Acute Flashcards
(41 cards)
Cardiac arrest
CPR: 15:2 /3:1
Shockable - VT/pulseless VT: 4J/kg
Non-shockable - PEA/asystole: adrenaline 10mcg/kg (0.1mL/kg 1:10 000) every 2 min for 20 min
SVT
Vagal stimulation
Shocked IV: adenosine 100-500mcg/kg every 2 min
Shocked no IV: synchronous DC shock 1-2J/kg
VT/VF
No pulse: synchronous DC shock 4J/kg
Pulse not shocked: amiodarone 5mg/kg
Pulse shocked: synchronous DC shock 1-2J/kg
Bradycardia
Vagal: atropine 20mcg/kg
Not vagal: adrenaline 10mcg/kg
Raised ICP
Mannitol
Shock
Inotropes
Cold shock: dobutamine/adrenaline
Warm (sepsis, anaphylaxis): dopamine/noradrenaline
Anaphylaxis
IM adrenaline 10mcg/kg (0.1mL 1:1000)
Neb adrenaline 500mcg/kg (0.5mL 1:1000), as adjunct
Estimated weight formula
<5yo = (2 x age) + 8 >6yo = (3 x age) + 7
Mean SBP formula
(2 x age) + 85
Anion gap formula
(Na + K) - (Cl + HCO3)
Normal = 10-15
Metabolic acidosis
Normal anion gap (Na + K) - (Cl + HCO3): RTA, diarrhoea, hyperchloraemia, Addisons
High anion gap i.e. high H+: SHOCK, hypoxia, DKA, renal failure
Metabolic alkalosis
Vomiting, steroid excess
Glasgow Coma Scale
Eye response:
4: Open spontaneously
3: Open to verbal command
2: Open in response to pain
1: No response
Verbal response:
5: Talking/orientated
4: Confused speech/disorientated
3: Inappropriate words
2: Incomprenhensible sounds
1: No response
Motor response:
6: Obeys commands
5: Localises pain
4: Withdraws from pain
3: Abnormal flexion
2: Extension
1: No response
Poisoning - causes of constricted pupils (miosis)
cOnstricted = Opioids, Organophosphates
Opiates: codeine, morphine, heroin
Organophosphate: insecticides, herbicides
Clonidine
Poisoning - causes of dilated pupils (mydriasis)
dilAted = Amphetamines, Atropine, tcA, Antihistamine
AmphetamINEs: cocaine, speed, crack, crystal meth
AtropINE
tcA: amytriptylINE, imipramINE
AntihistamINEs
Poisoning - causes of fever
Anticholinergics e.g. antihistamines, TCA
Ecstacy
Cocaine
Salicylates e.g. aspirin, NSAIDs
Poisoning - causes of hypothermia
Barbiturates e.g. phenobarbitone
Alcohol
Toxidromes - anticholinergics e.g. antihistamines, TCA (amitryptiline, imipramine)
Agitation Dry skin Dilated pupils (mydriasis) Fever Hallucination
Toxidromes - serotonin syndrome - SSRIs e.g. fluoxetine, sertraline, escitalopram
Hyperreflexia Hypertonia/rigidity Myoclonus Hyperthermia Autonomic instability
Toxidromes - tricyclic antidepressants e.g. amytriptiline, imipramide
Convulsions
Coma
Prolonged QRS
Toxidromes - Ecstacy
Agitated
Flushed
Sweaty
Dilated pupils (mydriasis)
Toxidromes - sympathomimetic e.g. amphetamines, cocaine
Sweating Tremor Hyperactive Dilated pupils (mydriasis) Dysrhythmia
Toxidromes - organophosphates e.g. pesticides, herbicides
Salivation Lacrimation Urination Sweating Constricted pupils (miosis) *opposite of anticholinergic*
Toxidromes - salicylates e.g. aspirin
Vomiting Tachypnoea Fever Bleeding Metabolic acidosis
