EMERGENCIES Flashcards
Headaches.
First and worse headache
Thunder clap headache
SUBARACHNOID HAEMORRHAGE
Headaches.
Unilateral headache and eye pain
cluster headache
glaucoma
Unilateral headache and ipsilateral (same sided) symptoms
migraine
tumour
vascular
Headaches.
Cough initiates headache
Raised ICP
Venous thrombosis
Benign intracranial hypertension
Headache worse in the mornings.
Worse on bending forwards
Raised ICP.
Venous thrombosis.
Benign intracranial hypertension
Persisting headache +/- scalp tenderness in over 50s
Giant cell arteritis
Headache with neck stiffness or fever
Meningitis
Two very important additional things to ask in a headache history
Any recent travel (malaria)
Pregnancy possibility (pre-eclampsia)
Stony dullness to percussion may indicate
Pleural effusion
Key investigations to remember in a patient with acute breathlessness
Baseline observations –> sats, HR, Temp, peak flow
ABGs if sats are below 94% –> concerns over acidosis, drugs or sepsis
ECG (signs of PE, Left ventricular hypertrophy, MI)
CXR –> rule out any other pathology
Baseline bloods –> glucose, FBC, u&e’s and consider drug screen
Life threatening differential diagnoses for acute chest pain
Acute MI
Angina / acute coronary syndrome
Aortic dissection
Tension pneumothorax
Pulmonary embolism
Oesophageal rupture
What do you give in benzo overdose
Flumazenil
Dose of adrenaline given in anaphylaxis management
0.5mg (0.5mls of 1:1000)
Mimics of anaphylaxis involve
Carcinoid syndrome
Pheochromocytoma
Hereditary angioedema
Systemic mastocytosis
Management of STEMI
300mg loading dose ASPIRIN ASAP
Angiography with primary PCI
- if within 12 hours of symptoms & PC can be done within 120 minutes
Fibrinolysis
- if within 12 hours of symptoms and PCI not possible in 120 minutes
- give antithrombin at same time
- ECG 60-90 mins post fibrinolysis