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Finals > Medical Emergencies > Flashcards

Medical Emergencies Flashcards

1
Q

What are the signs and symptoms of an MI?

A

Crushing central chest pain, radiating to left arm, neck and jaw

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2
Q

What is the ABCDE for a MI?

A

A - usually patent but potential for some sounds such as wheezing
B - increased RR, decreased SpO2, rapid
C - HR increases and decreases, BP increases and decreases, CRT increases, pallor
D - ACPVU: Alert but anxious
E - clammy, grey in colour, sweaty, nauseous, potential evidence of cyanosis (blue)

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3
Q

What is the management of a MI?

A
  • O2 15ltrs/min
  • administer 2 uffs of GTN (400 micrograms) sublingually and repeat after 3 mins, if pain remains. if symptoms alleviate then this was an agina attack
  • If pain still remains or worsens then 999 and adminsiter 300mg dispersible aspirin (chewed and swallowed ASAP), as this is likely an MI
  • Monitor and reassure pt until ambulance arrives
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4
Q

What are the 2 types of epileptic seizures?

A
  • Absence
  • Tonic-clonic
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5
Q

What are the signs and symptoms of absence seizures?

A
  • Blank stare
  • Zoning out
  • Usually short lasting
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6
Q

What are the 4 stages of a seizure?

A
  • Aura stage
  • Tonic stage
  • Clonic stage
  • Postictal stage
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7
Q

What are the signs and symtoms of the aura stage in a seizure?

A
  • Hallucination
  • Dizzy
  • Numbness
  • Distorted emotions
  • Confusion
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8
Q

What are the signs and symptoms of the tonic stage of a seizure?

A
  • Stiff body
  • Incontinence
  • Epileptic cry
  • Back arched
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9
Q

What are the signs and symptoms of the clonic stage of seizure?

A
  • Frothy saliva
  • blinking eyes
  • Jerky movements
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10
Q

What are the signs and symptoms of the postictal stage of a seizure?

A
  • Weak limbs
  • Exhaustion
  • Sleepy
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11
Q

What is the ABCDE of tonic clonic seizures

A

A - difficult to assess but often patent
B- increased RR but hard to assess, decreased SpO2 (difficult to get accurate reading, pasues in breathing (apnoea)
C - increased HR, hypertension
D - ACVPU - unresponsive
E - convulsions, flushed complexion, rigidity, urinary incontinence, frothing from mouth

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12
Q

What is the management of someone having a seizure?

A
  • move objects that may harm a patient during seizure
  • do not attempt to restrain patient or put anything in their mouth
  • time the seizure, if > 5 mins then classed as a “status epilepticus”. Administer 10mg midazolam buccally and phone for ambulance (also if seizures are intermittently occuring)
  • administer O2, 15 ltrs/min through non re-brearher mask
  • Continuously monitor until help arrives
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13
Q

What is the midazolam dosage for a 6-11 month old?

A

2.5mg

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14
Q

What is the midazolam dosage for a 1-4 yr old?

A

5mg

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15
Q

What is the midazolam dosage for a 5-9 yr old?

A

7.5mg

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16
Q

What is the midazolam dosage for 10 yrs +?

A

10mg

17
Q

What does blood glucose level need to be less than to be considered a hypo?

A

4mmols

18
Q

What is the ABCDE of a hypo?

A

A - patent
B - increased RR, decreased SpO2
C - tachycardia, hypertension, pallor, clammy
D - ACVPU: confused, blood glucose <4mmols
E - Slurred speech, shaking aggressive, appears drunk

19
Q

What is the management of a hypo?

A
  • O2 15 ltrs/min if patient allows
  • if patient conscious administer 10-20g oral glucose (repeat every 10-15 mins if required)
  • if patient unconscious then adminsiter 1mg glucagon intramuscularly
  • Give O2 as before and call 999
  • When patient regains consciousness adminsiter more oral gluocse to replenish their reserves
20
Q

What are the 2 types of asthma?

A

Acute severe
Life threatening

21
Q

What is the ABCDE of acute severe asthma?

