SIM session_useful info Flashcards

1
Q

What colour cannula should a patient who is in shock?

A

at least Grey 16G or Brown 14G (brown is bigger)

*not always practically easy if circulation is shout down so try with whatever you can

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2
Q

How we should treat a shocked patient’s hypotension?

A

1 litre of Hartmann’s solution

*pH neutral, crystalloid

*if saline is the only available fluid is fine to use it for short time/ resusitation

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3
Q

What’s the problem with bag of normal saline?

A

Saline is pretty acidic pH 5 -> be careful

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4
Q

What are the common vasopressors?

Where are they usually used?

A
  • adrenaline
  • noradrenaline
  • vasopressin analogue

*used usually in ITU; Rx for very septic patients when danger of fluid overload (and oedema)

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5
Q

Where is the lactate coming from?

A

Hypoxic tissues -> anaerobic respiration -> lactate is created

  • Anaerobic respiration is happening due to organ underperfusion/oxygen is not delivered to the tissues by blood
  • circulatory collapse = hypotension & small blood clots in the areas of tissue = ischaemia
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6
Q

What’s the normal lactate range

A

0.5-1 mmol/L

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7
Q

How high is lactate in lactic acidosis?

A

Lactic acidosis = lactate >4 mmol/L

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8
Q

Potential antibiotics used for abdominal sepsis

A
  • metronidazole
  • co-amoxiclav
  • cefuroxime
  • Tazocin = Piperacillin/Tazobactam -> cannot be used in penicillin allergy

*depends on local resistance pattern - local hospital policy

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9
Q

When to check lactate?

A

If a patient:

  • triggers NEWS of 5 or more (or 3 in a single category)
  • if there is a clinical concern - if they look sick
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10
Q

Red flags for sepsis (5)

A
  • significant hypotension
  • significant tachycardia (HR of 130 or more)
  • RR >25
  • acute confusion
  • decreased urine output
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11
Q

What questions do we ask if NEWS 5 or more?

A
  • do they look sick?
  • is it due to infection?
  • are they immunocompromised

Then screen for leg flags -> if present start SEPSIS 6

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