OSCE Management Flashcards
1
Q
Management of anaphylaxis
A
- Call for help
- Remove triggers and lay patient flat
- Give IM adrenaline (0.5ml 1in1000 dose)
- Establish airway, call anaesthetics
- Give oxygen
- Monitor O2 sats, BP, and ECG
- After 5 mins, give more adrenaline if needed and an IV fluid bolus
- If ineffective, start adrenaline infusion
2
Q
How is severity of asthma assessed?
A
- Peak flow (<33% is life-threatening)
- Reduced O2 sats
- Unable to complete sentences
- HR >110
- RR >22
Life threatening: exhaustion, silent chest, cyanosis, arrhythmia, hypotension, altered conscious level
3
Q
Management of acute asthma
A
- Give O2
- Give high-dose salbutamol
- If not better, give nebulised oxygen-driven salbutamol
- Always give oral prednisolone, give IV hydrocortisone or IM methylprednisolone if unable to swallow
- If needed, give negulised ipratropium bromide combined with salbutamol
- Consider a single dose of IV magnesium sulphate in severe cases
- If near-fatal, give IV aminophylline
4
Q
Management of hypoglycaemia?
A
- Offer oral glucose if able to swallow, repeat doses if needed
- If not responding, give IV 10% glucose or IM glucagon
5
Q
Management of upper GI variceal bleed?
A
- Offer terlipressin and oral antibiotics as prophylaxis
- Definitive treatment with band ligation. If that doesn’t work, consider trans jugular intrahepatic portosystemic shunts (TIPS)