A

A - wheezing on expiration
B - increased RR, decreased SpO2, rapid shallow breaths
C - Increased HR, hypertension, pallor
D - ACVPU - alert but anxious
E - Pale, distressed, use of accessory muscles for breathing, inability to complete sentences in one breath

22
Q

What is the ABCDE of life threatening asthma?

A

A - severe wheeze on expiration
B - decreased RR and effort, severely decreased SpO2, laboured breathing
C - decreased HR, cyanosis in lips/nose (blue)
D - ACVPU - confused due to hypoxia
E - grey/blue in colour, exhausted, sleepy

23
Q

What is the management of an asthma attack?

A
  • salbutamol inhaler: 1 puff of reliever inhaler every 30-60 secs, up to 10 puffs using spacer device - REMEMBER PRIME
  • call 999 if no improvement
  • 15ltrs/min O2 through non re-breather mask
  • repeat salbutamol after 10 mins if no improvement
  • plenty pf reassurance as patient will be distressed
  • sit patient upright and lean forward to open accessory muscles and aid with breathing
24
Q

What are the 2 different types of airway obstruction?

A

partial
complete

25
Q

What is the management of a choking patient?

A
  • encourage patient to cough
  • if there is an ineffecrive cough advise patient to stand up and lean them forward, supporting them across their front with one arm and position yourself at the side of patient
  • Give 5 hard back blows between the shoulder bladed with the flat of your hand, checking between each blow for signs of change
  • If back blows are unsuccessful, perform 5 abdominal thrusts by making a fist under the point of the patient’s ribcage at the diaphragm muscle, locate the landmark by finding the bellybutton with thumb of one hand and creating a fist, then roll up into position (between umbillicus and xiphisternum). Grab fist with other hand and pull inwards and upwards (J shape) check between each thrust for signs of change
  • phone ambulance early if no sign of recovery from patient
  • repeat the process until 1 of 2 things happen: the item is dislodged or the patient collapses
  • If patient collapses ensure abulance is updated and begin CPR
26
Q

What type of patient is excempt from abdominal thrusts when choking?

A

pregnant
bariatric patients if you cant physically wrap arms around them - if attempting, place hands higher up from sternum if possible

27
Q

What are the signs and symptoms of someone having an anaphylactic shock?

A
  • sudden onset and rapid progression of ABC problems
  • Usually skin and/or mucosal changes
28
Q

What is the ABCDE of anaphylaxis?

A

A - stridor, wheezing
B - increased RR, decreased SpO2, rapid shallow breaths
C - drastically decreased BP due to vasodilation, increased CRT, tachycardia, bounding pulse
D - ACVPU: A but with impending sense of doom
E - flushing, urticarial rash, angioedema of lips/nose/tongue, stomach cramps, urinary incontinence, bowel incontinence, vomiting, nausea

29
Q

What is the management of someone having an anaphylactic shock?

A
  • phone 999
  • remove the source if known
  • try to line the patient in supine position to restore BP
  • administer 1:1000 adrenaline IM 0.5mg recommended in the anterolateral thigh
  • O2 - 15 ltrs/min via non re-breather mask
  • If patient has no auto injector then use this first before using adrenaline on emergency kit
  • repeat after 5 mins if required
30
Q

what is the adrenaline dosage for 6mths-5yrs?

A

0.15mg

31
Q

What is the adrenaline dosage for 6-11yrs?

A

0.3mg

32
Q

What is the adrenaline dosage for 12+yrs?

A

0.5mg

33
Q

What is an acute paracetamol overdose?

A

extensive ingestion over a period of <1hr in the context of self harm

34
Q

what is a staggered paracetamol overdose?

A

excessive ingestion over >1hr in the context of treating pain (therapeutic overdose)
can also occur with intent of self harm

35
Q

what is the red flag dosage of paracetamol a patient can take in 24 hrs for you to be concerned?

A

≥75mg/kg in any 24 hr period

36
Q

What is the maximum recommended daily dose of paracetamol in a normal adult?

A

4g

37
Q

How do you calculate the dose in mg/kg in 24 hrs of paracetamol?

A

total dose in 24 hrs in mg/patients weight in kg

38
Q

What would you have been informed a patient has overdosed on paracetamol?

A

consult TOXBASE online
or
phone national poisons information service
if these are unavailable, contact local A&E directly

Finals (9 decks)

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