ABCDE

Question 1

What are three basic airway maneouvres?

Answer 1

jaw thrust, head tilt chin lift, naso/oropharyngeal airways

Question 2

What should you assess in B/breathing?

Answer 2

1. Observations
   - RR, SpO2
2. Inspection
   - JVP, signs of resp distress
3. Palpation
   - Trachea, chest expansion
4. Percussion
   - Hyper-resonance e.g. pneumothorax, dullness e.g. consolidation or pleural effusion
5. Auscultation
   - Bronchial breathing, reduced breath sounds, unilateral or bilateral crackles
6. Investigations
   - CXR and ABG

Question 3

What should you do for C/circulation?

Answer 3

1. Obs
   - HR, BP, temp
2. Inspection
   - JVP, dry mouth, peripheries (Warm, cold, cyanosed)
3. Exam
   - Cap refill
4. Palpation
   - Central and peripheral puls, ankle/sacral oedema
5. Auscultation
6. Fluid balance
7. Inv/procedures
   - cannulation, bloods and cultures, ECG, catheterisation, hypovolaemia–> fluid challenge/resus

Question 4

At which part of assessment should you pick up on hypovolaemia and how should you treat it?

Answer 4

circulation. Lay patient supine and raise legs, give 250ml-500ml over 15 mins (crystalloid)

Question 5

What should you do if they don’t respond to fluid challenge?

Answer 5

escalate, consider inotropic or vassopressor support

Question 6

What is done in D/disability?

Answer 6

Conscious level- AVPU, pupils, check drug charts.
Blood glucose, urine dip/keto
Imaging (CT head if intracranial pathology)

Question 7

What is assess in E/everything else?

Answer 7

expose patient

-rashes, abnormal bruising, calves, lines, catheter, surgical wounds, drain output

Question 8

Which will kill you faster- hypercapnia or hypoxia?

Answer 8

hypoxia

Question 9

Which pH disorder is asthma typically associated with during exacerbation?

Answer 9

respiratory alkalosis

Question 10

If a young person is retaining CO2 during asthmatic attack, should you be worried?

Answer 10

yes, this a medical emergency

Question 11

A patient required salbutamol neb and oxygen delivery. How can you maximise the amount of oxygen delivered?

Answer 11

Neb set to 6L of oxygen at wall (no more no less, unsure why) + can utilise nasal canula at 4L, therefore 10L total of oxygen

Question 12

What is the key to a good SBAR in a critically unwell patient?

Answer 12

Start with headline first…Express concern! E.g. ‘I have a 37 y/o lady with signs of upper GI bleeding, she is acutely unwell and I am very concerned and would appreciate your help.

Be specific with values- don’t say low BP or high HR, be precise with value e.g. systolic BP of 90 and HR of 130.

Question 13

What is the standard units of blood to transfuse when bleeding?

Answer 13

4 units of packed red cells

Question 14

Which antiemetic should you give to elderly patient?

Answer 14

ondansetron (cyclizine is poorly tolerated in elderly)

Question 15

Someone in A&E shows evidence of inferior STEMI. You wish to refer them for a PCI. What must you do first?

Answer 15

Fax ECG to PCI centre