10. ECG and X-Ray

Question 1

What are poor indications on an ECG?

Answer 1

ST elevation- bad things
ST depression- myocardial ischemaia
T wave inversion- myocardial ischemia

Question 2

How do you manage a patient with an ST elevated MI

Answer 2

Morphine
Nitrates
Aspirin 
Low molecular weight heparin 
Speak to cardiologist ASAP for PCI

Question 3

Describe the breakdown of an ECG sites

Answer 3

Lateral- I,AvL, V5, V6

Inferior- II, III, AvF

Septal- V1 and V2 (anteroseptal area)

Anterior-V1-V4

Question 4

What is a good website for critical care medicine?

Answer 4

Life in the fast lane website

Question 5

What is upper lobe venous diversion?

Answer 5

Caused by increased left atrial pressure in situations such as pulmonary oedema

The vasculature of the lower pulmonary tree is as thick as the upper

Question 6

What produces a bat wing appearance?

Answer 6

Pulmonary oedema

Question 7

If you are managing a deteriorating patient outside of critical care what should you do?

Answer 7

Look for co-morbidities
ECG and tropo Jin
Bloods (FBC, U&E’s, LFT’s, CRP)
Blood culture, sputum cultures 
CXR/CT

Question 8

What is the management of a patient outside of ICU who’s airways disease is worsening

Answer 8

Nebuliser bronchodilators
Oral corticosteroids
Antibiotics if increased sputum production
NIV is type 2 COPD patients

Question 9

What is the next line drug for someone who is penicillin allergic and can’t take co-amoxiclac

Answer 9

Doxycycline