Akuten Flashcards
blandade frågor om akutmedicin
Anafylaxi
Adrenalin 0,3 - 0,5 mg im
Ventrikelflimmer
Defibrillera + HLR 2 min
Ventrikeltachycardi
Defibrillera + HLR 2 min
Asystoli
Adrenalin 1 mg iv/io direkt! Sedan var fjärde minut + HLR 2 minuter
PEA Pulslös elektrisk aktivitet
Adrenalin 1mg iv/io direkt! Sedan var fjärde minut + HLR 2 minuter
Ventrikeltachycardi efter tre defibrilleringar
Adrenalin 1mg iv/io, sedan var fjärde minut + HLR 2 minuter
Ventrikelflimmer efter tre defibrilleringar
Adrenalin 1mg iv/io, sedan var fjärde minut + HLR 2 minuter
Ventrikelflimmer/ventrikeltachy efter tre defibrilleringar
Amiodaron (Cordarone) 300 mg iv/io
Ventrikelflimmer/ventrikeltachy efter fem defibrilleringar
Amiodaron (Cordarone) 150 mg iv/io
Medicinsk syrgas på mask - flöde?
5 - 15 L
MAPLES
Medications
Allergies
Past medical history
Life circumstances/ Last oral intake/ Last period
Ethanol / Events leading up to the illness/injury
Smoking/ Signs/ symtoms
4D
Danger - säkerhet, support, stabilisering?
Data - informationsinhämtning (point of care)
Diagnosis - mest sannolikt? “don’t miss”?
Decisions - vidare utredning/ behandling?
OPQRST
Onset Position Quality Relieving/aggravating Severity Time course \+ Specifika frågor
Huvudvärk:
- fyra akuta diagnoser du inte får missa
Meningit
Subarachnoidalblödning
Encephalit
Temporalisarterit
Bröstsmärta:
- fyra akuta diagnoser du inte får missa
Akut koronart syndrom
Lungemboli
Aortadissektion
Pneumothorax
Wells score
DVT-score (djup ventrombos) 2p - hög sannolikhet.
Cancer behandlad senaste halvåret eller palliation: +1
Benpares eller gips: +1
Immobilisering / kirurgi: +1
Ömhet över kärlsträngen: +1
Ensidig helbenssvullnad: +1
≥ 3 cm skillnad i vadomfång: +1
Pittingödem i det symptomatiska benet: +1
Ytliga kollateralvener (ej endast varicer): +1
Tidigare diagnosticerad DVT: +1
Annan diagnos minst lika trolig: -2
Ref: internetmedicin
ADD score
The aortic dissection detection risk score (ADD-RS) is a clinical decision tool that aids in grading the pretest probability of an acute aortic dissection. Scores range from 0-3, where 0 is classed as low risk, 1 is moderate risk and 2-3 is high risk
High-risk conditions
One point for any of the following to a maximum of 1:
Marfan’s syndrome, Loeys-Dietz syndrome, vascular Ehlers-Danlos syndrome, Turner’s syndrome or other connective tissue diseases
other predisposing genetic mutations, e.g. FBN1, TGFBR1
family history of aortic dissection
known aortic valve disease
recent aortic manipulation
known thoracic aortic aneurysm
High-risk pain features
One point for any of the following to a maximum of 1:
pain in the chest, back or abdomen that is
sudden onset
severe in intensity
ripping, tearing or sharp quality
High-risk examination findings
One point for any of the following to a maximum of 1:
pulse deficit
systolic blood pressure limb difference (>20 mmHg)
focal neurological deficit
new aortic murmur of aortic regurgitation
ref: radiopedia