19. Medical Emergencies

Question 1

Drugs and Equipment

1. List drugs in ME box
2. List key ME equipment

Answer 1

1. Salbutamol inhaler, aspirin (300mg dispersible tablets), glucagon (1mg/ml), adrenaline (1:1000 1ml, use 0.5ml), GTN (400mcg/dose), midazolam (10mg), oral glucose, oxygen (15l/min)
2. AED, O2 cylinder, BV mask, non-rebreathing mask

Question 2

Principles

1. Describe ABCDE and key features of each and how to manage if not right

Answer 2

1. Airway - talking, breathing, coughing. If not - triple manoeuvre, OPA, jaw thrust

Breathing - SoB, blue skin, cold, clutching chest. O2, OPA, triple manoeuvre

Circulation - cold, blue skin, check pulse (rate, rhythm, character, strength, pressure, temperature). Treat cause, keep warm, O2, elevate legs

Disability - AVSPU. Treat cause

Exposure - global overview, other symptoms (rash, etc)

Question 3

Faint

1. Outline physiology
2. 3 symptoms
3. How to manage

Answer 3

1. Transient loss of consciousness secondary to inadequate cerebral perfusion with oxygenated blood. Rapid reduction in blood pressure, often due to standing up too quickly, reduced blood flow to brain. Patient loses consciousness and protective reflexes and falls. Often rapid recovery of consciousness
2. Hypotension, reduced HR, reduced RR, compromised airway, pale, clammy, light-headed, malaise
3. Lie flat, raise legs, O2, glucose if required

Question 4

Asthma

1. 3 symptoms
2. How to manage

Answer 4

1. SoB, difficulty talking, increased HR, increased RR, wheeze, tripod position
2. Salbutamol inhaler (x4 via spacer if required), repeat as needed. If no response in 5mins, 999

Question 5

Anaphylaxis

1. 3 symptoms
2. How to manage

Answer 5

1. Airway swelling, stridor, wheeze, raised HR, raised HR, LoC, rash, flushing/pallor
2. 999, secure airway, lie patient flat, suction, O2, adrenaline (0.5ml into ALT), repeat every 5mins

Question 6

Fits

1. 3 symptoms
2. How to manage

Answer 6

1. Compromised airway, rapid RR if TC, unresponsive, seizure activity
2. Ensure safe environment, O2 (OPA if possible), buccal midazlolam if status epilepticus

Question 7

Hypoglycaemia

1. 3 symptoms
2. How to manage

Answer 7

1. Raised HR, raised RR, irritable, pale, confused; coma if severe
2. ABCDE, glucose if conscious, 1mg glucagon (ALT) if LoC, O2

Question 8

Angina, MI, cardiac arrests

1. 3 unstable angina symptoms
2. How to manage
3. 3 MI symptoms
4. How to manage
5. Cardiac arrest symptoms
6. How to manage

Answer 8

1. Central crushing chest pain, radiating to arm/jaw/back, SoB, increased RR, increased HR, hypotension, pale, clammy
2. 2 SL puffs GTN, O2, comfortable position
3. Unstable angina that doesn’t resolve
4. 300mg aspirin, O2, call 999, . 2 SL puffs GTN, comfortable position
5. LoC, maybe agonal breathing, pupil dilation
6. AED, O2 via BVM, call 999, CPR

Question 9

Choking

1. 3 symptoms
2. Management

Answer 9

1. Absent, wheeze, laboured breathing, cyanosis, clutch throat, frightened, pale
2. ABCDE, encourage cough, 5 back blows, 5 abdo thrusts, O2, repeat, if LoC as cardiac arrest