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PH4703-Practical therapeutics > Medical emergencies II > Flashcards

Medical emergencies II Flashcards

1
Q

What is a medical emergency

A
  1. Any presentation that needs immediate intervention
  2. Cannot wait for a routine appointment or referral
  3. Needs to be seen by an appropriate professional on the same day
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2
Q

High risk patient groups

A
  1. Children
  2. Elderly
  3. Immunosuppressed patients
  4. Pregnant women
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3
Q

Common medical emergencies

A
  • Sudden headache
  • Epistaxis
  • Breathing difficulties
  • Worsening infections
  • Anaphylaxis
  • Angio-oedema
  • Hypoglycaemia
  • SEPSIS
  • Trauma
  • DVT/PE
  • Overdose
  • Psychosis
  • Eye presentations
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4
Q

Photophobia and headache

Presentation

A
  • Teacher brought in colleague
  • Sudden onset of headache and photophobia
  • Patient holding head between hands, unable to move head due to discomfort
  • No recent trauma
  • No history of migraines or severe headaches
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5
Q

Nose bleed- epistaxis

A
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6
Q

Croup

A
  • Barking cough that sounds like a seal
  • Hoarse voice
  • Breathing difficulties
  • Rasping sounds when breathing in
  • Worse at night
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7
Q

Croup presentation and treatment

A
  • 18 month old child
  • Barking cough
  • Had recent cold
  • Mother concerned as struggling to breath
  • Worse at night
  • Dexamethasone oral solution (2mg/5mL)
    • PO (1 month -2 years) 150mcg/Kg single dose
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8
Q

Asthma attack presentation

A
  • 26 year old lady on salbutamol and clenil presents with worsening SOB
  • Persistent dry cough
  • Pulse 109 BPM
  • RR 22 breaths per min
  • Appers clammy and unable to speak in full sentences
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9
Q

Angina or Suspected MI

A
  • Aspirin dispersible tabs (300mg)
  • GTN
  • Call for 999
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10
Q

Cellulitis

A
  • Uncomplicated cellulitis is treatable in community
  • Alarming if worsening despite treatment
  • Potential complication of sepsis
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11
Q

Sepsis presentation

A
  • Patients returned from travel abroad to Nepal (Climbing Everest)
  • Was treated for a bite on hand with fluclox 500mg QDS
  • Returned after 5 days with tracking of symptoms (Lymphangitis)
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12
Q

Anaphylaxis

A
  • Itchy rash, throat or tongue swelling, SOB, vomiting, lightheadedness, and low blood pressure. These symptoms typically come on over minutes to hours
  • Lightheaded
  • Struggling to breath
  • Wheezing
  • Tachycardia
  • Clammy skin
  • Confusion and anxiety
  • Collapsing or losing consciousness
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13
Q

Anaphylaxis triggers

A
  • Foods- including nuts, milk, fish, shellfish, eggs and some fruits/colourings
  • Medication- Antibiotics/ NSAIDs/ General anaesthetics
  • Insect bites
  • Latex
  • Idiopathic anaphylaxis
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14
Q

Angio-oedema/ Allergic reaction

A
  • First dose of ACEI
  • 49 year old caucasian women took first dose
  • Swollen lips, tongue and throat
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15
Q

Diabetic hypoglycaemia

A
  • Hungry
  • Sweating
  • Tingling lips
  • Feels shaky or trembling
  • Dizziness
  • Tired
  • Tachycardia
  • Pale
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16
Q

Left untreated

A
  • Weakness
  • Blurred vision
  • Difficulty concentrating
  • Confusion
  • Slurred speech
  • Sleepy
  • Seizures
  • Collapsing
17
Q
A
18
Q

SEPSIS presentation

A
  • High fever, shaking
  • Struggling to breath
  • Onset within few hours
  • Young adult
  • Lactate positive
19
Q

Purpuric rash- Non-blanching

A
20
Q

Trauma to the head

A
  • Head injury
  • Vomiting
  • CT scan
21
Q

Overdose

A
  • Paracetamol/ Alcohol
  • Illicit drugs- Loss of consciousness/ RD
22
Q

DVT/PE

A
  • Unilateral calf swelling and pain
  • Heavy sensation
  • Swelling
  • Pain
  • Redness
  • Warmth to the touch
  • Worsening leg pain when bending the foot
  • Leg cramps (Especially at night and/or in the calf)
  • Discoloration of skin
23
Q

DVT/PE presentation

A
  • 69 year old lady
  • Discharged from hospital after knee replacement
  • Calls GP for a home visit due to leg swelling and pain
  • WELLs score
  • Risk factors
  • Treatment D-0 dimer and US urgent
  • See a lot of fo patients at the walk-in centre with this
24
Q

Fever- pyrexia

A
  • Uncontrolled with regular paracetamol and ibuprofen
  • Now feeling very unwell and weak
25
Q

Suicide attempt

A
  • Patient no longer feel able to cope or be in control
  • Emotional distress
  • Can’t cope with day-to-day life or work
  • Thinking about suicide or self-harm or experience hallucinations and hearing voices
26
Q

Warfarin and dental surgery

A
  • Patient presenting at pharmacist/GP clinic post-dental surgery
  • On warfarin
  • Persistent bleeding
27
Q

Chemical burn

A
  • Acute red eye
  • Diabetic, acute red eye with lens
  • Lose sight
  • Girl sprayed body spray into eye
28
Q

Appendicitis

A
  • Appendicitis typically starts with a pain in the middle of your abdomen that may come and go
  • Within hours, the pain travels to your right-hand side, where the appendix is usually located and becomes constant and severe
  • Pressing on this area, coughing, or walking may all make the pain worse
  • If you have appendicitis, you may also have other symptoms, including Nausea, vomiting, loss of appetite, diarrhoea, fever
29
Q

Appendicitis

Presentation

A
  • Young 37 year old male presented at A&E
  • Examined and sent home with hyoscine 10mg tabs QDS
  • Readmitted within 2 hours with unable to move
  • Appendicitis- could have been sepsis
  • Organ becomes septic and bursts
30
Q

Vasovagal- syncope

A
  • Unpleasant sight
  • Heat
  • Sudden pain
  • Coughing
  • Sneezing
  • Laughing
  • Sitting or standing up suddenly

PH4703-Practical therapeutics (36 decks)

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