Acute Emergencies and Pre-Hospital Care Flashcards
What does each letter stand for in the ABCDE approach?
Airway
Breathing
Circulation
Disability
Exposure
What are the key aspects of Airway?
Speak to the patient, is their airway clear?
Assess for any signs of choking or obstruction to the airway.
What are the key aspects of Breathing and how is the patient treated at this stage?
O2 sats -> if sats are below 94% then administer 15L of Oxygen through a non-rebreather mask.
RR
Tracheal deviation
Chest expansion
Percussion
Auscultation
What are the key aspects of Circulation and how is the patient treated at this stage?
Pulse
Cap refill
BP -> if they have low blood pressure, administer 500ml of saline in a bolus.
Listen to their heart
3 lead ECG -> if abnormalities 12 lead.
Temperature
Urine output
(if indicated) venipuncture
What are the key aspects of Disability and how is the patient treated at this stage?
Pupil reflexes
Blood glucose
GCS/ACVPU
What are the key aspects of Exposure and how is the patient treated at this stage?
Check all over the body for any potential signs of infection, bleeding or peripheral signs of illness or injury.
What are the main differentials for a patient presenting with acute abdominal pain? (mindmap it)
Acute cholecystitis
Ascending cholangitis
Acute Pancreatitis
Acute appendicitis
Ectopic pregnancy
PUD
Gallstones
GORD
Diverticulitis
Meckels Diverticulitis
Pelvic Inflammatory Disease
Intestinal obstruction
Gastroenteritis
Acute intestinal ischaemia/infarction/vasculitis
GI haemorrhage
Urinary tract stones
Urinary tract infection
Abdominal aortic aneurysm
Testicular torsion
MI
Pneumonia
IBD/IBS
Ovarian torsion/rupture
Splenic infarction
Pericarditis
Hepatitis
What are the main differentials for a patient presenting with acute chest pain? (mindmap it)
MI - Acute coronary syndrome
Stable angina
Dissecting thoracic aneurysm
Pericarditis
Cardiac tamponade
Myocarditis
Acute congestive heart failure
Arrhythmias
Pulmonary Embolus
Pneumothorax
Tension pneumothorax
Community-acquired pneumonia
Asthma
Pleural Effusion
Acute Pancreatitis
Oesophageal rupture
Peptic ulcer disease
Gastro-oesophageal reflux disease
Oesophageal spasm
Oesophagitis
Rib fracture
Costochondritis
Spinal Disorders
Rheumatoid arthritis
Psoriatic arthritis
Fibromyalgia
Cancer
Osteoporotic fracture
Herpes zoster
Pyschogenic
What are the main differentials for a patient presenting with an acutely unwell child? (mindmap it)
Excessive secretions
Croup
Bacterial trachitis
Epiglottitis
Inhaled foreign body
Anaphylaxis
Acute asthma
Pneumonia
SVT
Seizures
Sepsis
What are the main differentials for a patient presenting with acute shortness of breath? (mindmap it)
Congestive heart failure
Arrhythmias
Pericarditis
Acute MI
Anaemia
Chronic obstructive pulmonary disease
Asthma
Pneumonia
Pneumothorax
Tension pneumothorax
Pulmonary embolism
Pleural effusion
Metastatic disease
Pulmonary oedema
GORD with aspiration
Restrictive lung disease
Panic attacks
Hyperventilation
Pain
Anxiety
Upper airway obstruction - epiglottitis, foreign body, croup, EBV.
Aspirin overdose
What are the main differentials for a patient presenting with unilateral weakness?
TIA
Bells palsy
What are the main causes for a patient presenting with anaphylaxis?
Peanuts
Pulses
Tree nuts
Fish and shellfish
Eggs
Milk
Sesame
Venom: bee stings
Drugs: antibiotics, opioids or steroids
How would you manage a patient presenting with anaphylaxis?
IM adrenaline 1:1000 in the middle 1/3 of the thigh.
If no improvement in symptoms after 5 mins, repeat the dose.
If no improvement after 2 doses, give IM adrenaline every 5 minutes until a response is seen.
Remove trigger (bee sting, food etc)
Give the person O2 if they have low sats and fluids if their blood pressure is low.
Nebulised salbutamol can be given if the patient is wheezy.
