Medical Emergency Scenarios

Question 1

Acute abdomen

Answer 1

Bedside: urinalysis, bladder scan

Bloods: FBC, U&E, LFT, Amylase/Lipase, Clotting, G&S, CRP

Imaging: Erect CXR, CT, Ultrasound

Plan:
1. NBM - consider VRII if diabetic
2. IV fluids
3. IV antibiotics
4. IV analgesia/anti-emetics
5. D/w Surgical SpR

Question 2

Acute Asthma

Answer 2

Bedside: PEFR, ECG, ABG, SaO2

Bloods: FBC, U&E

Imaging: CXR

Plan:
1. D/w ITU/CCOT if severe or life-threatening
2. Salbutamol 5mg neb with high-flow O2
3. PO prednisolone 40mg OR IV hydrocortisone 100mg STAT
4. O2 - 15L/min via non-rebreathe

If life-threatening
- Add ipratropium nebs 500mcg 6hrly
- IV Magnesium sulphate 1.2g over 20mins

If responding to Tx
- 4 hourly salbutamol nebs
- PO Prednisolone 40mg OD for 5 days
- Monitor PEFR and sats

If NOT responding to Tx
- Refer to ITU
- Consider intubation and IV aminophylline