Emergency Medicine Flashcards
How should hypothermic patient be treated?
Rewarmed at a rate of at 0.5°C per hour to 34°C
What are NICE guideliens for CT head?
- suspicion of nonaccidental injury
- posttraumatic seizure but no history of epilepsy
- GCS less than 14
- suspected open or depressed skull fracture or tense fontanelle
- any sign of basal skull fracture
- focal neurological deficit
- laceration of more than 5 cm or bruising on the head of a child under 1 year
- further clinical deterioration
What patients are at greater risk of cervical spine injury?
Downs Syndrome
Rheumatoid Arthritis
What is appropriate fluid resucitation for burns victim?
Burn >10%
Then Hartmann solution
volume for first 24 hours = % burn x weight (kg) x 3
1/2 given over 8 hours, remainder over 16hours
What are the indications of inhalation injury?
History of exposure to smoke in confined space
Deposits around mouth or nose
Carbonaceous sputum
How do you manage suspected inhalation injury?
Give O2, call anaesthatist
burn can cause oedema that can close airway.
What are the symptoms of salicyte (aspirin) overdose?
Nausea, vomiting and tachypnoea after an acute ingestion that is followed by tinnitus, lethargy and altered mental status.
Respiratory alkalosis develops early after ingestion whilst metabolic acidosis is usually a late finding in acute toxicity.
What are the symptoms of NSAIDs overdose?
Nausea, vomiting and abdominal pain. With a moderate to severe overdose, tinnitus, drowsiness, seizures and acute kidney injury develop
What are the symptoms of histamine overdose?
Overdose may result in an anticholinergic effect of tachycardia, drowsiness, hallucinations and urinary retention
Broad QRS
What is management for histamine overdose?
Management is mainly supportive although decontamination with activated charcoal is reasonable. Benzodiazepines can be given for agitation, hallucination and seizures whilst IV sodium bicarbonate can be given if there is a widened QRS complex.
What is management of paracetamol overdose?
N-acetylcysteine
Monitor liver function
What is management of Salicyte (Aspirin) overdose?
Activated charcoal, fluid replacement and urine alkalinisation via intravenous sodium bicarbonate infusion with the aim of producing a urine pH 7.5–8.0
What is appropriate fluid resucitation for severe head injury?
Restricted to 70% of normal maintenance as inappropriate ADH secretion can occur with severe head injury
What is algorithm for status epilipticus stage 1?
x 2 dose buccal midazolam or rectal diazepam 0.5mg/kg (max 10kg) Or if IV access x1 dose 0.1mg/kg lorazepam (max 4mg)
What is algorith for status epilipticus stage 2?
Lorazepam 0.1mg/kg
If not working and patient not already taking phenytoin prepare phenytoin
IF patient is on phenytoin prepare phenobarbitone
Can give PR paraldehyde whilst phenytoin is being drawn up
