Emergency medicine Flashcards
Antihypertensives if younger than 55 or t2D
A A+C or A+D A+C+D A = ACEi C = CCB D = thiazide diuretic
Anti-hypertensives if older than 55 or black African
C
C+A or C+D
A+C+D
Ix ischaemic bowel
CT angiogram
Which blood vessels are affected by ischaemic bowel
Splanchnic arteries or bifurcation of aorta
Sx ischaemic bowel
Severe abdo pain
Flank pain and haematuria
Signs of renal disease
Tx cardiac tamponade
Pericardiocentesis
Sx cardiac tamponade
Beck’s triad (hypotension, quiet heart sounds, increased JVP)
SOB
Causes of cardiac tamponade
Cardiac wall rupture
Trauma
Dissection
Pericarditis
What is cardiac tamponade?
Pericardial effusion compresses heart
S/e ACEi
Dry cough
S/e B blockers
Contra indicated in asthma
Side effect CCBs
Flushing and headache
S/e furosemide
Hypokalaemia
S/e spironolactone
Hyperkalaeia
Extradural haemorrhage specifics
Rupture of middle meningeal artery (pterion)
Lucid interval
Craniotomy needed
Lemon shaped
Subarachnoid haemorrhage specifics
Thunderclap headache
Rupture of berry aneurysm
Subdural haematoma specifics
Banana shaped
Caused by venous rupture
Alcohol is risk factor
What type of shock is toxic shock syndrome?
Endotoxic
Which organism causes toxic shock syndrome?
Staph aureus
Sx toxic shock
Chills, myalgia, headache
Fever, tachycardia
Decreased SVR
Sunburn like rash
Sx CO poisoning
Headache, nausea and vomiting
Cherry red skin and lips
Sx aspirin overdose
Tinnitus, nausea and vomiting, tachypnoea
Acid-base for aspirin overdose
Respiratory alkalosis and anion gap metabolic acidosis
Treatment for aspirin overdose
Activated charcoal if less than an hour, if not then bicarbonate
Antidote for ethylene glycol
Fomepizole
Antidote for opioids
Naloxone
Antidote for methanol
Fomepizole
Antidote for benzos
Flumenazil
Antidote for tricyclics
Bicarbonate
Antidote for aspirin
Bicarbonate
Antidote for b blockers
Atropine
Antidote for organophosphates
Atropine
Patient ha smacker bleed and is on warfarin, what do you do?
Stop warfarin - give vit K and prothrombin
Pt has INR >8 and minor bleeding but is on warfarin, what do you do?
Stop warfarin and give vit K
Restart warfarin when INR <5
Pt has no bleeding but INR > 8 and is on warfarin, what do you do?
Stop warfarin, give oral vit K
Pt is not bleeding but has INR 5-8 and is on warfarin, what do you do?
Withold 1-2 warfarin doses
How often can you give adrenaline ?
Every 5 mins
Adrenaline if <6 y/o
150 micrograms
Adrenaline if 6-11 y/o
300 micrograms
Adrenaline if adult
500 micrograms
How long do you listen to heart sounds for to confirm death?
2 mins
How long do you list to breath sounds for to confirm death?
3 mins
Dressler’s syndrome
2-6 weeks post MI
Sx: fever, pleuritic pain, raised ESR
Most common cause of death after MI
VF
How to calculate total burn surface area
18 for each side of torso
4.5 for each side of arm/head
9 for each side of leg
1 for genitals
how to calculate fluid requirement for 24h
4 x body weight x TBSA
how quickly do you administer fluid replacement
Half of it should be in first 8h, half in following 16
what does 0.5% mean for local anaesthetics?
5mg
10% = 10mg/ml
20% = 20mg/mL
lidocaine max dose with and with our adrenaline
with is 7mg/kg
without is 5mg/kg - up to max of 200mg
bupivacaine max dose with and without adrenaline
2.5mg/kg without
3mg/kg with
fasting period of clear liquids
2h
fasting time of most other foods
6h
warfarin considerations surgery
stop 5 days before, give LMWH post-op
how far before surgery should you stop aspirin
7 days
how far before surgery should you stop DOAC
2 days
How far before surgery should you stop COCP
4 weeks
Adult considerations for head CT
GCS <13, neurological deficit, seizure
skull fracture
1+ vomiting
child considerations for head CT
GCS <14
3+ vomiting
5cm head laceration (if under 1yo)
where do you use 3/0 stitiches
trunk
where do you use 4/0 stitches
limbs
where do you use 5/0 stitches
hands
where do you use 6/0 stitches
face
