Emergency medicine

Question 1

Give the alphabet for emergency medicine

Answer 1

H - hazards
H - hello
H - help
A - airway
B - breathing
C - circulation
D - disability, drip, drugs, defib
F - fractures, fluids
G - glucose, GCS
H -Hb, Ht, head injury
I - insulin, infusion, injections
J - JVP
K - potassium and other electrolytes
L - LP
M - metabolic conditions, malaria
N - neurological, neck, NG tube
O - oxygen, observations
P - pulses, pupils, PEEP, poisoning
Q - quality control, Q waves
R - reflexes, respiration, re-evaluation
S - scan
T - temperature, tamponade
U - urine output, urea, U/S
V - vital signs, ventilator
W - wounds, withdrawal
X - xrays
Y -  yawn
Z - zzz

Question 2

What does RSI stand for?

Answer 2

Rapid sequence intubation

Question 3

Discuss RSI

Answer 3

1. Simultaneously administer sedative and NM block

Question 4

Give the 9Ps for RSI

Answer 4

Plan
Preparation – check machine, get equipment ready, suction, oxygen, etc.
Protect C-spine
Positioning (don’t over extend the neck)
Pre-oxygenation – 3 minutes at 15L/min, or 4 deep inhalations; or bag with crycoid pressure (to maintain Hb saturation during airway management)
Pre-treatment, (not in all pt’s) e.g. β-blocker, lignocaine, induction agent.
Paralysis (and induction), e.g. Propofol, Ketamine, Dormicum, Etomidate.
Placement with proof of ET tube (capnography).
Post-intubation management (secure tube, cuff pressure 15 – 25mmHg, elevate head of bed at least 30 degrees, etc.)