All of it Flashcards

1
Q

Signs of an aortic dissection? (3 key things)

A
  • Hypotension
  • Hoarseness + swallowing difficulties
  • Nil ECG changes
    + pain that radiates to the back
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2
Q

Do we need the cath lab? What is PPCI

A

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

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3
Q

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

A

Anti thrombolytic therapy

Clopidogrel 300-600
Tricgrelor 180
Drasurel 60

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4
Q

ACS includes (3) + management

A

Angina
NSTEMI
SETMI

1st line - asprin
2nd line - GTN

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5
Q

ALS Rythym

A

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

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6
Q

What do you charge the defib to?

A

200 biphasic
Can go up to 360

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7
Q

Etco2 during CPR & what is considered a poor outcome?

A

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

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8
Q

Normal Capnography? + Inspiratory & Ex

A

35-45 mmHg

Inspiratory = flat line
Ex = wave

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9
Q

Potential complications of IO access?

A

Heamotoma
Compartment syndrome

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10
Q

Narrow pulse pressure?

A

arterial vasoconstriction
e.g. Cardiogenic / hypovolemic shock

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11
Q

Normal PP?

A

35-45

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12
Q

Wide PP?

A

arterial vasodilation e.g. anaphylaxis or sepsis

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13
Q

Calcium Significance with the Heart

A

stabilises the <3 membranes

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14
Q

Heat exhaustion vs heat stroke

A

Exhaustion - under 40*
Stroke - over 40*

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15
Q

Naloxone dose

A

100 mcg increments

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16
Q

Tricyclic (anti-depressant) antidote?

A

sodium bicarb bolus

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17
Q

Cyanide positioning - antidote?

A

causes <3 toxicity
* B12 Injection 5mg

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18
Q

Choking

A

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

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19
Q

Defib or CPR?

A

DEFIB AS SOON AS POSSIBLE

20
Q

Odds game - % of a good outcome

A

every 1 min wasted = decrease 7-10%

21
Q

Post resus care?

A

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

22
Q

Define syncope

A

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

23
Q

Heart failure 2 classic signs

A

elevated JVP
pulmonary edema

24
Q

Synchronised cardioversion - why?

A
  1. Broad complex Tachy
  2. AF
  3. A flutter
  4. Reg Narrow complex
25
Q

SVT treatment

A

Vagal manoeuvres
+ adenosine

26
Q

Torsades

A

Stop all QT prolongation drugs
Correct electrolysers

GIVE Mag Sal 2g IV (10 min)

27
Q

If cardioverting an AF - what are the considerations

A

NOT until over 48 hours anti coag
> Try metoprolol 1mg first

Can also do an IV infusion of 300 mg over 20-60 min

28
Q

What increases the risk of secondary brain injury post resus?

A

Hypoxaemia + hypercarbia

29
Q

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

A

Right main bronchus

30
Q

Tachyarrhythmia algorithm

A
  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
31
Q

Bradycardia Algorithm

A

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

32
Q

Local Anaesthetic Toxicity

A

Signs ; LOC, Seziures

TREATMENT = Lipid Emulsion

33
Q

Arrest pathway for scans

A

CARDIAC > Angio

NON CARDIAC > CTB + CTPA

34
Q

Inotropes vs pressors

A

Ino - increases myocardial contractility

Pressors - increase vasoconstriction, increase systemic resistance (MAP)

35
Q

ABG during an arrest - what does it show us?

A

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

36
Q

When to stop CPR

A

Asystolic for more than 20 minutes

37
Q

PaC03 + HC03 ?

A

Pac02 = REP
HC03 = Metabolic

38
Q

Bicarb - what does it show us?

A
  • kidneys
39
Q

VBG in arrest - what does it reflect?

A

acid balance of tissues

40
Q

Principles of medical ethics

A

Autonomy
Beneficence
Non-malefience
Justice

41
Q

ASTHMA - Life treat

A

Increased PaC02 +- Mechanical vent with raised inflammatory pressures

VENT rate 10

42
Q

ASTHMA ;

Life treat
Acute Severe

A

Life treat = 1 x LOC, <3’s, Hypotension, silent chest

Acute = RR > 25 , HR 110, can’t complete sentence in one breath

43
Q

Wheezing in asthma?

A

Doesnt correlate to the severity of obstruction

44
Q

ASTHMA PATHWAY

A

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

45
Q

ASTHMA PATHWAY POST

A

1st line - salbutamol every 5-30 min
2nd line - ipratropium every 4-6 hours

+ Steriods

Pred 40-50 mg oral

46
Q
A