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Phase 2 - Cardioresp > Emergency Management > Flashcards

Emergency Management Flashcards

1
Q

Anaphylaxis Management

A

Send for help
Remove trigger
Maintain the airway - 100% O2, non-rebreathe mask
IM adrenalin 0.5mg (repeast every 5 mins for CVS management)
IV hydrocortisone 200mg
IV chlorpheniramine 10mg
Hypotensive = lie patient flat
Treating bronchospasm = salbutamol nebs
Treating larygneal oedema = adrenaline nebs

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2
Q

Asthma management

A

ABCDE

Sats = should be 94-98%, ABG is

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3
Q

Severe asthma management

A

Ipratropium bromide nebs - 500mg

Consider back to back salbutamol nebulisers

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4
Q

Life threatening or near fatal management

A

ITU or anaesthetist assessment
Urgent portable CXR
IV aminophylline (SM relaxation - improved ventilation)
Consider IV salbutamol if nebs are ineffective

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5
Q

Management of COPD acute exacerbation

A

ABCDE
O2 via fixed performance face mask (88-92%) guided by ABGs (24%)
Nebs - salbutamol (5mg/4 hrs) and ipratropium (0.5mg/6 hrs)
Steroids - 30mg prednisolone STAT and OD for 7 days
ABx - if raised WCC or CRP
NIV if there is no response/ type 2 resp failure and pH 7.25-7.35
ITU - pH

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6
Q

Pneumonia management

A

ABCDE
Sepsis features = treat via sepsis pathway
CURB-65 - treat via this protocol

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7
Q

Describe the CURB-65 score

A

Score which is linked to mortality over 30 days therefore determining severity
C - confusion, MMT 2 or more points worse
U - urea >7.0
R - respiratory rate > 30/min
B - BP

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8
Q

Massive haemoptysis management

A 
ABCDE
Lie patient on side of lesion
PO tranexamic acid for 5 days or IV
Stop NSAIDs/warfarin/anticoagulants
Consider vitamin K
CT aortogram
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9
Q

Tension pneumothroax management

A

Large bore IV cannula into the 2nd intercostal space, mid-clavicular line
Chest drain into the affected side
- don’t remove cannula until drain is working correctly

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10
Q

Pulmonary embolism management

A 
ABCDE
O2 if hypoxic
Fluids if hypotensive
Thrombolysis considered if massive PE on CTPA (alteplase)
Anticoagulate
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11
Q

Give some contraindications for thrombolysis

A 
Stroke within 6 months
CNS neoplasia
Recent trauma/surgery
GI bleed withing a month
Bleeding disorder
Aortic dissection
Warfarin
Pregnancy
Advanced liver disease 
Infective endocarditis
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12
Q

Give some complications of thrombolysis

A 
Bleeding
Haemorrhagic stroke
Hypotension
Reperfusion arrhythmias
Systemic embolisation of thrombus
Allergic reaction (alteplase)
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13
Q

Myocardial infarction management

A 
ABCDE
Morphine/diamorphine 2.5-10mg IV
Oxygen (if needed)
Nitrates - 2 spray sublingually
Aspirin 300mg
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14
Q

STEMI treatment

A

Percutaneous Coronary Intervention
or
Thrombolysis

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15
Q

NSTEMI treatment

A

Measure troponin I levels and then again about 3 hours later
Analgesia
Anti-ischaemic - Nitrates, ACEi, Beta-blockers, Ca channel antagonists, statins
Anti-platelet - aspirin, clopidogrel
Anti-thrombotic - LMWH
Can consider in PCI in severe cases

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16
Q

Narrow complex, regular tachycardia management

A

ABCDE
O2 if needed
IV access
Vagal manoeuvres
Adenosine (6mg IV bolus) then 12mg then 12mg
Then rate control - digoxin, atenolol, verapamil, amiodarone
DC cardioversion if adverse signs

17
Q

Narrow complex, irregular tachycardia management

A 
Treat as AF
1st - beta blocker
2nd - flecainide 2mg/kg/min
2nd - amiodarone (1200mg)
Anticoagulation
18
Q

Broad complex, regular tachycardia management

A

ABCDE
Amiodarone or lidocaine
Sedation and DC cardioversion
Straight to DC cardioversion if adverse signs

19
Q

Management of acute pulmonary oedema

A 
ABCDE
Sit upright
O2 - 100% via non-rebreathe mask 
IV access and monitor ECG
Morphine 2.5-5mg with anti-emetic (cyclizine 50mg IV)
Nitrate if low systolic BP
20
Q

How would you immediately manage somone with a STEMI?

A
  • IV access
  • Analgesia plus anti-emetic
  • Oxygen
  • Aspirin (300mg)
  • Pasugrel/clopidogrel/ticagrelor
  • Primary angioplasty (STEMI, onset within 12hrs)
21
Q

When would you perform an emergency CABG?

A

STEMI with failed PCI

Unfavourable anatomy with large portion of myocardium being affected

22
Q

What is the medication regime following an MI?

A 
ACE inhibitor (ARBs as alternative) 
Beta blocker (can use verapamil as an alternative)  
Statin (simvastatin 40 mgOD, use ezetimibe if already on full dose of statin)

Phase 2 - Cardioresp (13 decks)

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