Acute medicine Flashcards
How do you manage Paracetamol poisoning?
- Activated charcoal if ingested <1 hour ago
- NAC
- Liver transplant
How do you manage Opiate overdose?
Naloxone
How do you manage TCA overdose?
IV bicarbonate to reduce risk of arrhythmias
How do you approach an ABDCE - what investigations at each stage?
AIRWAY - NP airway/ET tube/LMA
BREATHING - RR/O2 sats/auscultate - give O2/salbutamol and ipratropium bromide
CIRCULATION - BP/HR/CRT/UO - fluid resuscitate, vasopressor, catheterise
D - GCS/AVPU/cap glucose - CT/IV dex
EXPOSURE - rash, burns
what is the canadian C spine score for?
assesses need for CT post neck injury - looks at high and low RF to assess
what causes a burn and a scald?
BURN - Injury by thermal/chemical/electrical/radiation energy
SCALD - contact with hot liquid/steam
how do you manage a patient presenting with a serious burn?
- ABCDE - prevent hypothermia and fluid resuscitate
- check nostrils - suggest inhalation injury
- assess area of skin affected (rule of 9s)
how do you manage a burn?
- stop burn and cool - remove clothing, brush chemicals aside and run under water for 20 minutes
- MINOR BURN - clean with soap and water and aspirate larger blisters. Non adhesive dressing. Give analgesia and check tetanus prophylaxis
- MAJOR BURN - check for signs of airway burn, ABG and elevate chest and head to 25 degrees to prevent oedema. Get IV access for fluid replacement and pain relief .
name some complications of burns
scars, fluid loss, infection
Name the reversible causes of a cardiac arrest (5H and 4T)
Hypoxia hypovolaemia hypo/hyperkalaemia hypothermia H ions (acidosis) thrombosis tamponade toxins tension pneumothorax
main sites where major haemorrhage can occur?
chest, pelvis, abdo, thigh
what is the lethal triad of major haemorrhage?
hypothermia
acidosis
acute coagulopathy of trauma
what do you give in the major haemmorhage protocol?
4 units of red cells
4 units of FFP
1 unit of platelets
