Medical emergency competency

Question 1

What are the signs and symptoms of adrenal crisis?

Answer 1

• collapse
• pallor
• cold and clammy skin
• hypotension and dizziness
• vomiting and diarrhoea

Question 2

What are the signs and symptoms of anaphylaxis?

Answer 2

• sudden onset
• flushing or pallor
• respiratory distress (stridor, wheeze, hoarseness)
• hypotension
• tachycardia
• skin or mucosal changes

Question 3

What are the signs and symptoms of asthma?

Answer 3

• breathlessness and wheeze
• inability to complete sentence in one breath
• cyanosis
• pulse <50
• exhaustion, decreased GCS

Question 4

What are the signs and symptoms of cardiac emergencies?

Answer 4

• chest pain that occurs suddenly and doesn’t go away
• pain that spreads to arms, neck, jaw, back or stomach
• feeling sick, sweaty, light-headed or SOB

Question 5

What are the signs and symptoms of epileptic seizures?

Answer 5

• sudden collapse and LOC
• rigidity and cyanosis
• jerking moments
• noisy breathing
• frothing at mouth
• incontinence

Question 6

What are the signs and symptoms of hypoglycaemia?

Answer 6

• shaking
• slurred speech
• sweating and paler
• blurred vision
• lethargy
• confusion, moody
• LOC

Question 7

What are the signs and symptoms of sepsis?

Answer 7

• deterioration in GCS
• resting systolic BP >90 or >40 difference
• respiratory rate >20
• oxygen sats <92%
• non-bleaching rash or mottled rash, cyanotic
• not passed urine in 18 hours

Question 8

What are the signs and symptoms of stroke?

Answer 8

• FAST
• facial weakness
• arm weakness
• speech problems
• (time to call 999)

Question 9

What are the signs and symptoms of syncope?

Answer 9

• light-headed
• collapse or LOC
• pallor, sweating, slow pulse, low BP
• nausea or vomiting

Question 10

What is the management of adrenal crisis?

Answer 10

ABCDE
- call 999 “addisonian crisis”
- lie flat
- administer oxygen 15l/min
- hydrocortisone 100mg IM

Question 11

What is the management of anaphylaxis?

Answer 11

ABCDE
- call 999 “anaphylaxis”
- lie flat, elevate legs
- administer oxygen 15l/min
- 500 micrograms adrenaline IM (0.5ml of1:1000)
- repeat at 5 min intervals

Question 12

What is the management of asthma?

Answer 12

ABCDE
- sit upright
- 2 puffs of 100 micrograms salbutamol
- repeat as necessary (max 10 puffs)
- if unresponsive, call 999
- administer oxygen 15l/min

Question 13

What is the management of cardiac emergencies?

Answer 13

• ABCDE
• call 999 “heart attack” - if known angina skip
• comfortable position, sitting up
• GTN spray 400-800mg sublingual
• dispersible aspirin to chew 300mg

Question 14

What is the management of epileptic seizures?

Answer 14

ABCDE
- safe environment to prevent injury
- administer oxygen 15l/min
- once seizure ceases, recovery position
- if prolonged convulsive seizures (>5 mins), 10mg midazolam in buccal sulcus

Question 15

What is the management of hypoglycaemia?

Answer 15

ABCDE
- offer 15-20g quick acting carbohydrate
- if impaired GCS, call 999 “hypoglycaemia”
- recovery position
- glucagon 1mg IM

Question 16

What is the management of sepsis?

Answer 16

ABCDE
- call 999 “red flag sepsis”
- administer oxygen 15l/min

Question 17

What is the management of stroke?

Answer 17

ABCDE
- call 999 “stroke”
- administer oxygen 15l/min
- patient is NBM

Question 18

What is the management of syncope?

Answer 18

ABCDE
- lie flat, elevate legs
- loosen tight clothing
- often conscious, offer glucose in water
- if no responsive, consider other diagnosis