Resuscitation in Special Circumstances

Question 1

Clinical features of benzodiazapine overdose

Answer 1

Respiratory depression, LoC, hypotension

Question 2

Treatment of benzodiazapine overdose

Answer 2

Flumazenil is antidote.
However, only give for reversal of sedation when there has been a single ingestion of a benzo, and no risk of seizures.

Otherwise, consider activated charcoal

and sodium bicarbonate

Question 3

When can you give activated charcoal?

Answer 3

If overdose happened within the hour,

and patient has intact or protected airway.

Question 4

Treatment of opioid overdose

Answer 4

Naloxone

Question 5

Modifications to ALS if patient is pregnant

Answer 5

Left lateral lie
Early intubation due to aspiration risk
Delivery via C-section if: baby is 20+ weeks gestation and no ROSC w/i 5 minutes of CPR

Question 6

Treatment of local anaesthetic toxicity

Answer 6

IV lipid

Question 7

Clinical features of tricyclic antidepressant overdose

Answer 7

Reduced consciousness
Tachycardia - common and specific
Hypotension

Anticholinergic Toxidrome:

• Dilated pupils
• Warm, dry, flushed skin
• Reduced bowel sounds
• Urinary retention

Question 8

Causes of hyperkalaemia

Answer 8

Drugs (K replacement, K-sparing diuretics, nephrotoxics)
Acidosis
Renal failure
DKA
Cell lysis (trauma, burns etc)
Addison's

Question 9

Treatment for anaphylaxis, including doses.

Answer 9

Adrenaline 500mcg IM, repeat every 4 minutes

Hydrocortisone 100-300mg IV

Chlorphenamine 10mg QDS

Supportive care:

• O2
• Fluids

Question 10

Severe vs life threatening asthma - features.

Answer 10

Severe:

• Unable to complete sentences or too breathless to talk.
• PEF 33-50%
• HR >125
• RR >40

Life-threatening (one of):

• Silent chest
• Sats <92%
• PEF <33%
• Cyanosis
• Poor respiratory effort
• Confusion