Approach to the critically ill patient Flashcards

1
Q

management in a critically ill patient

A

management cannot be delayed until a diagnosis is made
treatment is instituted whilst assessment is ongoing

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2
Q

if there is no pulse what do you do

A

BLS algorithm CPR: chest compressions and ventilations

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3
Q

if there is a pulse what steps do you take

A
  1. primary assessment
  2. AMPLE history
  3. secondary assessment
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4
Q

primary assessment

A

A- airway
B- breathing
C- circulation
D- disability
E- exposure

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5
Q

SAMPLE history

A

S- signs and symptoms
A- allergies
M- medication
P- past medical history
L- last oral meal
E- events leading up

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6
Q

Hello: AVPU

A

A- Alert
V- voice
P- pain
U- unresponsive

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7
Q

airways (C- spine control)

A
  • look in mouth if unconscious
  • listen
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8
Q

airway: stridor

A

upper airway obstruction

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9
Q

airway: gurgling sounds

A

secretions

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10
Q

how to open airway if no C- spine problem

A

head tilt chin

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11
Q

how to open airway if trauma

A

jaw thrust

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12
Q

to clear airway for secretions

A

suctioning

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13
Q

to clear airway for large objects

A

magills forceps

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14
Q

to maintain open airway

A

OPA (if tolerates)
NPA
LMA

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15
Q

to protect airway

A

ETT
Cric

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16
Q

airway drugs: adrenaline

A

airway swelling e.g. Anaphylaxis

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17
Q

airway drugs: RSI agents

A

ETT placement

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18
Q

breathing: presence of breathing

A

respiratory rate

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19
Q

breathing: effort of breathing

A

I- inspection
P- palpation
P- percussion
A- auscultation

20
Q

breathing: efficacy of breathing

A

colour
level of consciousness
sats monitor
ETCO2

21
Q

breathing: management

A
  • BVM
  • give oxygen if critically unwell
    *intubate and ventilate if needed
22
Q

breathing: tension pneumothorax management

A

needle decompression

23
Q
A
24
Q
A
25
Q

breathing: drugs

A

oxygen

26
Q

breathing: drugs if wheezing

A

beta agonists

27
Q

breathing: drugs if asthma

A

steroids

28
Q

circulation: assessment

A
  • heart rate
  • blood pressure
    *organ perfusion
29
Q

circulation: organ perfusion on skin

A

capillary refill time

30
Q

circulation: organ perfusion on brain

A

level of conscious

31
Q

circulation: organ perfusion on kidneys

A

urine output

32
Q

circulation: management option

A

attach 3 lead ecg

33
Q

Circulation: if patient has arrhythmia / chest pain

A

do a 12 lead ECG

34
Q

circulation management

A

IV lines
fluid
manage arrhythmias (SCV- supraventricular arrhythmia )
catheter and NGT

*take blood whilst putting up lines

35
Q

Circulation: drugs

A

fluid
anti- arrhythmias
inotropes if needed
ACS drugs
Diuretics if fluid overloaded

36
Q

disability options

A
  • GCS
    *Pupil response
    *gross neurological state- are all the limbs moving normally
    *glucose check
37
Q

disability : if glucose is low

A

dextrose/ glucose

38
Q

disability: seizures

A

benzos and anti-epileptics

39
Q
A
40
Q

overdose of opiate

A

narcian (naxolone)- reverses respiratory depression

41
Q

exposure

A

*look for trauma/ injury/ rashes
*take temperature
*prevent hypothermia

42
Q

exposure: intervention

A

warm up if cold
cool down if hot

43
Q

investigations

A

*radiology: CXR
*other investigations : that where not done when blood was taken

44
Q

secondary assessment

A

head to toe survey
back and front of patient

45
Q

prepare for transport

A

*prepare the patient
*prepare the receiving facility
*prepare the documentation
*prepare the transportation system