Medical Emergencies Flashcards
Management of Anaphylaxis: lateral
Antihistamines
Steroids
Glucagon(same pathway as adrenaline)
How long to keep patient after anaphylaxis management?
Around 6 hours in short stay
Rebound phenomenon?
Exists but In practice, dont’ see it much due to steroids
Status Epilepticus dangers?
Hypoxia
Excessive glutamate in brain from neutron firing
Don’t just paralyse them
Something bad underlying
Hyperthermia
Rhabdo
Lactic acidosis
How to stop status epilepticus?
Benzos
IV if possible
IM midazolam
Downside of benzos
Respiratory depression
When giving Midazolam for status epilepticus, how much to give?
10-20mg, you give a lot to terminate the seizing, then you intubate him, need to manage airways
Status epilepticus management drugs
Midazolam/clonazepam
Phenytoin 10mg/kg (dripped in over 30 min)
Levetiracetam: (Kepra)
If the above doesn’t work:
Barbitutates
Reversible causes of status epilepticus?
Hypoglycaemia Hypotension Hypoxia Head Trauma CNS infection Metabolic Drug OD Drug withdrawal CNS tumours or stroke
GCS 6, BP 140/80, pulse 90, sats 95%, 75 year old female unresponsive, likely?
Stroke
Hypoglycaemia
End-organ damage
Alcohol
3 reasons why someone is unresponsive
Sugar, O2
No transport: circ
End organ not working
How to give sugar to hypoglycaemic?
Buccal (icing mix)
Oral (if able)
IM glucagon (1mg ampoules)
IV/IO 50% dextrose 25-50ml (viscous)
Causes of hypoglycaemia?
Missed meal
Medication error
Concurrent illness
Diabetic Ketoacidosis
Hypovolaemia
Hyperglycaemic
Diabetic Ketoacidosis Rx?
Fluids
Insulin (Stop the ketosis-intracellular acidosis)
Think about the acidosis
Hypokalaemia (H+/K+ pump)
-low or normal (give K+ BEFORE insulin)
-If high (give insulin, K+ will come down)
