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Peri-op > Acute abdomen, ABCDE and AALS > Flashcards

Acute abdomen, ABCDE and AALS Flashcards

1
Q

What is meant by an acute abdomen?

A

Recent, rapid onset of urgent abdominal or pelvic pathology

Presents with abdominal pain

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2
Q

List 2 differentials for generalised abdominal pain

A
  1. Peritonitis
  2. Ruptured AAA
  3. Intestinal obstruction
  4. Ischaemic colitis
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3
Q

List 2 differentials for RUQ pain

A
  1. Biliary colic
  2. Acute cholecystitis
  3. Acute cholangitis
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4
Q

List 2 differentials for Epigastric pain

A
  1. Acute gastritis
  2. Peptic ulcer disease
  3. Pancreatitis
  4. Ruptured AAA
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5
Q

List 2 differentials for central abdominal pain

A
  1. Ruptured AAA
  2. Intestinal obstruction
  3. Ischaemic colitis
  4. Early stages of appendicitis
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6
Q

List 2 differentials for right iliac fossa pain

A
  1. Acute appendicitis
  2. Ectopic pregnancy
  3. Ruptured ovarian cyst
  4. Ovarian torsion
  5. Meckel’s diverticulitis
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7
Q

List 2 differentials for left iliac fossa pain

A
  1. Diverticulitis
  2. Ectopic pregnancy
  3. Ruptured ovarian cyst
  4. Ovarian torsion
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8
Q

List 2 differentials for suprapubic pain

A
  • Lower UTI
  • Acute urinary retention
  • PID
  • Prostatitis
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9
Q

List 2 differentials for loin to groin pain

A
  1. Renal colic (kidney stones)
  2. Ruptured abdominal aortic aneurysm
  3. Pyelonephritis
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10
Q

List 2 differentials for testicular pain

A
  • Testicular torsion
  • Epididymo-orchitis
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11
Q

List 4 signs of peritonitis

A
  1. Guarding
  2. Rigidity
  3. Rebound tenderness
  4. Coughing test
  5. Percussion tenderness
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12
Q

What is localised peritonitis?

List 2 causes

A

Underlying organ inflammation ie.

  1. Appendicitis
  2. Cholecystitis
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13
Q

What is generalised peritonitis?

List 2 causes

A

Perforation of an abdominal organ releasing contents into peritoneal cavity → inflammation ie.

  1. Perforated duodenal ulcer
  2. Ruptured appendix
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14
Q

SBP is associated with what/who?

Treatment?

A

Spontaneous infection of ascites in patients with liver disease

Treated with broad-spectrum antibiotics (poor prognosis)

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15
Q

What is assessed in A of the ABCDE assessment?

A

Airway

Ensure patient’s airway is patent and secure

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16
Q

What is assessed in B of the ABCDE assessment?

A

Breathing

  • Assess breathing
  • RR
  • O2 sats
  • auscultate lungs
  • provide O2 if required
17
Q

What is assessed in C of the ABCDE assessment?

A

Circulation

  • BP
  • HR
  • Ausculate heart
  • CRT
  • Gain IV access → take bloods and provide fluid if required
18
Q

What is assessed in D of the ABCDE assessment?

A

Disability

  • Assess consciousness level using AVPU or GCS
  • Check blood glucose
19
Q

What is assessed in E of the ABCDE assessment?

A

Exposure

Finish full assessment, incl examination of the abdomen

20
Q

How is the Adult advanced life support management divided?

A
  • ‘shockable’ rhythms: VF, pulseless VT
  • ‘non-shockable’ rhythms: asystole, PEA
21
Q

What is the standard ratio of chest compressions to ventilation in ALS?

A

30:2

Chest compressions are continued while a defibrillator is charged

22
Q

Protocol for non-shockable rhythms in ALS?

A

Adrenaline 1 mg as soon as possible

Continue CPR until the cause of arrest is identified and treated

Further adrenaline 1 mg IV should be given every 3-5 min during alternate 2 min loops of CPR

23
Q

Protocol for shockable rhythms if the arrest is unwitnessed?

A

Single shock followed by 2 minutes of CPR

After 3 cycles administer 1mg adrenaline and 300mg amiodarone while CPR is restarted

  • Further 150mg amiodarone after 5 shocks if patient is still in VF/pVT
  • Adrenaline should be repeated every 3-5 minutes whilst CPR continues
24
Q

Protocol for shockable rhythms if it is witnessed (connected to a monitor)

A

Upto 3 quick successive (stacked) shocks

1mg adrenaline and 300mg amiodarone while CPR is started

  • Further 150mg amiodarone after 5 shocks if patient is still in VF/pVT
  • Adrenaline should be repeated every 3-5 minutes whilst CPR continues

Check this

25
Q

What is recommended for drug delivery in ALS?

A

First line: IV access should be attempted

If IV access cannot be achieved then drugs should be given via the intraosseous route (IO)

26
Q

Medication and protocol for a VF/VT cardiac arrest?

A

Adrenaline 1 mg is given once chest compressions have restarted after the third shock

Repeat adrenaline 1mg every 3-5 minutes whilst ALS continues

27
Q

Causes of reversible cardiac arrest

(H’s and T’s)

A
  • Hypoxia
  • Hypovolaemia
  • Hyper/hypokalaemia, hypoglycaemia, hypocalcaemia, acidaemia
  • Hypothermia
  • Thrombosis (cardiac or pulmonary)
  • Tension pneumothorax
  • Tamponade
  • Toxins

Peri-op (22 decks)

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