medical emergencies

Question 1

adrenaline

Answer 1

1ml ampoules of 1:1000 solution

use 0.5ml in syringe for intramuscular injection (we have 2 doses, use second if unresponsive in 5mins at different site)

z track technique
legs above head

for anaphylaxis

Question 2

aspirin

Answer 2

300mg dispersible tablets, wait 10mins before any water needs absorbed by oral mucosa

for MI

Question 3

GTN spray

glyceryl trinate spray

Answer 3

400micrograms per metered dose

2 puffs under tongue

for MI

Question 4

salbutamol

Answer 4

100micrograms per acutation - try straight with them first

spacer device - 10x into it and getm to breathe into it for 20secs (no more as then start to breathe in CO2)

asthma

Question 5

glucagon

Answer 5

1mg for intramuscular injection

when unconcious, roll to combine contents inject with z track technique, then give sugar

hypoglycaemia (type 1), if concious try glucose sweets first

Question 6

midazolam

Answer 6

5mg/ml

use 10mg (2ml) via buccal sulcus if repeated or prolonged seizure

Question 7

oxygen cylinder

Answer 7

15l via non rebreathing mask
90% O2 delivery, aim for tightest seal
25mins worth of O2 in tank

Question 8

BLS

Answer 8

30 compressions to 2 rescue breaths

5-6cm deep
120 per min

BVM with humidity moisture exchange valve - ensure good seal

Question 9

acronym for BLS

Answer 9

DRS ABC

Danger
Response
Shout for help

Airways
Breathing
Circulation

Question 10

ac

acrnoym for med emergency

Answer 10

ABCDE

Airways
Breathing
Circualtion
Disability
Exposure

Question 11

paeds BLS

Answer 11

15 compressions to 2 rescue breaths

child similar to adult
infant - two fingers or two thumbs

Question 12

glucagon action

Answer 12

inc concentration of glucose in the blood by promoting gluconeogenesis and glycogenolysis to convert glycogen to glucose

hypoglyceamia

Question 13

signs of hypoglycaemic coma

Answer 13

pale
shaky
sweaty/clammy
dizzy
hungry
confusion
blurred vision
loss of conciousness

Question 14

hypoglycaemia tx
if concious and cooperative

Answer 14

delivery oral glucose 10-20g or sugary drinnk

Question 15

hypoglycaemia tx if unconcious/uncooperative

Answer 15

1mg IM glucagon injection and oral glucose when regain conciousness

if after 15mins not regained concsious 2nd dose glucagon

Question 16

midazolam mode of action

Answer 16

short-acting benzodiazepine
enhances the effect of neurotransmitter GABA on the GABA receptors resulting in neural inhibiton

resp despression
hypotension

Question 17

signs of eplieptic fit

Answer 17

loss of conciousness
uncontrollable muscle spasm
drooling
tonic (falls rigid)
clonic (sharp jerky movements)
hypotension
hypoxia
loss of airway tone

Question 18

medication of epileptic fit

Answer 18

100% oxygen 15l/min
midazolam 2ml (5mg/ml so 10mg) into buccal cavity
reppeat after 5mins if not worked

Question 19

salbutamol

action

Answer 19

short acting selective beta2-agonsit
relaxes smooth muscles in the brochi causing bronchdilation

asthma

Question 20

signs of asthma attack

Answer 20

airway constriction
fast breathing
wheeze
gasping
clutching chest
tachycardia

Question 21

adrenaline action

Answer 21

powerful vasoconstrictor
bronchodilator
inc contractility of myocardium

Question 22

aspirin
action

Answer 22

anti platelet
slows down platelet aggregration

Question 23

GTN spray
action

Answer 23

Vasodilator
* Venous only not arteries

Reduce preload, reduce strain on heart