Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 4 > Acute 1 > Flashcards

Acute 1 Flashcards

1
Q

What suggests partial loss of airway and give some examples

A
  • Added sounds
  • Snore (loss of tone, usually soft palate)
  • Gargle (fluid)
  • Stridor (laryngeal obstruction)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What suggests complete block of airway?

A
  • Silent airway
  • Seesaw breathing in peri-arrest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some causes of loss of airway?

A
  • LOC (most common, causes loss of tone)
  • Foreign bodies (most common in kids)
  • Blood or vomit
  • Oedema (burns, infection, anaphylaxis)
  • Tumour or abscess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the process of opening the airway?

A

1) Head tilt chin lift
2) Airway adjunct
3) Call anaesthetist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are 2 airway adjuncts and when are they used?

A
  • Nasopharyngeal (conscious patient, contraindicated in basal skull fracture)
  • Oropharyngeal (patient must be unconscious)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What action should you take in relation to breathing in A-E assessment?

A
  • 15L oxygen through non-rebreather to target sats
  • ABG pre- and post-oxygen
  • Reassess (are sats going up)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What action should you take in A-E in relation to circulation?

A
  • 2 wide bore cannulae and 500ml fluid bolus (250ml in CCF)
  • Relevant bloods
  • ECG
  • Urine output
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Consideration in disability for A-E?

A
  • Are they conscious
  • AVPU
  • GCS (if below 8 secure airway)
  • Blood glucose (if below 4 give 100ml 20% dextrose)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the big 3 for anaphylaxis?

A
  • Rapid onset and deterioration
  • Life threatening ABC symptoms
  • Skin and mucosal changes (absent in 20%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some triggers of anaphylaxis?

A
  • Venom (bee sting)
  • Food (nuts and shellfish mainly)
  • Latex (delayed onset and not as bad)
  • Drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What drugs can cause anaphylaxis?

A
  • Antibiotics, anaesthetics and contrast
  • NSAIDs (mast cell independent bronchospasm)
  • Vancomycin (non-allergic mast cell degranulation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the ranking system for anaphylaxis?

A

Ring and Messmer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the 4 levels of the Ring and Messmer system?

A

1) Skin changes only
2) Slight hypotension or tachycardia
3) Severe hypotension or tachycardia
4) Cardiac arrest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the basic management for anaphylaxis?

A

1) Adrenaline (0.5ml 1 in 1000; (repeated every 5 mins)
2) 500ml fluid bolus
3) Chlorpheniramine (IM or slow IV)
4) Hydrocortisone (IM or slow IV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What amounts of adrenaline are given to different ages in anaphylaxis?

A
  • Adults: 0.5ml 1 in 1000 (500mcg)
  • Kids 6-12: 0.3ml 1 in 1000 (300mcg)
  • Kids under 6: 0.15ml 1 in 1000
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What amounts of chlorpheniramine are give to different ages?

A
  • Adults: 10mcg
  • Kids 6-12: 5mcg
  • Kids under 6: 2.5mcg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What amounts of hydrocortisone are given to different ages?

A
  • Adults: 200mg
  • Kids 6-12: 100mg
  • Kid under 6: 50mg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the main investigation for anaphylaxis?

A
  • Mast cell try-take when stable
  • At 2 and 24 hours
19
Q

Further notes son anaphylaxis?

A
  • Can’t be diagnosed until seen specialist (suspected anaphylaxis before)
  • Admit kid under 16
  • Kids over 16 require 6-12 hours observation
20
Q

What are biphasic and refractive anaphylactic reactions?

A
  • Biphasic: second onset of symptoms within 72 hours despite no exposure to trigger
  • Refractory: continuing anaphylaxis despite 2 doses IM adrenaline
21
Q

What are the big 3 signs of sepsis?

A
  • Vasodilation
  • Oedema
  • Coagulation (DIC: test for with fibrinogen level)
22
Q

What are the 2 most common causes of sepsis?

A

1) Pneumonia (35%; strep pneumonia)
2) UTI (15%; E. coli; UTI most common in over 65s)

23
Q

What is the management for sepsis?

A

The Sepsis 6

24
Q

What are the 3 in for the sepsis 6?

A
  • IV broad spectrum antibiotics
  • 500ml IV fluids in 15 mins (30ml/kg/hour in septic shock)
  • 15L oxygen
25
Q

What are the 3 out for the sepsis 6?

A
  • Bloods cultures
  • Lactate (VBG)
  • Urine output
26
Q

What are some signs of sepsis?

A
  • Evidence of original infection
  • Oliguria
  • Cyanosis
  • New onset AF
  • Non-blanching rash (meningococcal)
  • Bounding pulse
  • Quick cap refill
27
Q

What QSOFA score suggests high mortality?

A

> 2

28
Q

What are the red flags for sepsis?

A
  • Confusion
  • RR>35
  • BP <90 or 20% lower than usual
  • Lactate >2
  • Coagulopathy
  • HR>130
  • Recent chemo
29
Q

What is neutropenic sepsis?

A
  • Sepsis with neutrophils <1
  • Temperature >35 in neutropenia is always sepsis
  • Requires immediate tazocin treatment
30
Q

What 2 drugs are in tacozin?

A

Piperacillin and tazobactam

31
Q

What its septic shock?

A
  • Sepsis that is not responding to treatment
  • BP <90
  • Lactate >4
32
Q

Where are the 2 general area the human body can bleed into?

A
  • Where there’s lots of space (abdomen, pelvis, long bone; results in typical symptoms)
  • Where’s there’s not much space (intracranial and pericardium; result in pressure symptoms)
33
Q

What are the typical symptoms of acute haemorrhage?

A
  • Pallor
  • Cold
  • Clammy
  • Tachycardia
34
Q

When might tachycardia be hidden in acute haemorrhage?

A
  • Young people compensate well (the narrow off cliff)
  • Old people on rate control drugs (e.g. beta-blockers)
35
Q

What is the classification of acute haemorrhage?

A

1) Normal physiology (<15%)
2) Slight hypotension or tachycardia (15-30%)
3) Severe hypotension or tachycardia (30-40%)
4) Major haemorrhage (>40%)

36
Q

When should you consider a concealed haemorrhage?

A

Young trauma patient who seems stable except fro tachycardia

37
Q

What is the lethal triad of haemorrhage and why?

A
  • Hypotension (keep warm)
  • Acidosis (from tissue hypo perfusion resulting in lactic acidosis)
  • Coagulopathy
38
Q

How do the lethal triad affect haemorrhage?

A

They all impair platelet function

39
Q

How do you prevent the lethal triad?

A

Damage control resuscitation

40
Q

What are the 3 components of damage control resus?

A
  • Permissive hypotension (MAP of 65 and systolic of 90)
  • Haemostatic resus
  • Early damage control surgery
41
Q

What are the BP targets in permissive hypotension?

A
  • MAP or 65
  • Systolic of 90
42
Q

How should haemostat resus be given?

A
  • Don’t use crystalloids
  • Give packed red cells, FFP and platelets in 2:1:1 ratio
43
Q

What other medications can be considered in acute haemorrhage?

A
  • TXA 1g bolus and then 1g over 8 hours
  • Calcium chloride 10% 10ml over 10 mins if calcium is below 1.1
44
Q

What is acute coagulopathy of bleeding?

A
  • Presents in the same way as acute haemorrhage but is independent of it
  • Due to protein C and systemic fibrinolysis
  • Manage the same as acute haemorrhage

Year 4 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions