medical emergencies

Question 1

what system is used to determine someones general health?

Answer 1

ASA system

Question 2

GDC principles for medical emergencies?

Answer 2

1. at least 2 people available to deal with emergency WHEN treatments planned
2. all members of staff should know their role
3. all members of staff trained, prepared, practice regularly

Question 3

how to clear airway

Answer 3

head tilt/chin lift
jaw thrust if injury or flexion deformity
finger sweep
suction
air way adjuncts e.g. geudel

Question 4

how to asses D = disability in ABCDE

Answer 4

ACVPU

Question 5

what position should you put someone suffering from anaphylaxis in?

Answer 5

lie flat + raise legs

Question 6

what position should you put someone who’s pregnant in?

Answer 6

left later position

not flat or right - if in late pregnancy as uterus can press ion on inferior vena cava

Question 7

what type of o2 is in emergency drug box?

Answer 7

CD type cycliner
lasts for 30 mins 15/litres/min
via non-rebreathe mask

Question 8

how would you respond to anaphylaxis?

Answer 8

call for ambulance
secure airway
lie flat with feet up
o2 100% 15 litres/min
adrenaline 0.5ml 1:1000 IM 
repeat in 5 mins if needed

Question 9

how to identify acute severe asthma attacks

Answer 9

A - inability to complete sentence in 1 breath
B - resp rate >25 per min
C - tachycardia >110 beat per min

Question 10

how to identify life threatening asthma

Answer 10

resp rate <8 per mine
bradycardia <50 per min
confusion, exhaustion, decreased consciousness

Question 11

how to respond to asthma attack

Answer 11

life threatening asthma - priority get to hospital

sit patient up
100% o2 15litres/min
patient bronchodilator 2 puffs - if unavailable salbutamol inhaler 4 puffs (100mg per actuation) through large volume spacer
repeat every 10 mins

Question 12

4 signs of cardiac arrest

Answer 12

1. loss of consciousness
2. absence of normal breathing
3. loss of pulse
4. dilation of pupils

Question 13

how to respond to angina/MI

Answer 13

diagnose - does it feel like normal angina attack?

100% o2 15litres/min
GTN 2 puffs (400mg per dose) sublingually
repeat after 3 mines 
if don't respond - call ambulance
300mg aspirin chew

Question 14

how to respond to epilepsy

Answer 14

move out of harm
if longer than 5 mins:
10mg midazolam topically into buccal cavity

in children - rectal diazepam or buccolam

Question 15

3 key signs of hypoglycaemia

Answer 15

1. aggression + confusion
2. sweating
3. tachycardia >110 per min

Question 16

how to respond to hypoglycaemia

Answer 16

100% o2 15litres/min
if conscious: 10-20g oral glucose every 10-15 mins
if unconscious: glucagon 1mg IM + oral glucose 10-20g when conscious

Question 17

diagnosis of hypoglycaemia

Answer 17

<4mmol/litres

Question 18

signs of Addisons crisis

Answer 18

loss of consciousness
rapid, weak, impalpable pulse
rapid fall in BP

Question 19

how to deal with Addisons crisis

Answer 19

lay patient flat + raise legs
O2
paramedics - 200mg IV hydrocortisone +IV fluids

Question 20

may medical emergency in children?

Answer 20

cardiopulmonary arrest

Question 21

how to secure paediatric airway

Answer 21

into neutral position - don’t extend neck

Question 22

how does breathing + pulse rate differ between adults + children

Answer 22

higher in children

Question 23

how to do CPR in child/infant?

Answer 23

5 initial ventilations before chest compressions
compress to one third of depth
2 finger for infants

Question 24

how to deal with choking in infant?

Answer 24

chest thrusts - reduces risk of rupture of liver + spleen
across lap
5 sharp inter-scapular blows

Question 25

2 shockable arrhythmias

Answer 25

VF + pulseless ventricular tachycardia

Question 26

2 non shockable arrhythmias

Answer 26

systole + PEA (pulseless electrical activity)

Question 27

what type of arrhythmia could be caused by the 4 hs of 4 ts?

Answer 27

PEA

must address these problems for recovery

Question 28

at what angle do you inject subcutaneous glucagon?

Answer 28

45 degrees to skin

Question 29

where do you inject epipen?

Answer 29

anterolateral thigh - hold for 10 seconds + rub in

Question 30

5 vital signs

Answer 30

1. BP
2. pulse rate
3. temp
4. resp rate
5. oxygen saturation

Question 31

what is NEWS?

Answer 31

national early warning score - overall score for vital sings

Question 32

normal temp range

Answer 32

35.5-37.5

Question 33

bradycardia rate

Answer 33

<50 beats per min

beta blockers, heart block, athletes

Question 34

tachycardia rate

Answer 34

> 90 beats per min

sepsis, shock, anxiety

Question 35

what is an irregularly irregular pulse a sign of?

Answer 35

atrial fibrillation

Question 36

what is a regularly irregular pulse a sign of?

Answer 36

heart block

Question 37

approx value for normal rest rate?

Answer 37

~14 breaths per min

Question 38

how far does chest compress in adult CPR?

Answer 38

1/3

Question 39

normal blood pressure range?

Answer 39

90/60 - 120/80

Question 40

blood pressure threshold for treatment?

Answer 40

140/90

Question 41

how to measure systolic pressure

Answer 41

korotkov sounds

Question 42

what does 120/80 mmhg mean?

Answer 42

120 systolic/ 80 diastolic