Medical Emergencies Flashcards
What is the order of patient assessment?
A airway
B breathing
C circulation
D disability
E exposure
What is involved in airway assessment?
Cause of airway obstruction - loss of consciousness, infection/ inflammation/ swelling
Recognition- talking?
Treatment - triple manoeuvre, oropharyngeal airway
What is the triple manoeuvre?
Head tilt
Chin tilt
Jaw lift
Need to hold patient in this position to keep airway open
How is an oropharyngeal airway measured?
Measured from angle of jaw to central incsors
What is involved in breathing assessment?
Causes - demand, infection, inflammation, neurological condition causing muscle weakness, fractured ribs causing hyperventilation
Recognition - rate/ look/ listen
Treatment - posture, oxygen, bronchodilators
What is the normal respiratory rate?
12-15 breaths per min
At what oxygen saturation will lips and fingers / tongue become cyanotic?
84% - lips and fingers will turn blue
60% - tongue will turn blue
What positioning will optimise breathing?
Tripod position (opens up intercostals)
What is involved in circulation assessment?
Causes - arrhythmia, ACS, HF
Recognition - pulse check
Treatment - treat cause/ elevate legs
What is the significance of bradycardia?
Usually end stage, failing organs
Difficult to treat
What is the cause of 120 bpm?
AF
What is the cause of <40 bpm?
Type 2 heart block
What pulse can be felt in the wrist/ brachial pulse/ in neck?
Can feel pulse in wrist at 100 bpm,
Brachial pulse at 70 bpm
In neck at 50 bpm
What is minimum bpm for organ perfusion?
45 bpm
What is the reason behind elevating legs?
Improves blood pressure as 350ml will go straight to central cavity.
What is involved in assessing disability?
Causes - drugs, brain injury, hypoglycaemia
Recognition - ACVPU/ GCS
Treatment - optimise ABC
What is ‘ACVPU’
Alert
Confusion
Verbal
Pressure
Unconscious
If scores in any of these (except A)- will score 3 on sepsis scale.
What is the presentation of anaphylaxis?
A - swelling, stridor
B - increased rate, wheeze
C - increased rate, hypotension
D - LOC
E - rash, swelling
What is the treatment of anaphylaxis?
Adrenaline 1:1000, 0.5mg (epi pen)
IM injection
What is the mechanisms of adrenaline in treatment of anaphylaxis?
Adrenaline aborts physiological cascade changes - peripheral vasoconstriction, central dilator.
Decreased swelling and histamine, bronchodilator
What is the presentation of angina/ MI?
A - talking
B - increased
C - increased
D - alert
E - pale, clammy, central crushing pain
What is the treatment of angina and MI?
GTN spray (400mg per dose) - 2 puffs sublingual (venous dilator), can repeat after 5 mins.
Aspirin 300mg crushed/ chewed if MI (no water as needs to be fully absorbed)
What is the difference between MI and stable angina with regards to the lumen of arteries?
MI- <1/3 occluded
Stable angina- up to 1/3 occluded, will recover after rest
What is the presentation of asthma?
A - difficult to complete sentences
B - increased rate with wheeze
C - increased rate
D - alert
E - tripods
