By Blok B., Dickson Cheung, Platts-Mills T.
First reduction for the Emergency drugs forums offers time-strapped emergency drugs citizens (taking annual in-training tests or the tip of residency board certification examination) and practitioners (renewing their certification) with a concise source providing fast, usually proven, high-yield evidence in line with the main lately administered in-service and board assessments. it's a entire overview of emergency medication issues validated at the written board examination. nearly a hundred twenty five medical photos and algorithms increase the textual content. Margin notes make stronger key issues. A bankruptcy on getting ready for the emergency medication board examination offers worthy suggestion on scheduling research time, tips to sign up for the examination, and what to anticipate on examination day.
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Extra info for First Aid for the Emergency Medicine Boards (FIRST AID Specialty Boards)
Evaluate for shockable rhythm. If present, administer shock. If any of the above is successful, check pulse and → postresuscitation therapy. Change of rhythm to pulseless electrical activity or asystole should initiate those algorithms (see below). Pulseless Electrical Activity (PEA) PEA patients may be differentiated into two groups: ■ ■ Those with electrical activity and echocardiographic evidence of cardiac motion Those with electrical activity in the absence of any cardiac motion ■ Patients in this group have a worse outcome than those with cardiac motion.
Intermittently assess for return of pulse or presence of shockable rhythm. A single dose of vasopressin may be substituted for the ﬁrst or second dose of epinephrine. Asystole Asystole is generally considered a preterminal rhythm. Survival from asystole is extremely poor. TREATMENT ■ ■ Consider similar reversible causes as for PEA (see page 40). Treatment is as for PEA. 10) Route of administration: ■ ■ ■ ■ The most rapidly available route should be used. Central venous access? ■ Provides the fastest drug delivery to the central circulation, but ■ Not preferred because of required delay in CPR and/or deﬁbrillation during line placement ■ Use if no other access available.
7. 12) ■ ■ ■ Narrow QRS complexes at rate of 120–200 bpm Absence of visible P waves ■ Retrograde P waves are buried in QRS. Regular rhythm TREATMENT ■ ■ ■ ■ Adenosine will be effective in If patient unstable → electrical cardioversion: ■ Synchronized ■ Begin with 50–100J Other therapy focused on interrupting circuit within AV node Vagal maneuvers ■ Valsalva ■ Carotid sinus massage ■ Be wary in elderly. ■ Ensure no carotid bruits ﬁrst. ■ Immerse face in cold water → dive reﬂex (more effective in infants).