amk emergency teach 20/5 Flashcards
fall from roof, pelvic fracture - low BP - unresponsive to voice
what is the most appropraite action
jaw thrust and assess airway
then adjuncts, supraglottic ariways, et tube ( protected airway) and then surgical airway
when would you get anaethetists to monitor a persons airway
below 8 GCS
and bag valve mask to take over ventilation
DR - direct risk - castrophic haemorrhage comes before airway in then ABCDE
non shcokable rhythm what do you do
cpr and IV img adrenaline
adrenaline very other cycle of cpr
if shcokable rythhm what do you do
cpr and deliver shock
after 3 shcoks go IV 1mg adrenaline and IV 300mg amiodarone
stemi damages what layer of the heart
subendocardial layer
NSTEMI mx
MONAC and add sodium fondaparinux for NSTEMI
prasugrel - people who are gong to undergo stemi
12 of sx and 2hr of medical conttact - PCI
after 2 hours - thrombolyissi
mx of HF
OMFG sit up
beware of lluid bouses in hypotensioj ( maybe 250ml , consider iontrohes or vasopressors)
what is an SVT
any narrow complex tachy ( below 120ms) originating from above the bundle of his
split into regulairty adn site ( either reg or ireegular and atrial ventricular)
most common is AVNRT ( also AF)
if unsatble HISS features ( syncope, low BP ) - syncrhonised shock on Q wave - low energy shock
* unsyncrohsied when you cant see naythign adn just shock anywhere with high energy)
if shock on t wave - precipitate v fib
cant see p wavss in SVT
if stable - modified valsalva
then adenosine large bore - 6,12,12
if asthamtic verapamil
if failed syncohrnised shock
risk of adenosine in SVT include
asprin overdose does what to ear
tinnitus
intialyy get alkalaoossi and hyperventilate to compensate
once aspirin is metabolised get acidodotic picture
digoxin causes what to vision
yellow green colourblind
antifreeze ehtylene glycol mx
gastric lavage or NG aspriation within an hour , after that fomepizole or ethnaol
early intoxication, comiting and haematemsis, seizures and eventuually leads to kidney dysfunction
aki damn drugs to stop
diuretics
ACEi and ARB
metfomin
NSAID
indications for dialysis
AEIOU BLAST
acidosi below 7.2
electorlytes - hgih k
intoxication
odeoam and ureaemia
infectious encephalitis
fever headache and altered mential state, convulsions, focal neural deficits
ct head and LP needed
managed with acyclovir and ceftrizxone
autoimmune encephaltiis
same features as infectious - no fever
same ix
managed with IV ig and steriods
palsmaphresis
urgent ct head 1hr
more than 2 vomit in head injru y
gcs below 13
post injyr seizures
base skull fractures
GCS below 15 after 2hr entering ed
mx of addisonian crisis
cx by low cortisol and adrenal failur e
IV fluids, IV hydrocortisone, and correct complciations - low blood sugar - dextrose, low bp - fludorcortisone
swap back to oral 3 day slater
mx of thyrotoxic storm
fx of thyroid disease
high outpu thf
managed with IV digoxin and propanolo, iv hydrocortisone and propylthiouracil
mx of myxedema crisis
low temp, ow RR< low HR, glucose low and comatosed
caused by criticlal ylow T3 anf T4
orrect complciation give IV T3 and 4 and IV hydrocortisone
MX of DKA
low insulin - raised glucagon creating ketosis and acidosis and hyperglyceami
comiting sweet smelling breath and abdo pain and shock and dehydration
fludi resis is key in 1 hour followed by fixed rat insulin infusion
aware of cx
dotn give more than 10mmol of potasisium an hour
