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ACC > Life-threatening Core Conditions > Flashcards

Life-threatening Core Conditions Flashcards

1
Q

What is the definition of sepsis?

A

Life threatening organ dysfunction caused by a dysregulated host response to an infection

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2
Q

What organisms are the causes of sepsis?

A 
90% gram positive bacteria & fungi
E.Coli
Candida
Staph Aureus
Strep
Coag-negative Staph
Enterococci
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3
Q

How is sepsis investigated?

A

Blood cultures
Urine output
ABG: paCO2 <4.3 diagnostic
Bloods: FBC, WCC, Creatinine, Urea, LFTs, Bilirubin, lactate

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4
Q

What antibiotics are used to treat the different causes of sepsis?

A 
Resp: Cefotaxime/Co-Amox/Moxifloxacin
MRSA: Vancomycin
Pseudomonas: Ciprofloxacin
Anaerobes: Amoxicillin &amp; Gentamicin &amp; Metronidazole
Crystalloid
Vasopressors: NorA
IV Hydrocortisone
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5
Q

Which rhythms are shockable and which are not?

A

Yes: Pulseless VT, VF
No: Asystole, Pulseless electrical activity

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6
Q

What are common causes of cardiac arrest?

A 
Ischaemia/ acute MI
Unspecified CVD
Cardiomyopathy
VT &amp; VF
Drug intoxication (Cocaine)
HypoV &amp; HyperK
Trauma &amp;Shock
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7
Q

How is a cardiac arrest managed?

A

CPR & Defibrillation
Adrenaline 1mg/3-5mins
Magnesium (if Torsades)
Amiodarone

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8
Q

What is anaphylaxis?

A

Acute, severe, life-threatening allergic reaction in pre-sensitised individuals with at least 2 organs involved

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9
Q

What are the causes of anaphylaxis?

A

Drugs: Mainly adults
Food: Mainly children
Insect bite/sting

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10
Q

What are the signs & symptoms of anaphylaxis?

A 
Acute onset &amp; fast progression
Urticaria
Flushing
Rhinitis
Angioedema
Dyspnoea
Wheezing/ stridor
Tightness of throat
Tachycardia
Syncope
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11
Q

How is anaphylaxis investigated?

A

Serum tryptase: ELEVATED, on arrival & 1hour later
ABG
DIAGNOSTIC criteria: All 3-
-Acute onset of illness with sudden progression
-Skin/mucosal changes
-Life threatening ABC problems

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12
Q

How is anaphylaxis treated?

A 
Establish airway- Oxygen 15L/min
Adrenaline/Epinephrine IM 500micro of 1:1000 repeat after 5mins
Supine with legs elevated
IV fluid challenge: 500-1L Crystalloid
Chlorphenamine: 10mg IV
Hydrocortisone: 200mg IV
Wheeze: Terbutaline
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13
Q

What type of reaction is anaphylaxis?

A

IgE mediated hypersensitivity reaction

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14
Q

In anaphylaxis what signs are classed as life threatening when present in assessment of ABC?

A

Airway: Swelling, stridor, hoarseness
Breathing: Rapid RR, wheeze, fatigue, cyanosis, sats <92%, confusion
Circulation: Pale, clammy, low BP, drowsy/coma, faintness

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15
Q

What is hypovolaemic shock?

A

Inadequate circulating volume secondary to fluid loss

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16
Q

What are the causes of hypovolaemic shock?

A

Burns
Haemorrhage: Trauma, GI bleed, ruptured AAA, obstetric trauma
Diarrhoea & vomiting
Diabetic ketoacidosis

17
Q

What is the pathophysiology of shock?

A

Inadequate delivery of oxygen to tissues results in a failure of aerobic metabolism leading to end organ dysfunction

18
Q

What are the different classes of hypovolaemic shock?

A

1: <750ml loss, HR <100, BP normal, RR normal, Slightly anxious
2: 750-1.5L loss, HR >100, RR 20-30, mildly anxious
3: 1.5-2L loss, HR >120, BP dec, RR 30-40
4: >2L loss, HR >140, BP dec, RR >35

19
Q

How is hypovolaemia investigated?

A 
Find cause
Obs
FAST Scan
ECG
ECHO
Bloods: Lactate
Those with hypovolaemic shock likely to have an AKI
20
Q

How is hypovolaemic shock treated?

A

RESUS
Massive haemorrhage protocol
Fluids: IV Hartmann’s

21
Q

What is septic shock?

A

Sepsis accompanied by hypotension & perfusion abnormalities despite adequate fluid resus

22
Q

How is septic shock treated?

A

Sepsis 6-repeat
Vasopressors
Look for cause of shock

23
Q

What causes hypothermia?

A 
Major haemorrhage
(hypoperfusion= low O2 delivery= less chemical reactions/min = dec heat generation)
Aggravated by cold surroundings + surgical intervention
24
Q

Define hypothermia

A

Temperature <36 for >4hours

25
Q

What are the complications of hypothermia?

A

Low CO
High SVR
Left shift of O2-Hb dissociation curve
Can induce coagulopathy

26
Q

What are the causes of coagulopathy?

A

Hypothermia
Activation of fibrinolytic system
Haemodilution from rests fluids

27
Q

How does hypothermia cause coagulopathy?

A

Imbalance between thromboxane & prostacyclin = platelet dysfunction & inhibits coagulation enzyme function

28
Q

What is the approximate time for anaphylaxis to occur?

A 
Food= <30mins
Injection= <5mins
29
Q

What are the reversible causes of cardiac arrest?

A 
Hyper/hypokalaemia (hypok= 1bag/4hours)
Hypothermia (Warmed fluids)
Hypovolaemia
Hypoxia
Tension pneumothorax
Tamponade
Toxins
Thromboembolic event (MI, PE)

ACC (21 decks)

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