Medical emergencies in the community

Question 1

How should unstable angina or NSTEMI be treated?

Answer 1

300mg Aspirin dispersible

PLUS

GTN:
1 or sprays
0.3-1mg tabs

Question 2

How should a STEMI be treated

Answer 2

Aspirin 300mg
GTN 1-2 puffs or 0.3-1mg tabs
Metoclopramide IV (5-10mg depending on weight)
Diamorphine or morphine (reduce dose by half in elderly)

Question 3

At what age should a child with an asthma attack be admitted to hospital?

Answer 3

Under 2 years

Question 4

What dose of prednisolone should be given to a child with an severe asthma attack?

Answer 4

1-2mg/kg (max. 40mg) for up to 3 days

(for children 11 years or under - over 11 treated as adults)

Can give longer than 3 days if needed

Question 5

what dose of prednisolone should be given to an adult with a severe asthma attack?

Answer 5

40-50mg for at least 5 days

Question 6

What are the 3 steps of treatment for a severe asthma attack?

Answer 6

1) salbutamol inhaler or nebs
2) prednisolone or hydrocortisone IV
3) Ipratropium nebs

Question 7

What is the dose of hydrocortisone for an adult experiencing an asthma attack?

Answer 7

100mg IV every 6 hours until conversion to prednisolone possible

Question 8

How is croup treated?

Answer 8

Dexamethasone 150mcg/kg as a single dose

(for children 1 month - 2 years)

Question 9

What dose of adrenaline should be given to a child up to 6 months?

Answer 9

100-150mcg

Question 10

What dose of adrenaline should be given to a child 6 months - 5 years?

Answer 10

150mcg

Question 11

What dose of adrenaline should be given to a child 6 - 11 years?

Answer 11

300mcg

Question 12

What dose of adrenaline should be given to a child 12-17 years?

Answer 12

500 mcg

(if child is small or pre-pubescent, give 300mcg)

Question 13

What dose of adrenaline should be given to an adult?

Answer 13

500mcg

Question 14

What are the treatments for menigococcal infections?

Answer 14

1st: Ben/Pen
2nd: Cefotaxime (if pen allergic)
3rd: Chloramphenicol (if severe pen allergy)

Single dose can be given before transfer as long as it doesn’t delay transfer

Question 15

How can you treat hypoglycaemia?

Answer 15

Give 15-20g of carbohydrate:
* 60–80 mL Lift® (previously Glucojuice®) oral glucose liquid
* 4–5 glucose tablets
* 1.5–2 tubes of glucose 40% oral gel
* 150–200 mL pure fruit juice
* 3–4 heaped teaspoonfuls of sugar dissolved in an appropriate volume of water

Question 16

IM/IV routes

How can you treat unresponsive hypoglycaemia?

Answer 16

IM Glucagon 1mg injection
IV glucose 10-20% infusion

Question 17

How can you treat status epillepticus?

Answer 17

Rectal diazepam 10-20mg
Buccal midazolam 10mg

Repeat once after 5-10mins if needed