Treatment plans

Question 1

What is the treatment plan for Sepsis?

Answer 1

Pre-alert and transfer to hospital.
Give benzylpenicillin if the non-blanching rash is present or urgent transfer is unavailable.
Do not give benzylpenicillin if history of anaphylaxis
Give oxygen and fluids if systolic below 100

Question 2

How is Sepsis identified?

Answer 2

RR above 20-25
HR above 100
systolic below 100
Temperature above 38.3 or below 36
new onset confusion

Question 3

What history makes sepsis more likely?

Answer 3

ACIDS
A - AIDS and arthritis (rheumatoid)
C - Cancer and chemotherapy
I - infection and immunocompromised (lupus)
D- Diabetes (type 1)
S- steroids

Question 4

What is the treatment for asthma?

Answer 4

Move to a calm environment
High flow oxygen
Nebulised salbutamol
nebulised ipratropium bromide
Hydrocortisone
Continuous salbutamol
adrenaline 1:1000
assess for bilateral tension pneumothorax

Question 5

What is the treatment for a STEMI?

Answer 5

MONA

M- morphine
O- Ondansetron and oxygen
A- spirin administered
N- nitrates (unless right ventricular or posterior involvement)

Pre-alert to PPCI

Question 6

What is the treatment for hypoglycemia?

Answer 6

Blood glucose reading before and after treatment
Conscious: glucose oral gel
Unconscious: glucose 10%
Unconscious and cannot gain IV: Glucagon
Wait 10 minutes for improvement
referral to an appropriate health care professional

Question 7

What is the treatment for a lower limb fracture?

Answer 7

PAIN
(P)ain scores were recorded: before and after analgesia
(A)nalgesia administered
(I)mmobilisation of limb
(N)umb- assessment of circulation and sensation below fracture

Question 8

How to check for low limb fracture?

Answer 8

Short and externally turned for hip fracture
Patella moved towards the outside of the leg is a knee dislocation

Question 9

What is the treatment for an elderly fall?

Answer 9

OHCRAP
O- Acquire all (O)bservations
(H)istory of fall
(H)eart (ECG)
(C)ause of fall (who, where, what, why, when)
R- Falls (R)eferral
A- mobility (A)ssessment
(P)ain assessment and medication

Question 10

What is the treatment for a self-harm patient?

Answer 10

History leading up to incident
Assessment (capacity)
Record all observations
Mechanism of injury and drugs
Social contact and suicide risk

Question 11

What is the treatment for a stroke?

Answer 11

(F)uck (B)rain (B)leed (P)erson
FAST assessment
BM measured
Blood pressure recorded
Pre-alert to stroke unit

Question 12

When does SPOC need to be called?

Answer 12

Falls
hypoglycaemia
Vulnerable adult/child

Question 13

When should crisis first response be called?

Answer 13

Mental health patient who doesn’t require physical aid

Question 14

What is the treatment plan for anaphylaxis?

Answer 14

Lie patient flat
500mcg (half dose) of IM adrenaline
Wait 5 minutes
If no improvements:
Second dose of 500mcg IM adrenaline
Gain vascular access and deliver fluid bolus

Question 15

What is the joules for shocking a paediatric?

Answer 15

Body in kg x 4

Question 16

What is the dose of adrenaline for a paediatric cardiac arrest?

Answer 16

Body weight in kg / 10 = ml of adrenaline
or body weight in kg x 10 = dose in mcg

Question 17

What is the dose of rectal diazepam in paediatrics?

Answer 17

Half dose if below 5 (5 milligrams)

Question 18

How is anaphylaxis identified?

Answer 18

Angiodema
Not breathing well
Auscultation suggests wheeze, stridor or silent chest
Puke and diarrhoea
Hives/rash/erythema

Question 19

What is the treatment for refractory anaphylaxis?

Answer 19

Rapid IV bolus
IM adrenaline every 5 minutes and monitor BP (increase indicate overdose)
High flow oxygen and keep within 94-98%