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Finals Flash Cards 🩺 > Emergencies > Flashcards

Emergencies Flashcards

1
Q

Commonly identified causes of anaphylaxis

A

Food (e.g. nuts)
Drugs
Venom (e.g. wasp sting)

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2
Q

What should you give in adult anaphylaxis?

A

500 micrograms adrenaline (0.5ml 1 in 1,000)

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3
Q

What should you give in anaphylaxis of a child age 6-12?

A

300 micrograms adrenaline (0.3ml 1 in 1,000)

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4
Q

What should you give in anaphylaxis of a child age 6 months to 6 years?

A

150 micrograms adrenaline (0.15ml 1 in 1,000)

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5
Q

What is the definition of refractory anaphylaxis?

A

Defined as respiratory and/or cardiovascular problems despite 2 doses of IM adrenaline

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6
Q

When should you refer to secondary care for burns?

A
  • All deep dermal and full-thickness burns
  • Superficial dermal burns of more than 3% TBSA in adults or more than 2% TBSA in children
  • Superficial dermal burns involving the face, hands, feet, perineum, genitalia, or any flexure
  • Any inhalation injury
  • Any electrical or chemical burn injury
  • Suspicion of non-accidental injury
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7
Q

What are the shockable rhythms?

A
  • Ventricular fibrillation
  • Pulseless Ventricular tachycardia
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8
Q

What are the non shockable rhythms?

A
  • Asystole
  • Pulseless-electrical activity
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9
Q

When should you give amiodarone in cardiac arrest?

A

Amiodarone 300mg should be given to patients who ate in VF/Pulseless VT after 3 shocks have been administered

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10
Q

What are the reversible causes of a cardiac arrest?

A

The ‘Hs’
- Hypoxia
- Hypovolaemia
- Hyperkalaemia, Hypokalaemia, hypoglycaemia, hypocalcaemia, acidaemia
- Hypothermia

The ‘Ts’
- Thrombosis
- Tension pneumothorax
- Tamponade
- Toxins

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11
Q

Mild hyperkalaemia?

A

5.5-5.9mmol/L

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12
Q

Moderate Hyperkalaemia?

A

6.0-6.4mmol/L

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13
Q

Severe Hyperkalaemia?

A

> 6.5mmol/L

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14
Q

What do you use to stabilise the cardiac membrane in Hyperkalaemia?

A

IV Calcium gluconate

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15
Q

What do you use to short term shift the potassium from ECF to ICF?

A
  • Combined insulin/dextrose infusion
  • Nebulised salbutamol
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16
Q

What do you use to remove potassium from the body in hyperkalaemia?

A
  • Calcium resonium (orally or enema)
  • Loop diuretics
  • Haemodialysis
17
Q

What is the definition of massive haemorrhage?

A

This is the loss of one blood volume in a 24 hour period or the loss of 50% of the circulating blood volume in 3 hours.
A blood loss of 150ml/min is also included.

18
Q

Management for paracetamol overdose?

A

Management
activated charcoal if ingested < 1 hour ago
N-acetylcysteine (NAC)
liver transplantation

19
Q

Management for Salicylate overdose?

A

Management
- Urinary alkalinization with IV bicarbonate
- Haemodialysis

20
Q

Management for opioid overdose?

A

Naloxone

21
Q

Management for cyanide poisoning?

A

Hydroxocobalamin

22
Q

What is Sepsis?

A

Life-threatening organ dysfunction caused by a dysregulated host response to infection

23
Q

What is the Sepsis Six?

A

Blood cultures
Urine output monitoring
Fluids
Antibiotics
Lactate
Oxygen

24
Q

What are the different groups of shock?

A
  • Septic
  • Haemorrhagic
  • Neurogenic
  • Cardiogenic
  • Anaphylactic
25
Q

What does a palpable femoral pulse equate to?

A

In order to generate a palpable femoral pulse an arterial pressure of >65mmHg is required

26
Q

When does Neurogenic shock most commonly occur?

A

Following a spinal cord transection

27
Q

What is Beck’s triad?

A

Elevated venous pressure, reduced arterial pressure, reduced heart sounds
Indicates Cardiac tamponade

28
Q

What the first-line treatment for bradycardia?

A

Atropine (500mcg IV)

29
Q

What is the management of Magnesium sulphate?

A

IV Magnesium Sulphate

30
Q

Risk factors for Necrotising fasciitis?

A
  • Skin factors: Recent trauma, burns or soft tissue infections
  • Diabetes mellitus
  • Intravenous drug use
  • Immunosuppression
31
Q

How do you treat Acute COPD?

A
  • Sit-up
  • 24% O2 Venturi mask (Aim 88-92%)
  • Vary FiO2 and SpO2 target according to ABG
  • Neb Salbutamol 5mg/4hr/Ipratropium 0.5mg/6h
  • Steroids Hydrocortisone 200mg IV or Prednisolone 40mg PO for 7-14 days
32
Q

When should you consider escalation in exacerbation of COPD?

A

Repeat nebulisers and consider aminophylline IV
Consider NIV (BiPAP) if pH <7.35 and/or RR >30
Consider invasive ventilation if pH<7.26

33
Q

What is the most appropriate perimeter to measure in suspected Carbon monoxide poisoning?

A

Carboxyhaemoglobin

34
Q

What features in examination or history are suspicious for smoke inhalation in burns

A

Burning sensation in the nose / throat
- Productive cough
- Stridor
- Dyspnoea
- Rhonchi
- Wheezing
- Hoarse voice
- Accessory muscle usage
- Tachypnoea
- Cyanosis
- Odynophagia
- Headache
- Delirium
- Hallucinations
- Decreasing consciousness / comatose
- Convulsions / seizures
- Hypertonia
- Facial burns / loss of facial or intranasal hair
- Soot in mouth or sputum

35
Q

What effect does carbon monoxide have on the oxyhaemoglobin dissociation
curve and how does this cause symptoms of carbon monoxide poisoning?

A

Carbon monoxide has a greater affinity for haemoglobin than oxygen (so readily
binds to Hb)
Causing the curve to shift to the left
Left shift → increased affinity of haemoglobin for oxygen / so haemoglobin holds onto
oxygen more tightly
Reducing the release of oxygen to tissues, causing hypoxia and the associated
symptoms
(eg inadequate oxygenation to brain because oxygen held tightly to Hb instead →
headaches / confusion / decreased consciousness)

36
Q

What is the difference between stridor and wheeze?

A

Stridor occurs when there is obstruction in the upper airway, wheeze occurs when there is obstruction in the lower airway/stridor more likely heard on inspiration and wheeze on expiration

37
Q

What position should be encouraged in anaphylaxis and why?

A

Flat with legs raised, to maximise venous return to the heart

38
Q

What direction does carbon monoxide shift the bohr curve and why?

A

Carbon monoxide has a high affinity for haemoglobin and myoglobin resulting in a left-shift of the oxygen dissociation curve and tissue hypoxia.

39
Q
A

Finals Flash Cards 🩺 (32 decks)

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