1. Drugs for V-fib/pulseless v-tach (new ACLS as of 2001)

"EVAL My Pumper":

Epinephrine 

Vasopressin 

Amiodarone (class IIb--better for heart failure) 

Lidocaine (indeterminate - better for young, healthy or persistent) 

MgSO4 (IIb for hypomagnesemic state or torsades) 

Procainamide (IIb for intermittent/recurrent VF/VT)

2. Trauma: motor vehicle accident considerations

I AM SCARED:

Impact (head-on, rear-end, t-bone, rollover, rotational etc.) 

Auto vs. pedestrian, bike, motorcycle (start @ speed >10mph) Medical history (cardiac, coagulolation, liver, immuno, obese, prego) 

Speed (>50 mph?) 

Compartment intrusion (>12 inches?) 

Age (<5 or >55 y.o.?) 

Restraints (lap & shoulder, either, airbag, infant or child seat?) Ejection/ Extrication (eject=25x greater death, extr>20min) 

Death (at scene, same vehicle, other)

3. Decompression sickness

Boyle's law: volume of gas is inversely proportionate to its pressure.

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Therefore, BOYLE:

Breathe (as you ascend) Or Your Lung Explodes · 

Breathe as you ascend after scuba diving, since the pressure decreases on surfacing, so the gas volume in lungs increases.

4. Pain history checklist

OLDER SAAB:

Onset 

Location Description (what does it feel like) 

Exacerbating factors 

Radiation 

Severity 

Associated symptoms 

Alleviating factors 

Before (ever experience this before)

5. Asystole: treatment

"Have some asystole "TEA":

Transcutaneous pacing 

Epinephrine 

Atropine

6.

O NAVEL:

Oxygen 

Naloxone 

Atropine 

Ventolin (albuterol) 

Epinephrine 

Lidocaine 

If you can't get IV access established, and have necessity to administer resuscitative medicationss, remember you have the airway and can give the above drugs. 

Drug delivery is enhanced if diluted with 10cc NS and rapid introduced for aeresolization. · 

7. Alternatively, bare bone version is ALE, as above. 

Atropine

Lidocaine

Epinephrine

8. RLQ pain: differential

APPENDICITIS:

Appendicitis/ Abscess PID/ 

Periods/Pancreatitis 

Ectopic pregnancies/ Endometriosis 

Neoplasia 

Diverticulitis 

Intussusception 

Crohns Disease/ Cyst (ovarian) 

IBD 

Torsion (ovary) 

Irritable Bowel Syndrome 

Stones

9. Subarachnoid hemorrhage (SAH) causes

BATS:

Berry aneurysm 

Arteriovenous malformation/ Adult polycystic kidney disease Trauma (eg being struck with baseball bat) 

Stroke

10. Syncope causes, by system

HEAD HEART VESSELS:

CNS causes include HEAD:

Hypoxia/ Hypoglycemia 

Epilepsy 

Anxiety 

Dysfunctional brain stem (basilvertebral TIA)

Cardiac causes are HEART: 

Heart attack 

Embolism (PE) 

Aortic obstruction (IHSS, AS or myxoma) 

Rhythm disturbance, 

ventricular Tachycardia

Vascular causes are VESSELS: 

Vasovagal 

Ectopic (reminds one of hypovolemia) 

Situational 

Subclavian steal 

ENT (glossopharyngeal neuralgia) 

Low systemic vascular resistance (Addison's, diabetic vascular neuropathy) Sensitive carotid sinus

11. Coma and signicantly reduced conscious state causes:

Causes COMA:

CO2 and CO excess 

Overdose: TCAs, Benzos, EtOH, insulin, paracetamol, etc. Metabolic: BSL, Na+, K+, Mg2+, urea, ammonia, etc. 

Apoplexy: stroke, SAH, extradural, subdural, Ca, meningitis, encephalitis, cerebral abscess, etc.

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