medical emergencies

Question 1

list some medical emergencies (9)

Answer 1

• myocardial infarction (heart attack)
• status epilepticus
• anaphylaxis (allergy)
• hypoglycaemia
• asthma attack or breathing difficulties
• choking
• bleeding
• stroke
• fainting

Question 2

what does AVPU mean?

Answer 2

scale to measure level of consciousness:
- alert
- voice
- pain
- unresponsive

Question 3

what is normal oxygen saturation?

Answer 3

≥96%

Question 4

what is normal respiration rate?

Answer 4

12-20 breaths/min

Question 5

what is normal pulse rate?

Answer 5

60-100bpm

Question 6

what is the order for giving basic life support?

Answer 6

DRS = danger, response/consciousness, shout for help
A = airway (chin lift, anything in throat)
B = breathing (look, listen, feel for 10s)
C = chest compressions if not breathing and defibrillator, dial 999
- if breathing then put into recovery position

Question 7

how are chest compressions done?

Answer 7

• cover pt’s nose/mouth (AGP)
• centre of chest, just under armpit level
• 5-6cm depth, 100-120bpm
• 30 compressions : 2 oxygen ventilations (15L/min)
• swap with another person every 2 mins to avoid fatigue
• stop with signs of life
• children = 5 initial rescue breaths, 15 compressions : 2 breaths

Question 8

how to manage myocardial infarction?

Answer 8

• sit pt up, dial for ambulance
• administer 2 sprays sublingual GTN, again 5 mins later if needed
• oxygen if saturation <96%
• check allergy, aspirin 300mg crushed or chewed
• Entonox for pain relief
• monitor pulse and oxygen saturation

Question 9

s/s of myocardial infarction

Answer 9

• central strangling pain >15 mins
• pain radiating to neck, jaws, left arm
• nausea, vomiting
• grey tinge, sweating, tachycardia

Question 10

how to manage status epilepticus?

Answer 10

• single dose 10mg buccal midazolam ≥10yo (7.5mg ≥5yo, 5mg ≥1yo)
• call 999
• time seizure
• protect pt’s head
• give oxygen when they regain consciousness

Question 11

what is status epilepticus?

Answer 11

any seizure lasting >5mins or a series of seizures where pt does not regain consciousness

Question 12

how to manage anaphylaxis?

Answer 12

• 500ug ≥12yo adrenaline IM with autoinjector (blue to sky, orange to thigh)
• 300ug <12yo, 150ug <6yo
• elevate legs if possible

Question 13

how to manage hypoglycaemia?

Answer 13

• BM test for baseline
• 1.5-2 tubes of glucogel if able to swallow
• glucagon 1mg IM if unable to swallow

Question 14

s/s of hypoglycaemia

Answer 14

• hungry, lethargic, tired
• BM test <4mmol/L

Question 15

how to manage asthma attack?

Answer 15

• sit pt upright
• salbutamol inhaler with spacer
• 2 puffs every 2 minutes for 10 mins or until recovered (maximum 10 puffs)
• no recovery = call 999

Question 16

s/s of asthma attack (3)

Answer 16

• breathlessness and expiratory wheeze
• cyanosis, reduced respiratory effort, reduced heart rate
• neurological signs, reduced consciousness

Question 17

how to manage choking?

Answer 17

• assess severity - can they talk/breathe?
• 5 back slaps first
• abdominal thrust

Question 18

how to conduct abdominal thrust for choking pt?

Answer 18

• stand behind and wrap arms around with fist below ribs
• thrust up to chest

Question 19

how to manage fainted pt?

Answer 19

• recline, ideally legs above head
• reassurance and slowly sit up
• no recovery = open airway, check breathing

Question 20

what does the FAST acronym mean for strokes?

Answer 20

Face - able to smile? drooping
Arms - able to raise both arms?
Speech - able to speak clearly and understand what you say?
Time - act fast and call 999