Medical emergencies (ED) Flashcards

1
Q

What doses of adrenaline are used for anaphylaxis?

A
  • < 6 months: 100 - 150 micrograms (0.1 - 0.15 ml 1 in 1,000)
  • 6 months - 6 years: 150 micrograms (0.15 ml 1 in 1,000)
  • 6-12 years: 300 micrograms (0.3ml 1 in 1,000)
  • Adult and child > 12 years: 500 micrograms (0.5ml 1 in 1,000)
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2
Q

What can be measured to establish whether a patient had a true episode of anaphylaxis?

A
  • Serum tryptase levels
  • Remain elevated for up to 12 hours following an acute episode of anaphylaxis
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3
Q

How can hypothermia be classified?

A
  • Mild hypothermia: 32-35°C
  • Moderate or severe hypothermia: < 32°C
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4
Q

What are common causes of hypothermia?

A
  • Exposure to cold in the environment is the major cause
  • Inadequate insulation in the operating room
  • Cardiopulmonary bypass
  • Newborn babies
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5
Q

What are complications of rapid re-warming in hypothermia?

A

Peripheral vasodilation and shock -> cardiac arrest

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6
Q

What is the immediate management of burns caused by heat?

A
  • Within 20 minutes of the injury irrigate the burn with cool (not iced) water for between 10 and 30 minutes
  • Cover the burn using cling film, layered, rather than wrapped around a limb
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7
Q

What is the immediate management of chemical burns?

A
  • Brush any powder off then irrigate with water
  • Attempts to neutralise the chemical are not recommended
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8
Q

What is the modern terminology for first, second and third degree burns?

A
  • First = superficial epidermal
  • Second = superficial/deep dermal
  • Third = full thickness
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9
Q

When are IV fluids required for burns?

A
  • Children with burns > 10% of total body surface area
  • Adults with burns > 15% of total body surface area
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10
Q

What does smoke inhalation lead to?

A
  • Airway lumen narrowing or blockage through bronchospasm
  • Increased mucus production
  • Oncreased airway blood flow
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11
Q

What should you assume in a patient who has suffered smoke inhalation?

A
  • That they have CO poisoning
  • Treat with high flow 100% O2 until the carboxyhaemoglobin is less than 10% of total haemoglobin
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12
Q

What are features of CO poisoning?

A
  • Headache
  • N+V
  • Vertigo
  • Confusion
  • Subjective weakness
  • ‘Pink’ skin and mucosa in severe toxicity
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13
Q

Why can pulse oximetry be falsely high in CO poisoning?

A

Due to similarities between oxyhemoglobin and carboxyhaemaglobin

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14
Q

What are typical carboxyhaemoglobin levels in:
1. Non-smokers
2. Smokers
3. Severe toxicity

A
  1. <3%
  2. <10%
  3. > 30%
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15
Q

What features indicate benzodiazepine overdose?

A
  • Drowsiness
  • Dysarthria
  • Ataxia
  • Nystagmus
  • Resp depression
  • Coma
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16
Q

What features indicate amphetamine overdose?

A
  • Initially excessive activity + wakefulness
  • Hallucinations, paranoia
  • HTN
  • Later convulsion, hyperthermia, exhaustion, coma
17
Q

What features indicate cocaine overdose?

A
  • Agitation
  • HTN
  • Tachycardia
  • Dilated pupils
  • Hyperthermia
  • Hypertonia, hyper-reflexia
  • Cardiac effects - chest pain, arrhythmias
18
Q

What features indicate opioid overdose?

A
  • Drowsiness
  • Coma
  • Resp depression
  • Pin point pupils
19
Q

What antidotes are available for certain poisons?

A
  • Acetylcysteine - paracetamol
  • Flumazenil injection - benzodiazepines
  • Naloxone - opioids
20
Q

What are causes of metabolic acidosis?

A
  • GI bicarb. loss - diarrhoea
  • Renal tubular acidosis
  • Addison’s
  • DKA
  • Alcohol
  • Shock/hypoxia
21
Q

What are causes of metabolic alkalosis?

A
  • Vomiting
  • Diuretics
  • Hypokalaemia
  • Primary hyperaldosteronism
  • Cushing’s syndrome
  • CAH
22
Q

What are causes of respiratory acidosis?

A
  • COPD
  • Decompensation in life-threatening asthma/pulmonary oedema
  • Sedative drugs - benzos, opiate overdose
23
Q

What are causes of respiratory alkalosis?

A
  • Anxiety -> hyperventilation
  • PE
  • Salicylate poisioning
  • CNS disorders - stroke, SAH, encephalitis
  • Altitude
  • Pregnancy
24
Q

How can blood product transfusion reactions be classified?

A
  • Immunological - acute haemolytic, non-haemolytic febrile, anaphylaxis
  • Infection
  • Transfusion-related acute lung injury (TRALI)
  • Transfusion-associated circulatory overload (TACO)