Palliative Emergencies

Question 1

Non-catastrophic haemorrhage management (5)?

Answer 1

1. Direct pressure / pressure dressings
2. Adrenaline 1:1000 soaked gauze
3. Tranexamic acid 1g TDS
4. Palliative Radiotherapy (e.g., GI Ca Bleed)
5. Interventional radiology e.g. embolic measures

Question 2

Aim for home/hospice Treatment for Catastrophic Massive Bleed in end-stage Palliative Pt? Medication?

Answer 2

Aim: Rapid Sedation

Meds:
1. Midazolam 10-20mg - injectable is preferable IM/SC/IV/ SL (i.e., buccal membrane - inner lining of cheeks)
2. Diazepam 10-20mg - rectal (PR)

Question 3

Osteonecrosis of jaw is long term side effect of what medication?

Answer 3

Bisphosphonates (long term side effect is?)

Question 4

HyperCalemia Levels.
Mild =
Moderate level =
Severe =
Lifethreatening =

Answer 4

Mild = 2.65 - 3.0 mmol/L –> fatigue, anorexia, nasuea

Moderate = 3.0 - 3.5 mmol/L –> vomiting, thirst, confusion, weakness, polyuria

Severe 3.5 - 4.0 mmol/L –> Dehydration, ileus, psychosis, drowsiness

Life-threatening = 4.0 + –> bradycardia, heart block, coma, cardiac arrest