Emergencies Flashcards
What overdosed drugs indicate the need of haemodialysis?
BLAST
Barbiturates
Lithium
Alcohol
Salicylates
Theophylline
What is the reversing agent in an overdose of benzodiazepines?
Flumanezil (if iatrogenic)
What is the reversing agent in an overdose of opiates?
Naloxene
What is the reversing agent in an overdose of paracetamol?
N-Acetylcysteine
What is the reversing agent in an overdose of aspirin?
Sodium bicarbonate
What is the reversing agent in an overdose of TCA?
Sodium bicarbonate
What is the reversing agent in an overdose of beta blockers?
Atropine (low HR), glucagon (low BP)
What is the reversing agent in an overdose of ethylene glycol (antifreeze)?
Fomepizole
What to do if patient develops a rash due to NAC in paracetamol OD?
stop, restart at lower rate (± chlorpheniramine)
What level of PT indicates transplant in paracetamol OD?
if >180 seconds on day 4 will need transplantation
Signs and symptoms of salicylate overdose
Specific - Tinnitus, hyperventilation, vertigo
Non-specific - vomiting, dehydration, sweating
Dose-related response to salicylate overdose
150mg/kg (mild)
250mg/kg (moderate)
>500mg/kg (severe)
>700mg/kg (fatal)
How do you calculate fluid resuscitation in burns management?
Fluid resuscitation –> Parkland’s formula; 14/16G cannulae in each ACF – even if through a burn site
Parkland formula = 4 (mL) x weight (kg) x % burn = mL Hartmann’s in first 24 hours (50% in 1st 8 hours)
I.E. 70kg adult with 23% burns = 4 x 70 x 23 = 6,440mL (3,220mL in first 8 hours)
What fluids do you use in burns management?
Crystalloid (e.g. Hartmann’s)
Causes of dominant R wave in V1/2
Posterior MI
PE
RBBB
RVH
Duchenne Muscular Dystrophy
Dextrocardia
WPW
Causes of raised JVP
○ Right-sided heart failure
○ Cardiac tamponade/pericardial effusion
○ TR
○ Complete heart block
○ SVC obstruction
Cough-initiated headache
Worse in the morning or bending forward
Raised ICP
Venous thrombosis
Unilateral headache and ipsilateral symptoms
Migraine
Tumour
Vascular
If a patient takes an overdose and has been stabilised - what next?
Perform a risk assessment for ongoing suicidal ideation and organise a review by the Psychiatric liaison service
If you have a “vulnerable adult support team” ask them to see the patient
Is the patient safe to be in the CDU/Short Stay Ward?
Does the patient have capacity? What if the patient wants to leave?
