Medical Emergencies

Question 1

Recommended drugs for ME

Answer 1

• Adrenaline, 1ml ampoules/ pre-filled syringes - EpiPen of 0.5ml of 1:1000 solution for IM injection
• Aspirin, 300mg dispersible tablets
• Glucagon, IM injection 1mg
• Glyceryl trinitrate (GTN) Spray, 400microgram/ metered dose
• Midazolam oromucosal solution, 5mg/ml, topical buccal administration
• Oral glucose
• Oxygen cylinder (15L/min)
• Salbutamol inhaler, 100 micrograms per actuation

Question 2

Key signs & Symptoms of Anaphylaxis

Answer 2

Key signs
- upper airway oedema & bronchospasm
- cause stridor and wheezing noises
- tachycardia (HR > 110/min)
- increased resp rate

Symptoms
- abdominal pain
- vomitting
- diarrhoea
- pallor/ flushing
- allergy

Question 3

Anaphylaxis steps

Answer 3

1. assess pt
2. call ambulance
3. secure pt’s airway, restore BP by laying pt flat and raising their feet
4. Administer 100% oxygen, 15L/min
5. Administer adrenaline, 0.5ml (1:1000) IM injection repeated after 5 mins

Question 4

Cardiac arrest then Anaphylaxis

Answer 4

• BLS first
• carry out early defibrillation

Question 5

Management of Mild Allergy

Answer 5

• 1 Cetirizine tablet 10mg
• 1 Chlorphenamine tablet 4mg
• 1 Loratadine tablet 10 mg

If have mild bronchospasm,
- Salbutamol inhaler, 4 puffs (100micrograms per actuation)
- 1 puff via spacer every 15s (max 10 puffs), repeat at 10-20 min intervals

Question 6

Key signs of Asthma

Answer 6

Life- threatening asthma
- cyanosis/ resp rate < 8/min
- bradycardia (HR<50/min)
- exhaustion, confusion

Acute severe
- inability to complete sentences in one breath
- resp rate > 25/min
- tachycardia (HR> 110/min)

Question 7

Management of Asthma

Answer 7

• assess pt
• sit pt upright
• administer 100% oxygen, 15L/min
• administer pt’s own bronchodilator (2 puffs) or salbutamol 4 puffs (100 micrograms/ actuation)

Question 8

Angina & Myocardial Infarction

Answer 8

• progressive onset pf pain across front of chest
• pain radiate down to shoulders and arms
• shortness of breath
• skin becomes pale and clammy
• nausea
• pulse weak and BP might fall

Question 9

Management of angina/ myocardial infarction

Answer 9

• administer 100% oxygen (15L/min)
• administer Glyceryl trinitrate (GTN) spray, 2 puffs (400 micrograms/ metered dose)
• if does not respond then send to hospital
• administer aspirin 300mg dispersible tablet orally

Question 10

Epilepsy

Answer 10

• assess patient
• do not try to restrain convulsive movements
• ensure pt is not at risk from injury
• secure patient’s airway
• administer 100% oxygen (15L/min)
• administer 10mg Midazolam (2ml oromucosal solution, 5mg/ml)

Question 11

Hypoglycaemia

Answer 11

• administer 100% oxygen (15L/min)

If pt conscious,
- administer oral glucose (10-20g)

If pt unconscious,
- administer glucagon 1mg Im injection
- then oral glucose

Question 12

Anxiety

Answer 12

• Diazepam tablets, 5mg
• Send: 1 tablet
• Label: 1 tablet 2 hours before procedure
• advise pt that they should not drive