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SDCEP guidance > medical emergencies > Flashcards

medical emergencies Flashcards

1
Q

what must be regularly done in practice?

A

stock and regularly check drugs and equipment

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2
Q

CPD

A

GDC recommends 10hrs per cycle (2hrs pa)

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3
Q

what does the BNF recommend as an emergency drug for the management of status epilepticus in GDP?

A

buccal midazolam

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4
Q

adrenline

A

1ml ampoules or prefilled syringes of 0.5ml of 1:1000 solution IM

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5
Q

aspirin

A

300mg dispersible tablets

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6
Q

glucagon

A

1mg IM

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7
Q

GTN spray

A

400mcg per metered dose

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8
Q

midazolam

A

oromucosal solution 5mg/ml
topical buccal administration
not licensed <3m/>18yrs

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9
Q

glucose

A

oral

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10
Q

O2 cylinder

A

2 size D/CD or 1 size E

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11
Q

salbutamol

A

inhaler

100mcg per acutation

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12
Q

optional drugs

A

cetirizine 10mg
chlorphenamine 4mg
loratidine 10mg

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13
Q

signs of anaphylaxis

A

upper airway oedema and bronchospasm
stridor and wheezing
tachycardia >110bpm, increased resp rate

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14
Q

symptoms of anaphylaxis

A

abdo pain, vomiting, diarrhoea, sense of impending doom
flushing (/pallor)
symptoms of mild allergy

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15
Q

managment of anaphylaxis

A

assess ABCDE
999
secure airway, help restore bp by laying flat and raising feet - DON’T stand
remove source if known
100% O2 15l/min
adrenaline 0.5ml (1:1000) IM, repeat after mins if needed
- children 6m-5yrs 0.15ml
- 6-11yrs 0.3ml
if cardiac arrest - BLS and early defibrillation

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16
Q

tx if signs of mild bronchospasm

A

salbutamol inhaler 4 puffs (100mcg per actuation) large vol spacer, repeat as needed
refer to GP

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17
Q

key signs of milder allergy

A

urticaria and rash (chest, hands, feet)
rhinitis, conjunctivitis
mild bronchospasm without evidence of severe SOB

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18
Q

signs of life-threatening asthma

A

cyanosis or resp rate <8 per min
bradycardia <50
exhaustion, confusion, reduced consciousness level

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19
Q

signs of acute severe asthma

A

unable to complete sentences in 1 breath
resp rate >25 per min
tachycardia (>110)

20
Q

tx of life-threatening asthma

A

999
assess pt
sit upright
100% O2 15l/min
2 puffs of pt own bronchodilator or salbutamol 4 puffs (100mcg per actuation) through large vol spacer, repeat as needed
- children 1 puff spacer every 15s (max 10), repeat at 10-20min intervals

21
Q

tx of acute severe asthma

A

assess pt
sit upright
100% O2 15l/min
2 puffs of pt own bronchodilator or salbutamol 4 puffs (100mcg per actuation) through large vol spacer, repeat as needed
- children 1 puff spacer every 15s (max 10), repeat at 10-20min intervals

if severe episode doesn’t respond to tx with bronchodilators within 5mins - hospital emergency

22
Q

ACS presentation

A

progressive onset of severe crushing pain in centre and across front of chest, may radiate to shoulders and down arms (usually left), neck, jaw, back

23
Q

symptoms of ACS

A 
SOB
increased resp rate
pale and clammy skin
nausea and vomiting common
may have weak pulse/bp may fall
24
Q

tx of ACS

A

assess
100% O2 15l/min
GTN 2 puffs (400mcg per metered dose) sublingually, repeat 3mins if pain remains

if pt doesn’t respond to GTN

  • 999
  • aspirin 300mg dispersible tablet (chew/in water) - send note with pt
  • if needed BLS
25
Q

signs of cardiac arrest

A

LOC
absence of normal breathing
loss of pulse
dilation of pupils

26
Q

tx of cardiac arrest

A

999
BLS, 100% O2 vent 15l/min
defib

27
Q

signs of epilepsy

A 
sudden LOC
rigid
fall
might give a cry
becomes cyanosed (tonic phase)
jerking movement of limbs, might bite tongue (clonic phase)
28
Q

symptoms of epilepsy

A

brief warning/aura

frothing from mouth and urinary incontinence

29
Q

epilepsy tx

A 
assess
don't try to restrain convulsive movements
ensure pt not at risk from injury
secure airway
100% O2 15l/min

seizure will typically last a few mins, pt might then become floppy but remain unconscious
once pt regains consciousness they may remain confused

30
Q

epilepsy tx if fit repeated/prolonged (5 or more mins)

A 
continue O2
10mg midazolam
 - use 2ml oromucosal solution 5mg/nl
 - topically into buccal cavity
 - not licensed for use in adults in status epilepticus, but is recommended by BNF

after convulsive movements have subsided, place pt in recovery position and check airway. Don’t send pt home until recovered fully

31
Q

epilepsy - when should you call 999?

A 
prolonged more than 5mins
repeated
1st episode for pt
atypical convulsion
injury occurred
difficulty monitoring pt
32
Q

signs of faint

A

feels faint dizzy lightheaded
slow pulse
LOC

33
Q

symptoms of faint

A

pallor and sweating

nausea and vomiting

34
Q

tx of faint

A

assess
lay flat and if not breathless raise feet
loosen any tight clothing around neck
100% O2 15l/min until consciousness regained

35
Q

signs of hypoglycaemia

A

aggression and confusion
sweating
tachycardia >110

36
Q

symptoms of hypoglycaemia

A 
shaking and trembling
difficulty in concentration/vagueness
slurring of speech
headache
fitting
unconsciousness
37
Q

tx of hypoglycaemia if pt conscious and cooperative

A

assess pt
100% O2 15l/min
oral glucose 10-20g, repeat if necessary after 10-15mins

38
Q

tx of hypoglycaemia if pt unconscious or uncooperative

A

assess pt
100% O2 15l/min
glucagon 1mg IM
oral glucose 10-20g when pt regains consciousness

39
Q

hypoglycaemia - when should you call 999?

A

if pt does not respond or any difficulty is experienced

40
Q

key signs of a stroke

A

facial weakness, one eye may droop or pt may only be able to move one side of mouth
arm weakness
communication problems - slurred speech, pt is unable to understand what is being said to them

41
Q

tx of stroke

A

assess pt
100% O2 15l/min
if unconscious and breathing secure airway and place in recovery position
999

42
Q

why are dental pts susceptible to aspiration and choking?

A

blood and secretions in mouth for prolonged periods
suppressed pharyngeal reflexes due to LA
imp material/dental equipment in mouths

43
Q

S+S of aspiration and choking

A 
cough and splutter
complain of difficulty breathing
stridor
'paradoxical' chest or abdo movements
cyanosed/LOC
44
Q

management of aspiration

A

encourage pt to cough vigorously
100% O2 15l/min
salbutamol inhaler 4 puffs (100mcg per actuation), through a large-vol spacer, repeat as needed
- children 1 puff every 15s (max 10) repeat at 10-20min intervals as needed

if you suspect a large fragment has been inhaled/swallowed but there are no S+S - refer to hospital for xray and removal of fragment if necessary

if pt symptomatic following aspiration refer to hospital as emergency

45
Q

management of choking

A

remove any visible foreign bodies in mouth and pharynx
encourage pt to cough
if pt unable to cough but remains conscious - back blows followed by abdo thrusts
if LOC - BLS, may also help to dislodge foreign body
999

SDCEP guidance (7 decks)

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