Term
| #1 cause of death in the first 4 decades of life |
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Definition
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Term
| what's the trimodal distribution of death due to trauma |
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Definition
-1st peak=seconds to minutes of injury
-2nd peak=minutes to hours
-3rd peak=several days to weeks |
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Term
| what injuries fall under the first peak |
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Definition
-brain laceration
-brainstem, spinal cord, heart & major blood vessel damage |
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Term
| what injuries fall into the 2nd peak |
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Definition
-NV compromise
-CV/pulm compromise
-abd hemorrhage
-multiple injuries w/ significant blood loss |
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Term
| which part of the trimodal distribution has been improved the most by ATLS |
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Definition
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Term
| what are the injuries that fall under the 3rd peak |
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Definition
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Term
| what's involved in the primary survery |
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Definition
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Term
| in this stage of the primary survey cervical spine is stabilized, airway is assessed and oxygen is supplied |
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Definition
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Term
| what do we always assume any pt w/ head injury, altered LOC or multiple blunt trauma has |
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Definition
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Term
| what can initially establish airway clearance while protecting the Cspine |
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Definition
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Term
| what are the pt's we assess airway (w/ the most importance) |
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Definition
-head/face
-neck/chest injuries
-alcohol intoxication
-drug OD
- |
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Term
| in which stage of the primary survey do we assess if respiration is adequate, chest wall, lungs, diaphragm through auscultation, inspection, palpation |
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Definition
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Term
| which pt's are we really concerned about which is why we performing the breathing part of the primary survey |
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Definition
-chest wall compression
-tension/open pneumothorax
-massive hemothorax
-flail chest |
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Term
| what are some options we have to ensure adequate ventilation |
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Definition
-needle decompression
-ET tube
-chest tube |
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Term
| how do we assess circulation |
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Definition
-auscultate heart sounds
-palpate peripheral pulses
-assess skin color, LOC |
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Term
| what needs to be avoided b/c it may cause crushing of underlying tissue & cause distal ischemia |
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Definition
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Term
| all hypotension w/o external hemorrhage is assumed to be |
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Definition
| -intra abd or intra thoracic in origin |
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Term
| what are some signs of decreased circulation |
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Definition
-hypotensive
-diminished LOC
-anxious |
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Term
| MCC of post-injury death in a trauma pt |
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Definition
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Term
| what's assessed in the D aspect of the primary survey |
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Definition
| neurologic disability (LOC, pupil size, motor response |
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Term
| what does AVPUG stand for |
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Definition
A=alert
V=response to vocal stimuli
P=response to painful stimuli
U=unresponsive
G=glasgow coma scale |
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Term
| what part of the spine is less injury prone |
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Definition
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Term
| complete spinal cord injury affects all neuro function.... |
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Definition
| below the level of injury |
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Term
| incomplete spinal cord severeing exhibits |
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Definition
| sacral sparing & affects either the central, anterior or a single side of the cord |
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Term
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Definition
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Term
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Definition
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Term
| what are the eye opening ratings on the GCS |
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Definition
-spontaneous (4)
-speech (3)
-pain (2)
-none (1) |
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Term
| verbal response score on the GCS |
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Definition
-oriented (5)
-confused (4)
-inappropriate (3)
-incomprehensible (2)
-none (1) |
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Term
| what's the motor response scoring for GCS |
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Definition
-obey commands (6)
-localize to pain (5)
-w/draw from pain (4)
-flex to pain (3)
-extend to pain (2)
-none (1) |
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Term
| what is the E in the primary survey |
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Definition
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Term
| what's the secondary survey (AMPLE) |
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Definition
Allergies
Meds
Past illness
Last meal
Events surrounding injury |
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Term
| 3 essential x-rays in the 2ndary survey |
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Definition
-lateral C spine
-AP chest
-AP pelvis |
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Term
| after you've done the primary & secondary survey what happens next |
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Definition
| -re-evalaute the pt for definitive care |
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Term
| what are the 3 basic trauma surgeries |
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Definition
-exploratory laparotomy
-thoractomy
-clam shell |
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Term
| what are some of the musculoskeletal potentially life threatening injuries |
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Definition
-vascular injuries
-compartment syndrome
-open fx's
-crush injuries
-major dislocations |
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Term
| what do u need to watch out for in crush injuries |
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Definition
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Term
| early care of MS injuries |
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Definition
-align & splint
-restore perfusion
-wound care
-tetanus prophylaxis |
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Term
| what do we use to assess circulation to the extremitis |
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Definition
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Term
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Definition
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Term
| gold standard for dx of cirulation |
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Definition
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Term
| what are some of the MC injuries from a fall from height |
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Definition
-calcaneus fx
-tibial plateau fx
-hip fx
-vertebral burst fx |
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Term
| what injuries are u worried about if someone was ejected from a vehicle |
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Definition
-closed head injury
-spine fx's |
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Term
| what do knee dislocations cause a problem with |
