Acute Flashcards
Cardiac arrest
CPR: 15:2 /3:1
Shockable - VT/pulseless VT: 4J/kg
Non-shockable - PEA/asystole: adrenaline 10mcg/kg (0.1mL/kg 1:10 000) every 2 min for 20 min
SVT
Vagal stimulation
Shocked IV: adenosine 100-500mcg/kg every 2 min
Shocked no IV: synchronous DC shock 1-2J/kg
VT/VF
No pulse: synchronous DC shock 4J/kg
Pulse not shocked: amiodarone 5mg/kg
Pulse shocked: synchronous DC shock 1-2J/kg
Bradycardia
Vagal: atropine 20mcg/kg
Not vagal: adrenaline 10mcg/kg
Raised ICP
Mannitol
Shock
Inotropes
Cold shock: dobutamine/adrenaline
Warm (sepsis, anaphylaxis): dopamine/noradrenaline
Anaphylaxis
IM adrenaline 10mcg/kg (0.1mL 1:1000)
Neb adrenaline 500mcg/kg (0.5mL 1:1000), as adjunct
Estimated weight formula
<5yo = (2 x age) + 8 >6yo = (3 x age) + 7
Mean SBP formula
(2 x age) + 85
Anion gap formula
(Na + K) - (Cl + HCO3)
Normal = 10-15
Metabolic acidosis
Normal anion gap (Na + K) - (Cl + HCO3): RTA, diarrhoea, hyperchloraemia, Addisons
High anion gap i.e. high H+: SHOCK, hypoxia, DKA, renal failure
Metabolic alkalosis
Vomiting, steroid excess
Glasgow Coma Scale
Eye response:
4: Open spontaneously
3: Open to verbal command
2: Open in response to pain
1: No response
Verbal response:
5: Talking/orientated
4: Confused speech/disorientated
3: Inappropriate words
2: Incomprenhensible sounds
1: No response
Motor response:
6: Obeys commands
5: Localises pain
4: Withdraws from pain
3: Abnormal flexion
2: Extension
1: No response
Poisoning - causes of constricted pupils (miosis)
cOnstricted = Opioids, Organophosphates
Opiates: codeine, morphine, heroin
Organophosphate: insecticides, herbicides
Clonidine
Poisoning - causes of dilated pupils (mydriasis)
dilAted = Amphetamines, Atropine, tcA, Antihistamine
AmphetamINEs: cocaine, speed, crack, crystal meth
AtropINE
tcA: amytriptylINE, imipramINE
AntihistamINEs
Poisoning - causes of fever
Anticholinergics e.g. antihistamines, TCA
Ecstacy
Cocaine
Salicylates e.g. aspirin, NSAIDs
Poisoning - causes of hypothermia
Barbiturates e.g. phenobarbitone
Alcohol
Toxidromes - anticholinergics e.g. antihistamines, TCA (amitryptiline, imipramine)
Agitation Dry skin Dilated pupils (mydriasis) Fever Hallucination
Toxidromes - serotonin syndrome - SSRIs e.g. fluoxetine, sertraline, escitalopram
Hyperreflexia Hypertonia/rigidity Myoclonus Hyperthermia Autonomic instability
Toxidromes - tricyclic antidepressants e.g. amytriptiline, imipramide
Convulsions
Coma
Prolonged QRS
Toxidromes - Ecstacy
Agitated
Flushed
Sweaty
Dilated pupils (mydriasis)
Toxidromes - sympathomimetic e.g. amphetamines, cocaine
Sweating Tremor Hyperactive Dilated pupils (mydriasis) Dysrhythmia
Toxidromes - organophosphates e.g. pesticides, herbicides
Salivation Lacrimation Urination Sweating Constricted pupils (miosis) *opposite of anticholinergic*
Toxidromes - salicylates e.g. aspirin
Vomiting Tachypnoea Fever Bleeding Metabolic acidosis
Toxidromes - phenothiazine e.g. antipsychotics, antiemetics
Ataxia
Oculogyric crisis
Torsion of head and neck - EPSE (extrapyramidal movement disorders with antipsychotics)
Toxidromes - opioids e.g. morphine, heroin, codeine
Respiratory depression
Constricted pupils (miosis)
Coma
Toxidromes - hydrocarbon (fumes)
Pulmonary oedema
Toxidromes - methanol (home alcohol)
Blindness
Toxidromes - calcium channel blockers e.g. verapamil
Heart block
Hypotension
Insulin resistance
Hypoglycaemia
Toxidromes - alcohol
Hypoglycaemia
Toxidromes - brown snake
Coagulopathy
Toxidromes - tiger snake
Neurotoxicity
Carbon manoxide poisoning treatment
100% O2
Hyperbaric oxygen
Methaemaglobinaemia poisoning treatment
Methaline blue
Cyanide poisoning treatment
Hydroxocobalamin
Antifreeze poisoning treatment
Fomepizole
Alcohol
Iron overload treatment
Desferroxamine
Opioid antidote
Naloxone
Extrapyramidal effects treatment
Benztropine
Malignant hyperthermia treatment
Zantropine
Snake bite treatment (brown snake, tiger snake)
Antivenom (IgG)
