All of it

Question 1

Signs of an aortic dissection? (3 key things)

Answer 1

• Hypotension
• Hoarseness + swallowing difficulties
• Nil ECG changes
  + pain that radiates to the back

Question 2

Do we need the cath lab? What is PPCI

Answer 2

Primary percutaneous coronary intervention

STEMI > Cath lab
or
STEMI > Thrombolysis (in or out of hospital) + Angio (blood thinners) - if this fails t/f to PCCI hospital

Question 3

What medication do you give to chest pain < prior to cath lab >

Answer 3

Anti thrombolytic therapy

Clopidogrel 300-600
Tricgrelor 180
Drasurel 60

Question 4

ACS includes (3) + management

Answer 4

Angina
NSTEMI
SETMI

1st line - asprin
2nd line - GTN

Question 5

ALS Rythym

Answer 5

CPR 30:2 > attach defib + monitor

SHOCK - shock, CPR 2 min, 2nd shock 1 mg adrenaline then every 2 loop + Amido. 300 mg after 3 shocks

NON SHOCK - CPR 2 min, 1 mg adrenaline immediately then every 2nd loop

Question 6

What do you charge the defib to?

Answer 6

200 biphasic
Can go up to 360

Question 7

Etco2 during CPR & what is considered a poor outcome?

Answer 7

Etco2 decreases during CPR as cardiac output in low and output is generated by compressions

> Failure to achieve > 10 mmHg after 20 min is linked to poor outcomes

Question 8

Normal Capnography? + Inspiratory & Ex

Answer 8

35-45 mmHg

Inspiratory = flat line
Ex = wave

Question 9

Potential complications of IO access?

Answer 9

Heamotoma
Compartment syndrome

Question 10

Narrow pulse pressure?

Answer 10

arterial vasoconstriction
e.g. Cardiogenic / hypovolemic shock

Question 11

Normal PP?

Answer 11

35-45

Question 12

Wide PP?

Answer 12

arterial vasodilation e.g. anaphylaxis or sepsis

Question 13

Calcium Significance with the Heart

Answer 13

stabilises the <3 membranes

Question 14

Heat exhaustion vs heat stroke

Answer 14

Exhaustion - under 40*
Stroke - over 40*

Question 15

Naloxone dose

Answer 15

100 mcg increments

Question 16

Tricyclic (anti-depressant) antidote?

Answer 16

sodium bicarb bolus

Question 17

Cyanide positioning - antidote?

Answer 17

causes <3 toxicity
* B12 Injection 5mg

Question 18

Choking

Answer 18

encourage coughing
OR
5 x back blows + 5 x chest thrusts

Question 19

Defib or CPR?

Answer 19

DEFIB AS SOON AS POSSIBLE

Question 20

Odds game - % of a good outcome

Answer 20

every 1 min wasted = decrease 7-10%

Question 21

Post resus care?

Answer 21

ABCDE
12 Lead
Treat causes
Aim sp02 94-98%
Normoglycemia + normocapnia
Targeted temp range

Question 22

Define syncope

Answer 22

Transit LOC due to a global reduction of blood flow to the brain

Question 23

Heart failure 2 classic signs

Answer 23

elevated JVP
pulmonary edema

Question 24

Synchronised cardioversion - why?

Answer 24

1. Broad complex Tachy
2. AF
3. A flutter
4. Reg Narrow complex

Question 25

SVT treatment

Answer 25

Vagal manoeuvres + adenosine

Question 26

Torsades

Answer 26

Stop all QT prolongation drugs Correct electrolysers GIVE Mag Sal 2g IV (10 min)

Question 27

If cardioverting an AF - what are the considerations

Answer 27

NOT until over 48 hours anti coag > Try metoprolol 1mg first Can also do an IV infusion of 300 mg over 20-60 min

Question 28

What increases the risk of secondary brain injury post resus?

Answer 28

Hypoxaemia + hypercarbia

Question 29

Where will an ETT tube go that is down too far?

Answer 29

Right main bronchus

Question 30

Tachyarrhythmia algorithm

Answer 30

1. Unstable? Syndromnised DC Shock (3 attempts) with sedation and amiodarone 2. Stable? A>Broad vs B>Narrow - irregular in either is probable AF (Dig. or amiodarone) - Narrow & regular (SVT) 6 mg adenosine IV

Question 31

Bradycardia Algorithm

Answer 31

Adverse features e.g. shock, syncope, MI YES = or if the risk of asystole = Atropine 500 or 600 mcg IV If not can sometimes monitor

Question 32

Local Anaesthetic Toxicity

Answer 32

Signs ; LOC, Seziures TREATMENT = Lipid Emulsion

Question 33

Arrest pathway for scans

Answer 33

CARDIAC > Angio NON CARDIAC > CTB + CTPA

Question 34

Inotropes vs pressors

Answer 34

Ino - increases myocardial contractility Pressors - increase vasoconstriction, increase systemic resistance (MAP)

Question 35

ABG during an arrest - what does it show us?

Answer 35

There is decreased perfusion during a arrest which will result in metabolic acidosis = decreased bicarb = <> base deficit (TREAT UNDERLYING CAUSE as opposed to giving bicarb) ** The rate at which this resolves in an indicator of tissue perfusion

Question 36

When to stop CPR

Answer 36

Asystolic for more than 20 minutes

Question 37

PaC03 + HC03 ?

Answer 37

Pac02 = REP HC03 = Metabolic

Question 38

Bicarb - what does it show us?

Answer 38

- kidneys

Question 39

VBG in arrest - what does it reflect?

Answer 39

acid balance of tissues

Question 40

Principles of medical ethics

Answer 40

Autonomy Beneficence Non-malefience Justice

Question 41

ASTHMA - Life treat

Answer 41

Increased PaC02 +- Mechanical vent with raised inflammatory pressures VENT rate 10

Question 42

ASTHMA ; Life treat Acute Severe

Answer 42

Life treat = 1 x LOC, <3's, Hypotension, silent chest Acute = RR > 25 , HR 110, can't complete sentence in one breath

Question 43

Wheezing in asthma?

Answer 43

Doesnt correlate to the severity of obstruction

Question 44

ASTHMA PATHWAY

Answer 44

AIM sp02 94-98% 1st line - salbutamol (5mg via nebs continous) 2nd line - ipratropium (every 20 min) 3rd line - mag sulfate (single infusion 10 mmol 20 min) + Steriods IV Hydracort 100 mg

Question 45

ASTHMA PATHWAY POST

Answer 45

1st line - salbutamol every 5-30 min 2nd line - ipratropium every 4-6 hours + Steriods Pred 40-50 mg oral