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Flashcards in Acute Care Deck (56)
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1

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

2

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)
O2 sats
Intervene: high-flow O2, ventilatory support

3

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

4

What assessments and interventions would you make for someone's Disability?

AVPU, glucose, GCS, pupil reation and size
Intervene: glucose

5

What assessments and interventions would you make for someone's Exposure?

Temperature, injury, rashes

6

What is the minute volume (in regards to respiration) comprised of?

Tidal volume x Respiratory Rate
Alveolar ventilation + Dead space ventilation

7

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

8

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

9

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

10

What is the consequence of alveolar hypoventilation and increase in alveolar CO2?

Hypoxia

11

Opioid analgesia is the commonest cause of hypercapnia secondary to reduced hypoxic drive. True/False?

True

12

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

13

What is cardiogenic shock?

Reduction in cardiac output due to reduced stroke volume due to reduced contractility
Essentially, "pump failure"

14

What is obstructive shock?

Mechanical obstruction of flow causes hypoperfusion
Caused by impaired filling or emptying of heart

15

What is hypovolaemic shock?

Inadequate circulating volume causes hypoperfusion

16

What is distributive shock?

Peripheral vasodilation causes reduced vascular resistance and thus fall in blood pressure
Results in inappropriate distribution of blood flow

17

List clinical features of tricyclic antidepressant/amphetamine
poisoning

Dilated pupils
Divergent squint
Tachycardia
Hyper-reflexia
Extensor plantar response

18

List clinical features of barbiturates/BZD/opioid poisoning

Coma
Hypotension
Respiratory depression
Pin-point pupils
Hypo-reflexia

19

List clinical features of salicylate poisoning

Tinnitus, deafness
Hyperventilation
Sweating
Nausea
Tachycardia

20

What are the most useful investigations in poisoned patients?

Paracetamol levels
Salicylate levels
Blood glucose
ABG's
Urea and electrolytes

21

What is the antidote for beta-blocker poisoning?

Glucagon
Atropine

22

What is the antidote for carbon monoxide poisoning?

Oxygen

23

What is the antidote for iron poisoning?

Desferrioxamine

24

What is the antidote for opioid poisoning?

Naloxone

25

What is the antidote for paracetamol poisoning?

Acetylcysteine
Methionine

26

What is the antidote for sulfonylurea poisoning?

Glucose
Octreotide

27

What is the antidote for warfarin poisoning?

Vitamin K
Clotting factors
FFP

28

List risk factors/drugs that can precipitate paracetamol poisoning

Alcoholics
Malnutrition
(drugs that induce hepatic enzymes)
Anticonvulsants
Rifampicin
St John's wort

29

List clinical features of paracetamol poisoning

Nausea, vomiting
Abdo pain
Tenderness over liver
Jaundice
Coma, hepatic encephalopathy (much later)

30

Liver function tests are usually normal in paracetamol poisoning until 18 hours after overdose. True/False?

True