AOBEM Emergency Medicine flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

TART mnemonic

Tissue texture abnormality, Asymmetry, Restriction of motion, and Tenderness define somatic dysfunction in osteopathic diagnosis and guide selection of manipulative technique.

Rumack-Matthew nomogram

A plot of serum acetaminophen concentration versus time after acute single ingestion used to decide whether N-acetylcysteine treatment is indicated, typically at 4 hours or later.

START triage

A mass-casualty triage system that sorts patients by respirations, perfusion, and mental status into immediate, delayed, minor, and expectant categories within seconds.

HEART score

A chest pain risk tool combining history, ECG, age, risk factors, and troponin; scores of 0 to 3 identify low-risk patients suitable for early discharge.

Counterstrain technique

An indirect osteopathic technique that places a tender point in a position of comfort for about 90 seconds to reduce muscle spindle activity and relieve somatic dysfunction.

Osmolal gap

The difference between measured and calculated osmolality; a gap greater than 10 suggests an unmeasured osmole such as methanol, ethylene glycol, or isopropanol.

NEXUS criteria

Five clinical criteria (midline tenderness, focal deficit, altered mental status, intoxication, distracting injury) that, when all absent, safely exclude cervical spine imaging.

Defibrillation energy

For adult cardiac arrest, biphasic shocks typically use 120 to 200 joules; resume chest compressions immediately after the shock without a pulse check.

Sodium bicarbonate in TCA

Sodium bicarbonate at 1 to 2 mEq/kg is given for tricyclic overdose with QRS widening greater than 100 ms or ventricular dysrhythmia due to sodium channel blockade.

Muscle energy technique

A direct osteopathic technique in which the patient performs a controlled isometric contraction against operator resistance for 3 to 5 seconds, followed by relaxation and repetition.

qSOFA score

A bedside score using systolic blood pressure of 100 mm Hg or less, respiratory rate of 22 or more, and altered mentation to identify sepsis patients at higher mortality risk.

STEMI reperfusion time

Primary PCI should be achieved within 90 minutes of first medical contact, or fibrinolysis within 30 minutes when PCI is not available in that window.

Cholinergic toxidrome

SLUDGE findings (salivation, lacrimation, urination, defecation, GI upset, emesis) with bronchorrhea and bradycardia; atropine treats secretions and bradycardia.

Cincinnati stroke scale

A prehospital screen for facial droop, arm drift, and abnormal speech that identifies likely stroke and triggers transport to a stroke center with advance notification.

Lymphatic pump technique

A rhythmic osteopathic technique using thoracic and pedal pumping motions to enhance venous and lymphatic return; contraindicated in acute infection, DVT, and decompensated heart failure.

Anaphylaxis treatment

Epinephrine 0.3 to 0.5 mg intramuscularly into the anterolateral thigh is first-line; antihistamines and steroids are adjuncts and never delay epinephrine.

Naloxone titration

Naloxone is given in small IV doses titrated to restore respirations, reducing precipitated withdrawal; observe for renarcotization because its duration may be shorter than the opioid.

Massive transfusion ratio

Hemorrhagic shock resuscitation uses balanced plasma, platelet, and red cell ratios near 1:1:1, with tranexamic acid given within 3 hours of traumatic injury.

Glasgow Coma Scale

A score from 3 to 15 combining eye opening, verbal response, and motor response; a score of 8 or less generally indicates need for airway protection.

Fomepizole indication

Fomepizole inhibits alcohol dehydrogenase and is used for methanol or ethylene glycol poisoning, with hemodialysis for severe acidosis or end-organ injury.

Pediatric ET tube size

Uncuffed tube size equals age in years divided by 4 plus 4 mm; cuffed tube size equals age divided by 4 plus 3.5 mm.

Boerhaave syndrome

Transmural esophageal rupture presenting with Mackler triad of vomiting, chest pain, and subcutaneous emphysema; it is a surgical emergency requiring prompt recognition.

Chapman reflex points

Anterior tender points used in osteopathic diagnosis of visceral dysfunction; treatment involves circular massage for 10 to 30 seconds to improve lymphatic and visceral function.

Hyperkalemia treatment

IV calcium stabilizes the myocardium, insulin with glucose and albuterol shift potassium intracellularly, and diuresis or dialysis removes potassium from the body.

Cyanide antidote

Hydroxocobalamin binds cyanide and is preferred in smoke inhalation with lactic acidosis; suspect co-toxicity with carbon monoxide and give 100% oxygen.

Perimortem cesarean timing

In maternal cardiac arrest, cesarean delivery is considered within 4 to 5 minutes of arrest when the uterus is at or above the umbilicus, to improve maternal resuscitation.

Cervical HVLA contraindications

Avoid high-velocity low-amplitude cervical thrust in atlantoaxial instability, vertebrobasilar insufficiency, severe osteoporosis, and acute ligamentous injury.

Hypothermia resuscitation rule

In hypothermic cardiac arrest, withhold epinephrine until core temperature exceeds 30 C and continue resuscitation with rewarming because patients are not dead until warm and dead.

Salicylate toxicity features

Mixed respiratory alkalosis and anion-gap metabolic acidosis with tinnitus; treatment includes urine alkalinization and hemodialysis for severe poisoning.

Ludwig angina

Bilateral submandibular cellulitis with tongue elevation that threatens the airway; requires early airway control and antibiotics covering oral flora.

Triage sieve and sort

The sieve rapidly assigns preliminary categories during a mass-casualty incident, and the sort refines treatment and transport priorities at the treatment area.

Spencer technique

A sequential osteopathic articulation of the shoulder and upper extremity used to improve motion in adhesive capsulitis and shoulder restriction.