Acutely Ill Patient Flashcards
Give some examples of shock
Hypovolemic
Distributive
Cardiogenic
Obstructive
Give causes of hypovolemic shock
Haemorrhage
Dehydration
Give examples of distributive shock
Blood goes into third space etc e.g.
Sepsis - gross vasodilation, increased oxygen demand from other issues
Neurogenic - injury to nervous system
Give examples of cardiogenic shock
Arrhythmia
Pump failure
Give examples of obstructive shock
Tamponade
Pneumothorax
Give some surgical conditions which can cause a patient to be acutely unwell
Appendicitis
Haemorrhage
Pancreatitis
What are the types of conditions can cause a patient to become acutely unwell?
Infection/inflammation Perforation Obstruction haemorrhage Ischaemia Trauma
Examples of inflammation
Oesophagitis Gastroenteritis Pancreatitis Appendicitis Colitis Diverticulits Cholangitis
Perforation of oesophagus can be caused by?
Boerhaave’s - vomiting against closed glottis
Malignancy
Perforation of stomach can be caused by?
Gastric ulcer
Perforation of duodenum can be caused by?
Duodenal ulcer
Perforation of small bowel can be caused by?
Foreign body
Crohn’s
Perforation of colon can be caused by?
Diverticulitis
Malignancy
Iatrogenic
Perforation of gallbadder can be caused by?
Gallstone ileus
Perforation of rectum can be caused by?
malignancy
Ischaemia of small bowel can be caused by?
Thrombus
Embolus
Ischaemia of colon can be caused by?
Watershed
What are the classifications of post-op complications?
Direct - procedure specific complications
Indirect - general complications
Examples of direct consequences resulting from the procedure
Leakage after GI resection and anastomosis
Biliary tree injury after cholecystectomy
Haemorrhage ischaemia after AAA repair
General post-op lung complications
Atelectasis - collapse of lung basses
Pneumonia
PE
Pneumothorax
General post-op renal complications
acute renal failure
General post-op endo complications
Glucose derangement
Addisons
Drugs
Withdrawal
General post-op cardiac complications
MI
Arrythmia
Tamponade
What is the systematic approach you take if someone seems to have a complication?
ABCDEFG
What are you looking out for when doing airway asssessment?
Look
Listen
Feel
Are they speaking to you?
Is there anything in their mouth?
Stridor?
Gurgling? Excess fluid production
Airway - what would you do if there was a problem?
Headtilt
Jawthrust
Gadelle
Give high flow oxygen
Breathing
Rate
Expansion
Percussion
Breath sounds
What would you do if there was a tension pneumothorax?
needle decompression - midclavicular line if tension pneumothorax
Circulation - things to check
Perfusion
Cap refill
HR
BP
THINK ABOUT WHETHER THEY ARE LOSING BLOOD VIA ABDOMEN
Circulation - things you might give
IV cannula
Bloods
Fluid
Disability - what are you looking at
Limbs
Neuro
Exposure - what are you looking out for?
Check for injuries and rashes, potentially anaphylaxis
What else might you do?
Pregnancy test (ectopic) Urine (urosepsis) ECG Blood gas FBC, kidney function Clotting Group and stain CXR mobile
Young pt with peritonitis and epigastric pain
Pancreatitis
Ruptured duodenitis
Old pt with peritonitis and epigastric pain
Pneumonia
AAA presentation
Groin strain
Back pain
What’s the word for air in the peritoneum?
Pneumoperitoneum
What is chilaiditi’s sign
Air in viscus between????
