Acute care Flashcards
what are the key blood tests to do in suspected paracetamol OD?
FBC, U&Es, LFTS, coagulation, glucose
coagulation will be 1st sign of liver damage - raised TT or INR
AST is most likely liver enzyme to rise - usually occurs after 18-24 hours
when can serum paracetamol levels be checked following OD?
4 hours post-consumption
how is paracetamol OD managed?
acetylcysteine
if a patient presents with a toxic OD of paracetamol (150mg/kg) within 8 hours of consumption, what can be given?
activated charcoal
can only send serum paracetamol after 4 hours
what is the antidote for benzos OD?
flumazenil
what is the antidote for opioid OD?
naloxone
what causes caridogenic shock?
reduced CO as a result of reduced cardiac contractility
name 2 physical signs that are specific to obstructive shock?
distended neck veins
raised JVP
what is the initial management of hypovolemic shock?
fluid challenge
what causes the bounding pulse seen in distributive shock?
seen in sepsis, anaphylaxis or cord damage
in distributive shock, there is peripheral vasodilation due to inflammatory mediators
to compensate for the resultant drop in BP, there is an increase in stroke volume, causing increased CO
the increased stroke volume causes a bounding pulse
what is the initial management of distributive shock?
- sepsis 6
- fluid challenge (500ml saline)
- +/- vasopressors
name the 4 main types of shock?
cardiogenic
hypovolemic
obstructive
distributive
name 3 causes of cardiogenic shock?
post MI
malignant dysrhythmia
acute myocarditis
in which type of shock must you be careful with fluid resuscitation?
cardiogenic shock
compare the immediate management of a cardiac arrest in adults and infants?
infants: 5 rescue breaths immediately, 15 compressions followed by 2 breaths
adults: 30 compressions followed by 2 breaths
