Emergency medicine Flashcards
How do you do an A & E assessment?
C ABCDE Control catastrohic haemorrhage Airway with C-spine protection Breathing with ventilation Circulation with haemorrhage control Disability with neurological status Exposure/environment
How do you do a handover in emergency medicine?
Age, time, mechanism, injuries, signs, treatment
Where are the junctional haemorrhage areas?
femoral, axillary, neck
What is a drug you can do to limit bleeding?
traexamic acid 1g 10 minute then 1g infusion
What are the 4 types of blast injury?
Primary - blast wave disrupts gas filled structures
Secondary - impact airborne debris
Tertiary - transmission of body
Quaternary - all other forces
Name 6 things measured in the NEWS2 score
respiratory rate oxygenation pulse and BP level of consiousness temperature
When would you consider a patient hypotensive?
BP <90, or a difference of 40 from their normal blood pressure
What are non-cardiac ways to measure circulation?
colour, capillary refill, saturations, decreased consiousness (brain perfusion), urine output (kidney perfusion)
What are the 3 broad categories of shock? [plumber]
Fluid - hypovolaemic, haemorrhagic
Pump - obstructive, cardiogenic
Pipes - distributive, septic, anaphylactic
What are some types of obstructive shock?
tension, pneumothorax, PE, tamponade
What are some types of cardiogenic shock?
ischaemic, arrhythmia
What are some types of distrubtive shock?
neurogenic, endocrine
Which three types of shock are you more likely to give fluids and vasopressor for?
hypovolaemic, septic, anaphylactic
What are the 3 things you should do if you see a patient in shock?
ask for help
O2
ABCDE
What are 5 potential causes of a coma?
seizure, infection, hypoxia, hypercapnia, CO poisoning, uraemia, hepatic encephalopathy, hypoglycaemia, hypothyroidism, hypothermia, opiates, benzos, tricyclics, alcohol
How would you score a GCS?
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
Give 3 indications for intubation
failure to maintain airway
insecure airway e.g. GCS<9
poor ventilation
impeding herniation
What is Cushing’s reflex?
ICP > 30mmHg
ischaemia in medullary vasomotor centre
hypertension
bradycardia
What is a score to measure sepsis risk?
SOFA score - sequential organ failure assessment
- resp, cardio, hepatic, coagulation, renal, neuro
What is a drug that can falsely raise lactate?
metformin
How would you manage sepsis?
BUFALO
What fracture do you need to look out for when elderly people have head injuries?
cervical fracture
What are some RF for elderly falls?
meds (gliclizide, benzodiazepines, antihypertensives)
UTIs
What is a FAST scan?
focused assessment with sonography in trauma - takes 15 mins
- low negative predictive value (can only see >250 ml blood in abdo)
