Emergency Medicine Flashcards
Inhaled Bronchodilators - Indications, Drugs, Doses, Frequency
Exacerbation of COPD, Exacerbation of Asthma
Salbutamol 5mg 4hrly
Ipratropium 500mcg 6hrly
Steroids for exacerbation of asthma
prednisolone 40-50mg PO
if can’t swallow 100mg IV hydrocortisone
Steroids for exacerbation of COPD
200mg IV hydrocortisone and 20mg prednisolone PO
Antibiotics for infective exacerbation of COPD
Send sputum cultures!
Moderate - Amoxicillin 500mg TDS PO 5 days
Severe or recent Abx - Co-Amoxiclav 625mg TDS PO 5 days
Penicillin Allergic - Doxycycline 200mg OD 5 days
Antibiotics for CAP by CURB65 score
Mild (0-1) Amoxicillin 500mg TDS 5 days / Doxycycline 200mg OD
Moderate (2) Amoxixillin 500mg TDS and Doxycycline 200mg OD
Severe (3-5) Co-amoxiclav 1.2g TDS IV and Doxycycline 200mg OD. If non-anaphylactic penicillin allergy use Meropenum 1g IV TDS and Doxycycline 200mg PO OD. If NBM use clarithromycin instead of doxy.
Antibiotics for HAP
Co-amoxiclav 1.2g IV TDS
if penicillin-allergic 200mg doxycycline OD PO
If NBM and non-anaphylactic penicillin allergy 1g IV meropenem TDS.
symptoms of aspirin OD (9)
Tinnitus (early)
nausea, vomiting, GI pain
confusion, psychotic symptoms, coma, resp arrest
Management of anaphylaxis
500mcg adrenaline IM
200mg IV hydrocortisone
10mg IV chlorphenamine
1000ml crystalloid fluid e.g. hartmann’s
What is livedo reticularis?
mottling of the skin due to reduced blood flow and reduced oxygenation. Not always pathological, especially in children, however it can be a sign of severe sepsis or DIC
What is the rule of 9s?
A way of estimating distribution of burns by area. Torso front or back = 18% Whole arm = 9% Front or back of leg= 9% Head and Neck = 4.5% Genitals = 1% Palm=1%
Parkland formula
fluid requirements in 24hrs after receiving burns
4 x weight in kg x % burn
Criteria to refer to burns unit x10
>5% in a child >10% in an adult >5% full thickness burns burns to face, hands, perineum, genitalia and major joints circumferential burns chemical or electrical burns burns in the presence of trauma or significant co-morbidity burns in the very young or the elderly burns in a pregnant patient suspicion of NIA
first aid advice for burns
run under cool water for 20 mins then cover in clingfilm. Do not apply gels or creams
Classifying burns
superficial - dry, minor blistering, painful. involve epidermis only.
partial thickness - moist, red, broken blisters, normal cap refill, usually painful. involve the dermis.
full thickness - dry, charred and often white, painless, cap refill is absent. involvement of subcutaneous tissue.
Managmement of partial thickness burns
de-roof blisters, non-adherent dressing, review in dressing clinic in 48hrs
