Emergency Medicine Mnemonics

Kendrick Extrication Device (K.E.D.): order of placing straps

"My Baby Looks Hot onight":
Middle
Bottom
Legs
Head
op
Note: K.E.D. is a device used to extract patients out of a crashed car or
similar tight space.
!ei"#re: $#ick %istory taking &'(:
&ocus: generalied vs. local activity
'ctivity: tonic!clonic vs. absence
(olor: red" blue" ashen!!possible indicator of hypoxia
ime: length of seiure
'st%ma ac#te attack: ) life t%reatening signs !H*(K:
!ilent chest
Hypotension
*ne third of best#predicted $%&
(yanosis
Konfusion
&its: ca#ses H*+',D:
Hypertension
*besity
+arfarin
'lcohol
,etardation
Drugs
Blacko#t-collapse: ca#ses HE .E!/' M(:
'(
Hypoglycemia
Epilepsy
.asovagal
Epilepsy
!ituation
/postural hypotension# /E
'rrthymia# 'ortic stenosis)*+,-.
Myocardial infarction
(arotid sinus hypersensitivity
!nake0ite scoring system / 01s:
oothless
!shirt
attooed
railer park
estosterone
e2uila )Et+*.
+ne point for each positive.
3 or more positive 01s suggests venomous bite.
Motor .e%icle (ollision (M.(): !ingle ve%icle M.( differential of
ca#ses 4 51s:
!uds )Et+*.
!uicide
!leep
!eiure
!ugar
!troke )bleed.
!tupidity
',D!: diagnostic criteria ',D!:
'cute onset
,atio )$a+6#%i+6. less than 677
Diffuse infiltration
!8an!9an :edge pressure less than ;< mm*g
',D!: f#ll differential (',D!1 H*/E 2! 3* ',D!:
(N5 disorders
'spiration )gastric.
,adiation
Drugs )heroin" morphine" barbiturates" etc.
!moke" toxic gas inhalation
Hypotension" shock
*xygen toxicity
/ancreatitis
Emboli
2nfection" sepsis
ransfusion reaction
!urgery )esp. cardiac.
3ear dro8ning
*bstetrical emergencies )eg eclampsia" *E==$.
hermal in>uries# burns
'ltitude sickness
,enal failure
D',
!=E
/ne#mot%orax: ca#ses !2" 3 (1s" 3 ,1s:
!pontaneous )often tall thin men.
2atrogenic
rauma
'sthma
'lveolitis
''D5
(+$D
(arcinoma
(ystic fibrosis
(oma: differential 43(*3!(2*4!:
4nits of insulin
3arcotics
(onvulsions
*xygen
3onorganic
!troke
(ocktail
2,$
*rganism
4rea
!hock
!%ock: general feat#res (H*,D 2EM:
(old" clammy skin
Hypotension
*liguria
,apid" shallo8 breathing
Dro8siness" confusion
2rritability
achycardia
Elevated or reduced central venous pressure
Multi!organ damage
!%ortness of 0reat%: s%ort differential '''' ////:
'ir8ay obstruction
'ngina
'nxiety
'sthma
/neumonia
/neumothorax
/ulmonary Edema
/ulmonary Embolus
Dyspnea: differential 3(1s: 0hree (ir8ays: 'ir8ay
obstruction" 'naphylaxis" 'sthma
3$1s: 0hree $ulmonary1s: /neumothorax" /E" /ulmonary edema
3,1s: 0hree ,ardiacs: (ardiogenic pulmonary edema" (ardiac
ischemia" (ardiac tamponade
3-1s: 0hree -etabolics: )D*(. DK(" *rganophosphates" (arbon
monoxide poisoning
!ei"#res: differential !2(K D,2&E,:
!ubstrates )sugar" oxygen.
2soniaid overdose
(ations )Na" ,a" -g.
Kids )ecclampsia.
Drugs )(,'/: (ocaine" ,um )alcohol." 'mphetamines"
/,$.
,um )alchohol 8ithdra8l.
2llnesses )chronic seiure disorder or other chronic disorder.
&ever )meningitis" encephalitis" abscess.
rauma )epidural" subdural" intraparynchymal hemorrhage.
