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The One Deck To Rule Them All > Acute Care > Flashcards

Acute Care Flashcards

1
Q

Motor findings for GCS

A
  1. None
  2. Extends to pain
  3. Flexion to pain
  4. Withdraws form pain
  5. Localises to pain
  6. Obeys commands
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2
Q

Verbal findings for GCS

A
  1. None
  2. Sounds
  3. Words
  4. Confused
  5. Orientated
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3
Q

Eye findings for GCS

A
  1. None
  2. To pain
  3. To speech
  4. Spontaneous
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4
Q

Max GCS

A

15

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5
Q

Min GCS

A

3

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6
Q

CPR of < 1 year old

A

Dry baby first

3 chest compressions : 1 breath

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7
Q

CPR of child

A

5 rescue breaths

15 chest compressions : 2 breaths

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8
Q

CPR of adult

A

30 chest compressions : 2 breaths

- check for femoral and brachial pulse

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9
Q

Shockable rhythms

A 
Ventricular Fibrillation (VF)
Ventricular Tachycardia (VT)
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10
Q

Non-shockable rhythms

A

Asystole

Pulseless Electrical Activity (PEA)

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11
Q

Management for VT/VF

A

Defibrillation: 3 shocks first
1mg of adrenaline (repeat every 3-5 mins)

  • witnessed: 3 stacked shocks
  • un-witnessed: 1 shock + CPR (2mins) x 3
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12
Q

Management of Asystole/PEA

A

1mg of adrenaline ASAP (repeat every 3-5mins)

CPR

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13
Q

Reversible causes of cardiac arrest

A

5Hs + 4Ts

Hypoxia
Hypovolaemia
Hypothermia
Hypoglycaemia/calcaemia/kalaemia
Hyperkalaemia

Thrombosis
Tension pneumothorax
Tamponade (cardiac)
Toxins

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14
Q

Management of hypothermia

A

Bring to 30 degrees

CPR + 3 x shocks

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15
Q

Specifics of chest compression in all children

A

100-120 compressions per min

1/3 depth of sternum

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16
Q

Acute fluid management for children

A

IV bolus of 20ml/kg 0.9% NaCl in < 10 mins

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17
Q

When to give fluids in burns

A

Adults: > 15% surface area burn
Children: > 10% surface area burn

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18
Q

Parkland formula for fluid resus in burns

A 
Surface area (%) x weight (kg) x 4ml 
First 50% given in first 8 hours
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19
Q

What fluid to use in burn management

A

Crystalloid fluid (Hartman’s/Ringer’s)

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20
Q

Superior fluid to be used in resuscitation

A

Crystalloid

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21
Q

Risk of using colloid fluid

A

Risk of anaphylaxis

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22
Q

Signs of too much fluid

A

Increased JVP
Ascites
Lung crackles
Tachypnoea

23
Q

Signs of too little fluid (negative fluid balance)

A 
Tachycardia
Hypotension
Oliguria
Sunken eyes
Decreased skin turgor
24
Q

Risk of using large volumes of 0.9% NaCl

A

Hyperchloraemic metabolic acidosis

25
Q

Maintenance fluid management for children

A

0.45% NaCl + 5% Dextrose

100ml/kg for first 10kg
50ml/kg for next 10kg
20ml/kg for next 10kg

26
Q

Contraindications for Hartmann’s fluid

A

Don’t use in hyperkalaemia as it contains potassium

27
Q

Daily requirements of maintenance fluid management in adults

A 
Water: 25-30ml/kg/day 
Potassium: 1mmol/kg/day
Sodium: 1mmol/kg/day
Chloride: 1mmol/kg/day
Glucose: 50-100g/day
28
Q

Maintenance fluid management for adults (70kg man)

A

1L normal saline + 40ml potassium
or
1L 5% dextrose + 40ml potassium

29
Q

Contents of 1L bag of normal (0.9%) NaCl saline solution

A

1L water
154 mmol sodium
154 mmol chloride

30
Q

Contents of 1L bag of 5% dextrose solution

A

1L water

50g glucose

31
Q

Total fluid in 70kg male

A

42L (100%)

32
Q

Total intracellular fluid

A

28L (60-65%)

33
Q

Total extracellular fluid

A

14L (35-40%)

34
Q

Extracellular fluid is made up of

A

Interstitial Fluid = 10L (24%)
Plasma = 3L (5%)
Transcellular fluid = 1L (3%)

35
Q

5 types of shock

A 
Septic 
Anaphylactic 
Neurogenic 
Cardiogenic
Haemorrhagic
36
Q

Types of shock that cause cold peripheries

A

Cardiogenic

Haemorrhagic

37
Q

Types of shock that cause warm peripheries

A

Distributive shocks:

  • Septic
  • Anaphylactic
  • Neurogenic
38
Q

Decreased SVR
Increased HR
Normal/increased CO
Decreased BP

A

Septic shock

39
Q

Temp < 36 or > 38
Hr > 90
RR > 20
WBC < 4000 or > 12,000

A

Septic shock

40
Q

Septic shock can lead to

A

Systemic inflammatory response syndrome (SIRS)

Multi organ failure

41
Q

Neutropenic sepsis

A

Sepsis with neutrophil count < 1 x 10(9)/L

42
Q

Why may you test a clotting screen in sepsis

A

To test for DIC

43
Q

Management for Sepsis

A

BUFALO - “Sepsis Six”

Blood cultures
Urine output
Fluids (IV)
Antibiotics
Lactate
Oxygen
44
Q

What is Starling’s law?

A

Reduced preload = reduced cardiac output = reduced peripheral tissue perfusion

45
Q

Shock occurring following a spinal cord transection

- often trauma/ RTA

A

Neurogenic shock

46
Q

Pathophysiology of neurogenic shock

A

Increased parasympathetic tone
Decreased sympathetic tone

= reduced peripheral vascular resistance mediated by vasodilation

= hypotension + bradycardia

47
Q 
Increased SVR
Increased HR
Decreased CO
Decreased BP
Hx of IHD
A

Cardiogenic shock

48
Q 
Increased SVR
Increased HR
Decreased CO
Decreased BP
Recent Hx of Blood loss
A

Haemorrhagic “Hypovolaemic”

49
Q

Volume of blood in average 70kg male

A

5L

  • 7% of body weight in adult
  • 9% of body weight in children
  • less in elderly
50
Q

4 Classifications of Haemorrhagic shock

A

I: <750ml loss
II: 750-1500ml loss
III: 1500-2000ml loss
IV: >2000ml

51
Q

Secure airway at what GCS

A

= 8

52
Q

igels (supra glottic airway) are used to intubate in

A

emergencies, especially cardiac

- cannot protect against aspiration

53
Q

Trachea tube is used to intubate when

A

there is risk of aspiration

54
Q

Guedel (oral airway) is used to

A

maintain airway

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