Medical emergencies

Question 1

What is thte current drugs recommended for medical emergencies

Answer 1

Adrenaline, 1-ml ampoules or prefilled syringes of 0.5 ml of 1:1000 solution for intramuscular (i.m.) injection

Aspirin, 300 mg dispersible tablets

Glucagon, for i.m. injection of 1 mg

Glyceryl trinitrate (GTN) spray, 400 micrograms per metered dose

Midazolam oromucosal solution, 5 mg/ml, for topical buccal administration

Oral glucose

Oxygen cylinder, two size D or two size CD or one size E

Salbutamol inhaler, 100 micrograms per actuation

Question 2

Key signs of anaphylaxis

Answer 2

Marked upper airway oedema and bronchospasm, causing stridor and wheezing

Tachycardia (heart rate > 110 per minute)

Increased respiratory rate

Question 3

What is the management of anaphylaxis

Answer 3

Administer 100% oxygen
-Flow rate: 15litres/minute.

Administer adrenaline, 0.5ml (1:1000), i.m. injection repeated after 5 minutes if needed

Question 4

Key signs of life-threatening asthma

Answer 4

Cyanosis or respiratory rate <8 per minute

Bradycardia (heart rate <50 per minute)

Exhaustion, confusion, decreased conscious level

Question 5

Key signs of acute severe asthma

Answer 5

Inability to complete sentences in one breath

Respiratory rate >25 per minute

Tachycardia (heart rate>110 per minute)

Question 6

Management for asthma attack

Answer 6

Administer 100% oxygen
-Flow rate: 15 litres/minute.

Administer the patient’s own bronchodilator (2 puffs); if unavailable, administer a salbutamol inhaler, 4 puffs (100 micrograms per actuation)

Question 7

Key Sign of Angina & myocardial infarction

Answer 7

Progressive onset of severe, crushing pain in the centre and across the front of chest; the pain might radiate to the shoulders and down the arms (more commonly the left), into the neck and jaw or through to the back

Question 8

Symptoms of Angina & myocardial infarction

Answer 8

Shortness of breath

Increased respiratory rate

Skin becomes pale and clammy

Nausea and vomiting are common

Pulse might be weak and blood pressure might fall

Question 9

Management of Angina & myocardial infarction

Answer 9

Administer 100% oxygen
-Flow rate: 15 litres/minute.

Administer glyceryl trinitrate spray, 2 puffs (400 micrograms per metered dose) sublingually, repeat after 3 minutes if chest pain remains.

Question 10

If in case of Angina & myocardial infarction and pt doesnt respond to first step whats next

Answer 10

Administer aspirin, 300 mg dispersible tablet, orally

Question 11

Key signs of epilepsy

Answer 11

Sudden loss of consciousness, patient may become rigid, fall, might give a cry and becomes cyanosed (tonic phase)

Jerking movements of the limbs; the tongue might be bitten (clonic phase)

Frothing from the mouth and urinary incontinence

Question 12

Management of epilepsy

Answer 12

Administer 100% oxygen
-Flow rate: 15 litres/minute.

Question 13

How long is classed as aprolonged epileptic fit and what to do

Answer 13

5+ mins

continue administering oxygen and administer 10 mg midazolam (use 2 ml oromucosal solution, 5 mg/ml) topically into the buccal cavity

After convulsive movements have subsided, place the patient in the recovery position and check the airway

Question 14

Key signs and symptoms of hypoglycemia

Answer 14

Aggression and confusion

Sweating

Tachycardia (heart rate >110 beats per minute)

Symptoms include:
Shaking and trembling, Difficulty in concentration/vagueness, Slurring of speech, Headache, Fitting, Unconsciousness

Question 15

Management of hypoglycemia

Answer 15

Administer 100% oxygen
-Flow rate: 15 litres/minute.

If the patient remains conscious and cooperative:
-Administer oral glucose (10-20 g), repeated if necessary after 10-15 minutes

If the patient is unconscious or uncooperative:
-Administer glucagon, 1 mg, i.m. injection

and

Administer oral glucose (10-20 g) when the patient regains consciousness.