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Definition
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Term
| if a pt is involved in a head on MVA what injuries are we looking for |
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Definition
-abd visceral/pelvic fx
-retroperitoneal bleed
-post. knee dislocation/popliteal artery injury
-supracondylar humeral fx
-brachial artery injury
-nerve injuries
-ant shoulder dislocation
-post hip dislcoation |
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Term
| most frequent manifestation of vascular injury |
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Definition
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Term
| which MS emergencies cause vascular injury |
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Definition
-post. knee dislocation
-supracondylar fx
-elbow dislocation
-injury to soft tissue |
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Term
| what is one of the most effective ways to tx an acute compartment syndrome |
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Definition
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Term
| this results from significant increased pressure on an extremitis |
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Definition
| acute compartment syndrome |
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Term
| what can dislocations cause |
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Definition
-cartilage cell death
-posttraumatic arthritis
-neurovascular injury
-ankylosis
-avascular necrosis |
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Term
| what are some of the ortho procedures |
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Definition
| -amputation, nail & plate, fx repiar, prosthetics, joint injection |
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Term
| when does death occur from burns |
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Definition
-immediately after
-later from multiorgan failure |
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Term
| what does a burn depth depend on |
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Definition
-temp
-duration of exposure
-specific heat |
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Term
| injury localized to the epidermis |
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Definition
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Term
| burn to the epidermis & superficial dermis |
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Definition
| superficial 2nd degree burn |
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Term
| burn through the epidermis and deep into the dermis |
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Definition
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Term
| full thickness injury through the epidermis & dermis in the subQ fat, underlying muscle, bone |
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Definition
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Term
| pt presents w/ a sunburn and on PE u find no blistering, moderately painful skin that will heal in a few days |
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Definition
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Term
| how do we tx 1st degree burns |
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Definition
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Term
| on PE we find a man who has a burn then extends into the dermis but not all the way through, distended blisters what degree burn is this and what do u want to tell the pt may develop in 24-48 hrs |
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Definition
-2nd degree (partial thickness)
-eschar |
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Term
| wound appear leathery, waxy, white w/ NO erythema that has minimal pain b/c the nerve ending have been burned |
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Definition
| deep-partial thickness 2nd degree burn |
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Term
| on PE we find a burn that has all layers destroyed that's dry and avascular |
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Definition
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Term
| what's the tx for 3rd degree burns |
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Definition
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Term
| what's the tx for 2nd degree burns |
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Definition
-excise tissue
-skin grafts |
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Term
| what's the rule of nines for adults |
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Definition
head=9%
UE=18% (9% each)
LE=36% (18% each)
chest=18%
back=18%
perineum=1% |
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Term
| what's the rule of nines for children |
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Definition
head=18% (front/back)
back=18%
chest=18%
UE=18% (9% each)
LE=27% (13.5 % each)
perineum=1% |
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Term
| what are some of the systemic changes w/ burns |
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Definition
-inflammatory/edema
-renal system
-GI system
-immune system
-hypermetabolism |
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Term
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Definition
-ABC's
-assess for inhalation (smoke, CO, facial burns, edema(
-assess extremities for circulatory compromise
-IV fluids
-foley cath
-draw labs |
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Term
| what are some further tx modalites for burns |
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Definition
| escharotomy, wound excision, skin grafting, prevent infxn, pain management |
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Term
| what are the complications of burns |
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Definition
inhalation injury
sepsis
multiorgan failure |
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Term
| 99% of snake bites are in this subfamily |
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Definition
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Term
| what does snake venom contain |
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Definition
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Term
| what do peptides do in the human |
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Definition
| damage vascular endothelium leading to edema & hypovolemic shock |
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Term
| what do enzymes in snake venom do to humans |
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Definition
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Term
| what do we want to avoid in wound care of snake bites |
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Definition
| cryotherapy, incision & suction, tourniquets, electric shock therapy |
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Term
| how often do u measure the extremity in snake bites |
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Definition
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Term
| what are the SE's of anti-venom |
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Definition
| anaphylaxis, serum sickness, anaphylactoid |
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Term
| what are some surgical tx's for snake bites |
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Definition
-wound debridement
-fasciotomy |
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Term
| how do we tx animal bites |
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Definition
-give tetanus
-debride
-primary or delayed primary closure |
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Term
| injury to the MCP joint from striking another person open mouth |
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Definition
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Term
| if we have a deep or infected animal bite what do we do |
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Definition
| surgical exploration & debridement in OR, IV abs |
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Term
| what are some of the microorganisms in dog/cat bites |
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Definition
pasturella multocida
staph
strep |
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Term
| what are the microorganisms in human bites |
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Definition
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Term
| what do brown recluse spider bites cause |
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Definition
| dermonecrosis, hemolysis, coagulation & platelet aggregation w/ a central area of necrosis |
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Term
| how do we tx brown recluse bites |
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Definition
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