ED Flashcards
What can aspirin cause
Tinnitus
AAA Tx
surgery
small PE Tx
1) DOAC (apixaban) for at least 3 months
PE Haemodynamically unstable Tx
Thrombolysis
DVT scorecard
Wells Score
acute ischaemic stroke tx
thromboylsis within 4.5hrs
2ndry prevention for stroke
clopidogrel OR asprin + MR dipyridmol
Scoring for deciding anticoagulation
CHA2DSVAS
SVT tx
1) vagal manoevours
2)rapid IV bolus 6mg adenosine, x 12mg, x18mg
3)electrical cardioversion
tachycardia tx
amiodarone
lidocaine
procainamide
pericarditis tx
NSAIDS + colchicine and treat underlying cause
cardiac tamponade tx
urgent pericardiocentesis
croup caused by
parainfluenza virus
croup tx in ED
high flow oxygen
nebulised adrenaline
bronchiolitis tx
humidified o2
nasogastric feeding if child cannot take enough fluid by mouth
suction
epiglottitis tx
immediate seniors help (anaesthetics, ent)
oxygen
iv antibiotics
Acute exacerbation of COPD tx
increase bronchodilator
prednisalone 30mg 5 days
abx if sputum purulent/green
primary pneumothorax tx
<2cm and pt not sob = discharge
2ndry pneumothorax tx
pt >50yrs and >2cm = chest drain
<1cm give o2 and admit 24hrs
tension pneumothorax tx
aspiratoin 5th ICS at anterior mid-axillary line
phimosis and paraphimosis and tx
foreskin cant be pulled
foreskin cant be put back
tx: squeezing, slit, circumcision surgery
hyperkalemia tx
iv calcium gluconate
acute urinary retention
bladder US, vol >300cc
decompress bladder with catheter
diverticulitis
oral abx, liquid diet, analgesia
acute appendicitis tx
appendectomy
acute cholecystitis features
URQ pain, radiate to shoulder
fever
Murphy’s sign: ask pt to breath in and pain when in contact with gallbladder
LFT’s normal
acute cholecystitis tx
iv abx
cholecystectomy within 1 week of diagnoses
acute pancreatitis features
severe epigastric pain, raidate to back
vomiting
periumbilical discolouration (cullen’s sign)
acute pancreatitis causes
I: idiopathic
G: gallstone
E: Ethanol
T: Trauma
S: steroids
M: mumps
A: autoimmune
S: scorpion sting
H: hypercalcaemia/ hypertriglyceridemia
E: ERCP
D: Drugs
pancreatitis tx
fluids
analgesia
nutrition
treat underlying cause
surgery
when do you intubate
gcs less than 8
ct in 1 hour
gcs<13 on inital assessment in ED
gcs < 15 at 2 hours after injury
sus skull fraction
1< vomiting episode
post traumatic seizure
focal neurological defcit
ct within 8hours
> 65years old
bleed or clotting disorder
anticoag tx
dangerous mechanism of injury
30mins amnesia
basal skull fracture features
panda eyes
csf rhinorrhea
battle sign
how much blood loss
hr normal: 10-15% blood loss
100bpm: 15-30%
120bpm: 30-40%
140: >40%
opioid overdose tx
iv naloxone
superficial burn
red and painful but do not blister
partial thickness burn
range from blistering to deep dermal burn.
appearance is shiny and sensation is intact
capillary refill blanches
full thickness burn
has leathery or waxy appearnace
white, brown, black
no blister and sensation lost
feel no pain
no cap refill
iv fluid replacement required for adult with ….. of total body surface area burned
15%
iv fluid replacement required for child with ….. of total body surface area burned
10%
parkland formula: to calculate fluids for patient
4 x weight (kgs) x % of area burned = ml of fluids
what value of blood glucose is considered hypoglycaemia
3.5mmol/L
hypoglycaemia tx conscious and unconscious
conscious: carb snack and glucose gel
unconscious: glucagon 1mg IM or glucose IV
types of iv gluose given for hyperglycaemia
1) glucose 10% 50ml (every 1-2mins until pt consious or max 250ml)
2) glucose 20% 75ml (over 10-15mins)
3) glucose 50% 25-50ml
iv for mallory weiss
endoscopy
acute alcohol withdrawal tx
benzodiazepines (chlordiazepoxide)
iv thiamine
delirium tremens tx
benzodiazepine(lorazapam)
iv thiamine
what is wernicke’s encephalopathy
vitamin b1(thiamine) deficiency
triad for wernicke’s encephalopathy
double vision
ataxia
confusion
anaphylaxis tx
IM adrenaline
adults: 0.5ml
6-12yrs: 0.3ml
<6ys: 0.15ml
cardio resus tx
10ml IV Adrenaline
bleeding peptic ucler tx
acid supression (ppi)
+/- endoscopic repair
perforated peptic ucler investigation
erect chest x-ray: air under diaphragm
perforated peptic ucler tx
surgical laparoscopic repair
haemothorax pc
hypotension
tachycardia
dullness on percussion
cxr: homogenous opacity on lower region of lung
tension pneumothorax tx
needle decompression 5th ICS mid axillary line
What is flail chest
multiple broken ribs due to trauma which move in during inspiration and out during expiration causing paradoxical breathing
aortic dissection pc
abrupt onset thoracic, abdo and/or back pain
sharp, tearing, ripping pain
aortic dissection tx
asecending: surgery
descending: medical management
what is toxic shock syndrome
multisystem inflammatory response to bacterial exotoxins (stahpylococci & streptococci)
toxic shock syndrome tx
same as sepsis along with steroids
generalised tonic/clonic seizure tx 3 steps
1)(MAX 2DOSES)
IV access: IV Lorazepam or Diazepam
No IV access: Buccal midazolam or rectal diazepam
2) IV Phenytoin or Phenobarbital
3) ICU referral
what is status epilepticus
single epileptic seizure lasting more than 5 minutes OR 2 seizures within 5 minutes without full recovery
adult resuscitation
30 chest compression
2 rescue breaths
continue CPR 30:2
child resuscitation
open airway
5 rescue breaths
15 chest compression
2 rescue breaths
15 chest compression
15:2
whats defiend as a narrow QRS
<0.12s
drugs that cause of hyperkalemia
potassium sparing diuretics
ACE inhibitors
ARBS
spironolactone