First aid & anaphylaxis

Question 1

What is the acronym to assess an unconscious patient?

Answer 1

DRABC 
Danger
response
airway 
breathing
circulation

Question 2

What are the situations that a defibrillator can be used in?

Answer 2

Cardiac arrhythmias
ventricular fibrillation
Pulse less ventricular tachycardia

Question 3

What can you not use a defribrillator in?

Answer 3

Asystole

Question 4

What are symptoms of anaphylaxis

Answer 4

Tachycardia
wheeze
angioedema
urticaria 
Shortness of breath 
cyanosis 
pale, clammy 
hoarse voice/stridour 
low BP (hypotension)

Question 5

What are some side effects of adrenaline?

Answer 5

Vomiting
arrhythmias
confusion
pallor

Question 6

What do you need to consider before administering adrenaline to a patient?

Answer 6

Consider their symptoms
dosage
expiry date
size of the patient

Question 7

What do you NOT need to consider before administering adrenaline to a patient?

Answer 7

verification of a prescription for adrenaline

Question 8

When administering the flu vaccine - what are some things that need to be done?

Answer 8

• Gain written consent
• Ensure patient stays for a short while in case of anaphylaxis
• note on PMR
• enter data onto online system
• inform practice of vaccination
• Inform pt that may feel mild temp, soreness on arm/muscle ache or slightly unwell but usually passes. If doesn’t pass within 48hrs see GP

Question 9

Who is exempt from paying for the flu vaccine? / at risk groups

Answer 9

Diabetics
Neurological disorders
>65 
carers etc and close contacts of immunocompromised pts
Chronic long term conditions e.g. heart, lung, liver (COPD, asthma, kidney and liver disease chronic 
pregnancy 
Children age 2-10 
Long term residential/nursing home 
Diabetics 
immunocompromised patients 
Health workers

Question 10

what are the 3 life threatening symptoms of anaphylaxis?

Answer 10

airway
breathing
circulatory

Question 11

What is the mechanism of adrenaline?

Answer 11

Alpha and Beta adrenergic agonist

Question 12

What is the problem if a patient is on beta blockers but needs adrenaline?

Answer 12

The adrenaline will not give a response because the beta adrenergic receptors are being occupied/blocked by the beta blockers

Question 13

What are the effects of adrenaline?

Answer 13

Agonist of alpha1 in BV causes vasoconstriction
Agonist of B2 in lungs helps airways to reduce wheeze
Agonist of beta receptors in mast cells to reduce histamine/rash
Agonist of B1 in heart to reduce tachycardia

Question 14

Why should you initiate adrenaline with caution if a patient is on digoxin?

Answer 14

Digoxin sensitises the heart to arrhythmias, may have to reduce adrenaline dose

Question 15

How do you distinguish between anaphylaxis and fainting?

Answer 15

Take their pulse in the neck. If there is a fast HR then it is anaphylaxis, if it is a slow HR it is fainting.

Question 16

You only have a 500mcg emerade in stock and a mother rushes in with her 2 year old who has just been stung by a wasp and whose a face is swelling up, struggling to breathe - would you use it?

Answer 16

Yes - it is a life and death situation. the 2 year old is most probably healthy so the heart would be fine with the level of adrenaline. When the paramedics arrive explain what you have given to ensure they are aware.

Question 17

How many epipens should patients carry with them?

Answer 17

2 - always ensure they are in date