Cardiac Emergencies

Question 1

Name 6 steps management acute pulmonary oedema

Answer 1

1 upright - reduce congestion and better vq ratio
2. Oxygen - at least 60%, flow rate 6-8 l/ min. many will need CPAP 5-10 cm h20
3. Iv loop diuretic: furosemide 40-80 mg bolus or torsemide 10-20mg bonus; repeat if necessary
4 if hypertensive crisis, iv glyceryl trinitrate 10-20 microg per min.
5. If hypotensive or shock, positive inotrope: dobutamine 2-3 micro g /kg / min and up titrate to max 15
6. Start life saving Hf therapy: ace-i, bb, aldactone, ARNI.

Question 2

Definite treatment acute coronary syndrome?

Answer 2

PCI <2 hours from diagnosis

Question 3

Treatment narrow complex tachycardia?

Answer 3

• Amiodarone first line
Or digoxin, verapamil -consult specialist
If haemodynamically unstable, cardioversion

Question 4

Treatment broad complex tachycardia?

Answer 4

Cardioversion best

Drug: lignocaine

Question 5

Name 2 indications amiodarone

Answer 5

• Narrow complex tachycardia

* A fib

Question 6

Nb side effect amiodarone?

Answer 6

Acute pulmonary toxicity/fibrosis