PassTest Acute Care Flashcards
If you are alone and find a responsive patient, what does the guideline suggest?
Leave patient to summon help
If a patient begins breathing after CPR, what does the guideline suggest?
Placing the patient in the recovery position
What do you do before starting chest compressions?
Check airway
What is the treatment for a post Dural puncture headache?
Blood patch - am injection of blood down the epidural tract
Once blood enters the epidural space it clots and forms a seal
Treat hyperkalaemia a
Give calcium gluconate 10% 10mls by slow IV injection
Then
10 units act rapid in 100ml of 20% glucose
Salbutamol nebs
Calcium resonium 15g orally or rectally
Where can you fit a CVC?
Internal jugular
Subclavian vein
Femoral vein
Venous cutdown on the basilic vein
(Depends on whether peripheral or central vein cannulation is required)
What prep is needed for insertion and maintenance of a CVC?
Patients coag status and platelet count should be normalised before insertion
Sterile insertion
After a subclavian or internal jugular catheter is inserted what needs done?
Chest radiograph
To prevent cardiac arrhythmias catheters in the right atrium or ventricle should be withdrawn until the
Tip is within the superior vena cava
What are the complications involved with CVC?
Pneumothorax
Accidental arterial cannulation
Sepsis
Who needs to diagnose brain death?
Two doctors at least one a consultant and both registered for 5 years
Causes of confusion in the ICU
Cerebral hypoxia Hypoglycaemia Sepsis or toxins Anaesthetic and other drugs Head injury
Anyone that has an anaphylactic reaction gets what home with them
Two adrenaline autoinjectors
Treat Addisonian crisis
Give 100mg hydrocortisone IM STAT
Dose of adrenaline for anaphylaxis in a kid under 6
150 micro grams IM
Dose of adrenaline for anaphylaxis in a kid between ages 6-12
300 micro grams IM
How are patients with traumatic brain injury treated ?
Maintain pco2 of 4.5
Maintain po2 above 13
Maintain oxygen above 95%
In extreme patients hyperventilation may help
Mild aspirin overdose presents as
Tinnitus nausea vomiting
In severe cases you can get hallucination sconfusions seizures and pulmonary oedema
When does hepatic necrosis develop after paracetamol overdose
After 24 hours
How do you treat laryngeal oedema and bronchospasm associated with inhalation burns?
Bronchodilators and steroids
Positive pressure ventilation
Prophylactic systemic antibiotic cover
IV crystalloid
Why is sodium nitroprusside in a bag?
Used to treat malignant hypertension and comes in a silver bag to be protected from sunlight which degraded it to cyanide
Treat cyanide poisoning with dicobalt edetate. If unavailable give sodium nitrate or sodium thiosulphate
Abdo pain nausea and then develops SOB (bilateral pulmonary infiltrates seen)
Is it ARDS associated with acute pancreatitis?
Raised j wave on ecg
Hypothermia
Woman on ocp with extreme abdo pain
Could it be acute porphyria?
List three things that cause SIRS other than sepsis
Acute pancreatitis
Major trauma
Burns
Give criteria for SIRS
Temp >38 or less than 36
HR>90
Resp rate >20
WBC >12000 or <4000
What is wernikes encephalopathy
Eye movement disorders ataxia and confusion
Thiamine deficiency
Treat digoxin toxicity
Digifab
If not available treat ventricular arrhythmias with phenytoin or lidocaine
What causes a stress ulcer in a critically ill patient?
Ischaemic injury time gastric mucosa loss of cytoprotectabts and disruption of the gastric mucosal barrier to acid injury
What are the main risk factors in ICU for a stress ulcer?
Resp failure Coagulopathy Sepsis Hypotension Hepatic/ renal failure
How do you prevent Cushings ulcer? And what is the main complication of this?
PPI H2RA
Pneumonia
What factors are involved in blood transfusion reactions?
Allergens
Gram negative endotoxins
What is the effect of transfusion reactions on liver function and clotting factors ?
Acute liver failure and hepatic coma are rare complications
Acute intravascikar coagulation
