ABCDE + ALS

Question 1

what does ABCDE stand for

Answer 1

Airway

Breathing

Circulation

Disability

Exposure

Question 2

How to assess an airway

Answer 2

check patency - can patient speak in full sentences?

Noises - gurgling/gasping/snoring/stridor/wheeze – partial obstruction?

Look in mouth if apporopriate- foreign body

Question 3

methods to open + maintain an airway

Answer 3

Head tilt + chin lift

Jaw thrust

Airway adjuncts

Suction i.e. vomit in mouth

Question 4

types of airway adjunct

Answer 4

oropharyngeal airway (guedel)

nasopharyngeal

supraglottic (Igel)

laryngeal mask airway

Question 5

how to assess breathing

Answer 5

Rate, rythmn, depth, acessory muscle use

Inspection - Neck + chest

Palpation - trachea + chest expansion

Percussion

Auscultation

Saturations

Question 6

signs of increased work of breathing

Answer 6

increased resp rate

accessory muscle use

grunting

subcostal recession

nasal flare

Question 7

how is oxygen given in an emergency situation

Answer 7

15L via non-rebreather mask

Question 8

how to assess circulation

Answer 8

Pulse - rate, rythmn, character

BP

Capillary refil time

Listen to heart

Feel patient - cold/clammy

Peripheries - perfusion / oedema

Question 9

what procedures should be performed when assessing circulation

Answer 9

IV access - grey wide bore gannulas

Emergency bloods e.g. FBC, U+Es, coag screen, LFTs, CRP

Fluid administration

ECG

Question 10

What fluid should be given if patient is hypotensive?

Answer 10

500mL Hartmanns / 0.9% Sodium chloride over 15 mins

(250ml if any evidence of HF)

Question 11

how to assess disability

Answer 11

AVPU

Pupils - equal / reactive

Blood sugar

GCS

Question 12

how to assess exposure

Answer 12

temperature

expose patient - looking for rashes/ trauma / clinical signs

output of drains, stomas, catheters

Question 13

What should you do if a patient is unresponsive + not breathing normally

Answer 13

call for help / resuscitation team

CPR 30:2

Attach defibrillator

Question 14

what are the shockable rythmns

Answer 14

Ventricullar fibrillation

Pulseless VT

Question 15

what rhythms are non-shockable

Answer 15

asystole

Pulseless electrical activity

Question 16

what drugs should be given in cardiac arrest?

Answer 16

Adrenaline 1mg IV every 3-5 mins

Amiodarone 300mg IV after 3 shocks

Question 17

What are the reversible causes of cardiac arrest?

Answer 17

Hypoxia

Hypovolaemia

Hypo/hyperkalaemia

Hypothermia

Thrombosis

Tension Pneumothorax

Tamponade - cardiac

Toxins

Question 18

treatment of hyperkalaemia

Answer 18

10mls 10% calcium gluconate

(+ glucose + insulin)

Question 19

signs of cardiac tamponade

Answer 19

Becks triad: low BP, increased JVP, muffled heart sounds

pulsus paradoxus (pulse fades on inspiration)

Kussmauls sign: increased JVP on inspiration

Question 20

how is cardiac tamponade diagnosed?

Answer 20

Echo

Question 21

treatment of cardiac tamponade

Answer 21

pericardiocentesis under echo guidance

Question 22

pathophysiology of a tension pneumothorax

Answer 22

trauma to chest wall creates a one way valve that lets air into, but not out of, the plural space – air is drawn into lungs + trapped in plural space during expiration

increasing pressure within thorax with each breath

Question 23

signs of tension pneumothorax

Answer 23

tracheal deviation away from affected side

reduced air entry on affected side

resonant percussion on affected side

tachycardia

hypotension

Question 24

management of tension pneumothorax

Answer 24

large bore cannula into 2nd intercostal space midclavicular line to relieve pressure, then chest train as definitive management

Question 25

what are the componenets of GCS

Answer 25

eye opening

best verbal response

best motor response

Question 26

what is the GCS scored out of?

Answer 26

15

Question 27

how is eye opening scored on GCS

Answer 27

4 = spontaneous

3 = to voice

2 = to pain

1 = none

Question 28

how is best verbal response scored on GCS?

Answer 28

5 = Orientated

4 = Confused

3 = Inappropriate words

2 = Sounds

1 = None

Question 29

how is best motor response scored on GCS

Answer 29

6 = Obeys commands

5 = Localises to pain

4 = Normal Flexion

3 = Abnormal flexion

2 = Extension

1 = None

Question 31

what physiological changes might a pregnant person display

Answer 31

resp: increased minute ventilation (increased resp rate + tidal volume), resp alkalsos, increased oxygen consumption

Cardio: increased cardiac output, decreased BP

Renal: decreased urea + creatinine due to increased GFR

Haemoglobin: anaemia