Medical Emergency Flashcards
What approach should be used when assessing a patient in a medical emergency
A- airway
B - breathing
C - circulation
D - disability
E - exposure
This should be constantly reassessed until the patient is stable
What is the triple manoeuvre for helping an airway
Head tilt
Chin lift
Jaw thrust
How do you measure an oropharyngeal airway
From the angle of the mandible to the tip of the incisors
Why do people with neurological conditions hypo-ventilate
This is because they have reduced muscle tone
What is the normal respiratory rate
12-15 breaths per minute
What is the normal 02 saturation
98%
If a patients lips and nails have become cyanotic, what percentage of 02 saturation have they passed
84%
If the patients tongue has changed colour due a breathing issue what is this a sign of and what is there 02 saturation
This is a sign of central cyanosis and 02 saturation would be about 60%
What is the optimum position for opening up the intercostal muscles
The tripod position
Patient is sitting slightly forward with arms propped in front,on table, bed or knees.
It allows for greater chest expansion and increased ability to use acessory muslces
At what beats per minute do the radial and brachial pulse disappear
Radial at 70
Brachial 60
What is a common cause for a drop in neurology and what should we test
Change in blood glucose
As per GDC guidance what level of o2 should we give any patient who is sick
15 litres via a non re-breathing mask
When doing ABCDE approach for a patient in anaphylaxis what might we see
A - swelling/ stridor
B - increased rate and a wheeze
C- increased rate, hypotension
D - LOC
E - itchy rash and swelling
How do we treat anaphylactic shock, what is the technique?
Intramuscular injection of 1;1000 adrenaline 0.5mg
- Apply tension and inject into anterolateral aspect middle third of the thigh
- aspirate
- come out half and let go of the tension then remove the rest of the needle
What is the technique called for giving I’m injection for anaphylactic shock and why do we do this
This is called the Z track technique and we do this to prevent loss of drug when removing the needle
Why do we give adrenaline to someone with anaphylactic shock
It is a bronchodilator - this will help the wheeze and open up the airway
It is a peripheral vasoconstrictor which helps reduce the
BP
It is a central vasodilator so getting more blood to the brain
Increases contractiiblity of the heart
Dampens the histamine
After injecting the adrenaline into an anaphylactic patient what else should we do
Establish and airway and give high flow 02
What would we see in the ABCDE for angina/mI
A - talking
B - increased
C - increased, may be a bit tachycardia due to their anxiety of thinking they are having a heart attack
D - alert
E - pale, clammy, central chest pain
◦ Central crushing radiating down left arm and jaw
How would you know if it was stable/unstable angina
Stable angina is chest pain on exertion and relived by rest whereas unstable comes on suddenly and isn’t relieved by rest
Ask the patient
How do we treat angina
GTN spray, 400micrograms per dose - 2 puffs sublingual
◦ This is symptom relief only
◦ Works very quickly as it gets into the circulation fast
◦ Vasodilator, reliving pressure on the heart and BP drops
◦ Always check the patients BP before giving this, it they have have a good strong pulse, they will tolerate it if not omit it.
If GTN spray doesn’t work for an angina patient what else can we give
Aspirin 300mg crushed or chewed if MI
◦ Chew it, if patient can’t it can be crushed
◦ Do not let them have a drink for 1o minutes to allow it to be absorbed into the oral mucosa
What kind of medication is aspirin and how quickly do we want the patient to be given it
This is an anti platelet medication - want this in the first 10 minutes of the MI
◦ It is also an anti-pyretic
◦ (reduce fever) and analgesic
In our ABCDE approach for Asthma what might we see
A - Difficult to complete sentences
B - increased rate with wheeze
C - increased rate
D - alert
E - tripods position
How do we treat asthma
Salbutamol 10 micrograms per actuation
Spacer device when appropriate
