Ch 7 - Accidents & poisoning

Question 1

Accident prevention can be categorized into: primary, secondary and tertiary - 1 sentence description

Answer 1

Primary - prevention of acident happening
secondary - reduction in severity should the accident happen e.g. seat belts
tertiary - efffective treatment once accident happens

Question 2

Features of serious head injuries where CT scan required (4)

Answer 2

LOC > 5 min
amnesia > 5 min
abnormal drowsiness
>3 episodes of vomitting 
signs of Basal skull fracture
low GCS
post traumatic seizure (no history of epilepsy)

Question 3

Management of Head injuries: mild, potentially severe (1), severe (3)

Answer 3

Mild - reassure and discharge
potentially severe - monitor to avoid secondary damage
severe - resusc + CT + neurosurgical referral

Question 4

Burns and scalds assessment (2) + how to calculate surface area affected

Answer 4

Resusc
smoke inhalation
Using Lund & browder chart

Question 5

Management of burns and scalds (3)

Answer 5

Resusc
Fluids + pain relief
Cling film wound (prevents infection + reduces pain)
irrigation if partial thickness wound covering

Question 6

Choking/ suffocation/ strangulation: Management - if can cough effectively (1), if cannot; conscious (2) vs unconscious (2)

Answer 6

Effective cough - encourage cough + monitor for deterioration
ineffective cough - conscious = 5 back slaps, 5 thrusts (chest in infants & abdo for older)
unconscious - deliver rescue breaths (5) > CPR 15:2

Question 7

Dog bite management: (5)

Answer 7

Copious wound irrigation + debridement
delayed wound closure (as this reduces infection incidence)
removal of foreign bodies
prophylactic ABs if suspect increased infection risk e.g. puncture marks
raise and immobilse limb
tetanus booster

Question 8

2 examples of chronic poisoning

Answer 8

Lead
parental smoking - higher incidence of asthma + pneumonia+ serous otitis media (also maternal smoking increases risk of SIDS)

Question 9

Features of poisoning + specific examples if possible (5)

Answer 9

Tachypnoea - aspirin, CO
Tachycardia - cocaine, antidepressants, amphetamines
low RR - alcohol + opiates
bradycardia - BBs 
HTN - cocaine, amphetamines
Hypotension - TCADs, opiates, iron
Mydriasis - cocaine, cannabis, amphetamines
Miosis - opiates, organophosphates