Medical emergencies part 2

Question 1

How do you manage asthma

Answer 1

◆ stop treatment + removes instruments from mouth
◆ sit in comfortable position
◆ administer salbutamol (10 activations/min) preferbly by spacer device
◆ adminster 02 at 15L/min
monitor vital signs

Question 2

what is the brown inhaler

Answer 2

Beclomethasone inhaler
(steroid preventer)
carried by patient all times + used daily

Question 3

what is the blue inhaler

Answer 3

Salbutamol inhaler
(B2 agonist- reliever)
prevent asthma attack + only one used in emergency

Question 4

what is anaphylaxis

Answer 4

severe life threatening , generalised or systemic hypersensitivity allergic reaction

Question 5

what are common triggers for anaphylaxis

Answer 5

drugs (penicillin)
latex
additives in medicine

Question 6

why is is tricky to diagnose anaphylaxis + what is vital to diagnose it

Answer 6

inconsistent clinical features
big range of presentations
ABCDE VITAL TO DIAGNOSE

Question 7

what are 4 triggers of asthma

Answer 7

stress
anxiety
infection
exposure to allergen

Question 8

what are the 3 clinical signs of acute severe asthma

Answer 8

◆ inability to complete sentences in 1 breath
◆ respiratory rate >25min
◆ tachycardia HR >110/min

Question 9

what are the 4 main clinical signs of life threatening asthma

Answer 9

◆ cyanosis (skin turns blue)
◆ RR < 8/min
◆ bradycardia HR < 50/min
◆ exhaustion, confusion ↓ consciousness

Question 10

What do you do if there’s no response or features of severe asthma present

Answer 10

◆ ambulance
◆ repeated dose of salbutamol every 10mins
◆ monitor vital signs
◆ check breathing + circulation, if absent, start CPR

Question 11

what are GIT signs + symptoms of anaphylaxis

Answer 11

◆ abdominal pain
◆ vomiting
◆ diarrhoea

Question 12

what are respiratory signs + symptoms of anaphylaxis

Answer 12

◆ stridor/wheezing
◆ rapid breathing
◆ swelling of throat ( laryngeal oedema + bronchospasm)
◆ respiratory arrest -> cardiac arrest

Question 13

what is the circulatory symptom of anaphylaxis and describe the chain reaction

Answer 13

◆ vasodilation -> hypovolaemia (↓ blood vol) -> ↓ BP -> pale/clammy-> drowsy/faint -> collapse -> cardiac arrest

Question 14

how do you manage anaphylaxis

Answer 14

ABCDE (airway, breathing, circulation, disability, exposure)
◆ ambulance
◆ adrenaline 500µg (0.5ml of 1:1000 solution) intramuscular injection
◆ patient flat + raise legs to restore BP
◆ oxygen at 15L/min
◆ monitor vital sings
◆ unresponsive -> CPR

Question 15

what are the different way you can inject adrenaline for anaphylaxis

Answer 15

◆ adrenaline injection
◆epipen
◆ injecting adrenaline IM
◆ emirade pen
◆ epipen auto injection IM

Question 16

what is angina

Answer 16

acute chest pain of cardiac origin, crushing pain

can radiate to jaw, neck, shoulder, back

Question 17

what are clinical signs of angina

Answer 17

◆ shortness breath + ↑ RR
◆ fast + slow HR , ↓ BP
◆ poor peripheral perfusion
◆ faintness

Question 18

how do you manage angina

Answer 18

◆ 2 sprays of GTN spray sublingually
◆ administer O2 at 15L/min + monitor vital signs
◆ if not responds, repeat GTN spray after 5 mins
◆ if no improvement of repeated doses of GTN spray - suspect MI

Question 19

what are clinical signs of MI

Answer 19

same as angina but ↑ severity
◆ short breath, nausea + vomiting
◆ pale, clammy + cyanosis 
◆weak + irregular pulse
rapid loss of consciousness

Question 20

how do you manage MI

Answer 20

◆ ambulance
◆ give Aspirin 300mg single dose orally (crushed/chewed)
◆ administer O2 15L/min + monitor vital signs
◆ if unresponsive check signs of life, if absent start CPR

Question 21

what are the drugs given in cardiac emergencies

Answer 21

GTN (Glyceryl trinitrate) spray

aspirin 300mg tablet

Question 22

what are common triggers for epileptic seizures

Answer 22

stress/ anxiety
dehydration/starvation
temp extremes
bright/flashing lights

Question 23

what are signs + symptoms of epileptic seizures

Answer 23

◆ tonic phase = sudden consciousness loss , rigid, falls, cyanosis
◆ clonic phase = jerking limb movements, tongue can be bitten
◆ can be frothing

Question 24

how do you manage a epileptic seizure

Answer 24

◆ don’t restrain convulsive movement
◆ check blood glucose, frothing can be sign of hypoglycaemia
◆ if low glucose -> oral glucose or glucagon
◆ put in recovery position, clear airway + give O2 15L/min
◆ give medication only in prolonged seizures
◆ ambulance
◆ Midazolam buccally
( adults +>10yrs = 10mg)
(5-10yrs = 7.5mg)
(1-5yrs = 5mg)