Emergency

Question 1

SBAR?

Answer 1

Situation
Background
Assessment
Response

Question 2

What are WETFAG calculations?

Answer 2

Weight
Energy
Tube diameter
Fluid bolus
Adrenaline
Glucose

Question 3

How do you calculate weight in child age less than 1?

Answer 3

Weight (0-12 months) = (0.5 x age in months) + 4

Question 4

How do you calculate weight in child age 1-5 years old?

Answer 4

Weight (1-5 years) = (2 x age in years) + 8

Question 5

How do you calculate weight in a child aged 6-12 years old?

Answer 5

Weight (6-12 years) = (3 x age in years) + 7

Question 6

How much energy does a child expend per kg?

Answer 6

4 joules/kg

Question 7

How do you work out tube diameter in a child?

Answer 7

4 + (age/4) mm

Question 8

How much do you give as a fluid bolus normally and in trauma?

Answer 8

Normally = 20ml/kg
trauma = 10ml/kg

Question 9

Dose of adrenaline do you give to infants?

Answer 9

0.1 ml/kg of 1/10,000

Question 10

Dose of glucose do you give to infants?

Answer 10

5ml/kg of 10% dextrose

Question 11

3Es of B in ABCDE?

Answer 11

effort - RR, RDS
efficacy - sats
Effect - on other systems

Question 12

3Ps of C in ABCDE?

Answer 12

Pulse - rate, rhythm, volume
Perfusion - CRT, temp, skin turgour
Pressure - BP

Question 13

3Ps of D in ABCDE?

Answer 13

Posture - hypotonic, floppy
AVPU
Pupils - reactive

Question 14

DEFG

Answer 14

Don’t ever forget glucose

Question 15

E in ABCDE?

Answer 15

Rashes, bleeding, infection, trauma

Question 16

Investigations for meningitis?

Answer 16

FBC
CRP
U&E
Coag
Meningococcal PCR
Urine
LP
CXR

Question 17

When is LP contraindicated?

Answer 17

Signs of increased ICP
After convulsions
Coag abnormalities
INfection at LP site
Shock

Question 18

Explain GCS?

Answer 18

Eyes (4)
spontaneous
voice
pain
none

Verbal (5)
spontaneous 
confused
inappropriate words
incomprehensible sounds
none

Motor (6)
Normal
Localises to pain
Withdraws from nailbed pain
Decorticate movements to pain (flex)
Decerebrate movements to pain (extend)
None

Question 19

SH questions to ask a child experiencing seizures?

Answer 19

Does the child go to nursery?
Unwell contacts?
vaccinations up to date?
Social worker?

Question 20

What does the 5in1 vaccine contain and what ages is it administered?

Answer 20

Polio, Pertussis, Diphtheria, Tetanus, Haemophillus type b

Question 21

What vaccines are given at ages 2 months, 3 months and 4 months?

Answer 21

2 months = 5in1 and pneumococcus
3 months = 5in1 and Men c
4 months = 5in 1 and Men c and pneumococcus

Question 22

What 3 (4 total) vaccines do you get when you turn 1?

Answer 22

H.Influenzae and MenC
MMR
Pneumococcal

Question 23

Preschool aged 3 to 5 what 2 vaccines do you get?

Answer 23

MMR second dose

4in1 booster

Question 24

What vaccine do girls get age 13 to 18?

Answer 24

HPV

Question 25

Which 3 causes of meningitis are vaccinated against?

Answer 25

Streptococcus pneumoniae
Haemophillus infuenzae type B
Meningococcal serotype C

Question 26

3 things likely to be high in a patient with meningococcal sepsis?

Answer 26

high WCC
High Neutrophils
High CRP

Question 27

What is the usual WCC of the CSF? what 2 white cells are usually found in normal csf?

Answer 27

under 5/ml

Usually mononuclear - lymphocytes and monocytes

Question 28

What is the usual level of protein in the CSF?

Answer 28

0.2-0.4g/ml

Question 29

In meningitis what should CSF be sent for?

Answer 29

Culture and gram stain

Question 30

Characteristics of DIC?

Answer 30

Haemorrhage and microvascular thrombosis

Question 31

3 causes of DIC?

Answer 31

Sepsis
Malignancy
Trauma

Question 32

What 4 things would laboratory findings show in DIC?

Answer 32

Prolonged INR
Thrombocytopenia
Reduced fibrinogen
Reduced Hb if there is mass bleeding

Question 33

How do you treat DIC (2)?

Answer 33

Fibrinogen replacement

FFP

Question 34

What is the current chemoprophylactic treatment for meningitis outbreaks?

Answer 34

Ciproxin