Environmental and unique situations Flashcards
Mild
Mod
Severe
Hypothermia
32-35
28-32
<28
Initial resus of a drowned patient
Check for signs of life
5 rescue breaths
CPR 30:2
How to recognise a venomous snake bite
Non venomous
Two clear puncture wounds
Two sets of fang mark lines
Contraindication to organ donation
CJD
active HIV
uncontrolled infection (donor sepsis)
metastatic or non-curable malignant disease
Past history of malignancy that poses risk for transmission no matter how long the apparent disease-free period (e.g. melanoma, choriocarcinoma)
Arrest management and hypothermia
Up to what temp are drugs withheld
Between what temp is the drug interval doubed
30 degrees
30-35
What dose of calcium chloride is given in a patient who is in arrest and found to have hyperkalaemia
10ml 10% calcium chloride (1g)
Cut off temp for heat stroke
40.6
Swiss staging system for hypothermia
I – clearly conscious and shivering
II – impaired consciousness without shivering
III – unconscious
IV – not breathing
V – death due to irreversible hypothermia
Nerve agents MOA
They act by inhibiting acetylcholinesterase (AChE), an enzyme that catalyses the breakdown of the neurotransmitter acetylcholine (ACh), resulting in an accumulation of ACh at both muscarinic and nicotinic cholinergic receptors.
Antidotes for nerve agents
MOA
atropine and pralidoxime
Atropine - muscarinic acetylcholine receptor antagonist, blocking the effects of excess acetylcholine.
Pralidoxime - reactivating acetylcholinesterase
Antidotal therapy in cases of serotonin syndrome (when supportive measures don’t work)
cyproheptadine
Antidotal therapy in cases of neuroleptic malignant syndrome (when supportive measures don’t work)
Bromocriptine
Amantadine
Dantrolene
Cutis marmorata
Rash associated with decompression sickness
Acronym for symptoms of organophosphate poisoning
Salivation
Lacrimation
Urination
Diarrhoea
GI upset
Emesis
SLUDGE
Hydrogen Sulphide poisoning symptoms and antidote
Mydriasis, cyanosis and increased respiratory rate
Sodium Nitrite
Hydrofluoric acid poisoning symptoms and antidote
Rapid onset severe pain and erythema
Calcium gluconate
Antibiotic guidelines for lyme disease
First-choice – oral doxycycline 100 mg bd (or 200 mg od) for 21 days
Second-choice – oral amoxicillin 1 g tds for 21 days
Third-choice – oral azithromycin 500 mg od for 17 days
Patients suspected of having Lyme disease but without the characteristic rash, first-line diagnostic test is:
Enzyme-linked immunosorbent assay (ELISA)
Which type of acid-base disorder would you expect to be present at high altitude?
Respiratory alkalosis
Which type of arrhythmia is most common with an AC electrical injury
VF
Which type of arrhythmia is most common with an DC electrical injury
Aystole
Which organ system is the first to show signs of radiation exposure?
GI
