EDH - ED Hospital Learning

Question 1

Mx for all OD patients:

Answer 1

1. VBG
2. Paracetamol levels
3. ECG
4. U-dipstick

Question 2

What to look for on XR when infection (cellulitis)?

Answer 2

Air in soft tissue - gas gangrene

Question 3

What to exclude in pt with back pain?

Answer 3

1. Focal neurology
2. Bladder or bowel changes

Question 4

Mx for TBI patient:

Answer 4

1. IVL
2. Bloods: VBG/ FBC/ U&E/ INR
3. +/- C-spine collar (if C-spine tenderness)
4. Book CTB
5. +/- Load with phenytoin

Question 5

What to exclude when head injury/ lacerations to face or head?

Answer 5

1. No TBI
2. No palpable skull #s
3. No signs BOS #
4. No signs local cellulitis

Question 6

Grading of TBI - Severe:

Answer 6

Severe:
1. GCS < 9
2. LOC > 24 hrs
3. Alteration of consciousness > 7 days
4. Normal or abnormal findings on imaging

Question 7

Grading of TBI - Mild:

Answer 7

Mild:
1. GCS 13-15
2. LOC < 30 min
3. Alteration of consciousness < 24 hrs
4. Normal findings imaging

Question 8

Grading of TBI - Moderate:

Answer 8

Moderate:
1. GCS 9-12
2. LOC 30 min - 24 hrs
3. Alteration of consciousness 24 hrs - 7 days
4. Normal or abnormal findings on imaging

Question 9

Grading of power:

Answer 9

0 - No contraction
1 - Flicker of contraction
2 - Movement with gravity eliminated
3 - Movement against gravity
4 - Movement against gravity + resistance
5 - Normal power

Question 10

Alvarado score for appendicitis:

Answer 10

MANTRELS

Sx:
M - migratory abdo pain localising to RIF
A - anorexia
N - nausea/vomiting

Signs:
T - tenderness RIF
R - rebound tenderness
E - elevated temp > 37.3

Lab:
L - leukocytosis > 10 000
S - (left) shift neutrophilia > 70%

Question 11

DIMTOPS for delirious patient:

Answer 11

1. Drugs - alcohol, heroin, cannabis, BZDs, chronic meds
2. Infection - meningitis, encephalitis, CAP, UTI, septicaemia, malaria
3. Metabolic & endocrine - hypo/hyper-Na, Ca, Mg, glycaemia, thyroidism
4. Trauma & toxins - CO inhalation
5. O - hypoxia/ hypotension
6. Psychiatric (psychosis, dementia) & post-ictal state
7. Space occupying lesion

Question 12

Dosage for loading TBI patient with Epilim?

Answer 12

20 mg/kg

Question 13

Sedation for psych patient:

Answer 13

1. Midazolam 10 mg IMI stat
2. Etamine 40 mg IVI stat

Question 14

Dosage for loading TBI patient with Epilim?

Answer 14

20 mg/kg

Question 15

Sedation for psych patient:

Answer 15

1. Midazolam 10 mg IMI stat
2. Etamine 40 mg IVI stat