Emergencies

Question 1

What is the technique for chest compressions?

Answer 1

Hands of middle of lower half of sternum
Depress sternum 5-6cm
At rate of 100-120bpm

Question 2

Where are defibrillation pads placed?

Answer 2

Right of upper sternum, below clavicle

Mid-axillary line level with V6 electrode

Question 3

In cardiac arrest, when would you give adrenaline?

Answer 3

In VF/VT after three shocks

In PEA/asystole as soon as possible

Question 4

In cardiac arrest, what drug and how much do you give?

Answer 4

1mg IV adrenaline

Question 5

What are the sepsis six?

Answer 5

Give oxygen
Give fluids
Take blood for FBC, cultures, etc
Give antibiotics
Measure lactate
Measure urine output

Question 6

What would you give to a patient presenting with unstable angina/ACS?

Answer 6

Oxygen
Opioid analgesia (eg morphine)
Aspirin (and clopidogrel)
Nitrate (GTN)

Question 7

When would you treat a bradyarrhythmia?

Answer 7

When patient is unwell and there is risk of asystole

Question 8

What and how much is given first line to treat a bradyarrhythmia?

Answer 8

500mcg IV atropine

Question 9

How would you treat an unstable (or with adverse features) tachycardia?

Answer 9

Synchronised DC shocks with amiodarone 300mg IV over 10-20 mins

Question 10

What drug and how much do you give in anaphylaxis?

Answer 10

0.5ml (of 1:1000 solution) of adrenaline IM

Question 11

What is a common cause of cardiorespiratory arrest in children?

Answer 11

Hypoxia

Question 12

Once you have confirmed a child is unresponsive and shouted for help, what do you do next?

Answer 12

Open airway and give 5 rescue breaths (if not breathing normally)

Question 13

What is the ratio of breaths to compressions in paediatric life support?

Answer 13

15 compressions to 2 breaths

Question 14

What are good compressions in infants and children?

Answer 14

Over lower half of sternum
At least one-third of chest deep compression
Rate of 100-120bpm

Question 15

In a non-shockable rhythm in children, how much and by what route should adrenaline be given?

Answer 15

10micrograms/kg bodyweight IV

Question 16

In cardiac arrest (both adult and paediatric), how frequently should adrenaline be given?

Answer 16

Every 3-5 minutes

Question 17

In an unconscious patient who is choking, what should you do?

Answer 17

Open airway

Start CPR

Question 18

In a conscious patient who is choking, what should you do?

Answer 18

Encourage cough, if ineffective give either 5 back blows or 5 abdominal thrusts

Question 19

What should you do if there is spontaneous return of circulation?

Answer 19

Use ABCD approach
Controlled oxygenation and ventilation
12-lead ECG
Treat precipitating cause
Temperature control

Question 20

How would you control an irregular narrow complex tachycardia? What is it likely to be?

Answer 20

Probable atrial fibrillation

Control with: beta-blocker or diltiazem, and consider digoxin if heart failure

Question 21

What is a regular broad complex tachycardia likely to be and how would you control it?

Answer 21

Ventricular tachycardia

Give amiodarone 300mg IV over 20-60mins and give adenosine 6mg rapid IV

Question 22

How would you treat a regular narrow complex tachycardia?

Answer 22

Vagal manoeuvres and adenosine 6mg IV rapid bolus

Monitor ECG continuously

Question 23

What is a regular narrow complex tachycardia likely to be if he treatment restores sinus rhythm?

Answer 23

Re-entry paroxysmal supra-ventricular tachycardia