Extra: toxocologic )'2L: heo" '5(" 2soniaid"
Lithium. and 3 'nti1s: )'ntihistamine overdose" 'ntidepressant
overdose" 'nticonvulsants )too high dilanitin" tegretol. or beno
8ithdra8l.
,at poison )organophospates poisoning.
/ne#monia: %ospitalisation criteria 'B(D:
'ge greater than /7
Blood urea greater than 4 mmol#l
(onfusion
Diastolic ?$ less than /7 mm*g
*ospitalise the pneumonia patient if 6 or more of these criteria are met.
Myocardial infarction: some emergency treatment dr#gs
'B(D:
'spirin
Beta blockers
(lot busters )thromboytics.
Dynamite )nitrates.
Malaria: complications of falcipar#m malaria (H'/L23:
(erebral malaria# (oma
Hypoglycemia
'naemia
/ulmonary edema
Lactic acidosis
2nfections
3ecrois of renal tubules )(0N.
M2: immediate treatment D*5'!H:
Diamorphine
*xygen
50N spray
'sprin 377mg
!treptokinase
Heparin
/ain %istory c%ecklist *LDE, !''B:
*nset
Location
Description )8hat does it feel like.
Exacerbating factors
,adiation
!everity
'ssociated symptoms
'lleviating factors
Before )ever experience this before.
/#lseless Electrical 'ctivity (/E'): c%ecklist /E':
/ulses check
Epinepherine
'tropine
/E'-'systole ('(L!): etiology 2(H/'D:
2nfarction
ension pneumothorax
(ardiac tamponade
Hypovolemia# Hypothermia# Hypo!" Hyperkalemia# Hypomagnesmia#
Hypoxemia
/ulmonary embolism
'cidosis
Drug overdose
ra#ma: motor ve%icle accident considerations 2 'M !(',ED:
2mpact )head!on" rear!end" t!bone" rollover" rotational etc..
'uto vs. pedestrian" bike" motorcycle )start @ speed A;7mph.
Medical history )cardiac" coagulolation" liver" immuno" obese" prego.
!peed )AB7 mphC.
(ompartment intrusion )A;6 inchesC.
'ge )DB or ABB y.o.C.
,estraints )lap E shoulder" either" airbag" infant or child seatC.
E>ection# Extrication )e>ectF6Bx greater death" extrA67min.
Death )at scene" same vehicle" other.
.6fi0-p#lseless v6tac% (ne7 '(L! as of 899:) "E.'L My
/umper":
Epinephrine
.asopressin
'miodarone )class ''b!!better for heart failure.
Lidocaine )indeterminate ! better for young" healthy or persistent.
Mg5+G )''b for hypomagnesemic state or torsades.
/rocainamide )''b for intermittent#recurrent H%#H0.
'systole: treatment "*ave some asystole "E'":
ranscutaneous pacing
Epi
'tropine
;./: raised ;./ differential /<,! )EK9 8aves.:
/ericardial effusion
<uantity of fluid raised )fluid over load.
,ight heart failure
!uperior vena caval obstruction
ricuspid stenosis# ricuspid regurgitation# amponade
)cardiac.
;./: raised ;./: extra6cardiac ca#ses &' /E':
&ever
'naemia
hyrotoxicosis
/regnancy
Exercise
'!H fistula
0hese are in addition to all the cardiac ones )pericardial effusion" &*%"
tricuspid stenosis" 5H, obstruction" etc..
Endotrac%ial t#0e delivera0le dr#gs * 3'.EL:
*xygen
3aloxone
'tropine
.entolin )albuterol.
Epinephrine
Lidocaine
'f you can1t get 'H access established" and have necessity to administer
resuscitative meds" remember you have the air8ay and can give the above drugs.
Drug delivery is enhanced if diluted 8ith ;7cc N5 and rapid introduced for
aeresoliation.
(lternatively" bare bone version is 'LE" as above.
!yncope ca#ses= 0y system HE'D HE', .E!!EL!:
,N5 causes include *E(D:
Hypoxia# Hypoglycemia
Epilepsy
'nxiety
Dysfunctional brain stem )basivertebral 0'(.
