Emergency by Dr Cintia Flashcards

1
Q

Snakes CLINICAL FEATURES

A

Bleeding, headache, muscle damage, nausea, vomiting, abd pain

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2
Q

Snakes TREATMENT (4)

A
  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
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3
Q

Jellyfish TREATMENT

A
  • In Queensland: Vinegar + Antivenom, Morphine for Irukandji - In Victoria: Hot water (45C for 20 mins)
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4
Q

Human, cat, dogs Bites TREATMENT (5)

A

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

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5
Q

Deadly Sidney Funnel Web CLINICAL FEATURES

A

Resp depression, salivation, numbness, tingling around mouth

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6
Q

Deadly Sidney Funnel Web TREATMENT

A

Tx=snakebite

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7
Q

Victorian Funnel Web Spider CLINICAL FEATURES

A

Headache, nausea

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8
Q

Victorian Funnel Web Spider TREATMENT

A

Wash area, apply cold pack and give simple analgesic.

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9
Q

Red back spider (Black widow) CLINICAL FEATURES

A

Slow progression

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10
Q

Red black spider (Black widow) TREATMENT

A

-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

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11
Q

Lyssavirus CLINICAL FEATURES

A

Bats. Incubation: 3-8w

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12
Q

Lyssavirus TREATMENT

A

Wash wound and give rabies vaccine (if immunised) and Igs (within 48hrs)

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13
Q

Cardiac Arrest (Vfib) TREATMENT (4)

A
  1. CPR (30:2)
  2. Shock+CPR for 2 mins
  3. 2nd Shock
  4. Adrenaline IM
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14
Q

Bleeding CLINICAL FEATURES (4)

A
  • Class I (<15%): Normal
  • Class II (15-30%): HR 100-120
  • Class III (30-40%): Low BP
  • Class IV (>40%): Very low BP, >140HR
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15
Q

Gunshot Wound - INVESTIGATION (Stable Patient):

A
  1. X-ray.
  2. Triple Contrast CT
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16
Q

Gunshot Wound - INVESTIGATION (Unstable Patient):

A
  1. Exploratory Laparotomy
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17
Q

Ramsay Hunt Syndrome CLINICAL FEATURES

A

Ipsilateral facial palsy, ear pain, vesicles in ear/mouth

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18
Q

Ramsay Hunt Syndrome TREATMENT (3)

A

1.Control pain: Nortriptyline, amitriptyline, gabapentin
2.Famciclovir, Valacyclovir, Acyclovir (within 72 hrs)
3.Oral Steroids for 7 days (Esp>50yo)

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19
Q

Head Trauma FIRST INVESTIGATION

A
  1. CT
20
Q

Chest Trauma FIRST INVESTIGATION (2)

A
  1. CXR
  2. FAST US (Haem unstable)
21
Q

Chest Trauma BEST INVESTIGATION (2)

A

1.CT
2.MRI (For spinal cord, ligamentous injuries, epidural haematoma)

22
Q

Abdomen Trauma BEST INVESTIGATION

A

-Haem stable: CT
-Haem unstable: FAST US, dx peritoneal lavage

23
Q

Spine Trauma CLINICAL FEATURES

A

Neurogenic shock (Dec BP, Dec HR)

24
Q

Spine Trauma TREATMENT (5):

A

1.ABCDE
2.Ox if Sat<94%
3.Trendelemburg position
4.Atropine if HR<40
5.Adrenaline and Dopamine (If resistant)

25
Q

Flail chest CLINICAL FEATURES

A

Paradoxical resp

26
Q

Flail chest TREATMENT (4):

A

1.Oxygen
2.Pain management & Pulm toilet
3. Intubation & mechanical ventilation (Positive Pressure)
4. Prophylactic bilateral chest tube

27
Q

Haemothorax CLINICAL FEATURES

A

Dull resonance

28
Q

Haemothorax TREATMENT

A
  1. Water-sealed chest tube
29
Q

Pulmonary Contusion CLINICAL FEATURES

A

Symptoms hours after initial injury (like lucid)

30
Q

Pulmonary Contusion TREATMENT

A
  1. Oxygen & Pulm toilet.
31
Q

Urethral Injury CLINICAL FEATURES

A

Blood in urethra, inability to void

32
Q

Urethral Injury FIRST INVESTIGATION

A
  1. Retrograde urethrogram
33
Q

Urethral Injury TREATMENT

A
  1. Suprapubic catheter
34
Q

Foreign Body Ingestion CLINICAL FEATURES

A

High Risk: button batteries, >6cms, two magnets, sharp, lead object

35
Q

Foreign Body Ingestion FIRST INVESTIGATION

A
  1. X-ray
36
Q

Foreign Body Ingestion TREATMENT (High/Low Risk):

A
  1. High risk: Referral
  2. Low risk: Observe
37
Q

Burns CLINICAL FEATURES

A

Anterior (Posterior is the same)
- Genitals: 1%
- Face: 4.5%
- Upper limb: 4.5%
- Lower limb: 9%
- Thorax and abdomen: 18%
1st Degree: Erythema
2nd Degree: Erythema + Blister
3rd Degree: Pale, charred skin

38
Q

Burns TREATMENT (5):

A
  1. Analgesia
  2. Hydration
  3. Clean with water
  4. Remove foreign material
  5. Deroofing blister
39
Q

Burns around face/neck, hoarseness TREATMENT (2)

A
  1. Oxygen by face mask
  2. Intubation
40
Q

CO poisoning TREATMENT (2):

A

1.High flow (10-15L) Normobaric Ox via Non-rebreathing mask
2.Hyperbaric oxygen to comatose, pregnant, MI, seizures.

41
Q

Dehydration CLINICAL FEATURES (3 levels):

A

-Mild: Normal
-Mod: Mild hypotension, in kids (>2 refill time)
-Severe: Marked loss of skin turgor, severe hypotension, in kids (>3 refill time)

42
Q

Dehydration TREATMENT

A
  • Mild-Mod: Oral hydration (2-3Lt in 24 hours)
  • Severe: 20mL/kg of IV hydration
    (adults). 10-20mL/kg for children - If dehydration + Hypochloremic alkalosis: 0.9% NS+5% dextrose - For colostomy is 3lt for men and 2lt for women.
43
Q

Alkali Ingestion TREATMENT

A

Oral fluids. No gastric emptying

44
Q

Organophosphate Poisoning CLINICAL FEATURES

A

Diarrhoea, urination, miosis, bronchospasm, bradycardia, sweating, lacrimation

45
Q

Organophosphate Poisoning TREATMENT

A

Atropine + Pralidoxime

46
Q

Anticholinergic syndrome CLINICAL FEATURES

A

Constipation, urinary retention, mydriasis, bronchodilation, tachycardia, reduced sweat and tears