Emergency Flashcards
How is anaphylaxis diagnosed?
Acute onset of illness with skin or mucosa features PLUS resp compromise, low BP or GI features OR acute bronchospasm or hypotension after exposure to probable allergen (even w/o skin involvement).
How is anaphylaxis managed?
Followup
Adrenaline 0.5mg = 0.5ml of 1:1000 IM (10microg/kg in kids), anterolateral thigh, 5minly. Lie flat or sit up if breathing difficulty, high flow oxygen, IV access, cardiac monitoring. Consider 2d steroids, nebulised ventolin or adrenaline for airways.
F/U: Med alert bracelet, epipen, allergist.
What is first aid for burns?
Remove clothing/jewellery, cold running water for 20mins, cover with cling film lengthways, deroof blisters if >5mm or crossing joints.
What are the features of epidermal, superficial and mid dermal burns?
E: Red, painful, brisk CRT, 7d heal. SD: pink, painful brisk CRT, blisters, 14d may scar. Mid dermal: dark pink, sluggish cap refill, variable sensation.
What dressings are used for burns?
Epidermal: hydrate + moisturise, hydrogel can soothe. Superficial dermal: foam first for moisture 3d then hydrocolloid. Mid dermal - consider silver.
How are opioid, amphetamine and cannabis overdoses managed?
Op: aim RR >12 and sats >90%, IV naloxone 0.05mg OR 1.8mg nasal spray, manage airway more than GCS. Others depends on symptoms, benzos if agitated, support.
How are community needle stick injuries managed?
Wash soap and water, check tetanus, determine risk (known carrier, deep/large injection). Low risk: only check Hep B Ab, give booster if needed or Ig + vaccine if not immunised.
Acute seizure management
Active treatment if haemodynamic instability or lasting >5min: monitor, oxygen, check BSL. Midazolam 10mg (0.15mg/kg) IM.
Snake bite management and risks
Pressure bandage whole limb, immobilise limb + pt, tetanus, manage ABCs. Contact poison centre. Need hospital w critical care, 24h lab for coags and antivenom. R: venom induced consumption coagulopathy, neurotoxicity, myotoxicity.
Spider bite features/management
Big black - risk local neuromuscular, later sweating, HTN, arrhythmia. Manage as snake, observe for 2 hr or 4 hr if symptoms. Red back: local piloerection, radiating pain up lymphatics. Analgesia, ice/heat, tetanus, no antivenom.
Box jellyfish features and management
Northern Australia, linear sting. Remove stings w sea water, apply vinegar, cold pack, CPR. Antivenom given in resus of ED only.
Bluebottle and tiny box jellyfish features and management
BB: immediate pain, linear eruption. Wash w sea water, remove tentacles, hot water 20min. TB: mild sting then delayed cramps, sweat, N/V. Wash w sea water, remove tentacles, hot water may help, no vinegar.
