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im a doctor :) > emergencies > Flashcards

emergencies Flashcards

1
Q

why do we do needle decompression

A

in an emergency setting to buy you some time before inserting a chest drain

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2
Q

needle decompression

A

done in 2nd intercostal space mid clav

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3
Q

chets drain

A

done in 5th itercostal mid axiallary

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4
Q

so where is the first rib

A

you wont be able to feel it as its bascially under the clavicle so the first rib you feel is the 2nd rib

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5
Q

why is a atnesion penumothorax a emergency

A

as the mediastinal shift occurs it causes a sn obstructive shock compressing the vana cava and not alloweing blood to reach the heart

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6
Q

so what are the 3 signs that would alert you to a tension pneumor

A
  1. TACHY + HYPO (SIGNS OF SHCOK)
  2. ABSENT BREATH SOUNDS
  3. DYSPNEAC

JVP AND TRACHEAL SHIFT ARE MUCH LATER SIGNS

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7
Q

which do you treat with a 3 way dressing

A

OPEN

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8
Q

PRIMARY PNEUMO

A

HAPPNES WITHOUT ANY CHEST PROBLEMS UNDERLYING DISEASE

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9
Q

how to avoid hitting the nerves and vessels

A

when in the space always go over the bottom rib as the bundle is underneth the top rib!

e.g 2nd intecostal space is between 2nd and 3rd rib so lie the needle over the 3rd rib .

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10
Q

DESCRIBE RECOVERY POSTION

A
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11
Q

MNEUMOIC FOR ALTERNED MENTAL STATUS

A

A- ALCOHOL, ACIDOSIS, AMMONIA , ARRYTHMIAS
E- EPILESY
I- INFECTIONS
O - OVERODES, OXYGEN, OPIATES
UR-UREMIA

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12
Q
A
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13
Q

Non shockable tx

A

Cprand adrenaline (amiodorone later on)

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14
Q

Non shcoabkle rtyhme

A

Pea
Asytole

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15
Q

Shockable rhythms

A

Vtach (plus less)
V fib

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16
Q

Why is torsdades dangerous

A

Can lead to v fib

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17
Q

What do you use to shock in a cardiac arrest

A

De fib

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18
Q

Causes of carriac arrest

A

5 h
4 t

19
Q

How do you recognise a cardiac arrest

A

Absent breathing or agonal
No central pulse
So don’t just rely on peripheral ? Ask ababa

20
Q

What’s a Farida arrest call number

A

2222

21
Q

How long do you do cpr for

A

2 mins then check for a rhythm

22
Q

What is something imprortanf before you shock someone

A

Remove oxygen
Tell people to stand clear

23
Q

What is the joules for cardiac arrest

A

Not specified in guideline

Range from 120~ 360

24
Q

Algorithm for shockable Rythm

A

ABCDE
Secure airway
Give oxygen

Shock
Resume cpr for 2 mins

After 3 rounds of shocks 300mg amiodorone and 1mg adrenaline IV or IO

Then repeat adrenaline every 3~5 mins I.e every other cycle

After 5 shocks give 150 mg amiodorone

25
Q

Algorith, for non shockable

A

ABCDE
Secure
Oxygen

Cpr
Adrenaline 1mg iv or io
T
Keep giving every 3-5 mins or every other cycle

Cannot shock or give Amod wrong unless rhythm changes to a shockable one

26
Q

Every time you do a Rythm check what should you do

A

Always stop compressions and pause a little

27
Q

Every time you do a Rythm check what should you do

A

Always stop compressions and pause a little

28
Q

What’s the definition of septic shock

A
  1. Despite aggressive resuscitation cannot maintain a MAP above 65 so need vasopresssor
  2. Lactate more than 2 despite fluids
29
Q

What kind of vasopressor do we give in septic shock

A

Noradrenaline first line

30
Q

News parameters how many

A

6

31
Q

What’s are the cut offs for news

A
  1. 5 or more
    3 or more in 1 section
32
Q

In terms of news of o2 says what to always remember

A

To add 2 to the score of a patient if they are receiving supplemental oxygen

33
Q

What’s more important in terms of bp for a deteririoting patient

A

Hypo

Because hyper can be due to pain or distress

34
Q

What is a news score we are very worried about

A

7 plus

35
Q

Traffic light system news

A

Less than 5
5/6 moderate or a single 3
7+ severe

36
Q

DKA

A

Triad

Hypergycelmia
Ketonemia more than3
Acidosis <7.2 or bicarbonate <15

Nb! Hyperglycaemia may not always be present in DKA (euglycemic dka)

37
Q

What is DKA associated with

A

Type 1 but it can happen in type 2 very rare

Young kids

38
Q

DKA happens commonly

A

In children

39
Q

Signs of DKA

A

Fruity breath
Tacky
Hypo

Abdomen pain
Vomitting
Dehydrated
Kussmail breathing
Altered mental status

40
Q

Protocol for DKA

A
  1. Start fluids
  2. Them start insulin infusion 0.1 units per kg per hour 1 hour after starting fluids

Theee is a a risk of hypokalemia so think about adding potassium

41
Q

To what level would you consider adding glucose in DKA

A

Once the glucose falls below 14

42
Q

malignant hypertension

whats the main thing we are worried about here

A

> 180/120

encephlopathy as leads to edema of brain

43
Q

what are the signs of end organ failure in hypertension

A
  1. headache
  2. vision- retinal hemorrgage, papilledema
  3. kidney
  4. encephalopathy
    seizure
  5. heart
44
Q

what are we aiming the drop for and why in malignant hypertension

1st line

A

around 160/100 otherise can cause a stroke ischemic

ca channel blocker

im a doctor :) (48 decks)

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