,ardiac causes are *E(&0:
Heart attack
Embolism )$E.
'ortic obstruction )'*55" (5 or myxoma.
,hythm disturbance" ventricular
achycardia
Hascular causes are HE55E=5:
.asovagal
Ectopic )reminds one of hypovolemia.
!ituational
!ubclavian steal
EN0 )glossopharyngeal neuralgia.
Lo8 systemic vascular resistance )(ddison1s" diabetic vascular
neuropathy.
!ensitive carotid sinus
'trial fi0rillation: ca#ses of ne7 onset HE ',2'L &2B!:
hyroid
Hypothermia
Embolism )$.E..
'lcohol
rauma )cardiac contusion.
,ecent surgery )post ,(?9.
2schemia
'trial enlargement
Lone or idiopathic
&ever" anemia" high!output states
2nfarct
Bad valves )mitral stenosis.
!timulants )cocaine" theo" amphet" caffeine.
3e#rological focal deficits ;7 51s:
!ugar )hypo" hyper.
!troke
!eiure )0odd1s paralysis.
!ubdural hematoma
!ubarachnoid hemorrhage
!pace occupying lesion )tumor" avm" aneurysm" abscess.
!pinal cord syndromes
!omatoform )conversion reaction.
!clerosis )-5.
!ome migraines
Miosis: ca#ses of pin6point p#pils (/, *3 !L2ME:
(lonidine
/henothiaines
,esting )deep sleep.
*piates
3arcotics
!troke )pontine hemorrhage.
Lomotil )diphenoxylate.
2nsecticides
Mushrooms# Muscarinic )inocybe" clitocybe.
Eye drops
Meningicoccal meningitis: complications !'D ,E/:
!epsis# !hock# !ubdural effusion
'taxia# 'bscess )brain.
D',# Deafness
,etardation
Epilepsy
/aralysis
'ctivated c%arcoal: contraindications (HEM2('L (am/:
(yanide
Hydrocarbons
Ethanol
Metals
2ron
(austics
'ir8ay unprotected
Lithium
('Mphor
/otassium
2pecac: contraindications G ,1s:
(omatose
(onvulsing
(orrosive
hydro(arbon
*rganop%osp%ates poisoning: symptoms D4MBBEL!:
Diarrhea
4rination
Miosis
Bradycardia
Bronchospasm
Emesis
Lacrimation
!alivation
(oma and signicantly red#ced conscio#s state ca#ses: ca#ses
(*M':
(+6 and ,+ excess
*verdose: 0,(s" ?enos" Et+*" insulin" paracetamol" etc.
Metabolic: ?5=" NaI" KI" -g6I" urea" ammonia" etc.
'poplexy: stroke" 5(*" extradural" subdural" ,a" meningitis"
encephalitis" cerebral abscess" etc.
(%est pain: differential (HE! /'23:
(ostochondritis# (ocaine abuse
Herpes oster# Hyperventilation
Esophagitis# Esophageal spasm
!tenosis )(5.
rauma
/E# /neumonia# /neumothorax# /ericarditis# /ancreatitis
'ngina# 'ortic dissection# 'ortic anerusym
2nfarction# 2H disk disease
3europsychiatric disorders )e.g. depression" Da ,osta1s.
.entric#lar fi0rillation: treatment "5hock" 5hock" 5hock"
Everybody 5hock" =ittle 5hock" ?ig 5hock" -omma 5hock" $oppa 5hock":
5hockF Defibrillate
EverybodyF Epinephine
=ittleF =idocaine
?igF ?retylium
-ommaF -g5+G
$oppaF $ocainamide
&all: potential ca#ses 2>.E &'LLE3:
2llness
.estibular
Environmental
&eet# &oot8ear
'lcohol and drugs
Lo8 blood pressure
Lo8 +6 states
Ears# Eyes
3europathy
,L< pain: differential '//E3D2(22!:
'ppendicitis# 'bscess
/'D# /eriod
/ancreatitis
Ectopic# Endometriosis
3eoplasia
Diverticulitis
2ntussusception
(rohns Disease# (yst )ovarian.
2?D
orsion )ovary.
2rritable ?o8el 5yndrome
!tones
Decompression sickness ?oyle1s la8: volume of gas is
inversely proportionate to its pressure.
