Emergencies in Depth Flashcards
What is the chain of survival in cardiac arrest?
Basic life support (chest compressions)
Defibrillation as soon as possible
Advanced life support from trained health professionals
Good post-resuscitation care.
How soon does irreversible brain damage occur after complete failure of circulation?
3-4 minutes.
What three interventions are known to increase survival from cardiac arrest?
Chest compression
Defibrillation
Airway management
What are the four elements of basic life support, in order?
Initial assessment
Airway clearance and maintenance
Rescue breathing
Chest compression to support the circulation.
What percentage of normal blood flow do optimal chest compressions achieve? Why is this important?
30% of normal cerebral blood flow
15% of coronary blood flow
Even with chest compressions the heart must be restarted as soon as possible to stop irreversible brain damage (which occurs after just a few minutes).
You’re alone and witness an adult cardiac arrest. What is more important, finding a defibrillator or starting chest compressions?
Finding the defibrillator.
Arrest in adults is usually a primary cardiac event (damage to the heart causing ventricular fibrillation). Restarting the heart is therefore the priority.
However, once attempts are made to find the defibrillator, chest compressions are the next step.
Initial management of upper GI bleeds
Admission
Telemetry cardiac monitoring
Regular blood pressure every 5 minutes
Two large bore cannulae
What are the scoring systems for upper GI bleeds?
Rockall and Glasgow-Blatchford
How do you do a rockall score?
Clinical findings: age, comorbidities, evidence of haemodynamic shock
Endoscopic findings: diagnosis, stigmata of recent haemorrhage
How do you do a Glasgow-blatchford score?
Urea Haemoglobin Systolic BP Heart rate Malaena Syncope Liver disease or cardiac failure
