Updated: Oct 17, 2022
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1. Patients suspected of having meningitis or pertussis are cared for under droplet precaution. Patients with hepatitis B are cared for under body fluid precaution.
2. Avoid succinylcholine (Anectine) in patients with hyperkalemia or history of malignant hyperthermia.
3. Hypemic hypoxia is caused by a lack of RBCs to carry oxygen, as in anemia from hemorrhage or GI bleed (Hypemic = Anemic).
4. Systemic vascular resistance (SVR) is low in distributive shock – neurogenic, anaphylactic, and septic shock. SVR is high in hypovolemic, cardiogenic, and obstructive shock.
5. A “lens-shaped” (lemon) area appears on head CT in epidural bleed, and a “crescent-shape” (banana) in subdural hematoma.
6. Needle decompression is the emergency treatment for tension pneumothorax. Needle pericardiocentesis is emergency treatment for pericardial tamponade.
7. Creatine kinase (CK) and potassium are elevated in rhabdomyolysis. Increase IVFs until urine output > 100 mL/hour. Call receiving facility to prepare for dialysis.
8. A normal shock index is 0.5 to 0.7, a patient with a shock index above 0.9 should be treated for shock.
9. IABP typically used in cardiogenic shock. IABP absolute contraindications – aortic aneurysm, aortic insufficiency, and aortic stents. Inflates during diastole to perfuse coronary arteries. Deflates during systole to decrease oxygen consumption.
10. Fundal height reaches the umbilicus at 20 weeks. Height may be elevated in intrauterine bleeding from placental abruption. Normal fetal heart tones (FHT) are 120-160 bpm. Turn patient 15 degrees to avoid supine vena cava syndrome.
11. Boyle’s law – trapped gas expands with altitude. Barogastralgia occurs on ascent, so unclamp NG tube.
12. “Steeple sign” is seen on chest x-ray in croup. “Thumbprint sign” is seen on lateral neck film in epiglottitis.
13. Cardiac output (CO) is high in the hyperdynamic phase of septic shock.
14. Hypoxia – adjust FiO2 and add PEEP. Hypercarbia – adjust tidal volume and rate.
15. Symptoms of organophosphate pesticide exposure include excessive salivation, lacrimation, and respiratory secretions (bronchorrhea). Treat with Atropine and 2-PAM.
16. Place a rigid eye shield over a ruptured globe for transport, with no excess pressure.
17. Magnesium is administered in gestational hypertension to decrease the risk of seizures.
18. The aorta tears more at the ligamentum arteriosus in trauma, suspect with first and/or second rib fractures.
19. The small bowel is the most common organ injured in penetrating abdominal trauma.
20. Suspect septic shock in patient with brisk capillary refill, bounding peripheral pulses, and petechial rash.
CFRN CTRN Sample Key Points Resources
1. ASTNA. Holleran, RS, Wolfe, Jr, AC, and Franks, MA. Patient Transport: Principles and Practice, 5th ed.
2. American Heart Association, Manual of Advanced Life Support (ACLS), 2020.
3. American Heart Association, Manual of Pediatric Advanced Life Support (PALS), 2020.
4. Emergency Nurses Association. Trauma Nursing Core Curriculum, 8th ed., 2019.
5. Emergency Nurses Association. Sheehy’s Emergency Nursing Principles and Practice, 7th ed. Elsevier, 2020.