Emergency Flashcards
When can activated charcoal be given?
Those who present within 1hour, fully conscious and protected airway
In potential trauma - initial steps
1) Airway
2) Cervical spine immobilisation
What is an appropriate Ix for cervical spine fracture?
CT scan of neck
In pt who is hypotensive + tachycardic, but adequately (overloaded even, e.g., pulmonary oedema) what is the most appropriate next treatment?
IV noradrenaline
Mx for TCA overdose
IV sodium bicarbonate
Mx beta blocker OD
glucagon
Ix to confirm anaphylaxis
elevated mast cell tryptase
Initial mx anaphylaxis
0.5mg of IM 1 in 1000 adrenaline
+ remove source of reaction
+ monitor >6h due to risk biphasic reaction
What is pathophysiology behind anaphylaxis
- Sensitisation phase
- Immune system encounters allergen & produces allergen specific IgE
- asyx - Reaction phase
- Re-exposure to allergen -> cross links w IgE on surface of mast cells
- Degranulation of mast cells -> histamine release
Fever + rash + lymphadenopathy + deranged LFTs + eosinophilia
Drug reaction w eosinophilia and systemic syx (DRESS)
- basc a v severe drug reaction
Hypersensitivity types
Type 1 - Anaphylaxis: Ig E; e.g., allergy
Type 2 - antiBody: IgG; e.g., goodpastures
Type 3 - immune Complx: IgG/IgM; e.g., SLE
Type 4 - Delayed: T-cell; e.g., contact derm
Type 5 - autoimmunE: IgG/IgM; e.g., Graves, MG
Sepsis 6
3 in
- high flow O2
- Fluid challenge
- IV abx
3 out
- Bloods incl lactate
- Blood culture
- Urine output
Primary care mx if suspected meningococcal disease
IM benxylpenicillin 1.2g
Mx if contact w pt who has meningococcal meningitis
Ciprofloxacin 500mg STAT
Encapsulated yeast on india ink staining of CSF
cryptococcal meningitis (seen in HIV)