Acute care Flashcards
Anaphylaxis, adrenaline dose
IM (repeat after 5 mins if no improvement)
Adult (>12y) 500micrograms/0.5ml
Child (6-12y) 300micrograms/0.3ml
Child under 6 150micrograms (0.15ml)
Suggest what you might examine to assess fluid status?
pulse BP Cap refill JVP presence of oedema postural hypotension
2 blood tests to help assess fluid status?
FBC
U+E
How often should a patient on maintenance fluids be reassessed?
Daily
Basic fluid resus dose?
0.9%NaCl 500ml in less than 15 mins
What is the maximum number of boluses of crystalloid that can be given before seeking expert help?
4x 500ml bolus
So, a total of 2L
Routine fluid maintenance: advised liquidintake?
25-30ml/Kg/day
Routine fluid maintenance:
Advised potassium, sodium and chloride intake?
1mmol/kg/day
Routine fluid maintenance:
Advised intake of glucose?
50-100g/day
helps prevent starvation ketosis
In what patient groups would you want to prescribe less fluid?
Elderly/frail
renal impairment
Cardiac failure
Malnourished (or other risk of refeeding syndrome)
Give 4 reasons to perform a clotting screen
Suspected coagulopathy
Monitoring a patient who is taking anti-coagulants
Routine pre-op
Check synthetic function of liver
What tests are on the coagulation screen?
PT/INR
APTT
Thrombin time
prothrombin time measures which pathway?
Extrinsic
PT (play tennis outside)
Activated partial thromboplastin time (APTT) measures which pathway?
Intrinsic
APTT (play table tennis inside)
Which diseases would result in an abnormal APTT
Haemophilia (A,B and C)
vW disease
