Oxygen [hypoxia, hypercarbia] Nociception [pain] Full bladder Uremia Sugar [hypo/hyperglycemia] Infection Opiates Natremia [hypo/hyper] Show Details / Rate It ---Dr. Sonali Vadi

 

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Endotrachial tube deliverable drugs

O NAVEL: Oxygen Naloxone Atropine Ventolin (albuterol) Epinephrine Lidocaine · If you can't get IV access established, and have necessity to administer resuscitative meds, remember you have the airway and can give the above drugs. · Drug delivery is enhanced if diluted with 10cc NS and rapid introduced for aeresolization. · Alternatively, bare bone version is ALE, as above. Show Details / Rate It ---Robert Lueken and Marc Eastern Virginia Medical School

Syncope causes, by system

HEAD HEART VESSELS: · CNS causes include HEAD: Hypoxia/ Hypoglycemia Epilepsy Anxiety Dysfunctional brain stem (basivertebral TIA) · Cardiac causes are HEART: Heart attack Embolism (PE) Aortic obstruction (IHSS, AS or myxoma) Rhythm disturbance, ventricular Tachycardia · Vascular causes are VESSELS: Vasovagal Ectopic (reminds one of hypovolemia) Situational Subclavian steal ENT (glossopharyngeal neuralgia) Low systemic vascular resistance (Addison's, diabetic vascular neuropathy) Sensitive carotid sinus Show Details / Rate It ---Bill Young MD University of Kentucky Dept of Emergency Medicine

Atrial fibrillation: causes of new onset

THE ATRIAL FIBS: Thyroid Hypothermia Embolism (P.E.) Alcohol Trauma (cardiac contusion) Recent surgery (post CABG) Ischemia Atrial enlargement Lone or idiopathic Fever, anemia, high-output states Infarct Bad valves (mitral stenosis) Stimulants (cocaine, theo, amphet, caffeine) Show Details / Rate It ---Sam LaCapra, M.D., F.A.C.E.P. Emergency Physician

Neurological focal deficits

10 S's: Sugar (hypo, hyper) Stroke Seizure (Todd's paralysis) Subdural hematoma Subarachnoid hemorrhage Space occupying lesion (tumor, avm, aneurysm, abscess) Spinal cord syndromes Somatoform (conversion reaction) Sclerosis (MS) Some migraines Show Details / Rate It ---Sam LaCapra, M.D., F.A.C.E.P. Emergency Physician

Miosis: causes of pin-point pupils

CPR ON SLIME: Clonidine Phenothiazines Resting (deep sleep) Opiates Narcotics Stroke (pontine hemorrhage) Lomotil (diphenoxylate) Insecticides Mushrooms/ Muscarinic (inocybe, clitocybe) Eye drops Show Details / Rate It ---Sam LaCapra, M.D., F.A.C.E.P. Emergency Physician

Meningicoccal meningitis: complications

SAD REP: Sepsis/ Shock/ Subdural effusion Ataxia/ Abscess (brain) DIC/ Deafness Retardation Epilepsy Paralysis Show Details / Rate It ---Richard Thompson Queens University, Belfast, NI

Activated charcoal: contraindications

CHEMICAL CamP: Cyanide Hydrocarbons Ethanol Metals Iron Caustics Airway unprotected Lithium CAMphor Potassium Show Details / Rate It ---Vince Yamashiroya

Ipecac: contraindications

4 C's: Comatose Convulsing Corrosive hydroCarbon Show Details / Rate It ---Vince Yamashiroya

Organophosphates poisoning: symptoms

DUMBBELS: Diarrhea Urination Miosis Bradycardia Bronchospasm Emesis Lacrimation Salivation Show Details / Rate It ---Martin Herman Le Bonheur Children's Medical Center

