Basic Revision Flashcards
What are the 10 steps of ECG interpretation?
- Rate
- Rhythm
- Axis
- P-wave
- P-R interval
- QRS complex
- ST segment
- T-wave
- QT interval
- Interpret rhythm
Describe a normal P wave
present, round, upright, less than 0.12secs (3 boxes), less than 2.5mm amplitude
What is the normal QRS axis?
-30 to +90
What is Left avis deviation?
- 30 to -90
What is right axis deviation?
+ 90 to 180
Which direction does the current travel between leads?
from negative to positive
How do you recognise a first degree AV block?
Prolonged QRS
What type of block has an increasing P-R interval until a QRS is dropped?
Second degree type 1, wenckeback or Mobitz AV block
How do you recognise a second degree type 2 AV block?
Normal PR interval, with an intermittent complete block.
What is a second degree advanced or 2:1 AV block?
regularly dropped QRS resulting in 2:1, 3:1 or greater conduction ratio?
How do you recognise a third degree AV block?
No association between P wave and QRS complex
Which leads do you use to look for a bundle branch block?
V1 & V6
How do you determine a left or right bundle branch block?
Prolonged QRS, WiLLiaM MaRRoW
Which leads show a high lateral aspect?
Lead I and aVL
Which leads show the septal aspect?
V1 & V2
Leads I, II and III show which aspect?
inferior
Leads V3 & V4 show which aspect?
Anterior
Which leads show the lower septal ascpect?
V5 & V6
What are the reversible causes of cardiac arrest?
The four H’s and Four T’s:
- hypoxia
- hypovolemia
- hyper/hypothermia
- hyper/hypoglycemia
- tension
- tamponade
- thrombosis
- toxins
What is the SIRS criteria?
- temperature over 38.5 or under 35.5
- heart rate above 90bpm
- respiration rate below 10 or above 20
What are the signs of shock?
- tachycardia
- tachypnea
- hypotension
how do you calculate the approx normal paediatric systolic blood pressure?
(age in years x 2) + 80
Name the altered level of consciousness differentials
A: alcohol/ arrhythmia E: epilepsy/ electrolytes I: infection O: overdose U: underdose/ uremia T: toxins/ trauma/ temperature/ tumor I: insulin P: poison/ psychosis S: sepsis/ stroke/ shock
Classify the severity of a TBI
Severe = GCS 8 or less Moderate = GCS 9 - 12/13 Mild = GCS 13/14 - 15
What is Cushing’s triad? What does it indicate?
triad of symptoms:
- bradycardia
- irregular bradypnea
- widening pulse pressure (increasing SBP/ SBP hypertension)
indicates increased ICP
what are indicators of pneumothorax?
- tachycardia
- SOB
- chest pain
how is MAP calculated?
(2x DBP) + SBP / 3
what is pulse pressure?
SBP - DBP
How do you calculate CPP? What is the normal ICP?
CPP = MAP - ICP
normal ICP = 7 - 15mmHg
What is the target CPP?
Above 70 mmHg
What is the NEXUS criteria?
For spinal clearance:
- No midline cervical tenderness
- No focal neurological deficits
- No altered LOC
- No evidence of intoxication
- No painful distracting injury
What is the canadian C-spine rule?
High risk criteria: - age 65 or above - dangerous mechanism - paraesthesia in extremities IMAGING REQUIRED
At least ONE low risk criteria: - simple rear end MVC - ambulatory at any time - sitting position - no neck pain at scene - no midline tenderness IF NONE- IMAGING REQUIRED if one or more:
ask patient to turn head 45 degrees both left and right. Can do it? (despite pain)- no imaging required
What is the parkland formula?
Estimation of the fluids required for a patient with serious burns.
Adults: If >20% TBSA.
4ml/kg/% TBSA
Paediatrics: If >10% TBSA.
3-4ml/kg/%
half given in first 8hrs, half in following 16hrs.
What is the weight used for newborn drug calculations?
3.5kg
How do you estimate the weight of an infant?
(0.5 x months) + 4
How do you calculate the expected weight of a 1 - 5 year old?
(2 x years) + 8
How do calculate the weight of a child between 6 and 12 years of age?
(3 x years) + 7
What are the 6 R’s of pharmacology?
Right person Right drug Right dose Right route Right time Right documentation
What is the volume calculation for drug doses?
Dose required x Stock volume
Strength supplied 1
What is the recommended defibrillation setting for paediatrics?
4 Joules / kg
What is the structure of a handover?
I: introduction M: mechanism/ medical complaint I: injures S: signs and symptoms T: treatment and trends A: allergies M: medications B: background O: other info
How do you give a sit rep/ major incident sit rep?
M: major incident declared? E: exact location T: type of incident H: hazards A: access/ egress N: no. of casualties E: emergency services present/ required
