Emergency List Flashcards
What condition gives you SUDDEN, severe onset, epigastric or generalised upper abdomen pain. Can radiate to the back or flank, worsen by movement and is alleviated by leaning forward, or assuming the foetal position?
Acute Pancreatitis
Ecchymoses (blueish colour) over the Cullens sign, Grey-turners sign is indicative of what condition?
Haemorrhagic pancreatitis
When is the next step for someone who has suspected acute pancreatitis?
Emergency / immediate hospital admission for specialist assessment.
Should you do bloods / imagining in primary care if you suspect acute pancreatitis?
NO - immediate emergency hospital admission.
When do you consider ERCP (endoscopic retrograde cholangiopancreatography)?
Within 72 hours of those with gallstons and cholangitis, jaundice or common bile duct obstruction.
When do you give activated charcole for paracetamol overdose?
If its within 1 hour of consuming the tablets.
When do you give IV Acetylcysteine for Paracetamol overdose?
This is most effective if given within 8 hours of administration, but can be up to 24 hours.
If there is a staggered overdose* or there is doubt over the time of paracetamol ingestion, regardless of the plasma paracetamol concentration (graph)
what does N-Acetylcysteine do?
Protects the liver from liver necrosis, and thus encephalopathy coma and death from paracetamol overdose. it increases glutathione as it is a precursor of this molecule.
what is the toxic level of paracetamol overdose?
150MG/KG
what is the toxic metabolite of acetaminophen?
NAPQI
when would you do a paracetamol concentration graph?
After 4 hours - and if it falls above or on the therapeutic line - N-acetylcysteine must be given.
How do you give n-acetylcysteine
Infused over 1 hour
