Acute severe colitis

Question 1

Airway, Breathing

Answer 1

B: Do ABG to see quick Hb

Question 2

Circulation

Answer 2

Look, listen, feel
HR, BP
ECG

IV access
Bloods: AA: FBC, UEs, LFTs, CRP, Ca, amylase, glucose, blood cultures

Surgical: group and save, crossmatch, clotting

Management:
1. Rehydrate - IV fluids NaCl
2. Consider IV iron or blood transfusion
3. Hydrocortisone 100 mgs IV
4. Inform charge nurse: consider PPE

Question 3

E

Answer 3

Temperature
DRE
urine dip
catheter
Abdo exam
Stool sample MC&S

Definitive Ix:
1. Stool cultures x3 (include cdiff)
2. Stool chart recording
3. Consider infective serology (CMV, HIV)
4. AXR (thump printing, toxic megacolon)
5. Urgent inpatient flexible sigmoidoscopy and biopsy (megacolon)

Definitive management:
1. Hydrocortisone IV
2. Thromboprophylaxis
3. PPE
4. Surgical work up

Question 4

Important bits:

Answer 4

Truelove and Wits score:
* bowel movements
* blood in stool
* pyrexia
* pulse >90
* anaemia
* ESR

ESCALATE to gastro and surg SpR

ΓΕΝΙΚΑ: σκέψου
Blood transfusion HB
Fluids
Hydrocortisone
Stool cultures
Surgical work up