Coma and signicantly reduced conscious state causes: causes

COMA: CO2 and CO excess Overdose: TCAs, Benzos, EtOH, insulin, paracetamol, etc. Metabolic: BSL, Na+, K+, Mg2+, urea, ammonia, etc. Apoplexy: stroke, SAH, extradural, subdural, Ca, meningitis, encephalitis, cerebral abscess, etc. Show Details / Rate It ---Steve Gust HMO, Gove District Hospital, NT Australia

 

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Malaria: complications of falciparum malaria

CHAPLIN: Cerebral malaria/ Coma Hypoglycemia Anaemia Pulmonary edema Lactic acidosis Infections Necrois of renal tubules (ATN) Show Details / Rate It ---Dr. Harsh Sharma BJMC, Pune, India

MI: immediate treatment

DOGASH: Diamorphine Oxygen GTN spray Asprin 300mg Streptokinase Heparin Show Details / Rate It ---Ken Hodson Medical Student, University of Bristol

Pain history checklist

OLDER SAAB: Onset Location Description (what does it feel like) Exacerbating factors Radiation Severity Associated symptoms Alleviating factors Before (ever experience this before) Show Details / Rate It ---Lissa Bird, NREMT-P

Pulseless Electrical Activity (PEA): checklist

PEA: Pulses check Epinepherine Atropine Show Details / Rate It ---Anonymous Contributor

PEA/Asystole (ACLS): etiology

ITCHPAD: Infarction Tension pneumothorax Cardiac tamponade Hypovolemia/ Hypothermia/ Hypo-, Hyperkalemia/ Hypomagnesmia/ Hypoxemia Pulmonary embolism Acidosis Drug overdose Show Details / Rate It ---Carl Roberts A.S.EMS, CCEMT-P, CFP US Army Special Forces

Trauma: motor vehicle accident considerations

I AM SCARED: Impact (head-on, rear-end, t-bone, rollover, rotational etc.) Auto vs. pedestrian, bike, motorcycle (start @ speed >10mph) Medical history (cardiac, coagulolation, liver, immuno, obese, prego) Speed (>50 mph?) Compartment intrusion (>12 inches?) Age (<5 or >55 y.o.?) Restraints (lap & shoulder, either, airbag, infant or child seat?) Ejection/ Extrication (eject=25x greater death, extr>20min) Death (at scene, same vehicle, other) Show Details / Rate It ---Brenda L. Snyder, RN, CEN, PHRN George Washington University Hospital, Washington, D.C.

V-fib/pulseless v-tach (new ACLS as of 2001)

"EVAL My Pumper": Epinephrine Vasopressin Amiodarone (class IIb--better for heart failure) Lidocaine (indeterminate - better for young, healthy or persistent) MgSO4 (IIb for hypomagnesemic state or torsades) Procainamide (IIb for intermittent/recurrent VF/VT) Show Details / Rate It ---Brenda L. Snyder, RN, CEN, PHRN George Washington University Hospital, Washington, D.C.

Asystole: treatment

"Have some asystole "TEA": Transcutaneous pacing Epi Atropine Show Details / Rate It ---Brenda L. Snyder, RN, CEN, PHRN George Washington University Hospital, Washington, D.C.

JVP: raised JVP differential

PQRST (EKG waves): Pericardial effusion Quantity of fluid raised (fluid over load) Right heart failure Superior vena caval obstruction Tricuspid stenosis/ Tricuspid regurgitation/ Tamponade (cardiac) Show Details / Rate It ---Dr. Mohsin Maqbool Bahawal-Victoria Hospital, Bahawalpur

JVP: raised JVP: extra-cardiac causes

FAT PEA: Fever Anaemia Thyrotoxicosis Pregnancy Exercise A-V fistula · These are in addition to all the cardiac ones (pericardial effusion, RHF, tricuspid stenosis, SVC obstruction, etc). Show Details / Rate It ---Rajeev Peravali Year 3 Medical student, Birmingham University, UK

 

