ER Board flashcards

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

STEMI contiguous lead criteria

New ST elevation ≥1 mm in two contiguous limb leads or ≥2 mm in two contiguous precordial leads, using sex- and age-specific V2-V3 thresholds.

Aortic dissection initial therapy

Treat with intravenous beta-blockade to heart rate below 60 beats/min, then add a vasodilator to target systolic pressure 100-120 mm Hg before definitive imaging.

Cardiac tamponade signs

Hypotension, elevated jugular venous pressure, and muffled heart sounds form Beck triad; electrical alternans and pulsus paradoxus may also occur.

Adenosine dose for SVT

For stable supraventricular tachycardia, give adenosine 6 mg rapid IV push, then 12 mg if needed, after vagal maneuvers and with continuous cardiac monitoring.

Tension pneumothorax decompression

In suspected tension pneumothorax, perform immediate needle decompression at the second intercostal space midclavicular line or fifth intercostal space anterior axillary line.

COPD oxygen target

In acute COPD exacerbation with carbon dioxide retention risk, titrate oxygen to a pulse oximetry saturation of 88% to 92%.

Berlin ARDS criteria

ARDS requires acute onset within one week, bilateral opacities, PaO2/FiO2 ≤300 with PEEP ≥5 cm H2O, and respiratory failure not fully explained by cardiac failure.

Light criteria exudate

Pleural fluid is exudative if protein ratio >0.5, lactate dehydrogenase ratio >0.6, or pleural LDH exceeds two-thirds the upper normal serum limit.

Hemorrhagic shock class III

Class III hemorrhage loses 30-40% blood volume, causing tachycardia, hypotension, narrowed pulse pressure, oliguria, and altered mental status despite initial compensation.

Compartment syndrome pressure

Acute compartment syndrome is suggested by pain with passive stretch and compartment pressure above 30 mm Hg or within 30 mm Hg of diastolic pressure.

Pelvic binder placement

Apply a pelvic binder at the level of the greater trochanters, not the iliac crests, to reduce pelvic volume and stabilize suspected pelvic ring fractures.

Neurogenic shock features

Neurogenic shock after spinal cord injury causes hypotension with bradycardia from loss of sympathetic tone; treat with fluids and vasopressors such as norepinephrine.

Status epilepticus first-line

Give a benzodiazepine as first-line therapy for status epilepticus, such as intramuscular midazolam or intravenous lorazepam, before loading a second-line antiseizure drug.

Stroke thrombolysis window

Intravenous thrombolysis for acute ischemic stroke is generally given within 4.5 hours of symptom onset after excluding hemorrhage; selected patients may qualify for thrombectomy up to 24 hours.

Subarachnoid hemorrhage CT

A noncontrast head CT is highly sensitive for subarachnoid hemorrhage within six hours of onset; if negative with ongoing suspicion, perform lumbar puncture.

Increased intracranial pressure

Elevate the head to 30 degrees, maintain normoxia and normotension, and use hypertonic saline or mannitol; brief hyperventilation is a temporizing measure for herniation.

KDIGO acute kidney injury

Acute kidney injury is defined by creatinine rise ≥0.3 mg/dL within 48 hours, ≥1.5 times baseline within 7 days, or urine output <0.5 mL/kg/hour for 6 hours.

Hyperkalemia membrane stabilization

For hyperkalemia with ECG changes, give intravenous calcium first to stabilize the myocardium, then shift potassium intracellularly with insulin plus glucose and albuterol.

Testicular torsion management

Testicular torsion is a surgical emergency; urgent detorsion should not be delayed for imaging when history and examination strongly suggest torsion.

Variceal bleed initial drugs

For suspected variceal upper gastrointestinal bleeding, start octreotide or terlipressin plus prophylactic ceftriaxone and arrange urgent endoscopy after resuscitation.

Acetaminophen toxicity antidote

N-acetylcysteine is the antidote for acetaminophen toxicity; risk is assessed with the Rumack-Matthew nomogram using a timed serum acetaminophen level.

DKA potassium rule

In diabetic ketoacidosis, hold insulin when potassium is below 3.3 mmol/L and replace potassium first; insulin can be started once potassium is above 3.3.

Carbon monoxide treatment

Give 100% oxygen for carbon monoxide poisoning; hyperbaric oxygen is considered for severe poisoning, loss of consciousness, acidosis, or pregnancy.

Organophosphate antidotes

Organophosphate poisoning causes cholinergic toxicity; treat with atropine for muscarinic effects and pralidoxime for nicotinic effects, plus decontamination.

Febrile neutropenia definition

Febrile neutropenia is a temperature ≥38.3°C once or ≥38.0°C sustained for one hour with absolute neutrophil count below 500 cells/µL.

TTP treatment

Thrombotic thrombocytopenic purpura from severe ADAMTS13 deficiency is treated urgently with plasma exchange; platelet transfusion is avoided unless life-threatening bleeding occurs.

Septic shock antibiotics

In septic shock, obtain blood cultures and give broad-spectrum antibiotics within one hour; do not delay antibiotics for cultures or imaging.

Tumor lysis syndrome

Tumor lysis syndrome causes hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia; treat with aggressive hydration and rasburicase for elevated uric acid.

Ectopic pregnancy discriminatory zone

A transvaginal ultrasound should detect an intrauterine pregnancy when serum beta-hCG exceeds 1,500-3,000 mIU/mL; absence raises concern for ectopic pregnancy.

Severe preeclampsia magnesium

Magnesium sulfate prevents and treats seizures in severe preeclampsia; monitor reflexes, respiratory rate, and urine output, with calcium gluconate as antidote for toxicity.

Pediatric febrile seizure

A simple febrile seizure occurs in children aged 6 months to 5 years, lasts under 15 minutes, and is generalized; it does not require long-term antiseizure medication.

Postpartum hemorrhage cause

Uterine atony is the most common cause of postpartum hemorrhage; initial management includes fundal massage, oxytocin, and tranexamic acid.