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CSI 1b > Emergency > Flashcards

Emergency Flashcards

(52 cards)

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1
Q

What does ABCDE stand for?

A

Airway
Breathing
Circulation
Disability
Exposure

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2
Q

NEWS2 contents?

A

Respiration rate
SpO2%
Air or oxygen?
Systolic blood pressure
Pulse
Consciousness
Temperature

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3
Q

Normal range for respiration rate?

A

12-20

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4
Q

Normal SpO2 (scale 1 and 2)

A

Scale 1 - over 96%
Scale 2 - 88-92% (over 93% on air)

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5
Q

How many points if on oxygen?

A

2

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6
Q

Normal systolic blood pressure?

A

111-219

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7
Q

Normal pulse (per minute)

A

51-90

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8
Q

How many points if not alert?

A

3

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9
Q

Normal temperature?

A

36.1-38

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10
Q

NEWS2 score meaning?

A

0-4 - low risk, ward-based response
Red score (3 in any individual parameter) - low-medium risk, urgent ward-based response
Aggregate score 5-6 - medium, key threshold for urgent response
Aggregate score 7 or more - high, urgent or emergency response (with critical care skills)

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11
Q

NEWS2 scores frequency of monitoring?

A

0 - minimum 12 hourly
1-4 - minimum 4-6 hourly
3 in single parameter - minimum hourly
5 or more - minimum 1 hourly
7 or more - continuous monitoring of vital signs

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12
Q

Surgical sieve categories?

A

Primary neurological
Infection
Cardio respiratory
Gastro-intestinal
Metabolic/endocrine
Toxins
Psychiatric

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13
Q

MIDNIT

A

Metabolic
Inflammation
Degenerative
Neoplastic
Infection
Trauma

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14
Q

Airways assessment

A

Verbalising?
Foreign objects
Excessive secretions?
Snoring/stridor?
Mouth or tongue swelling?

consider airway opening manoeuvres if unsafe

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15
Q

Breathing assessment?

A

Respiratory rate
Oxygen saturation (before and after oxygen)
Respiratory distress?
Wheeze?
Smoker?

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16
Q

Circulation assessment?

A

Blood pressure?
Heart rate?
Heart sounds?
ECG?
Peripheral capillary refill?
Peripheries (temp and appearance)

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17
Q

Disability assessment?

A

Blood glucose?
Temperature?
Confused? (ACVPU or GCS)
Moving limbs?
PEARL?
Toxins? (Alcohol)

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18
Q

GCS?

A

Glasgow coma score
Eye opening response, verbal response and motor response
13-15 = minor brain injury
9-12 = moderate brain injury
3-8 = severe brain injury

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19
Q

PEARL

A

Pupils equal and reactive to light

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20
Q

Exposure assessments?

A

Rashes?
Injection/track marks?
Trauma to limbs or head?
External bleeding?
Abdominal examination

completely expose - front and back, top to bottom

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21
Q

Why is low systolic blood pressure so worrying?

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A

It can lead to circulatory shock (inadequate blood flow to tissues)
Give IV fluids to manage

22
Q

What is circulatory shock?

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A

When inadequate blood flow results in damage to body tissues

23
Q

Hypovolemic shock?

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A

Loss of plasma or blood volume

due to dehydration, blood loss, burns

24
Q

Cardiogenic shock?

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A

Heart cannot generate enough cardiac output so arteries do not have enough blood flow and tissues are not being perfused

myocardial infarction, serious cardiomyopathy

25
Obstructive shock?
Due to obstruction in circulation, usually indirect impact on the heart *pneumothorax, pulmonary embolism*
26
Distributive shock?
Most common form of shock Blood volume is being distributed elsewhere due to very profound vasodilation *septic, anaphylactic, neurogenic*
27
Percentage of each type of shock?
Distributive (septic) - 62% Cardiogenic - 16% Hypovolemic - 16% Distributive (nonseptic) - 4% Obstructive - 2%
28
Signs of tissue hypoperfusion?
Brain - altered mental state Skin - mottled, clammy Kidney - oliguria Tachycardia Elevated blood lactate
29
If cardiac output falls, which types of shock are considered?
Hypovolemic, Cardiogenic, obstructive
30
If cardiac output is high, which type of shock is considered?
Distributive
31
If cardiac output is low and venous pressure (CVP) is high, which types of shock are considered?
Cardiogenic, obstructive
32
If cardiac output is low and venous pressure (CVP) is low, which type of shock is considered?
Hypovolemic
33
Systemic inflammatory response syndrome (SIRS) criteria?
High or low temp High heart rate High respiratory rate High or low WBC count *2 or more needed *
34
Sepsis criteria?
SIRS criteria + infection
35
Severe sepsis criteria?
Sepsis + evidence of organ dysfunction, hypotension or hypoperfusion
36
Septic shock criteria?
Severe sepsis + hypotension despite adequate fluid resuscitation
37
Sepsis six?
1. Give O2 to keep stats above 94% 2. Take blood cultures 3. Give IV antibiotics 4. Give a fluid challenge 5. Measure lactate 6. Measure urine output *take 3 give 3*
38
Which biochemical tests are most indicative of sepsis?
CRP - inflammation during infection Lactate - high during tissue hypoperfusion WBC and neutrophils - indication of infection
39
Which organs have pain localised in the left iliac fossa?
Descending colon, sigmoid colon
40
Example condition that will present as pain in left iliac fossa?
Sigmoid diverticulitis
41
What are diverticula?
A pouch-like out-pouching that is in the colon region. When there is no pain, is called diverticulosis. When there is pain it is called diverticula disease. When it becomes infected and inflamed, it is called diverticulitis.
42
Left upper quadrant organs?
Left portion of liver Larger portion of stomach Pancreas Left kidney Spleen Portions of transverse and descending colon Parts of small intestine
43
Right upper quadrant organs?
Right portion of liver Gallbladder Right kidney Small portion of stomach Portion of ascending and transverse colon Parts of small intestine
44
Left lower quadrant organs?
Majority of small intestine Descending colon Sigmoid colon Left female reproductive organs Left ureter
45
Right lower quadrant organs?
Caecum Appendix Right female reproductive organs Right ureter
46
What is diverticulosis?
When the innermost layer of digestive tract pushes through weak spots in outermost layer of digestive tract
47
What causes diverticulosis?
Low fibre diets which leads to constipation and increased pressure in digestive tract
48
Symptoms of diverticulosis?
Bloating, abdominal cramps, constipation
49
How is diverticulosis diagnosed?
Sigmoidoscopy, CT scan or barium X-ray
50
Medications for diverticulosis?
Psyllium Methylcellulose Polycarbophil
51
Dietary changes for diverticulosis?
High fibre diet (20-35g recommended) More fruit, vegetables, grains
52
Diverticulosis complications?
Diverticulitis - inflammation of pouches Abscess/peritonitis - collection of pus Diverticular haemorrhage Colonic obstruction

CSI 1b (8 decks)

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