Emergency Med Flashcards
sever limb pain, worse on extension.
very tender muscles
parasthesia
Compartment syndrome
Mx of compartment syndrome
urgent fasciotomy, analgesia, fluids
Type 1 Resp failure + Mx
hypoxia (can’t breathe in)
CPAP
Type 2 Resp failure + Mx
hypercapnia (can’t breathe out)
BiPAP
Antifreeze poisoning Mx
- fomepizole
- ethanol
- haemodialysis
Mx of acute exacerbation of COPD
- oxygen (blue venturi)
- nebulised salbutamol
- IV hydrocortisone
scoring for PE and interventions
Wells score to test the risk for DVT
>4 CTPA
<4 D Dimer result in 4 hrs
Mx of PE
DOAC (rivaroxaban)
Px of upper GI bleed
coffee ground vomit, black tarry stool
fluid resus, RBC transfusion and platelets in upper GI bleed
normal saline
RBC if Hb is <70
platelets if <50
Mx of oesophageal varices
terlipressin IV + ABs
endoscopy
narrow complex tachycardia Mx
vagal maneuvres
adenosine
broad complex tach Mx
amiodarone
torsades des pointes Mx
magnesium sulphate
indications for DC cardioversion
HISS
heart failure, ischaemia, shock, syncope
emergency Mx of angle closure glaucome
oral acetozolomide + timolol drops
emergency Mx of acute asthma
nebulised salbutamol
hydrocortisone IV or pred PO
life threatening asthma
33 92 CHEST
PEF <33%
Sats <92
Cyanosis
Hypotension
Exhaustion
Silent chest
Tachycardia
emergency Mx of acute COPD
nebulised salbutamol
hydrocortison IV or pred PO
presentation of pulmonary edema
extreme dyspnea, anxiety
signs of fluid overload: raised JVP, peripheral oedema, S3 gallop
Mx of pulmonary edema
furosemide IV
emergency Mx of addisonian crisis
IV hydrocortisone
emergency Mx of anaphylaxis
IM adrenaline
emergency Mx of aspirin overdose
sodium bicarb + KCL
emergency Mx of AF <48 hrs, no life-threatening signs
rate control (beta blocker / verapamil / diltiazem)
emergency mx of AF, life threatening
HISS (heart failure, ischaemia, shock, syncope)
immediate DC cardioversion
Mx of AF >48 hrs
anticoagulation for 3 weeks, cardioversion
Mx of Pul Embolism
anticoagulation (DOAC e.g. apixaban)
thrombolysis (alteplase) in massive PE
Mx of status epilepticus
- Iv lorazepam / PR diazepam
- valproate
regular SVT Mx
- vagal maneuvres
- adenosine IV
asthmatic Pt with regular SVT
use verapamil instead of adenosine
broad complex tachycardia MX
amiodarone
Mx of bradycardia
- atropine
- transcutaneous pacing
grey-turners sign
flank bruising
suggests retroperitoneal bleeding
cullens sign
peri-umbilical bruising
suggests abdominal bleeding
signs of transfusion reaction
pyrexia
tachycardia
SOB
loss of consciousness
fluid resus for burns
follow the parkland formula
children: 3ml/kg/TBSA
adults: 4……..
give half for 8 hrs, remaining half for 16 hrs
what would you see on ABG in an opiate overdose
hypercapnia
respiratory acidosis
pinpoint pupils
opiate overdose
what does a benzodiazepine overdose look like
Mx
reduced GCS
reduced RR
hypotension
bradycardia
supportive Mx
beta blocker overdose Px
Mx
bradycardia
hypotension
syncope
arrythmia
drowsiness
Mx: bradycardia (atropine/isoprenaline); hypotension (glucagon)
what acid base disturbance does ethylene glycol poisoning cause
metabolic acidosis
presentation of paracetamol overdose
nausea, vomiting, pallor
jaundice, confusion, deranged LFTs
what does a positive FAST scan show
intra abdominal bleeding
where is the carina bifurcation
T4-5 intervertebral disc
triple a screening
<3cm no more screening
3-4.5 = every year
4.5-5.5 = every 3 months
> 5.5 = surgery
acute mountain sickness
cause and Px
Mx
light headed ness, infrequent dull headaches
stop ascent until they acclimatise
what can acute mountains sickness develop into
high altitude cerebral oedema (HACE)
high altitude pulmonary oedema (HAPE)
Px and MX of HACE
ataxia, confusion, progressive decline of mental function and consciousness
Mx: dexamethasone and hyperbaric treatment
Px of HAPE
productive cough
dyspnea
hypoxaemia
tachycardia
Digoxin overdose
Nausea
Vomiting
Diarrhoea
Visual disturbance (yellow halo)
Amitriptyline overdose
Tachycardia
Hypotension
Seizures
initial fluid resus for burns
hartmanns (or any crystalloid compared to colloid)
first line for acute symptomatic SIADH
hypertonic saline 3%
boaerhaave syndrome vs mallory weiss tear
boerhaave is the full oesophageal tear
MW is a laceration in the inner wall of the oesophagus
both after forceful vomiting
boerhaave: haemodynamic instability, subcutaneous emphysema, GI contents enter the thoracic cavity, sepsis
Mw: blood vomiting
imaging for urethral injury in trauma
retrograde urethography
which layers of the aorta are dilated in AAA rupture
all 3: intima, media, adventitia
difference between rhythm in A fib and A flutter
A flutter is regular e.g. 2:1 whereas A fib is irregular
2 episodes of vomiting: when is CT head
1 hr
normal anion gap values
8-14
what do you see on ABG in aspirin overdose
mixed primary respiratory alkalosis and metabolic acidosis
3 causes of metabolic acidosis with normal anion gap
diarrhoea
renal tubular acidosis
addisons disease
3 causes of metabolic acidosis with raised anion gap
lactate
urate
DKA