ABCDE - Specific Flashcards
What should be added to the second bag of fluids in DKA in most cases?
40mmol KCl
What four drugs should you give to a patient with ACS? How would you give each one?
Morphine (IV), GTN (sublingual), aspirin and ticagrelor (oral)
You shouldn’t give IV furosemide to patients with pulmonary oedema who have what clinical sign? What should you do instead?
Hypotension - contact the critical care team
What dose of nebulised ipratropium bromide should be given in acute asthma/COPD?
500mcg
What should be done when blood glucose falls below 15mmol/l in DKA?
Start an infusion of 5% dextrose in 0.9% saline
What products will you be given upon activation of the major haemorrhage protocol?
4 x units of RBCs and 4 x units of FFP
What dose of IV lorazepam should be given for a seizure?
4mg
Assuming the patient has had no other benzodiazepines, how soon can a dose be repeated in a seizing patient?
After 5 minutes
What three drugs should you give to a patient with anaphylaxis? How would you give each one?
Adrenaline (IM), hydrocortisone (IV) and chlorphenamine (IV)
What dose of oral aspirin should be given in ACS?
300mg
How often can the dose of adrenaline be repeated in anaphylaxis?
Every 5 minutes
How often can nebulised salbutamol be repeated?
Every 15 - 30 minutes
What dose of oral ticagrelor should be given in ACS?
180mg
Patients with clinical evidence of a STEMI require what further intervention?
Primary PCI
What medications are given to drive potassium into cells in hyperkalaemia?
10 units Actrapid in 50ml 50% dextrose
What further intervention can be considered for patients with acute COPD who are not improving and have evidence of type 2 respiratory failure?
Non-invasive ventilation
What dose of IV amiodarone should be given in cardiac arrest?
300mg
What dose of IV metronidazole should be given to septic patients?
500mg (tds)
What investigation can be used to give you a rapid lactate measurement in septic patients?
ABG/VBG
What is the immediate emergency treatment for a tension pneumothorax?
Needle decompression into the 2nd intercostal space, mid-clavicular line (on the affected side)
How often can a dose of sublingual GTN be repeated in ACS?
Every 5 minutes, up to 3 times
If a patient with DKA has a systolic BP > 90mmHg, what fluids should be given?
1L of 0.9% saline over 1 hour
When should IV amiodarone be given in cardiac arrest?
After 3 shocks
If there is no response to benzodiazepines in a seizing patient, what drug should be tried next?
IV infusion of phenytoin
What dose of chlorphenamine should be given in anaphylaxis?
10mg
What are some additional interventions if a COPD exacerbation is suspected to be infective?
Take blood and sputum cultures, give antibiotics
What antibiotics should be given to patients with sepsis of unknown origin who are penicillin allergic?
IV vancomycin, metronidazole and gentamicin
What dose of oral prednisolone should be given in acute COPD?
30mg
What medication should be given to patients in acute pulmonary oedema?
IV furosemide 40mg
What are the two treatment options for severe hypoglycaemia?
150ml 10% glucose over 10-15 minutes OR 1mg glucagon IM
What is included in the sepsis 6 bundle?
Take blood cultures, serial lactate measurements and urine output; give oxygen, IV fluids and IV antibiotics
What dose of IV morphine is a reasonable starting point for patients with ACS?
5mg (may consider giving less for frail patients)
What dose of sublingual GTN should be given in ACS?
400mcg
What additional medication may be given in trauma patients where the major haemorrhage protocol has been activated?
1g tranexamic acid IV
What antibiotics should be given to patients with sepsis of unknown origin?
IV amoxicillin, metronidazole and gentamicin
What dose of nebulised salbutamol should be given in acute asthma/COPD?
5mg
Giving GTN for ACS is contraindicated in patients with which clinical sign?
Hypotension
In trauma situations, in what ratio should RBCs and FFP be given in the major haemorrhage protocol?
1: 1
What is the management for a patient with a massive PE (i.e. PE with haemodynamic instability)?
Thrombolysis with IV alteplase
When should IV adrenaline be given in cardiac arrest?
Every 3-5 minutes
What dose of naloxone should be given in opioid overdose?
400mcg IV
What is the management for a patient with a PE without haemodynamic instability?
Oral rivaroxaban 15mg
What dose of oral prednisolone should be given in acute asthma?
40-50mg
What dose of IV hydrocortisone should be given in acute asthma?
100mg
In non-trauma situations, in what ratio should RBCs and FFP be given in the major haemorrhage protocol?
2: 1
What antibiotic should be given for an infective COPD exacerbation?
Oral amoxicillin 500mg
What dose of IV adrenaline should be given in cardiac arrest?
1mg of 1: 10,000
What dose of IV amoxicillin should be given to septic patients?
1g (tds)
What dose of adrenaline should be given in anaphylaxis?
0.5mls 1: 1000 (500mcg)
What dose of PR diazepam should be given for a seizure?
10mg
What dose of hydrocortisone should be given in anaphylaxis?
200mg
How should patients with DKA be given insulin?
Fixed rate infusion - 0.1 units/kg/hour
What three drugs should you give to a patient with acute asthma? How would you give each one?
Salbutamol (neb), ipratropium bromide (neb) and prednisolone (oral)/hydrocortisone (IV)
What dose of buccal midazolam should be given for a seizure?
10mg
How may benzodiazepines be given in the treatment of seizures?
IV lorazepam, buccal midazolam or PR diazepam
What insulin should be given in DKA?
50 units Actrapid in 50mls 0.9% saline
How should patients with HHS be rehydrated?
0.9% saline infusion over 48 hours
After initiating cardiac monitoring, what drug is given to stabilise the cardiac membrane in hyperkalaemia?
10mls 10% calcium gluconate
What are the most important investigations to do in an individual with DKA?
ABG and ECG
After treatment for DKA, when should individuals be switched from a fixed rate infusion to a sliding scale?
When blood glucose is < 11mmol/L
What should be done with regards to an individual’s normal insulin regime when being treated for DKA?
Continue long acting insulin, stop short acting insulin
