Fever Treatment
| Acetaminophen | Ibuprofen | |
| Children | 15 mg/kg orally | 10 mg/kg orally |
| Adults | 1 g orally | 400 mg orally |
PEA/Asystole
- CPR at 30:2
- Next:
- Epinephrine 1 mg Q3-5 min
- Consider Vasopressin 40 units in place of 1st or 2nd epinephrine dose
- Next:
- Evaluate and treat causes (Hs and Ts)
Hs and Ts
| Treatment | |
| Hypovolemia | Volume resuscitation |
| Hypoxemia | intubation oxygen chest tube |
| H+ (acidosis) | Bicarbonate |
| Hyperkalemia | calcium chloride/gluconate bicarbonate insulin and glucose |
| Hypokalemia | potassium chloride |
| Hypoglycemia | D50 |
| Hypothermia | warming |
| Tamponade | pericardiocentesis |
| Tension pneumothorax | needle decompression chest tube |
| Thrombosis (MI) | cardiac catheterization thrombolytic |
| Throbosis (PE) | thrombolytic thrombectomy |
| Trauma | ACLS protocol |
| Toxins or Tablets |
Acute Alcohol Withdrawal
- Treatment:
- IV fluids – dehydrated
- IV supplemental nutrition
- potassium
- magnesium
- phosphate
- thiamine – wernicke encelopathy
- glucose
- Benzodiazepines – reduce sxs and prevent delirium tremens
- diazepam
- lorazepam
- chlordiazepoxide
- Propofol – refractory delirium tremens
- Intubation and mechanical ventilation – severe withdrawal
Carbon Monoxide Poisoning
- Treatment:
- high-flow oxygen
- intubation
- hyperbaric oxygen
Cat and Dog Bites
- Treatment:
- ampicillin-sulbactam
- piperacillin-tazobactam
- ticarcillin-clavulanate
- 3rd gen cephalosporin + metronidazole
- fluoroquinolone + metronidazole
- Imipenem-cilastatin
- meropenem
- ertapenem
- Prophylaxis:
- amoxicillin-clavulanate
- 1 of these:
- penicillin VK
- Cerfuroxime
- TMP-SMX
- Doxycycline
- Moxifloxacin
- plus:
- Clindamycin
- Metronidazole
Cyanide Poisoning
- Treatment:
- hydroxocobalamin
- sodium thiosulfate
- amyl or sodium nitrate
Emergent Hemodialysis
- Indications:
- Metabolic acidosis
- Hyperkalemia
- > 6.5 mEq/L
- Rising rapidly
- Refractory volume overload
- Toxic levels of dialyzable drugs and alcohols
- Uremia
Heat Exhaustion
- Presentation:
- difficulty with exercise
- core body temp 101-104F
- No CNS dysfunction
- Dx:
- rectal thermometer
Heat Stroke
- Presentation:
- core body temp > 104F
- CNS dysfunction
- Dx:
- rectal thermometer
Malignant Hyperthermia
- Causes:
- Volatile anestheics
- halothane
- desflurane
- enflurane
- isoflurane
- sevoflurane
- Succinylcholine
- Volatile anestheics
- Treatment:
- stop offending agent
- 100% oxygen
- hyperventilation
- dantrolene
- Core temp > 39C (102.2F)
- cool the pt
- Acidosis
- bicarbonate
- Dysrhythmias
- ACLS protocols
- Hyperkalemia
- calcium chloride
- bicarbonate
- furosemide
- insulin and glucose
Methemoglobinemia
- Treatment:
- Acquired methemoglobinemia
- avoid triggering agent
- dapsone
- topical anesthetics
- aniline dyes
- methylene blue or ascorbic acid
- blood or exchange transfuction
- hyperabric oxygen
- avoid triggering agent
- Acquired methemoglobinemia
Tetanus Vaccine
- Td – every 10 years ≥
- Tdap Booster – 1x between 19-64 Yo
| ≥ 3 prior tetanus immunizations | Uncertain or < 3 prior tetanus immunizations | |
| Non-tetanus-prone wound, LE, clean and minor | Td if > 10 years since last dose | Td (DT if < 7 Yo) -> complete series (3 total) |
| Tetanus-prone wound (dirt, contamination, puncture, crush injury) | Td if > 5 years since last dose | Td (DT if < 7 Yo) + tetanus Ig 250 units IM at a site other than Td -> complete series |
Urethral Injury
- Presentation:
- high riding prostate
- blood at urethral meatus
- Dx:
- retrograde cystourethrogram
