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BDS3 OSCE > Emergency Medicine > Flashcards

Emergency Medicine Flashcards

1
Q

What will you find in a dental emergency kit

A 
Adrenaline
Aspirin
Glucagon 
Glyceryl triturate (GTN) 
Midazolam oromucosal solution 
Oral glucose
Oxygen cylinder 
Salbutamol Inhaler
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2
Q

What does the adrenaline come as

A

Prefilled syringes

IM injection

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3
Q

What does the aspirin come as

A

300 mg tablets

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4
Q

What does glucagon come as

A

IM injection
1mg
In fridge

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5
Q

What does GTN come as

A

400 mg per metered dose

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6
Q

How is midazlolam oromucosal solution administered

A

5mg/ml

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7
Q

What can be given as oral glucose

A

fizzy drinks e.g coke (NOT DIET)
glucose gel
powdered glucose
sugar lumps

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8
Q

What does the salbutamol inhaler come as

A

100 mg per actuation

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9
Q

What are the key signs of anaphylaxis

A

Upper airway oedema (stridor and wheezing)
Tachycardia (>110BPM)
Increased respiratory rate

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10
Q

What are the key symptoms of anaphylaxis

A

Abdominal pain, vomiting, diarrhoea
Flushing
Symptoms of mild allergy

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11
Q

What is the priority for a px with anaphylaxis

A

emergency transfer to hospital

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12
Q

What is the management for anaphyalxis

A 
ambulance
secure px airway and restore BP - lay px flat 
remove source of anaphylaxis if known 
oxygen
adrenalin 
if cardiac arrest after then BLS
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13
Q

What are the key signs for allergies

A

○ Hives and rash, particularly on hands, chest & feet
○ Rhinitis, conjuctivitis
○ Mild bronchospasm without evidence of severe shortness of breath

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14
Q

What is the management of mild allergies

A

cetirizine OR chlorphenamine OR loratadine

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15
Q

If a px showing signs of mild allergy shows mild bronchospasm then what should be administered

A

a salbutamol inhaler (4 puffs, through a large volume spacer as needed)

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16
Q

What should you do after the px has shown signs of mild allergies

A

refer to GP

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17
Q

What are the key signs of LIFE THREATENING asthma

A

○ Cyanosis or respiratory rate <8 PM
○ Bradycardia <50 BPM
○ Exhaustion, confusion, decreased conscious level

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18
Q

What are the key signs of ACUTE SEVERE asthma

A

○ Inability to complete sentences in one breath
○ Respiratory rate >25 PM
Tachycardia >110 BPM

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19
Q

If a px is showing symptoms of life threatening asthma what is the priority

A

emergency hospital transfer

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20
Q

What is the management of asthma

A

Sit px upright
oxgen
administer px own bronchodilator

21
Q

If during an asthma attack a px inhaler isn’t present what should be administered instead

A

salbutamol inhaler, 4 puffs through a large volume spacer, repeat as needed (1 puff for children)

22
Q

If a patient is suffering from a severe episode of asthma and does not respond to treatment with bronchodilators within 5 mins of administration then what is required

A

emergency hospital transfer

23
Q

What are the key signs of acute coronary syndromes

A

Progressive onset of severe crushing pain in centre and across the chest

Pain may radiate to the shoulders and down the arms (left more common) and into the neck and jaw or through the back

24
Q

What are the key symptoms of acute coronary syndromes

A 
○ Shortness of breath
○ Increased respiratory rate
○ Skin becomes pale and clammy 
○ Nausea and vomiting are common
○ Pulse might be weak and BP may fall
25
Q

What is the management of ACS

A 
sit px upright
oxygen
GTN
if no response to GTN then MI - AMBULANCE 
ADMINISTER ASPIRIN
26
Q

What are the signs of cardiac arrest

A

○ Unconscious
○ Absence of normal breathing
○ Loss of pulse
Dilation of pupils

27
Q

What is the management for cardiac arrest

A

Call for ambulance
BLS using 100% oxygen or ventilation
Early defibrillation

28
Q

What are the key signs of epilepsy

A

○ Sudden loss of consciousness, may become rigid, fall, might give a cry and becomes cyanosed

○ Jerking movements of the limbs and the tongue may be bitten

29
Q

What are the key symptoms of epilepsy

A

○ Brief warning or ‘aura’

○ Frothing from the mouth and urinary incontinence

30
Q

What is the management of epilepsy

A

Do not try to restrain convulsive movements

Ensure the patient is not at risk from injury

Secure the px airway

Administer 100% oxygen - flow rate 15L/min

31
Q

If a fit is repeated or prolonged (>5min) what should be done

A

continue w/ oxygen

administer midazolam

after convulsive movements have subsided place the px in the recovery position and check the airway

32
Q

When should you give medication to someone having a seizure

A

Only give medication if convulsive seizures are prolonged or recur in quick succession

33
Q

When should you call an ambulance for epilepsy

A

If the convulsive seizures are prolonged (>5min) or recur in quick succession, first episode of epilepsy, convulsion was atypical, injury occurred or there is difficulty

34
Q

What are the key signs of someone who is faint

A

Patient feels faint, dizzy, light-headed
Slow pulse rate
Loss of consciousness

35
Q

What are the key symptoms of someone who is faint

A

Pallor and sweating

Nausea and vomiting

36
Q

What is the management of someone who is faint

A

○ Lay flat and raise feet, loosen tight clothing around the neck
○ Administer 100% oxygen until consciousness regained

37
Q

What are the key signs of hypoglycemia

A

○ Aggression and confusion
○ Sweating
Tachycardia (>110BPM

38
Q

What are the key symptoms of hypoglycemia

A 
○ Shaking and trembling
○ Difficulty in concentration 
○ Slurring of speech
○ Headache
○ Fitting
Unconscious
39
Q

What is the management of hypoglycemia if the patient is conscious and cooperative

A 
Oxygen 
Oral glucose (10-20g) and repeat if necessary
40
Q

What is the management of hypoglycemia if the patient is unconscious or uncooperative

A

glucagon - IM injection

oral glucose when patient regains consciousness

41
Q

When should an ambulance be called for a hypoglycemic

A

If px does not respond or difficulty is experienced

42
Q

What are the key signs of a stroke

A

○ Facial weakness/eye drooping
○ Arm weakness
○ Communication problems - slurred speech, unable to understand what is being said to them

43
Q

What is the priority for a stroke

A

EMERGENCY HOSPITAL TRANSFER

44
Q

What is the management of a stroke

A

Oxygen
If px is unconscious and breathing then secure airway and put in recovery
Ambulance

45
Q

What are the key signs of aspiration and choking

A

○ Px may cough and splutter
○ Px may complain of breathing difficulty
○ Breathing may become noisy on inspiration (stridor)
○ Px may develop paradoxical chest or abdominal movements
○ May become cyanosed and lose consciousness

46
Q

What is the management for aspiration

A

Encourage coughing
Oxygen
Salbutamol inhaler

47
Q

If you suspect that a large fragment has been inhaled or swallowed but there are no signs what do you do

A

refer to hospital for x-ray and removal of the fragment

48
Q

If a patient is asymptomatic following aspiration what should you do

A

emergency hospital transfer

ambulance

49
Q

What is the management of choking

A

○ Remove visible foreign bodies
○ Encourage coughing
○ If px is unable to cough but remains conscious then commence back blows followed by abdominal thrust
○ If becomes unconscious the BLS needs to be started
Call an ambulance and transfer patient to hospital as an emergency

BDS3 OSCE (65 decks)

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