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Emergency medicine > Emergency medicine > Flashcards

Emergency medicine Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

How do you do an A & E assessment?

A 
C ABCDE
Control catastrohic haemorrhage
Airway with C-spine protection 
Breathing with ventilation 
Circulation with haemorrhage control 
Disability with neurological status 
Exposure/environment
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2
Q

How do you do a handover in emergency medicine?

A

Age, time, mechanism, injuries, signs, treatment

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3
Q

Where are the junctional haemorrhage areas?

A

femoral, axillary, neck

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4
Q

What is a drug you can do to limit bleeding?

A

traexamic acid 1g 10 minute then 1g infusion

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5
Q

What are the 4 types of blast injury?

A

Primary - blast wave disrupts gas filled structures
Secondary - impact airborne debris
Tertiary - transmission of body
Quaternary - all other forces

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6
Q

Name 6 things measured in the NEWS2 score

A 
respiratory rate 
oxygenation 
pulse and BP 
level of consiousness 
temperature
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7
Q

When would you consider a patient hypotensive?

A

BP <90, or a difference of 40 from their normal blood pressure

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8
Q

What are non-cardiac ways to measure circulation?

A

colour, capillary refill, saturations, decreased consiousness (brain perfusion), urine output (kidney perfusion)

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9
Q

What are the 3 broad categories of shock? [plumber]

A

Fluid - hypovolaemic, haemorrhagic
Pump - obstructive, cardiogenic
Pipes - distributive, septic, anaphylactic

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10
Q

What are some types of obstructive shock?

A

tension, pneumothorax, PE, tamponade

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11
Q

What are some types of cardiogenic shock?

A

ischaemic, arrhythmia

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12
Q

What are some types of distrubtive shock?

A

neurogenic, endocrine

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13
Q

Which three types of shock are you more likely to give fluids and vasopressor for?

A

hypovolaemic, septic, anaphylactic

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14
Q

What are the 3 things you should do if you see a patient in shock?

A

ask for help
O2
ABCDE

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15
Q

What are 5 potential causes of a coma?

A

seizure, infection, hypoxia, hypercapnia, CO poisoning, uraemia, hepatic encephalopathy, hypoglycaemia, hypothyroidism, hypothermia, opiates, benzos, tricyclics, alcohol

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16
Q

How would you score a GCS?

A 
Eye open 
4 - spontaneously
3- verbal
2- pain
1- none
verbal response 
5 - orientated
4- confused 
3 - inappropriate 
2 - incomprehensible
1 - none
motor response 
6 - obeys
5 - purposeful to pain 
4 - withdraws (clavicle)
3 - flexes to pain 
2 - extends to pain 
1 - none
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17
Q

Give 3 indications for intubation

A

failure to maintain airway
insecure airway e.g. GCS<9
poor ventilation
impeding herniation

18
Q

What is Cushing’s reflex?

A

ICP > 30mmHg
ischaemia in medullary vasomotor centre
hypertension
bradycardia

19
Q

What is a score to measure sepsis risk?

A

SOFA score - sequential organ failure assessment

- resp, cardio, hepatic, coagulation, renal, neuro

20
Q

What is a drug that can falsely raise lactate?

A

metformin

21
Q

How would you manage sepsis?

A

BUFALO

22
Q

What fracture do you need to look out for when elderly people have head injuries?

A

cervical fracture

23
Q

What are some RF for elderly falls?

A

meds (gliclizide, benzodiazepines, antihypertensives)

UTIs

24
Q

What is a FAST scan?

A

focused assessment with sonography in trauma - takes 15 mins
- low negative predictive value (can only see >250 ml blood in abdo)

25
Q

What is included in trauma series of XR?

A

AP chesst, pelvis, c-spine

26
Q

What type of hip fracture is a pelvic binder used to treat?

A

AP compression fracture

27
Q

What are C-spine views?

A

lateral, AP, odontoid peg view (open mouth)

28
Q

How would you interpret CT head?

A

basic overview, brain tissue (grey), CSF (dark grey), gas (black), bone (white)

29
Q

When would you do a CT in trauma?

A

if haemodynamically unstable
mechanism of injury - more than one system
findings of XR/FAST scan are inconclusive or suggest injury
obvious severe injury

30
Q

What does AVPU stand for?

A

alert, voice, pain, unresponsive

31
Q

What is included in neuro secondary survey?

A

general motor
reflexes
tone
cranial nerve and brainstem

32
Q

What are indications to intubate?

A

absent gag, GCS <9, AVPU < 9
failure to maintain airway
poor ventilation
impending herniation

33
Q

How would you optimise cerbral perfusion?

A

optomise BP to reduce ICP
cerebral dehydration with mannitol or hypertonic saline
reduce cerebral blood volume - head to 30 degrees, avoid hypoxia

34
Q

What is Cushing’s reflex?

A

ICP >30mmHg
ischaemia medually vasomotor centre
hypertension
bradycardia

35
Q

What approach do you take in major trauma?

A 
C ABCDE
Control catasrophic haemorrhage 
airway - c spine protection 
breathing with ventilation 
circulation with haemorrhage control 
disability - neuro status 
exposure/environment
- do not move from one system to another
36
Q

What is the difference between incision and laceration?

A

incision - blade

laceration - tear

37
Q

How do you assess A on emergency approach?

How would you treat it if a problem was found?

A

Look - accessory, breathing?
Listen - gurgling, snoring, stridor etc.
Feel - airflow?

Treat - jawthrust, guedel, recovery position, nasal airway, intubation, gentle suction

38
Q

How do you assess B on emergency approach?

A

Look - expansion, cyanosis, tachypnoea, saturations
Listen - absent or added sound
Feel - central trachea, symmetry, percussion, feel before listening

39
Q

How do you assess C on emergency approach?

A

Look - colour, cap refil, sats, bleeding, decreased consiousness
Listen - heart sounds
Feel - pulse, BP

40
Q

What is the dose of adrenaline in anaphylactic shock?

A

adult 500 micrograms (0.5mL)
child (6-12) 300 micrograms
Child <6 150 micrograms

41
Q

What drugs do you give in anaphylaxis?

A

adrenaline
IV fluid challenge
chlorphenamine
hydrocortisone

42
Q

How would you treat ethylene glycol poisoning?

A

IV fomepizole or ethanol

supportive measures

Emergency medicine (9 decks)

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