Emergency by Dr Cintia Flashcards
Snakes CLINICAL FEATURES
Bleeding, headache, muscle damage, nausea, vomiting, abd pain
Snakes TREATMENT (4)
1.Pressure Immobilisation Bandage.
-Don’t clean the wound
-Don’t apply PIB if more than 1 hour has passed since bite,
2.IV line
3.Take blood
4.Give antivenom (Monovalent of most common snakes in area preferred)
- Admit all cases for at least 12 hours
- Remove PIB when pt is stable
Jellyfish TREATMENT
- In Queensland: Vinegar + Antivenom, Morphine for Irukandji - In Victoria: Hot water (45C for 20 mins)
Human, cat, dogs Bites TREATMENT (5)
1.Wound care (Wash, elevate, immobilisation)
2.Tetanus prophylaxis
3.Post-Exposure prophylaxis: HIV,
HBV (Vaccine+Ig)
4.Atb Prophylaxis (Amoxi/Clav): Indicated if >8hrs delay presentation, bite in hands, feet, face, genitalia, bones, joints, immunocompromised.
5.Review in 24-48 hours
Deadly Sidney Funnel Web CLINICAL FEATURES
Resp depression, salivation, numbness, tingling around mouth
Deadly Sidney Funnel Web TREATMENT
Tx=snakebite
Victorian Funnel Web Spider CLINICAL FEATURES
Headache, nausea
Victorian Funnel Web Spider TREATMENT
Wash area, apply cold pack and give simple analgesic.
Red back spider (Black widow) CLINICAL FEATURES
Slow progression
Red black spider (Black widow) TREATMENT
-Wash area, apply cold pack and give simple analgesic.
-No improvement, rest and reassure, immobilise w/ splint, antihistamine IM for 15 mins, give antivenom IM
Lyssavirus CLINICAL FEATURES
Bats. Incubation: 3-8w
Lyssavirus TREATMENT
Wash wound and give rabies vaccine (if immunised) and Igs (within 48hrs)
Cardiac Arrest (Vfib) TREATMENT (4)
- CPR (30:2)
- Shock+CPR for 2 mins
- 2nd Shock
- Adrenaline IM
Bleeding CLINICAL FEATURES (4)
- Class I (<15%): Normal
- Class II (15-30%): HR 100-120
- Class III (30-40%): Low BP
- Class IV (>40%): Very low BP, >140HR
Gunshot Wound - INVESTIGATION (Stable Patient):
- X-ray.
- Triple Contrast CT
Gunshot Wound - INVESTIGATION (Unstable Patient):
- Exploratory Laparotomy
Ramsay Hunt Syndrome CLINICAL FEATURES
Ipsilateral facial palsy, ear pain, vesicles in ear/mouth
Ramsay Hunt Syndrome TREATMENT (3)
1.Control pain: Nortriptyline, amitriptyline, gabapentin
2.Famciclovir, Valacyclovir, Acyclovir (within 72 hrs)
3.Oral Steroids for 7 days (Esp>50yo)