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APLS > Apls > Flashcards

Apls Flashcards

1
Q

What checks do you need to do post intubation?

A

Connect Capnometer + pulse oximeter
Auscultate both axillae and the stomach

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2
Q

What is the most concerning complication of intubation?

A

Accidental oesophageal intubation

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3
Q

What are the causes of a gradual fall in expired CO2 in a ventilated patient?

A

Cardiac arrest
Inadequate chest compressions
Pulmonary embolism

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4
Q

What are the causes of a a sudden drop in expired CO2 in a ventilated patient?

A

Disconnection of breathing system
Extubation
Ventilator Failure

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5
Q

What is appropriate dose for IV morphine?

A

0.1mg/kg bolus
Wait 10 minutes
Then titrate upwards

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6
Q

Define situational awareness

A

The cognitive process for building and maintains awareness of a workplace situation or event

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7
Q

What are the pre-terminal signs of hypoxia?

A

Bradycardia
Cyanosis
Drowsiness

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8
Q

What are the causes of a bounding pulse ?

A

Increased cardiac output (e.g. septicaemia)
Arterio-Venous systemic shunt (e.g. PDA)
Hypercapnia

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9
Q

What should be your initial fluid resuscitation?

A

10ml/ kg of crystalloid

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10
Q

How do you treat DKA?

A

Treat shock (if present) with 10ml/kg fluid bolus
Rehydration fluid > 48 hours
Insulin infusion 0.05-0.1 unit/kg/hour 1-2 hours AFTER initiating rehydration and maintenance fluid
Glucose infusion once BM <14

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11
Q

In DKA what does sodium do? And what does it do after treatment?

A

It’s low
Goes up as glucose goes down

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12
Q

What are feature of cardiac cause for breathing difficulties?

A

Cyanosis not correcting with O2
Tachycardia out of proportion with respiratory symptoms
Raised JVP
Gallop rythm
Enlarged liver
Absent femoral pulses.

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13
Q

What causes cardio genie shock?

A

Arrhythmias
Cardiomyopathy
Myocardial contusion
Heart failure

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14
Q

What causes distributive shock?

A

Spinal cord injury
Anaphylaxis
Vasodilatory drugs
Sepsis

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15
Q

What causes obstructive shock?

A

Flail chest
Pneumothorax
Pulmonary embolism
Cardiac tamponade

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16
Q

What causes hypovolaemic shock

A

Intussusceptions
Gastroenteritis
Haemorrhage
Burns
Peritonitis

17
Q

What is clinical picture for toxic shock syndrome?

A

Fever. Diffuse erythema. Headache, confusion, conjunctival and mucosal hyperaemia, vomiting, water diarrhoea +- history of infected wound/ burn/ surgery/ deep seated infection

18
Q

What is management of toxic shock syndrome

A

IV fluclox and vancomycin!

19
Q

What are the causes of yacht arrhythmias?

A

Metabolic disturbance
Long QT
cardiomyopathy
Poisoning
Re-entrant congenital conduction pathway abnormality

20
Q

How to treat SVT in context of no clinical shock

A

Bagel manoeuvre
Adenosine 0.1-0.2 mg/kg
After 1 min adenosine 300mcg/kg

21
Q

How to treat SVT with clinical shock and defib available

A

Synchronous DC shock 1J/kg
Synchronous DC shock 2J/ kg
Consider amiodarone

22
Q

How to treat SVT with clinical shock and no defibrillator available?

A

Vagal manoeuvre
Adenosine 0.1-0.2 mg/kg
After 2 mins adenosine 200mcg/ kg
After 1 min adenosine 300mcg/kg

23
Q

Describe decerebate posturing

A

Both arms and legs are rigid and extended, head arches backwards, toes point down

24
Q

Describe decorticate posturing

A

Rigid with flexed arms , clenched fists and extended legs

25
Q

What in posturing is sign of impending herniation?

A

Progression from decorticate ( flexed arms ) to decerebrate (extended posture )

26
Q

Barbiturates poisoning causes what?

A

Hypothermia

27
Q

After x2 doses of benzodiazepines, what comes next in seizure management ?

A

Phenytoin,
Whilst it’s being drawn up give Paradehyde 0.8ml/kg of 50:50 mixture with oil.

28
Q

What are the conditions that should be checked for during primary survey and treated immediately in chest injuries

A

Airway obstruction
Tension pneumothorax
Open pneumothorax
Massive haemothorax
Flail chest
Cardiac tamponade

29
Q

What is the volume of resuscitated blood given in emergency as first bolus?

A

5ml/kg

30
Q

What are the components of a secondary survey?

A

Respiration, circulation, nervous system, metabolism, host defence

31
Q

In head injuries what are the indications for immediate intubation?

A

Coma/ GCS <8
Hypoxemia OR hypercapnia on blood gas
Spontaneous hyperventilation
Respiratory irregularities
Unstable facial fractures
Seizure
Copious bleeding from mouth

32
Q

What is the formula for estimating a child’s weight?

A

(Age + 4) x2

33
Q

What is the formula for calculating ETT tube insertion depth?

A

Age/2 +12

34
Q

What is acronym for information communicated to pre alert team?

A

ATMISTER
age
Time of incident
Mechanism
Injury suspected
Signs
Treatment
ETA
Requirement

35
Q

What is acronym for safe transfer and retrieval?

A

Assessment
control
Communication
Evaluation
Preparation and packaging
Transport

APLS (1 decks)

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