Acute Care and Trauma and Mental Health Flashcards

Question

Arterial blood gas

Answer 1

Used to determine gas exchange levels in the blood related to respiratory, metabolic, and renal function.

Answer 2

- to identify acid/base disorders, with or without compensation (may present with SOB, difficulty breathing, confusion, nausea) - Perform when suspecting kidney failure, heart failure, uncontrolled diabetes, haemorrhage, chemical poisoning, drug overdose, shock

Answer 3

Local hematoma Artery vasospasm Infection at puncture site feeling faint

Answer 4

Step 1: Look at the pH Normal (7.35-7.45) >7.45 alkalaemia <7.35 acidaemia Step 2: Look at the PaCO2 Normal (4.7-6 kPa) >6 acidifying <4.7 alkalinising Align step 1 with step 2. If they both align then the problem is respiratory. E.G. Step 1: pH low Step 2: PaCO2 high =resp. acidosis Step 3: Look at the bicarbonate or base excess Base excess normal (-2 to +2) Bicarbonate normal (22-26 mmol/L) ``` E.G. pH low PaCO2 high Bicarb. high Respiratory acidosis, partially compensated ```

Answer 5

Respiratory acidosis Step 1 and step 2 align

Answer 6

Respiratory alkalosis | Step 1 and step 2 align

Answer 7

Excessive ingestion of aspirin causing toxicity. | Ingestion of 10-20 grams causes moderate to severe toxicity in adults

Answer 8

Increases respiratory rate and depth by stimulating CNS. Hyperventilation produces respiratory alkalosis in the early phase. Body compensates: Increase in urinary bicarbonate and K+ excretion -> dehydration and hypokalaemia Loss of bicarbonate together with build up of lactic acid lead to metabolic acidosis Severe: CNS depression and resp failure

Answer 9

Excess CO2 excretion -> hypocapnia | ->alkalosis

Answer 10

one of the most common drug overdoses Early: Flushed appearance, fever, sweating, hyperventilation, dizziness, tinitus, deafness Late: Lethargy, confusion, convulsions, drowsiness, respiratory depression, coma ``` exam: fever tachycardia hyperventilation epigastric tenderness ```

Answer 11

blood: salicylate levels in the blood, Potassium levels abg: may show metabolic acidosis and respiratory alkalosis ECG: hypokalaemia (small t waves, u waves)

Answer 12

1. Assess thickness (epidermis, partial, full thickness) 2. Assess Body surface area covered by burn 3. Assess location 4. Mechanism of injury

Answer 13

Injection of a local anesthetic into the space outside the dura mater of the spinal cord in the lower back region to produce loss of sensation below the waist.

Answer 14

Epidurals can be used during childbirth, including caesareans, during surgery, and after surgery

Answer 15

``` Inadequate pain relief headache Nerve damage low BP loss of bladder control ```

Answer 16

Excessive fear and worry, triggered by internal or external events, interferes with normal daily activity, and leads to impairment of functioning. Genetic factors play a role. Heritability estimated at approximately 30% co-morbidity with other anxiety disorders is common

Answer 17

Persistent sad, anxious, or empty mood Feelings of hopelessness or pessimism Feelings of guilt, worthlessness, or helplessness Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex Decreased energy, fatigue, being "slowed down" Difficulty concentrating, remembering, or making decisions Insomnia, early morning awakening or oversleeping Appetite and/or weight loss, or overeating and weight gain Thoughts of death or suicide, suicide attempts Restlessness, irritability Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders and chronic pain

Answer 18

Suspect this if, after head injury, conscious levels falls or is slow to improve, or there is a lucid interval. - no loss of consciousness followed by decreasing loss of consciousness - After initial slight drowsiness seems fine

Answer 19

Temporary improvement in a patient's condition after a traumatic brain injury, after which the condition deteriorates. Indicative of an Epidural haematoma

Answer 20

May last a few hours to a few days before the bleed declares itself by decreased GCS from rising ICP. Increasingly severe headache, vomiting, confusion, and fits follow. (+/- brisk reflexes, up going plantars, hemiparesis) Bleeding continues: Ipsilateral pupil dilates, coma deepens, bilateral limb weakness develops, breathing deep and irregular (brainstem compression) Death follows a period of coma and is due to respiratory arrest.

Answer 21

CT: Haematoma (round, lens-shaped) Skull x-ray: Looking for fractures (increases risk of EH massively) Lumbar puncture is contraindicated

Answer 22

Systemic, dysfunctional inflammatory response that requires long ICU stay and has a high mortality.

Answer 23

Spectrum from mild to severe: - SIRS - Sepsis - Septic Shock - MODS

Answer 24

``` 2 out: -Temperature >38 or <36 -Heart rate >90 -RR >20 or PaCO2 <32 (Normally 40) -WCC >12000 or <4000 or >10% band cells (immature WCC) ```

Answer 25

SIRS and confirmed infection

Answer 26

Sepsis and hypotension that does not go away

Answer 27

Multiple Organ Dysfunction Syndrome Sever septic shock+ organ failure

Answer 28

Opioid overdose triad: pinpoint pupils + unconsciousness+ respiratory depression Can lead to respiratory depression and death Combining opioids with alcohol and sedative medication increases the risk of respiratory depression and death

Answer 29

- people with opioid dependence, in particular following reduced tolerance - people who also drink alcohol and sedative medication

Answer 30

- commonest overdose - first 24 hours asymptomatic - after 24 hours hepatic necrosis begins (elevated transaminases, RUQ pain, and jaundice) and can progress to acute liver failure