Treatment Flashcards
PPH
More than 500mls of bloodloss with 24 hours of birth (however secondary PPH can be up to 6 weeks and treatment principles are the same). Most commonly causes by tone (uterus not contracting), trauma, tissue (retained placenta) and thrombus.
Treatment-
-LATER
-place pressure on any compressible bleeding
-seek help from LMC
-administer 10 units oxytocin
-if placenta has not delivered and LMC if not available seek clinical advice about applying cord traction.
-TXA
-Fluids 500 mls
-massage uterus
-bimanual compression if shock is severe and pt is deteriorating
-Adrenaline infusion
-keep pt warm
Differentiating VT from SVT with aberrancy
A broad complex tachycardia in a compromised pt even if it can not be differentiated should be treated as VT if uncertain
VT- more common in older pt with IHD
Concordance in precordial leads, capture and fusion beats, RAD, regular.
Antepartum Haemorrhage
PV bleeding 20 weeks gestation and prior to birth. Usually caused by placental praevia and placental abruption.
Treatment- tilt pt to there left to prevent supine hypotension, contact LMC.
Treat with fluid and TXA if required. Lowered threshold for administering fluid as bleeding is more likely controlled, and blood loss can harm baby.
V4R and posterior ECG
V4R- move lead 4 to opposite side
Posterior- move V4 (V7) to just under scapula, most lateral, move V5 (V8) to middle, move V6 (V9) to next door to spine.
Serotonin syndrome
Is a life threatening toxidrome causes by increased serotonin levels.
This can occur secondary to overdose or accidently with changes to prescription medication and/or interactions between illicit drugs such as MDMA and LSD.
SSRIS include citalopram, fluoxetine, venafelaxine,.
Other drugs that can have effect, ondansetron, metoclopramide, amphetamines, MDMA, LSD, fentanyl, tramadol, sodium valproate.
Serotonin regulates neuronal function, temperature and mood.
Serotonin syndrome often presents with a temperature, muscle rigidity, spasms, seizures. Agitation, confusions, restlessness. Tachycardia, tachypnoea HTN, diaphoresis, mydriasis, drooling. If severe can lead to coma.
Treatment-
-Monitor ABC- keep close eye on BGL and ECG
-cool patient if required
-administer fluid if temp above 39 degrees, of if signs of poor perfusion.
-If agitated or seizure sedate, as continued muscle movement expends more energy.
TCA overdose
Tricyclic antidepressants have a broad range of activity and when taken in excess can be very dangerous.
They block sodium channels.
This causes prolonged