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ARDS: diagnostic criteria

ARDS: Acute onset Ratio (PaO2/FiO2) less than 200 Diffuse infiltration Swan-Ganz Wedge pressure less than 19 mmHg Show Details / Rate It ---Fahed Al-Daour

ARDS: full differential

CARDS? HOPE ITS NOT ARDS: CNS disorders Aspiration (gastric) Radiation Drugs (heroin, morphine, barbiturates, etc) Smoke, toxic gas inhalation Hypotension, shock Oxygen toxicity Pancreatitis Emboli Infection, sepsis Transfusion reaction Surgery (esp. cardiac) Near drowning Obstetrical emergencies (eg eclampsia, HELLP) Thermal injuries/ burns Altitude sickness Renal failure DIC SLE Show Details / Rate It ---Fahed Al-Daour

Pneumothorax: causes

SIT, 3 A's, 3 C's: Spontaneous (often tall thin men) Iatrogenic Trauma Asthma Alveolitis AIDS COPD Carcinoma Cystic fibrosis Show Details / Rate It ---Jamal Khan Birmingham University Medical Student

Coma: differential

UNCONSCIOUS: Units of insulin Narcotics Convulsions Oxygen Nonorganic Stroke Cocktail ICP Organism Urea Shock Show Details / Rate It ---Tom Hiser Clear Lake Emergency Medical Corps

Shock: general features

CHORD ITEM: Cold, clammy skin Hypotension Oliguria Rapid, shallow breathing Drowsiness, confusion Irritability Tachycardia Elevated or reduced central venous pressure Multi-organ damage Show Details / Rate It ---Seyi Kayode College of Health Sciences, Obafemi Awolowo University, Ile-ife, Osun State, Nigeria

Shortness of breath: short differential

AAAA PPPP: Airway obstruction Angina Anxiety Asthma Pneumonia Pneumothorax Pulmonary Edema Pulmonary Embolus Show Details / Rate It ---Anonymous Contributor

Dyspnea: differential

3A's: Three Airways: Airway obstruction, Anaphylaxis, Asthma 3P's: Three Pulmonary's: Pneumothorax, PE, Pulmonary edema 3C's: Three Cardiacs: Cardiogenic pulmonary edema, Cardiac ischemia, Cardiac tamponade 3M's: Three Metabolics: (DOC) DKA, Organophosphates, Carbon monoxide poisoning Show Details / Rate It ---Joseph Rogers, MD Duke University

Seizures: differential

SICK DRIFTER: Substrates (sugar, oxygen) Isoniazid overdose Cations (Na, Ca, Mg) Kids (ecclampsia) Drugs (CRAP: Cocaine, Rum (alcohol), Amphetamines, PCP) Rum (alchohol withdrawl) Illnesses (chronic seizure disorder or other chronic disorder) Fever (meningitis, encephalitis, abscess) Trauma (epidural, subdural, intraparynchymal hemorrhage) Extra: toxocologic (TAIL: Theo, ASA, Isoniazid, Lithium) and 3 Anti's: (Antihistamine overdose, Antidepressant overdose, Anticonvulsants (too high dilanitin, tegretol) or benzo withdrawl. Rat poison (organophospates poisoning) Show Details / Rate It ---Joseph Rogers, MD Duke University

Asthma acute attack: 5 life threatening signs

SHOCK: Silent chest Hypotension One third of best/predicted PFR Cyanosis Konfusion Show Details / Rate It ---Anonymous Contributor

Fits: causes

HOWARD: Hypertension Obesity Warfarin Alcohol Retardation Drugs Show Details / Rate It

 

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Blackout/collapse: causes

THE VESPA MC: TIA Hypoglycemia Epilepsy Vasovagal Epilepsy Situation Ppostural hypotension/ PE Arrthymia/ Aortic stenosis(HOCM) Myocardial infarction Carotid sinus hypersensitivity Show Details / Rate It ---Jude McSharry University College Hospital Galway