Flashcards in Acute Care Deck (56)
What assessments and interventions would you make for someone's Airway?
Look (obstruction, breathing, resp muscles, cyanosis)
Listen (stridor, snoring, gurgling)
Intervene: head-tilt, chin-lift, jaw-thrust
What assessments and interventions would you make for someone's Breathing?
Look (chest movement, rate, depth, cyanosis)
Listen (breath sounds bilaterally)
Feel (air movement, trachea)
Intervene: high-flow O2, ventilatory support
What assessments and interventions would you make for someone's Circulation?
Pulse, blood pressure, cap refill, JVP
Intervene: 2x IV access, fluids, blood samples, ECG
What assessments and interventions would you make for someone's Disability?
AVPU, glucose, GCS, pupil reation and size
What assessments and interventions would you make for someone's Exposure?
Temperature, injury, rashes
What is the minute volume (in regards to respiration) comprised of?
Tidal volume x Respiratory Rate
Alveolar ventilation + Dead space ventilation
A healthy lung would have ventilation:perfusion (V:Q) ratio of 1. What would the V:Q ratio be in a shunt?
Q would be higher than V, signifying wasted perfusion
A healthy lung would have ventilation:perfusion (V:Q) ratio of 1. What would the V:Q ratio be if there is dead space?
V would be higher than Q, signifying wasted ventilation
Why does CO2 retention suggest low alveolar ventilation?
Due to physiological dead space, alveoli aren't perfused and there is an overall decrease in alveolar ventilation, which impedes CO2 elimination
What is the consequence of alveolar hypoventilation and increase in alveolar CO2?
Opioid analgesia is the commonest cause of hypercapnia secondary to reduced hypoxic drive. True/False?
What is hypoxic drive of respiration?
Due to chronic hypercapnia, body relies on O2 levels to control breathing - if high O2 levels detected, respiratory drive/effort will be decrease
This is why caution should be taken when giving high-flow O2 to COPD patients
What is cardiogenic shock?
Reduction in cardiac output due to reduced stroke volume due to reduced contractility
Essentially, "pump failure"
What is obstructive shock?
Mechanical obstruction of flow causes hypoperfusion
Caused by impaired filling or emptying of heart
What is hypovolaemic shock?
Inadequate circulating volume causes hypoperfusion
What is distributive shock?
Peripheral vasodilation causes reduced vascular resistance and thus fall in blood pressure
Results in inappropriate distribution of blood flow
List clinical features of tricyclic antidepressant/amphetamine
Extensor plantar response
List clinical features of barbiturates/BZD/opioid poisoning
List clinical features of salicylate poisoning
What are the most useful investigations in poisoned patients?
Urea and electrolytes
What is the antidote for beta-blocker poisoning?
What is the antidote for carbon monoxide poisoning?
What is the antidote for iron poisoning?
What is the antidote for opioid poisoning?
What is the antidote for paracetamol poisoning?
What is the antidote for sulfonylurea poisoning?
What is the antidote for warfarin poisoning?
List risk factors/drugs that can precipitate paracetamol poisoning
(drugs that induce hepatic enzymes)
St John's wort
List clinical features of paracetamol poisoning
Tenderness over liver
Coma, hepatic encephalopathy (much later)