Emergencies Flashcards
What is the technique for chest compressions?
Hands of middle of lower half of sternum
Depress sternum 5-6cm
At rate of 100-120bpm
Where are defibrillation pads placed?
Right of upper sternum, below clavicle
Mid-axillary line level with V6 electrode
In cardiac arrest, when would you give adrenaline?
In VF/VT after three shocks
In PEA/asystole as soon as possible
In cardiac arrest, what drug and how much do you give?
1mg IV adrenaline
What are the sepsis six?
Give oxygen Give fluids Take blood for FBC, cultures, etc Give antibiotics Measure lactate Measure urine output
What would you give to a patient presenting with unstable angina/ACS?
Oxygen
Opioid analgesia (eg morphine)
Aspirin (and clopidogrel)
Nitrate (GTN)
When would you treat a bradyarrhythmia?
When patient is unwell and there is risk of asystole
What and how much is given first line to treat a bradyarrhythmia?
500mcg IV atropine
How would you treat an unstable (or with adverse features) tachycardia?
Synchronised DC shocks with amiodarone 300mg IV over 10-20 mins
What drug and how much do you give in anaphylaxis?
0.5ml (of 1:1000 solution) of adrenaline IM
What is a common cause of cardiorespiratory arrest in children?
Hypoxia
Once you have confirmed a child is unresponsive and shouted for help, what do you do next?
Open airway and give 5 rescue breaths (if not breathing normally)
What is the ratio of breaths to compressions in paediatric life support?
15 compressions to 2 breaths
What are good compressions in infants and children?
Over lower half of sternum
At least one-third of chest deep compression
Rate of 100-120bpm
In a non-shockable rhythm in children, how much and by what route should adrenaline be given?
10micrograms/kg bodyweight IV
In cardiac arrest (both adult and paediatric), how frequently should adrenaline be given?
Every 3-5 minutes
In an unconscious patient who is choking, what should you do?
Open airway
Start CPR
In a conscious patient who is choking, what should you do?
Encourage cough, if ineffective give either 5 back blows or 5 abdominal thrusts
What should you do if there is spontaneous return of circulation?
Use ABCD approach Controlled oxygenation and ventilation 12-lead ECG Treat precipitating cause Temperature control
How would you control an irregular narrow complex tachycardia? What is it likely to be?
Probable atrial fibrillation
Control with: beta-blocker or diltiazem, and consider digoxin if heart failure
What is a regular broad complex tachycardia likely to be and how would you control it?
Ventricular tachycardia
Give amiodarone 300mg IV over 20-60mins and give adenosine 6mg rapid IV
How would you treat a regular narrow complex tachycardia?
Vagal manoeuvres and adenosine 6mg IV rapid bolus
Monitor ECG continuously
What is a regular narrow complex tachycardia likely to be if he treatment restores sinus rhythm?
Re-entry paroxysmal supra-ventricular tachycardia
