Emergency Flashcards
What are the common causes of Acute Life Threatening Event?
Occur in infants (esp
What is the pathophysiology of anaphylaxis?
Ig-E and non Ig-E activation of mast cells and basophils -> production and release of severe inflammatory and vasoactive substances
Histamine Tryptase Heparin Prostaglandins Leukotrienes Cytokines
Angioedema Bronchospasm Bronchorrhea Laryngospasm Vascular permeability
What are common causes of anaphylaxis?
Food - milk, eggs, soy, fish, shellfish, tree nuts and legumes
Medicine - penicillin, anaesthetic, analgesics, opiates, contrast
Biologicals - venoms, vaccines
Others - latex
What are risk factors for anaphylaxis?
Younger age - smaller airways Asthma Chronic GI symptoms Hypotension and bradycardia Previous or family history of anaphylaxis
What are presenting features of anaphylaxis?
Acute onset of skin +/- mucosal symptoms with respiratory compromise or reduced BP
How is anaphylaxis managed?
IM Adrenaline 1:1000
12yo 0.5mg
IM or slow infusion hydrocortisone and chlorpheniramine
Who is at risk of accidental poisoning?
Mean age of 30 months
Poor parental input
Toddlers who can walk
How does a paracetamol OD present?
Large ingestion is uncommon
Gastric irritation and liver failure 3-5 days post OD
Check plasma conc after 4 hrs
>150ml/kg then start IV acetylcysteine
Monitor prothrombin, LFTs and creatinine
How does an NSAID OD present?
Mild N+V Electrolyte abnormalities Altered conscious level Tachypnoea Coma Tinnitus and nystagmus
Activated charcoal
How does an iron OD present?
V+D
Haematemesis
Melaena
Acute GI ulceration
Later: Drowsiness Coma Shock Liver failure Hypoglycaemia Convulsions
Do AXR to count number of tablets taken
Serum iron levels
IV desferrioxamine for chlelation
How does a methadone OD present?
Pinpoint pupils Constipation N+V Spasms Hypotension Weak pulse Shallow slow breathing -> coma, peripheral shut down
IV nalaxone
How does an alcohol OD present?
Hypoglycaemia
Coma
Respiratory failure
Monitor blood glucose, alcohol levels
IV dextrose if needed
How does a detergent OD present?
Dyspnoea
Dysphagia
Oral, cheek and abdo pain
N+V
Do not induce emesis or neutralise the agent
Gastric emptying and decontamination via NG tube
What are risk factors for SIDS?
Infant - 1-6 months (peak at 12 weeks), low birth weight, prem, multiple birth
Parents - low income, poor housing, maternal age
What is the epidemiology of drowning?
Leading cause of accidental death under 15yo
Prevent by warming them up while CPR with rescue breaths
Pulmonary odema can occur 72hrs after due to secondary surfactant deficiency
