Emergency Flashcards
What approach is used in an emergency
ABCDE
What does ABCDE stand for
Airway
Breathing
Circulation
Disability
Exposure
SBAR approach
Communication
Situation, background, assessment, recommend
RSVP approach
Communication
Eason, story, vital signs, plan
Airway
Is airway secure (safe and patent) or compromised
- able to talk
- use of accessory muscles
- ab movements
- breathing noises
- central cyanosis
Action for blocked airway
Airway opening manoeuvres
Suction
Advanced airway interventions
Then give high conc o2
Breathing
Obtain o2 sats and resp rate
Feel trachea for deviation
Check calves for dvt
Do they smoke
Action for breathing problems
Depends on cause (adrenaline, chest drainage, bronchodilators)
Arterial blood gas analysis
Sit up
Circulation
Hypovolemia primary cause if circulatory failure
- CRT
- ECG (12 lead)
- BP, HR, heart sounds
- evidence of bleeding
- limb tempt
- colour of colour of hands
Action of circulatory failure
Fluid challenge
Replace blood
Action for anaphylaxis
Adrenaline
Action for pneumothorax
Chest drainage
Action for opioid overdose
Naloxone
Action for airway disease
Bronchodilators
Disability
Level of consciousness and neurological functioning
Take temp
Measure glucose
Neurological status assessment (acvpu or gcs)
Pupil size (pearl)
Acvpu
Alert
Confused
Responding to voice
Responding to pain
Unresponsive
GCS
Eye movement 4
Vocal 5
Motor 6
Action for disability
Analgesia
Specific action for provlem
Exposure
Examine head to toe and front to back
Respect dignity, minimise heat loss
Take full clinical history ad review
Symptom sieve
Broad categories for explaining a condition
Symptoms sieve used for patient with altered mental state
Primary neurological
Infection
Cardiorespiratory
GI
Metabolic/ endocrine
Toxins
Psychiatry
Normal RR
12-20
Normal o2
95+
(92-98)
Aim for 98 unless COPD pt aim for 94
Normal bp
120/80
Normal hr
60-100
Arterial blood gas gives info about
Co2
PEARL
pupils equal and responding to oight
Capillary refill shows
Peripheral tissue perfusion
Capillary refill time should be
Less than 2 seconds
Normal glucose
5-6
Action for low bp
Iv fluid
4 types of circulatory shock
Hypovolemic
Obstructive
Distributive
Cardiogenic
Hypovolemic shock
Loss of blood flow
Obstructive shock
Physical obstruction to blood flow
Cardiogenic shock
Ventricular failure
Distributive shock
Vasodilation
Sinus tachycardia
Consistent
Causes of Hypovolemic shock
Blood loss
Internal bleeding (distended abdomen)
Dehydration (d&v)
Burns
Causes of Cardiogenic shock
Myocardial infarction
Spasm
Cardiac rupture
Cardiomyopathy
Causes of obstructive shock
Pericardial tamponade
Tension pneumothorax
Pulmonary embolism
Causes of distributive shock
Anaphylaxis
Sepsis
Signs of sepsis
Fever
Hypotension
Inc heart rate
Flushed
Tissue hypoperfusion
Altered mental state
Sepsis diagnosis
4 stages, if suspected do sepsis 6
Stage 1 sepsis diagnosis
SIRS - at least 1 of
Temp >38 <36
HR >90
RR >20 (Tachypnoea)
WBC >12 <4
Stage 2 sepsis diagnosis
Evidence of infection (blood culture)
Stage 3 sepsis diagnosis
Severe sepsis
Sepsis with evidence of organ dysfunction, hypotension or hypoperfusion
(Lactate or urine output)
Stage 4 sepsis diagnosis
Septic shock
Severe sepsis with hypotension despite adequate fluid resuscitation
Sepsis 6
Give o2
Take blood cultures
Give iv antibiotic
Give fluid challenge
Take lactate
Take urine output
Fluid challenge
Give 250-500ml crystalline solution acccutely within 15 mins see if bp comes back up
CRP produced by
Liver
Sign of inflammation
Lactate sign of
Hypoperfusion
Vasodilation causes hypoperfusion not enough o2 to tissues so undergo anaerobic resp
Neutrophillia sign of
Bacterial infection
GGT test
Liver condition
Pain in left iliac fossa likely due to
Sigmoid colon
In women, extreme torsion, infection of reproductive system
Diverticulae
Singular outpouching due to inner most layer of digestive tract pushing through weak spots in outermost layer
Diverticulosis
Severreal diverticuli
Diverticulitis
Inflammation of diverticuli due to faeces
Sepsis from diverticuli
Infection in diverticuli bursts and bacteria enters the bloodstream
Symptoms of diverticulosis
Bloating
Abdominal cramps
Constipation
No obvious symptoms usually only diagnosed due to something else
9 abdominopelvic regions
L and r hypochondriac, epigastric
L and r lumbar, umbilical
L and r iliac, hypogastric (pubic)
Left hypochondriac
Left kidney
Pancreas
Parts of colon
Part of spleen
Part of stomach
Epigastric
Majority of stomach
Parts of liver and pancreas
Part of duodenum
Part of spleen
Adrenal glands
Right hypochondriac
R portion of liver
Gallbladder
Right kidney
Parts of small intestine
Left lumbar
Descending colon
Left kidney
Part of spleen
Umbilical
Umbilicus
Part of duodenum, jejunum, ileum
Transverse colon
Bottom portions of the kidneys
Right lumbar
Gallbladder
Right kidney
Part of the spleen
Right lumbar
Gallbladder
Right kidney
Part of the spleen
Left iliac
Part of descending colon
Sigmoid colon
Left iliac fossa
Hypogastric
Bladder
Parts of sigmoid colon
Snus
Uterus
Ovaries
Prostate
Right iliac
Appendix
Caecum
Right iliac fossa
Airway obstruction can lead to
Hypoxia
GCS less than 8
Intubate
Pain in right upper quadrant
Infection or inflammation of gallbladder and liver
Or peptic ulcers in stomach
Pain in left upper quadrant
Malrotation of intestine and colon
Right lower quadrant pain
Appendicitis
Left lower quadrant pain
Colitis (inflammation of large intestine)
Pelvic inflammatory disease and ovarian cysts
Where in the gut to diverticula most commonly form
Large colon to rectum
