Handbook emergencies Flashcards
Primary survery
Airway: patency, obstruction?
Breathing: RR, bilateral chest movements, percuss, auscultate
Circulation: pulse, BP, peripherally shut down? cap refill
Disability: AVPU, GCS, pupils (size, equality, reactions)
Exposure: undress patient
Red flag headache features
- first and worst
- thunderclap
- unilateral/eye pain
- unilateral + ipsilateral symptoms
- cough initiated
- worse in morning
- scalp tenderness
- fever/neck stiffness
- change in pattern of usual
- dec consciousness
DDx for wheezing
asthma
COPD
HF
anaphylaxis
DDx for stridor
foreign body/tumour
acute epiglottitis
anaphylaxis
trauma e.g. laryngeal fracture
DDx for crepitations
HF
pneumonia
bronchiectasis
fibrosis
DDx for breathlessness and chest clear on examination
- PE
- hyperventilation
- metabolic acidosis
- anaemia
- drugs e.g. salicylates
- shock
- PCP pneumonia
- CNS causes
investigations in breathlessness
baseline obs (sats, pulse, temp, peak flow)
ABG
ECG
CXR
baseline bloods
life threatening causes of chest pain
acute MI
angina/ACS
aortic dissection
tension pneuothorax
PE
oesophageal rupture
key investigations in chest pain
CXR
ECG
FBC, U&Es, troponin
Motor aspect of GCS
6: obeys command
5: localising to pain
4: withdrawing to pain
3: flexor response to pain
2: extensor response to pain
1: no response to pain
Verbal aspect of GCS
5: orientated (time, place, person)
4: confused
3: inappropriate speech
2: incomprehensible sounds
1: none
Eye aspect of GCS
4: spontaneous
3: in response to speech
2: in response to pain
1: none
septic shock
sepsis +
- lactate >2 mmol/L despite adequate fluid resus
- require vasopressors to maintain MAP >65mmHg
mimics of anaphylaxis
carcinoid
phaechromocytoma
systemic mastocytosis
hereditary angioedema
management of anaphylaxis
- secure airway
- remove cause, raising feet to help circulation
- adrenaline IM 0.5mg
- repeat every 5 mins
- chlorphenamine and hydrocortisone
- saline
