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If a burn victim suffers circumferential burns, what should be considered?
Escharotomy to relieve pressure and prevent compartment syndrome.
If a burn victim has singed nose hairs, wheezing, and soot in the mouth or nose, what should be done?
Immediate airway evaluation and intervention, as these signs indicate possible inhalation injury.
If a burn victim is having confusion and cherry red skin, what is that a sign of and what test should be done?
This indicates carbon monoxide poisoning; a carboxyhemoglobin level test should be performed.
What is treatment for carbon monoxide poisoning?
The primary treatment is administering 100% oxygen to displace carbon monoxide from hemoglobin and reduce its half-life.
In a patient with ATIII deficiency, why is heparin ineffective?
Because antithrombin III (ATIII) is required for heparin to exert its anticoagulant effect; deficiency leads to reduced efficacy.
If someone suffered an electrical burn, what is the first test to do?
An EKG should be performed to assess for cardiac arrhythmias due to potential electrical injury.
If a patient has inward movement of the right ribcage with inspiration, what is that a sign of?
A sign of paradoxical movement, indicating possible flail chest or diaphragm impairment.
If someone suffered a gunshot wound to the abdomen, what should be done?
Exploratory laparotomy is required to assess for internal injuries and potential organ damage.
If someone suffered a stab wound to the abdomen but they are stable, what should be done?
FAST exam should be performed to evaluate for internal bleeding and organ injury.
If someone suffers lower rib fracture with bleeding into abdomen, what got ruptured?
The spleen or liver may have ruptured, causing internal bleeding.
What is Kehr sign?
Kehr sign is referred pain in the left shoulder due to irritation of the diaphragm, often associated with splenic injury.
What is the handlebar sign?
The handlebar sign is a clinical indicator of abdominal injuries, particularly in children, caused by pressure from the handlebars of a bicycle leading to contusions or organ damage.
If there is blood at the urethral meatus and a high riding prostate, what is that indicative of?
It is indicative of a possible posterior urethral or bladder injury, often associated with pelvic fractures.
In a urethral injury, what is the first test to be done?
The first test to be done is a retrograde urethrogram (RUG) to assess the extent of the injury.
If the retrograde urethrography is normal in a urethral injury, what is done next?
A cystoscopy is performed to evaluate for any associated injuries or complications.
What should you look for when doing retrograde urethrography and cystoscopy?
You should look for evidence of urethral injury, including extravasation of contrast, strictures, or lacerations during retrograde urethrography, and any abnormalities in the bladder or urethra during cystoscopy.
What happens if the extravasation is intraperitoneal?
It may require surgical intervention due to potential complications such as peritonitis.
Which fractures require emergent surgical evaluation?
Depressed skull, open, femoral neck, severely displaced
If a patient develops fever with non-productive cough on the first post-operative day, what should that be concerning for?
It may indicate atelectasis or pneumonia.
What is the most common cause of necrotizing fasciitis?
Group A Streptococcus infection.
On post-op day 7 or later, if the incision site starts to become painful with salmon colored fluid, what is that concerning for?
It may indicate a surgical site infection or abscess formation. This could suggest an infection that may require emergency intervention.
Do benign lung nodules have to be removed?
Generally, they do not need to be removed unless there are specific concerns for malignancy or if they cause symptoms.
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