Trauma/Emergency Flashcards
Cushing’s triad?
Bradycardia, HTN, Wide pulse pressure
Dose of adrenaline in anaphylaxis?
0.5mg 1:1000 IM
Dose of adrenaline in cardiac arrest?
1mg - 10ml 1:10000 IV
1ml 1:1000
In a non-urgent scenario how quickly should 1 unit of RBCs be transfused?
90 -120 minutes
4 criteria for brainstem testing?
- Deep coma of unknown cause
- Reversible causes excluded
- No sedation
- Normal electrolytes
6 tests to confirm brainstem death?
Pupillary light reflex
Corneal reflex
Ocular vesitublar reflex
Cough reflex
Absent response to super-orbitl pressure
No spontaneous respiratory effort
ABG in salicylate poisoning?
1. Immediately
2. A few hours later
- Respiratory alkalosis
- Metabolic acidosis
Respiratory alkalosis affect in calcium and phosphate?
Hypocalcaemia
Normal phosphate
Brainstem testing should be carried out by?
2 separate doctors on separate occasions
What deficiency increases risk of anaphylactic reaction to a blood transfusion?
IgA deficiency
Management of patients on anticoagulation with head injury?
CT head within 8 hours
At what paracetamol OD should NAC be started before return of plasma-paracetamol concentration?
150mg/kg (if presented 8-24 hours post ingestion)
Maintenance fluid requirement?
20-30ml/kg
Management of paracetamol OD if > 24 hours since ingestion and patient is jaundice, hepatic tenderness or raised ALT?
Start NAC immediately
Signs and symptoms of hypernatraemia?
Jittery movements
Increased muscle tone
Hyperreflexia
Convulsions
Drowsiness
Coma
Inidications for IV Magnesium Sulphate in hypomagnesaemia?
Mg < 0.4 or
tetany/ arrythmia/ seizures
Management of patient requiring immediate surgery, that is on Warfarin?
4 factor prothrombin complex concentrate
Widened QRS or arrhythmia in tricyclic overdose?
Give bicarbonate IV
LSD intoxication symptoms?
Colourful visual hallucinations
Depersonalisation
Psyhcosis
Paranoia
Overdose of what illicit drugs can cause serotonin syndrome?
Ecstacy
Which other electrolyte abnormally has a similar presentation to hypomagnesiaemia?
Hypocalcaemia
ASA if BMI is > 40?
ASA III
Hypothyroidism VT?
TDP
Type of reaction that NAC can cause ?
Non-IgE mediated mast cell release
Pulmonary oedema and severe metabolic acidosis are indications for what?
Haemodialysis
What markers are raised in neuroleptic malignant syndrome?
CK and WCC
Single most important prognostic factor in paracetamol OD?
Arterial pH
Management of high altitude cerebral oedema?
Prevention = acetazolamide
Treatment = dexamethasone
In trauma what do you measure from fluid leaking from nose or ear to check if it is CSF?
Glucose