Basic Revision

Question 1

What are the 10 steps of ECG interpretation?

Answer 1

1. Rate
2. Rhythm
3. Axis
4. P-wave
5. P-R interval
6. QRS complex
7. ST segment
8. T-wave
9. QT interval
10. Interpret rhythm

Question 2

Describe a normal P wave

Answer 2

present, round, upright, less than 0.12secs (3 boxes), less than 2.5mm amplitude

Question 3

What is the normal QRS axis?

Answer 3

-30 to +90

Question 4

What is Left avis deviation?

Answer 4

• 30 to -90

Question 5

What is right axis deviation?

Answer 5

+ 90 to 180

Question 6

Which direction does the current travel between leads?

Answer 6

from negative to positive

Question 7

How do you recognise a first degree AV block?

Answer 7

Prolonged QRS

Question 8

What type of block has an increasing P-R interval until a QRS is dropped?

Answer 8

Second degree type 1, wenckeback or Mobitz AV block

Question 9

How do you recognise a second degree type 2 AV block?

Answer 9

Normal PR interval, with an intermittent complete block.

Question 10

What is a second degree advanced or 2:1 AV block?

Answer 10

regularly dropped QRS resulting in 2:1, 3:1 or greater conduction ratio?

Question 11

How do you recognise a third degree AV block?

Answer 11

No association between P wave and QRS complex

Question 12

Which leads do you use to look for a bundle branch block?

Answer 12

V1 & V6

Question 13

How do you determine a left or right bundle branch block?

Answer 13

Prolonged QRS, WiLLiaM MaRRoW

Question 14

Which leads show a high lateral aspect?

Answer 14

Lead I and aVL

Question 15

Which leads show the septal aspect?

Answer 15

V1 & V2

Question 16

Leads I, II and III show which aspect?

Answer 16

inferior

Question 17

Leads V3 & V4 show which aspect?

Answer 17

Anterior

Question 18

Which leads show the lower septal ascpect?

Answer 18

V5 & V6

Question 19

What are the reversible causes of cardiac arrest?

Answer 19

The four H’s and Four T’s:

• hypoxia
• hypovolemia
• hyper/hypothermia
• hyper/hypoglycemia
• tension
• tamponade
• thrombosis
• toxins

Question 20

What is the SIRS criteria?

Answer 20

• temperature over 38.5 or under 35.5
• heart rate above 90bpm
• respiration rate below 10 or above 20

Question 21

What are the signs of shock?

Answer 21

• tachycardia
• tachypnea
• hypotension

Question 22

how do you calculate the approx normal paediatric systolic blood pressure?

Answer 22

(age in years x 2) + 80

Question 23

Name the altered level of consciousness differentials

Answer 23

A: alcohol/ arrhythmia
E: epilepsy/ electrolytes
I: infection
O: overdose
U: underdose/ uremia
T: toxins/ trauma/ temperature/ tumor
I: insulin
P: poison/ psychosis
S: sepsis/ stroke/ shock

Question 24

Classify the severity of a TBI

Answer 24

Severe = GCS 8 or less
Moderate = GCS 9 - 12/13
Mild = GCS 13/14 - 15

Question 25

What is Cushing's triad? What does it indicate?

Answer 25

triad of symptoms: - bradycardia - irregular bradypnea - widening pulse pressure (increasing SBP/ SBP hypertension) indicates increased ICP

Question 26

what are indicators of pneumothorax?

Answer 26

- tachycardia - SOB - chest pain

Question 27

how is MAP calculated?

Answer 27

(2x DBP) + SBP / 3

Question 28

what is pulse pressure?

Answer 28

SBP - DBP

Question 29

How do you calculate CPP? What is the normal ICP?

Answer 29

CPP = MAP - ICP normal ICP = 7 - 15mmHg

Question 30

What is the target CPP?

Answer 30

Above 70 mmHg

Question 31

What is the NEXUS criteria?

Answer 31

For spinal clearance: 1. No midline cervical tenderness 2. No focal neurological deficits 3. No altered LOC 4. No evidence of intoxication 5. No painful distracting injury

Question 32

What is the canadian C-spine rule?

Answer 32

``` High risk criteria: - age 65 or above - dangerous mechanism - paraesthesia in extremities IMAGING REQUIRED ``` ``` At least ONE low risk criteria: - simple rear end MVC - ambulatory at any time - sitting position - no neck pain at scene - no midline tenderness IF NONE- IMAGING REQUIRED if one or more: ``` ask patient to turn head 45 degrees both left and right. Can do it? (despite pain)- no imaging required

Question 33

What is the parkland formula?

Answer 33

Estimation of the fluids required for a patient with serious burns. Adults: If >20% TBSA. 4ml/kg/% TBSA Paediatrics: If >10% TBSA. 3-4ml/kg/% half given in first 8hrs, half in following 16hrs.

Question 34

What is the weight used for newborn drug calculations?

Answer 34

3.5kg

Question 35

How do you estimate the weight of an infant?

Answer 35

(0.5 x months) + 4

Question 36

How do you calculate the expected weight of a 1 - 5 year old?

Answer 36

(2 x years) + 8

Question 37

How do calculate the weight of a child between 6 and 12 years of age?

Answer 37

(3 x years) + 7

Question 38

What are the 6 R's of pharmacology?

Answer 38

``` Right person Right drug Right dose Right route Right time Right documentation ```

Question 39

What is the volume calculation for drug doses?

Answer 39

Dose required x Stock volume | Strength supplied 1

Question 40

What is the recommended defibrillation setting for paediatrics?

Answer 40

4 Joules / kg

Question 41

What is the structure of a handover?

Answer 41

``` I: introduction M: mechanism/ medical complaint I: injures S: signs and symptoms T: treatment and trends A: allergies M: medications B: background O: other info ```

Question 42

How do you give a sit rep/ major incident sit rep?

Answer 42

``` M: major incident declared? E: exact location T: type of incident H: hazards A: access/ egress N: no. of casualties E: emergency services present/ required ```