medical emergencies Flashcards
What is a cardiac arrest?
When the heart stops pumping blood around the body due to a disruption in electrical activity.
What is the difference between a heart attack and cardiac arrest?
Myocardial Infarction occurs when the artery supply to the heart becomes blocked causing damage to the heart muscle.
How often should you complete BLS training?
Annually
Expand the DRS ABC acronym:
D anger
R esponse
S hout for help
A irway
B reathing
C irculation / call 999
What are 2 examples of ‘shockable rhythms’?
- Ventricular Fibrillation
- Ventricular Tachycardia
What are 2 ‘non-shockable rhythms’?
- Asystole (no electrical activity)
- Pulseless Electrical Acitivity
What is the correct depth and rate of compressions in an adult?
Depth of 5-6 cm
Rate of 100-120 per min.
What is the correct ratio of compressions to breaths in an adult?
30:2
What is the depth of compressions used in children?
4-5cm
How many rescue breaths should be administered to a paediatric patient and when?
5 rescue breaths should be administered before starting compressions.
Explain the correct order of action on a choking patient.
- Encourage coughing.
- Lean them forwards and deliver 5 back blows.
- Abdominal thrusts.
- Repeat if this has been ineffective.
Commence CPR if the victim becomes unresponsive
What immunological process occurs in IMMEDIATE ANAPHYLAXIS?
Mast cell activation releases histamines.
Define Anaphylaxis
The severe, potentially life threatening generalised allergic reaction characterised by rapidly developing symptoms
What are the 2 types of anaphylaxis?
- Uniphasic
- Biphasic
Uniphasic Anaphylaxis
Quick onset with rapidly worsening symptoms.
Once treated, symptoms leave and don’t return.
Biphasic Anaphylaxis
Starts with a mild-severe reaction followed by a period of time with no symptoms.
Symptoms then start to increase with bleeding and blood pressure problems .
If anaphylaxis is suspected to be biphasic, how should the pt be managed?
The pt should be monitored 6-12 hours after the reaction.
What are the 3 symptoms of anaphylaxis?
- Skin Changes (redness and itching)
- Mucosal Changes (swelling)
- Swallowing/Breathing difficulties
3 examples of antibiotic with a potential to cause anaphylaxis.
- amoxicillin
- phenoxymethylpenicillin
- metronidazole
Which antiseptic prescribed to clean sockets following XLA has the potential to cause anaphylaxis?
Chlorhexidine
What component of alvogyl has the potential to cause anaphylaxis?
Idodoform (iodine)
What dose of adrenaline should be administered to children UNDER 6?
150 micrograms (0.15 ml of 1:1000)
What dose of adrenaline should be administered to children between 6 - 12?
300 micrograms (0.3 ml of 1:1000)
What dose of adrenaline should be administered to ADULTS and CHILDREN OVER 12?
500 micrograms (0.5 ml of 1:1000)
At what interval should doses of adrenaline be repeated until an adequate response has been achieved?
5 minute intervals
At what angle should the adrenaline be administered in the anteriolateral thigh?
90º
Which component found in fluoride varnish has the potential to cause an asthma attack?
Colophony
What type of inhaler is BLUE
The reliever inhaler (SABA)
What type of inhaler is BROWN/orange/burgandy?
The preventer inhaler (corticosteroids)
What type of inhaler is GREEN?
Long Acting Beta Agonist
Which type of inhaler is PURPLE/red & white?
LABA and Corticosteroid COMBINATION
How does the blue reliever inhaler work during an asthma attack?
Quickly relaxes the muscles surrounding the narrowed airways, making it easier to breathe.
Which SABA is used in a reliever inhaler?
Salbutamol
Why is it beneficial to use a spacer during an asthma attack?
Makes the inhaler easier to use and helps deliver the medication to the lungs.
When is the head tilt, chin lift contraindicated?
When the pt has a suspected cervical spine injury.
