Mod 9a: emergencies

Question 1

How does an emergency differ from urgent situation

Answer 1

Emergency is a threat to life, surgery within 1-2 hrs

Urgent requires surgery within 24 hrs, allows time for optimisation

Question 2

What is a purple triage colour

Answer 2

time elapsed, needs to be reclassified

Question 3

What is blue triage colour

Answer 3

elective surgery/surgery withinh 72 hrs/next elective list

Question 4

What is green triage colour

Answer 4

surgery within 24 hrs

Question 5

What is yellow triage score

Answer 5

surgery within 6 hrs

Question 6

What is orange triage colour

Answer 6

surgery within 2 hrs

Question 7

What is red triage colour

Answer 7

immediate surgery

Question 8

What are common general surgery emergencies

Answer 8

*Appendicectomy
*Incision and drainage of abscesses
*Laparatomies for bowel obstruction
*Strangulated hernia
*Acute upper or lower gastro-intestinal bleed

Question 9

What are trauma surgical emergencies

Answer 9

*Blunt
*Penetrating

Question 10

What are gynae surgical emergencies

Answer 10

*Ruptured ectopic
pregnancy
*Evacuation of retained
products of conception

Question 11

What are obstetric surgical emergencies

Answer 11

*Caesarean sections with a
variety of indications
*Retained placenta

Question 12

What are orthopaedic surgical emergencies

Answer 12

*Open fracture
debridement
*Poly-trauma

Question 13

What are vascular surgical emergencies

Answer 13

*Ruptured abdominal aortic
aneurysm
*Amputations

Question 14

What are neurosurgery emergencies

Answer 14

*Intracranial haemorrhage
with raised intracranial
pressure or falling Glasgow
coma scale (GCS

Question 15

What are ENT emergencies

Answer 15

*Epistaxis
*Tonsillar abscess

Question 16

What situational factors contribute to risk in surgery

Answer 16

• Limited time to assess
  and prepare patient
• Junior staff
• After hours
• Uncertain diagnoses
• Situational awareness of
  staff may vary

Question 17

What clinical factors contribute to emergency risks

Answer 17

• Full stomach
• Intravascular depletion
• Electrolyte derangements
• Anaemia and
  coagulation
  abnormalities
• Co-morbidity
• Pain

Question 18

What must be communicated with the surgeons in emergency surgeries

Answer 18

surgical diagnosis
magnitude of surgery
urgency
outstanding work up
method of anaesthesia
post-op requirements

Question 19

What CVS complications must be anticipated

Answer 19

Ongoing haemorrhage
Hypovolaemia
Hypotension
Coagulopathies
Dysrhythmias

Question 20

What trauma complications must be anticipated

Answer 20

C spine injuries
Airway injury

Question 21

What metabolic complications must be anticipated for

Answer 21

Electrolyte abnormalities
Renal dysfunction

Question 22

What categories of complications must be anticipated

Answer 22

CVS
Trauma
Adverse drug reactions
Metabolic
Hypothermia
Sepsis and septic shock

Question 23

What must be checked in preoperative evaluation?

Answer 23

History:
- starved
- Current problem list
- Co morbidity
Examination:
- airway assessment
- fluid status
- CVS and resp
Basic investigations:
- renal function
- FBC + X-match
- ABG+lactate
- Serum glucose
- CXR
- ECG
Surgical investigations:
- U/S
- C/T