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CSI 1b > Emergency > Flashcards

Emergency Flashcards

1
Q

What does ABCDE stand for?

A

Airway
Breathing
Circulation
Disability
Exposure

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2
Q

NEWS2 contents?

A

Respiration rate
SpO2%
Air or oxygen?
Systolic blood pressure
Pulse
Consciousness
Temperature

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3
Q

Normal range for respiration rate?

A

12-20

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4
Q

Normal SpO2 (scale 1 and 2)

A

Scale 1 - over 96%
Scale 2 - 88-92% (over 93% on air)

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5
Q

How many points if on oxygen?

A

2

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6
Q

Normal systolic blood pressure?

A

111-219

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7
Q

Normal pulse (per minute)

A

51-90

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8
Q

How many points if not alert?

A

3

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9
Q

Normal temperature?

A

36.1-38

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10
Q

NEWS2 score meaning?

A

0-4 - low risk, ward-based response
Red score (3 in any individual parameter) - low-medium risk, urgent ward-based response
Aggregate score 5-6 - medium, key threshold for urgent response
Aggregate score 7 or more - high, urgent or emergency response (with critical care skills)

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11
Q

NEWS2 scores frequency of monitoring?

A

0 - minimum 12 hourly
1-4 - minimum 4-6 hourly
3 in single parameter - minimum hourly
5 or more - minimum 1 hourly
7 or more - continuous monitoring of vital signs

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12
Q

Surgical sieve categories?

A

Primary neurological
Infection
Cardio respiratory
Gastro-intestinal
Metabolic/endocrine
Toxins
Psychiatric

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13
Q

MIDNIT

A

Metabolic
Inflammation
Degenerative
Neoplastic
Infection
Trauma

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14
Q

Airways assessment

A

Verbalising?
Foreign objects
Excessive secretions?
Snoring/stridor?
Mouth or tongue swelling?

consider airway opening manoeuvres if unsafe

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15
Q

Breathing assessment?

A

Respiratory rate
Oxygen saturation (before and after oxygen)
Respiratory distress?
Wheeze?
Smoker?

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16
Q

Circulation assessment?

A

Blood pressure?
Heart rate?
Heart sounds?
ECG?
Peripheral capillary refill?
Peripheries (temp and appearance)

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17
Q

Disability assessment?

A

Blood glucose?
Temperature?
Confused? (ACVPU or GCS)
Moving limbs?
PEARL?
Toxins? (Alcohol)

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18
Q

GCS?

A

Glasgow coma score
Eye opening response, verbal response and motor response
13-15 = minor brain injury
9-12 = moderate brain injury
3-8 = severe brain injury

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19
Q

PEARL

A

Pupils equal and reactive to light

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20
Q

Exposure assessments?

A

Rashes?
Injection/track marks?
Trauma to limbs or head?
External bleeding?
Abdominal examination

completely expose - front and back, top to bottom

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21
Q

Why is low systolic blood pressure so worrying?

A

It can lead to circulatory shock (inadequate blood flow to tissues)
Give IV fluids to manage

22
Q

What is circulatory shock?

A

When inadequate blood flow results in damage to body tissues

23
Q

Hypovolemic shock?

A

Loss of plasma or blood volume

due to dehydration, blood loss, burns

24
Q

Cardiogenic shock?

A

Heart cannot generate enough cardiac output so arteries do not have enough blood flow and tissues are not being perfused

myocardial infarction, serious cardiomyopathy

25
Q

Obstructive shock?

A

Due to obstruction in circulation, usually indirect impact on the heart

pneumothorax, pulmonary embolism

26
Q

Distributive shock?

A

Most common form of shock
Blood volume is being distributed elsewhere due to very profound vasodilation

septic, anaphylactic, neurogenic

27
Q

Percentage of each type of shock?

A

Distributive (septic) - 62%
Cardiogenic - 16%
Hypovolemic - 16%
Distributive (nonseptic) - 4%
Obstructive - 2%

28
Q

Signs of tissue hypoperfusion?

A

Brain - altered mental state
Skin - mottled, clammy
Kidney - oliguria
Tachycardia
Elevated blood lactate

29
Q

If cardiac output falls, which types of shock are considered?

A

Hypovolemic, Cardiogenic, obstructive

30
Q

If cardiac output is high, which type of shock is considered?

A

Distributive

31
Q

If cardiac output is low and venous pressure (CVP) is high, which types of shock are considered?

A

Cardiogenic, obstructive

32
Q

If cardiac output is low and venous pressure (CVP) is low, which type of shock is considered?

A

Hypovolemic

33
Q

Systemic inflammatory response syndrome (SIRS) criteria?

A

High or low temp
High heart rate
High respiratory rate
High or low WBC count

*2 or more needed *

34
Q

Sepsis criteria?

A

SIRS criteria + infection

35
Q

Severe sepsis criteria?

A

Sepsis + evidence of organ dysfunction, hypotension or hypoperfusion

36
Q

Septic shock criteria?

A

Severe sepsis + hypotension despite adequate fluid resuscitation

37
Q

Sepsis six?

A
  1. Give O2 to keep stats above 94%
  2. Take blood cultures
  3. Give IV antibiotics
  4. Give a fluid challenge
  5. Measure lactate
  6. Measure urine output

take 3 give 3

38
Q

Which biochemical tests are most indicative of sepsis?

A

CRP - inflammation during infection
Lactate - high during tissue hypoperfusion
WBC and neutrophils - indication of infection

39
Q

Which organs have pain localised in the left iliac fossa?

A

Descending colon, sigmoid colon

40
Q

Example condition that will present as pain in left iliac fossa?

A

Sigmoid diverticulitis

41
Q

What are diverticula?

A

A pouch-like out-pouching that is in the colon region.
When there is no pain, is called diverticulosis.
When there is pain it is called diverticula disease.
When it becomes infected and inflamed, it is called diverticulitis.

42
Q

Left upper quadrant organs?

A

Left portion of liver
Larger portion of stomach
Pancreas
Left kidney
Spleen
Portions of transverse and descending colon
Parts of small intestine

43
Q

Right upper quadrant organs?

A

Right portion of liver
Gallbladder
Right kidney
Small portion of stomach
Portion of ascending and transverse colon
Parts of small intestine

44
Q

Left lower quadrant organs?

A

Majority of small intestine
Descending colon
Sigmoid colon
Left female reproductive organs
Left ureter

45
Q

Right lower quadrant organs?

A

Caecum
Appendix
Right female reproductive organs
Right ureter

46
Q

What is diverticulosis?

A

When the innermost layer of digestive tract pushes through weak spots in outermost layer of digestive tract

47
Q

What causes diverticulosis?

A

Low fibre diets which leads to constipation and increased pressure in digestive tract

48
Q

Symptoms of diverticulosis?

A

Bloating, abdominal cramps, constipation

49
Q

How is diverticulosis diagnosed?

A

Sigmoidoscopy, CT scan or barium X-ray

50
Q

Medications for diverticulosis?

A

Psyllium
Methylcellulose
Polycarbophil

51
Q

Dietary changes for diverticulosis?

A

High fibre diet (20-35g recommended)
More fruit, vegetables, grains

52
Q

Diverticulosis complications?

A

Diverticulitis - inflammation of pouches
Abscess/peritonitis - collection of pus
Diverticular haemorrhage
Colonic obstruction

CSI 1b (8 decks)

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