Acute Care Flashcards
What do you give to a patient whose heart rate is low - Medication?
Atropine
What is the long term treatment of bradycardia?
Pacemaker
What would you use for a patient with tachycardia?
Beta-blockers
What are 3 potential triggers of sinus tachycardia?
Alcohol
Caffeine
Nicotine
What to give to a patient to increase contractility of their heart?
Adrenaline
Noradrenaline
Positive Inotropes
What could you give to decrease heart contractility?
Labetalol - cardiac specific beta blocker
What will increase systolic and diastolic BP and preload?
FLUIDS
What drug would be used to decrease systolic BP?
Calcium Channel Blocker
What could be used to decrease diastolic BP and preload?
Diuretics
What are the 3 main brain bleeds?
Subarachnoid
Subdural
Extradural
What is the common cause of a subarachnoid haemorrhage?
And what is the treatment?
A ruptured brain aneurysm
Coil or clip the aneurysm
Subdural haemorrhages can be acute or chronic. How would you diagnose a subdural haemorrhage on a CT brain.
Banana shape.
Acute - hyperdense - lighter
Chronic - Hypodense - darker
What is the common cause of chronic subdural haemorrhage?
Older person on anti-coagulant who has had a minor fall or head injury or a alcoholic.
What is the management for subdural haematoma? (large, small, acute and chronic)
If small and asymptomatic then would want to observe and treat conservatively.
If larger, symptomatic or has midline shift then want to do surgery.
If chronic then want to do burr holes to drain.
If acute want to do a craniotomy.
What is the common cause of a acute subdural haematoma?
serious high speed head injury
e.g. car crash, fall or violent assault
On a CT head there is a haematoma the shape of a lemon. What is the name of this?
Extradural haematoma
What is the main cause of extradural haematoma?
Skull fracture - trauma
What artery is most commonly responsible for a extradural haematoma?
Middle meningeal artery
What is the management for a extradural haematoma?
Initially stabilise the patient
Burr holes or craniotomy dependent on severity and time scale of bleed.
What is the adrenaline dose for anaphylaxis in a adult?
1:1000 concentration
500 mcg IM (0.5ml)
What is the adrenaline dose for anaphylaxis in a child between 6-12?
1:1000
300mcg (0.3ml)
What is the adrenaline dose for anaphylaxis in a child between 6 years to 6 months?
1:1000
150mcg (0.15 ml)
What is the adrenaline dose for anaphylaxis in a child under 6 months old?
1:1000
100-150mcg (0.1-0.15 ml)
What is the adrenaline dose for cardiac arrest?
1:10000
100mcg/ml
10ml to give 1mg
What is the sepsis 6?
Give fluids Give oxygen Give IV antibiotics Take a urine sample Take a lactate Take blood cultures
What are the 5 potential causes for shock?
Cardiogenic Septic Neurogenic Hypovolaemia Anaphylactic
What are the potential causes of cardiorespiratory arrest?
4H’s and 4T’s
Hypoxia
Hypovolaemia
Hyperkalaemia/Hypokalaemia
Hypothermia
Tension Pneumothorax
Cardiac Tamponade
Drug toxicity and therapeutics
Thromboembolism
What drugs should be stopped in AKI as they may worsen renal function?
NAAAD?
NSAID (except aspirin at 75mg) Aminoglycosides ACE inhibitor ARB Diuretics
What drugs should be stopped in AKI due to increased risk of toxicity? (3)
Lithium
Metformin
Digoxin
What ECG changes are shows with Hyperkalaemia?
Tented T waves
Loss of P waves
broad QRS complexes
Sinusoidal wave pattern
What can be given to manage hyperkalaemia?
Calcium gluconate
Dextrose/insulin
What ECG changes are shown in hypokalaemia?
U waves Small or absent T waves Prolonged PR interval ST depression Long QT
