Medical emergencies

Question 1

What is the characteristic rash in anaphylaxis?

What type of hypersensitive response is it?

Answer 1

• uriticarial, raised lumps

- Type 1 IgE mediated

Question 2

What are the common causes?

Answer 2

• nuts
• shellfish
• penicillin
• insect stings

Question 3

signs and symptoms of anaphylaxis?

Answer 3

• itching, sweating
• diarrhoea, vomiting
• urticaria, wheeze
• laryngeal obstruction
• cyanosis, tachycardia

Question 4

How is anaphylaxis treated (including doses and route)?

If there is wheeze?

Answer 4

• adrenaline (1:1000) 0.5mg IM
• hydrocortisone 200mg IV
• chlorphenamine 10mg IV
• salbutamol 5mg NEB

Question 5

what specific blood test should be done in anaphylaxis?

Answer 5

• mast cell tryptase

Question 6

What other management procedure should be done in anaphylaxis apart from drugs?

Answer 6

• fluid challenge

Question 7

If a person is choking what is the first thing to do?

Answer 7

• encourage an effective cough

Question 8

If a person can not cough what should be done?

What should then happen if they become unconscious?

Answer 8

• 5 back blows
• 5 abdominal thrusts
• continually re-assess
• begin CPR

Question 9

What are the symptoms of epiglottitis?

Answer 9

• sore throat, painful swallowing
• inability to swallow saliva ( drooling)
• pyrexia
• respiratory distress (stridor, weak/ silent chest, tachycardia)

Question 10

What is the cause?

What should you not do?

Answer 10

• Haemophilus influenza (type b)
• examine the throat of a child with suspected epiglottitis
• ENT may examine with fibre- optic laryngoscopy

Question 11

How is it managed?

Answer 11

• Cephalosporins e.g. cefuroxime IV for 7-10 days

- may require intubation and management on ICU

Question 12

How should a cardiac arrest be confirmed and what should you do immediately?

Answer 12

• Listen for breathing and pulse (head tilt chin lift)
• put out a crash call (adult/ paeds/ obstetric)
• Start CPR

Question 13

What are the two shockable rhythms?

How long should you perform CPR before re-checking the rhythm?

What drugs should be given and what dose, how often?

Answer 13

• VF and pulseless VT
• Every 2 mins
• Adrenaline (1:10,000) 1mg IV every 3-5 mins

Question 14

What are the two non- shockable rhythms?

What drug should be given?

What should you start to think about in non- shockable rhythms?

Answer 14

• PEA (pulseless electrical activity)
• Asystole
• adrenaline (1:10,000) 1mg every 3-5 mins
• reversible causes

Question 15

what are the reversible causes of cardiac arrest?

Answer 15

• Hypoxia
• Hyperkalaemia/ electrolyte imbalance)
• Hypothermia
• Hypovolaemia
• Tension pneumothorax
• Tamponade
• Toxins
• Thromboembolism