What is the purpose of an oropharyngeal airway?
To prevent the tongue from obstructing the airway.
When should the OPA be used on a patient?
When the patient is unresponsive with an ABSENT gag reflex.
What are the 3 sizes of OPA?
00 (used in babies)
0 (used in infants)
1-4 (used in adults)
How would you insert an OPA in an adult?
(I-I-R-L)
- Invert
- Insert - until reaching junction of hard-soft palate.
- Rotate
- Locate.
How would you insert an OPA in a child?
Insert the way it sits due to children having a larger soft palate.
How to correctly size a OPA
Measure the distance between the incisors and the angle of the mandible.
When would the use of a nasopharyngeal airway be indicated?
When the patient is conscious/responsive/unconcious.
Useful for patients with TRISMUS (clenching) and those who have an in tact gag reflex.
How would you correctly size a NPA?
Measure from the tragus of the ear to the tip of the nostril.
What is a potential complication of inserting an NPA and how would you manage this?
The insertion will cause a nosebleed so it is useful to have suction ready.
How is the NPA inserted?
- Insert into the largest nostril.
- Apply lubricant.
- Insert with the bevel running along the septum.
How much oxygen should be administered?
15 litres per minute through a non-rebreathe mask.
What value indicates normal blood glucose levels?
4-6
In which 3 situation should CPR be stopped?
When the healthcare professional stops you.
When the victim is definitely waking.
You become exhaused.
TRUE or FALSE: Before starting chest compressions on a child in cardiac arrest, you should give 5 rescue breaths?
True
Adult compressions should be between what depth?
5-6mm
What is the ideal rate of chest compressions?
100-120
Urticarial rash is seen in which medical emergency 80% of the time?
Anaphylaxis
(Urticarial Rash = HIVES)
Which receptors does salbutamol work on in smooth muscle?
Beta 2 adrenergic receptors
(short acting BETA agonist)
TRUE or FALSE: Patients will use secondary muscles in addition to primary muscles when undergoing an acute asthma attack?
TRUE
Which are the 3 secondary muscles of breathing?
- Trapezius
- Scalenes
- Sternocleidomastoid
(intercostal muscles)
If, after giving an injection of adrenaline the pt remains unresponsive, what should you do?
Wait 5 mins and then administer a 2nd injection.
What is the tonic stage of a seizure?
straightening / stiffening of the limbs
What is the clonic phase of seizures?
violent, rhythmic contractions
What defines hypoglycaemia (value)?
when blood glucose levels fall below 3 mmol/l
When should you consider transferring an epileptic pt to hospitals?
(3 factors)
- multiple seizures
- pts first ever seizure
- if the seizure lasts longer than 15 mins
What is the most common side effect of GTN?
headaches - due to peripheral vasodilation
For every minute someone is in cardiac arrest, their chance of survival decreases by what percentage?
10%
The brain can receive permanent damage if the blood supply is cut off for over how many mins?
4 mins
When opening someone’s airway with a suspected C spine injury, which movement is done instead of head tilt, chin lift?
Jaw thrust
Max age for paeds pads to be used:
<8 years (depends on size)
Dose of aspirin to be given during MI:
300mg
Which 3 common medications can cause an acute asthma attack?
- aspirin
- ibuprofen
- beta blockers
Which seizure is being described?
Impaired consciousness with more subtle symptoms - e.g: light turn of the head with no collapsing and no post-ictal phase.
Absence seizure
Which seizure is being described?
Involves very brief spasms in a few areas or all over.
My logic seizure
Which seizure is being described?
Involves losing muscle activity for greater than 1 second, typically occurring on both sides of the body.
atonic seizure
Which anticonvulsant can cause medication-induced B12 deficiency which can cause oral ulceration and glossitis?
carbamazepine
Which medical emergency involves a seizure which has continued for 5 mins and therefore leaves the individual at risk of hypoxia to the brain?
Status Epilepticus
