emergency Flashcards
1
Q
acute HF
A
sit upright stop IVI high flow O2 Iv furosemide - 0.5kg/day wt loss aim CPAP or ionotropes if needed
2
Q
acute pulmonary oedema
A
sit upright high flow O2 IV furosemide GTN x2 puffs if sBP>90 - Iv nitrates if no improvement if sBP>100
3
Q
anaphylaxis - acute management
A
airway - secure, anaesthetist breathing - widespread wheeze - 15L non-rebreathe - neb salbutamol if wheeze 500mcg 1:1000 adrenaline - repeat in 5 mins if no imrpovement 10mg chlorampheniramine slow IV 200mg IV hydrocortisone slow IV IV fluids if shock - 500ml over 10-15mins
4
Q
anaphylaxis management once stable
A
monitor - pulse, o2, hr, ECG, BP serum tryptase at 1-4hr prednisolone PO 3-5D epipen followup at GP in 3-5D allergy clinic referral document
5
Q
acute asthma
A
OsHIT ME
oxygen - 15L non rebreathe neb salbutamol + oxygen driven 5-10mg + iptratropium 500microgram - back to back nebs every 15-30mins hyodrocortisone IV 100mg magnesium sulphate IV aminophyalline IV - senior escalate
oral pred 40-50mg for 5D
6
Q
acute COPD
A
oxygen via venturi mask aim for 88-92% neb salb 5-10mg + ipatropium 0.5mg oral pred 30mg OD for 7D abx - doxy 5-7D if increase purlunece, increase sputum, IN sOb resp team
7
Q
hyperkalaemia
A
Iv calcium gluconate 10ml 10% over 10 mins
IV insulin and dextrose 25g
salbutamol neb
cause
8
Q
hypoglycaemia
A
conscious
- 15-20g of sA carb e.g. 2 pieces of toast
- glucogel/ oral glucose tablets
- IM glucagon - dipping consciousness
unconscious
- im 1mg glucagon or 100ml 20% glucose
9
Q
hyperlgycaemia - DKA
A
0.9% saline 1L over 1hr IV insulin 0.1unit/kg/hr 2/3rd L over 2hrs - from bag 2, add potassium if <5.4 and glucose if <14 with 125ml/hr 10% dextrose 4th bag over 4hr
monitor fluid output - catheter, fluid balance
wait til eating and drinking to restart s.c. insulin (sA)
1hr late stop fixed rate
prophylactic LMWH
10
Q
hyperglycaemia - HHs
A
0.9% saline 1L over 1hr then 3-6L over 12hrs
prophylatic LMWH
11
Q
status epilepticus
A
IV lorazepam 4mg
- buccal midazolam 10mg in community
- x2, wait 5 mins
30 mins - status delcared
Iv phenytoin at 20mg/kg slow Iv
anaesthetist/ ITU
12
Q
naloxone
A
400mcg
13
Q
flumenazil
A
200mcg over 10 secs
14
Q
iron
A
dessferrioxamine
