Acute Care - ABCDE and Trauma Flashcards
what can cause a metabolic acidosis with a raised anion gap?
poisoning
e.g salicylate
methanol
DKA
what is the ABG progression with salicylic acid?
resp alkalosis (due to hypoventilation) met acidosis
what is the ABG with DKA?
met acidosis
for c, in cABCDE, what are the floor and 4 places to check?
chest
abdo (feel)
pelvis
long bones (pulses)
what should be given to all pts to try stop bleeding?
tranxemic acid (antifibrinolytic)
in A, what should be done?
look (mouth and chest moving)
listen
feel
what is the difference between stridor and wheeze?
stridor is inspiratory
wheeze is expiratory
what can be changed in A?
suction head tilt chin lift protect C spine nasopharyngeal oropharyngeal (guedell) laryngeal (igel)
how are guedell airways measured?
mandible to incisors
in B, what should be done?
look for hypoxia signs sP02 RR chest movements trachea chest expansion auscultate percuss
what can be changed in B?
oxygen (15L/min in a non rebreather)
nebuliser
ABG
CXR
what should be done in C?
pulse CRT HR BP feel calves abdo exam pelvic binder/Kendrick splint
what can be changed in C?
fluids ECG IV access (grey) G+S/crossmatch
what can be done in D?
AVPU GCS pupils BM temperature recovery position
what can be changed in D?
give glucose/insulin
warm
what should be done in E?
expose patient
temperature
fluid balance
SEWS
what scan can be done in E?
FAST SCAN (US for fluid in RUQ LF pericardium rectovesical/uterine pouch)
what is a tension pneumothorax?
one way valve between lung and pleural cavity
lung collapses
signs of a tension pneumothorax?
tracheal deviation
reduced breath sounds
hyper resonant percussion
Tx for tension pneumothorax?
large bore cannula to 2nd ICS
what is a haemothorax? signs?
blood collecting in the pleural cavity
dull percussion
low BP
tachycardic
Tx for haemothorax?
fluids
blood
chest drain
thoracotomy
what happens in a flail chest?
several rib # create an area of the chest that moves paradoxically
what is an open pneumothorax?
chest wound
sucks in air to the pleural space
can progress to tension pneumothorax
what can cause distributive shock?
anaphylaxis
burns
neurogenic
what happens in distributive shock?
excessive systemic vasodilation and leakage of fluid from the capillaries to tissue
what happens in cardiogenic shock?
heart fails to pump enough blood round the body
what happens in obstructive shock?
inability to produce a CO despite normal myocardial function and intravascular volume
what is the triangle of safety in the axilla?
pec major
lat dorsi
5th ICS
when inserting a chest drain, should you aim superior or inferior? why?
inferior
NVB runs alongside inferior aspect of the rib
what is cushing’s response?
when ICP raises
HR + RR drop
BP rises
difference between a G+S and a crossmatch?
G+S - blood type (better acutely as faster)
crossmatch - full Abs and issues blood