0herefore" B*?LE:
Breathe )as you ascend.
*r
?our
Lung
Explodes
?reathe as you ascend after scuba diving" since the pressure decreases on
surfacing" so the gas volume in lungs increases.
4nconcio#sness: differential &2!H !H'/ED:
&ainted
2llness# 2nfantile febrile convulsions
!hock
Head in>uries
!troke ),HE.
Heart problems
'sphxia
/oisons
Epilepsy
Diabetes
Endotrac%eal t#0e: tro#0les%ooting D*/E?:
Displaced: esophagus" right mainstem" back of throat" etc
*bstructed: secretions" blood" mucus plug" kink" etc
/neumothorax
E2uipment: malfunctions" +6" E00" ?H-" ventilator" monitor
?ou: your approach" techni2ue: missing somethingC
*rganop%osp%ates poisoning symptoms M2LE!:
Miosis
2ncreased urinary fre2uency
Lacrimation
Enuresis
!alivation
(%est pain treatment= for n#rses "M*.E your
patientJ":
Monitor: put patient on cardiac monitor
*xygen: put patient on +6
.enous: gain large bore venous access
EK9: ;6 lead EK9
2(4 conf#sion ca#ses 2(4 (*3&4!2*3:
2,K psychosis
(ardiac output lo8 Lhypotension" post cardiac arrestM
4ncontrolled temperature Lhypo#hyperthermiaM
(onvulsion Lpost ictalM
*xygen Lhypoxia" hypercarbiaM
3ociception LpainM
&ull bladder
4remia
!ugar Lhypo#hyperglycemiaM
2nfection
*piates
3atremia Lhypo#hyperM
(oma: conditions to excl#de as ca#se M2D'!:
Meningitis
2ntoxication
Diabetes
'ir )respiratory failure.
!ubdural# !ubarachnoid hemorrhage
,es#scitation: 0asic steps 'B(DE:
'ir8ay
Breathing
(irculation
Drugs
Environment
Malignant %ypert%ermia treatment "!ome Hot
Dude Better 5ive 2ced &luids &astJ" )*ot
dude F hypothermia.:
!top triggering agents
Hyperventilate# Hundred percent oxygen
Dantrolene )6.Bmg#kg.
Bicarbonate
5lucose and insulin
2H %luids and cooling blanket
&luid output monitoring# &urosemide# &ast heart
LtachycardiaM
.fi0-.tac% dr#gs #sed according to '(L! "Every Little
Boy Must /ray":
Epinephrine
Lidocaine
Bretylium
Magsulfate
/rocainamide
(oma ca#ses c%ecklist 'E2*4 2/!:
'cidosis# 'lcohol
Epilepsy
2nfection
*verdosed
4remia
rauma to head
2nsulin: too little or or too much
/yschosis episode
!troke occurred
!%ock: types ,3 (H'M/!:
,espiratory
3eurogenic
(ardiogenic
Hemorrhagic
'naphylactic
Metabolic
/sychogenic
!eptic
(lternatively: "M,. (.H. !3'/"" or "3H (,'M/!"
!%ock: signs and symptoms . !/',( (4BE:
hirst
.omiting
!8eating
/ulse 8eak
'nxious
,espirations shallo8#rapid
(ool
(yanotic
4nconscious
B$ lo8
Eyes blank
&all: potential ca#ses (L'DE !/'DE:
(ardiovascular# (erebrovascular
Locomotor )skeletal" muscular" neurological.
'geing )increased body s8ay" decreased reaction time.
Drugs )esp. antihypertensives" antipsychotics.
Environmental
!ensory deficits )eg. visual problems.
/sychological# /sychiatric )depression.
'cute illness
Dementia
Epilepsy
'c#te L.& management LM3*/:
Lasex )frusemide.
Morphine )diamorphine.
3itrates
*xygen )sit patient up.
/ulmonary ventilation )if doing badly.
!#0arac%noid %emorr%age (!'H) ca#ses B'!:
Berry aneurysm
'rteriovenous malformation# 'dult polycystic kidney disease
rauma )eg being struck 8ith baseball 0at.
!troke