CENP flashcards

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

Shock index

Shock index is heart rate divided by systolic blood pressure. A value above 0.9 in an adult suggests occult hemodynamic instability even when the measured blood pressure still appears normal.

Cushing triad

The Cushing triad consists of hypertension with widened pulse pressure, bradycardia, and irregular respirations. It is a late and ominous sign of rising intracranial pressure and impending herniation.

Anion gap formula

Anion gap equals sodium minus the sum of chloride and bicarbonate. Normal is roughly 8 to 12 mEq/L; an elevated gap suggests ketoacidosis, lactic acidosis, renal failure, or toxin ingestion.

qSOFA criteria

qSOFA assigns one point each for respiratory rate 22 or higher, systolic blood pressure 100 mmHg or lower, and Glasgow Coma Scale below 15. Two or more points flag high mortality risk.

Glasgow Coma Scale scoring

The Glasgow Coma Scale sums eye opening (1-4), verbal response (1-5), and motor response (1-6) for a total of 3 to 15. The motor component best predicts outcome.

Anaphylaxis epinephrine dose

Anaphylaxis is treated with intramuscular epinephrine 0.3 to 0.5 mg of the 1:1000 concentration injected into the anterolateral thigh, repeated every 5 to 15 minutes as needed.

Status epilepticus first-line therapy

Status epilepticus is continuous seizure activity lasting 5 minutes or longer. Intravenous benzodiazepines such as lorazepam are first-line, followed by a second-line anticonvulsant such as levetiracetam.

DKA insulin infusion rate

Diabetic ketoacidosis is managed with isotonic fluids and an insulin infusion of 0.1 units/kg/hour, with potassium repletion once potassium is below 5.2 mEq/L and urine output is adequate.

Hyperkalemia with ECG changes

Hyperkalemia with ECG changes is treated first with intravenous calcium to stabilize the myocardium, then insulin with glucose and inhaled beta-agonist to shift potassium into cells.

Sepsis-3 definition

Sepsis is suspected infection plus a SOFA score increase of 2 or more. Septic shock adds a vasopressor requirement to keep mean arterial pressure at 65 mmHg and lactate above 2 mmol/L.

Permissive hypotension in trauma

In hemorrhagic shock from trauma, permissive hypotension targets a systolic pressure near 90 mmHg until bleeding is controlled. Traumatic brain injury is the exception, requiring systolic pressure of at least 110 mmHg.

Parkland burn formula

The Parkland formula gives 4 mL/kg per percent total body surface area burned of lactated Ringer's over 24 hours, with half administered in the first 8 hours after injury.

Adult Rule of Nines

In adults the Rule of Nines assigns 9% to the head, 9% to each arm, 18% to each leg, 18% to the anterior trunk, 18% to the posterior trunk, and 1% to the perineum.

Tranexamic acid in trauma

Tranexamic acid given as 1 gram over 10 minutes followed by 1 gram over 8 hours reduces mortality when administered within 3 hours of traumatic injury with suspected bleeding.

Needle decompression site

For tension pneumothorax, needle decompression is performed in the fifth intercostal space at the anterior axillary line, or alternatively in the second intercostal space at the midclavicular line.

Seldinger technique

The Seldinger technique places a catheter over a guidewire: insert the needle, thread the wire, remove the needle, dilate the tract, advance the catheter over the wire, and confirm position.

Thoracentesis rib margin

During thoracentesis the needle is passed just above the superior margin of the rib, avoiding the intercostal neurovascular bundle that runs along the inferior margin of each rib.

Lumbar puncture landmark

Lumbar puncture is performed at the L3-L4 or L4-L5 interspace, at or below the line connecting the iliac crests, to avoid puncturing the conus medullaris.

Biphasic defibrillation energy

For biphasic defibrillators, initial energy for ventricular fibrillation or pulseless ventricular tachycardia is typically 120 to 200 joules, with later shocks at the device maximum.

Pediatric hypotension threshold

In children 1 to 10 years old, hypotension is a systolic pressure below 70 plus twice the age in years. Hypotension is a late finding, so shock often exists with normal pressure.

Left lateral tilt pregnancy

After 20 weeks gestation the gravid uterus compresses the inferior vena cava. Manual left uterine displacement or a 15 to 30 degree left lateral tilt improves venous return during maternal resuscitation.

Perimortem cesarean timing

In maternal cardiac arrest with a uterine fundus at or above the umbilicus, perimortem cesarean delivery is considered within 4 to 5 minutes of arrest to improve outcomes.

Pediatric defibrillation energy

Pediatric defibrillation for ventricular fibrillation uses 2 joules per kilogram for the first shock and 4 joules per kilogram for subsequent shocks, not exceeding adult energy settings.

Pediatric weight estimate

A rapid estimated weight in kilograms for children 1 to 10 years old equals twice the age in years plus 8, guiding medication dosing and equipment sizing during resuscitation.

EMTALA obligation

EMTALA requires Medicare-participating hospitals to provide a medical screening examination and stabilizing treatment for any emergency medical condition regardless of insurance status or ability to pay.

Decision-making capacity

Capacity is a clinical determination that a patient can understand information, appreciate consequences, reason through options, and communicate a choice; competence is a legal status decided by courts.

SBAR handoff

SBAR structures clinical handoff as Situation, Background, Assessment, and Recommendation, reducing omissions and improving clarity during transitions of care between providers.

Against medical advice documentation

Before an against-medical-advice departure, the clinician assesses decision-making capacity, explains risks and alternatives, offers treatment, and documents the discussion and the patient's stated reason.

Number needed to treat

Number needed to treat equals 1 divided by the absolute risk reduction. It estimates how many patients must receive an intervention for one additional patient to benefit.

Likelihood ratio interpretation

A positive likelihood ratio above 10 and a negative likelihood ratio below 0.1 meaningfully change post-test probability, while ratios near 1 leave probability essentially unchanged.

Teach-back method

Teach-back asks patients to restate instructions in their own words. It confirms actual comprehension and reveals gaps, rather than asking whether the patient understood.

Sensitivity definition

Sensitivity is the proportion of people with disease who test positive. Highly sensitive tests are useful for ruling out disease when the result is negative, because false negatives are few.