What are some things to look at/for during 'E'?
Bleeding/bruising, rashes, signs of infection, lines/drains, calves
Urine output is considered to be reduced if it is less than what?
What is the normal range for respiratory rate?
What additional blood tests should be done in a patient with potential sepsis?
CRP, lactate and blood cultures
What additional investigation should you consider in any female of child-bearing age with shock, abdominal pain or gynaecological symptoms?
Urinary pregnancy test
What should you do if the patient cannot talk?
Look for signs of airway compromise- open the mouth and inspect for any obvious obstruction
In a patient who is elderly/frail or has heart/renal failure, what would you prescribe for a fluid challenge?
250ml 0.9% NaCl over 15 minutes
At the beginning of the station, what monitoring should you ask someone to set up for you?
Cardiac monitor, BP cuff and sats probe
If a patient is bleeding and shocked, after initiating a fluid challenge, what should you do?
A GCS of what warrants urgent expert help from an anaesthetist?
8 or below
If you suspect a patient has an airway obstruction, who should you call?
On call anaesthetist and emergency medical team
What are some differentials if the trachea is deviated towards the affected side?
Lung collapse, pneumonectomy
If the patient appears short of breath, what is the first intervention (if possible)?
Get them to sit upright
In most medical emergencies, who would you want to contact?
Med reg on call and critical care team
What are the three core blood tests that should be done in any unwell patient?
FBC, U&E, LFTs
What are the two main investigations within 'B', that are useful in almost any critically unwell patient?
ABG and CXR
How many times can you repeat a fluid challenge?
In what patients should you consider taking bloods for a group and save?
Anyone who had a small bleed (resolved) or who may require surgical intervention
What are some differentials if the trachea is deviated away from the affected side?
Tension pneumothorax, effusion
At the beginning of the station, what three things should you make sure are easily accessible, or ask someone to get for you?
Patient's notes, obs chart and Kardex
What additional blood test should be done in a patient with potential ACS?
In an otherwise healthy patient, what would you prescribe for a fluid challenge?
500ml 0.9% NaCl over 15 minutes
If a capillary blood glucose is elevated, what investigation should you do next?
What is the first management step in any patient who is hypovolaemic?
Fluid challenge (reassess after)
In what patients should you consider taking bloods for a coagulation screen?
Anyone who is bleeding or you suspect has hepatobiliary disease
What 4 questions should you ask yourself after finishing an ABCDE assessment?
Are further investigations required? Are further interventions required? Who do you need to contact? Where does this patient need to go?
What are the two main investigations within 'C', that are useful in almost any critically unwell patient?
Bloods and 12-lead ECG
What are some interventions/investigations to consider as part of 'E' if you haven't already?
Cultures (other than blood), antibiotics, analgesia
What additional blood test should be done in a patient who you suspect to have taken an overdose?
What oxygen should you use for any critically unwell patient?
15L through a non-rebreather mask