CoTE Flashcards
what is rhabdomyolysis
end result of any disease process that causes myocyte lysis
Aetiology of rhabdomyolysis
- injury to sarcolemma
- release of ions, myoglobin, creatine kinase, urates into circulation
- electrolyte disturbances, acidaemia, DIC, renal failure, multi-organ failure
some drugs which can induce rhabdomyolysis
- cocaine, amphetamines
- narcotics, barbiturates
- diuretics
- statins
- antipsychotics
- muscles protein supplements
key diagnostic factors of rhabdomyolysis (3)
- recent crush injury
- prolonged immobilisation
- muscular pain
- dark red urine (urinary myoglobin)
diagnostic inx of rhabdomyolysis
serum creatine levels are at least 5 times than normal
inx for rhabdomyolysis
- CK
- electrolytes: ↑K, Mg, PO4 ↓Ca-
- ↑urea + creatinine
- ↑AAT, ALT
- ↓Hb + platelets
- ↑PTT, aPTT, INR
- urine +ve for blood
- ↑myoglobin levrld
Management for rhabdomyolysis
1st line: hydration therapy (normal saline or lactated Ringer’s solution)
adjunct: urine alkalisation (myoglobin is toxic to renal tubules in acidic urine
If anuric or unresponsive: haemodialysis
what is an advance directive (3)
- a document written at a time when the patient is of sound mind
- about his/her preferences w/ respect to medical treatment
- should they later become unable to express those wishes directly
what is a lasting power of attorney
- a legal document which allows individuals to give people they trust
- the authority to manage their affairs
- if they lack capacity to make certain decisions in the future
what are the 2 types of lasting power of attorney
- health & welfare
2. property & finance
what is independent mental capacity advocate (IMCA)
- a legal safeguard for people who lack capacity
- to make specific important decisions
- when there is no one else independent of services to represent the individual
what is liberty protection safeguards
- provides protection for people aged 16+
- who need to be deprived of their liberty
- in order to enable their care/treatment
- and lack the mental capacity to consent to their arrangements
deprivation of liberty safeguards authorisation can last up to a maximum of how much time?
12 months
