1. 40% CV (>2000) = unconscious

Emergency Care Flashcards by Charlotte cleasby

causes of normal anion gap metabolic acidosis

diarrhoea
RTA
Addisons

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causes of shock due to low CO

CO = HR x SV
1. Hypovolaemia
2. Pump failure

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causes of shock due to low SVR

MAP = CO x SVR
1. Sepsis
2. Anaphylaxis
3. Neurogenic
4. Endocrine failure

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classes of shock

<15% circulating volume (<750ml) = compensated
15-30% CV (750-1500ml) = tachycardic
30-40% CV (1500-2000) = hypotensive
> 40% CV (>2000) = unconscious

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when can you discharge in anaphylaxis?

don’t discharge for 6-12 hours
biphasic response

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Canadian C-spine rules vs NEXUS rules

Canadian: do they need immobilisation
Nexus: need to meet to clear a C spine

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resus of a significant haemorrhage

1:1:1 (plasma, platelets, packed RBCs)

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what is included in secondary survey?

AMPLE
exam
other test
= minimise risk of missed injuries

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what is tertiary survey?

24 hours later
detects changes

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causes of coma

Metabolic: drugs, hypoxia, hypothermia, sepsis, hypoglycaemia, myxoedema
Neurological: trauma, infection, tumour, vascular, epilepsy

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pupils:
normal direct and consensual reflexes

intact midbrain

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pupils:
midposition (3-5mm), non reactive and irregular

midbrain lesion

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pupils:
unilateral fixed and dilated

3rd nerve compression

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pupils:
small and reactive

pontine

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V1-V4 territory and supply

anteroseptal
LAD

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II, III, aVF territory and supply

inferior
RC

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V4-6, I, aVL territory and supply

anterolateral
LAD or LC

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I, aVL, V5-V6 territory and supply

Lateral
LC

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Tall R waves V1-V2 territory and supply

Posterior
LC or RC

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treatment of heart block post-MI

Inferior = atropine
Anterior = pacemaker

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differentials for acute rupture (3-5 days) post MI

papillary muscle or ventricular septal

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differentials for rupture 5 days to 2 weeks post MI

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LVFW rupture

symptoms of LVFW aneurysm

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SOB
persistent ST elevation
no chest pain
LVF

management of LVFW aneurysm

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anticoagulant

when to avoid fondaprinoux and give what instead?

if PCI is possible (only used for fibrinolysis) if PCI, give LMWH

causes of cardiogenic shock

MI arrythmias tamponade PE myocarditis

investigations in cardiogenic shock

ECG ABG CXR Echo U&Es Trop BNP UO Swans Gantz catheter

management of cardiogenic shock

ensure fluid filled dobutamine

ALTS, when to give adrenaline and amiodarone?

- adrenaline every 3-5 mins (10mL, 1 in 10,000 IV) - amiodarone after 3 shocks

causes of bradycardia

physiological cardiac: post MI, sick sinus non-cardiac: vasovagal, hypothermia drug-induced

management of bradycardia

atropine transcutaenous pacing

COPD exacerbation immediate management

24% oxygen nebs steroids

indications for NIV (BiPAP)

- COPD with resp acidosis - T2RF secondary to chest wall deformity, NM disease, OSA - cardiogenic pulmonary oedema - weaning from tracheal intubation

treatment of PE in someone who is hemodynamically unstable

thrombolysis (heparin and alteplase)

what measurement is used to classify ARDS?

dec arterial PaO2/FiO2 ratio

mild, moderate and severe ARDS

mild : 201-300mmHg moderate: 101-200 severe: <100

management of ARDS

- central venous access = ionotropes - IV = broad spectrum Abx, diuretics - 60-100% oxygen non-shocked = sit upright shocked = colloid infusion

variceal bleed management

- terlipressin, Abx - gastric varices: endoscopic injection, TIPS - oesophageal varices: endoscopic band ligation, Sengstaken-Blakemore

non-variceal bleed management

endoscopic - mechanical clips and adrenaline - thermal coagulation, adrenaline

indications for immediate CT spine (<1 hour)

GCS < 13 on initial assessment Patient intubated Ruling out needed (e.g. for surgery) Clinical suspicion and age >65yo, focal neuro deficit, high impact injury, paraesthesia in limbs

spinal cord compression above L1

UMN signs and sensory level

spinal cord compression below L1

LMN signs and peripheral numbness

DKA complications

VTE prophylaxis cerebral oedema aspiration pneumonia

measuring amount of burns

Lund and Browder rule

causes of distributive shock

sepsis anaphylaxis neurogenic

first drugs for STEMI

aspirin 300mg and Clopi 300mg (DAPT continued for 1 year)

NSTEMI important drug

add fondaprinux

what drug to avoid in hypotension?

nitrates

management of Raised ICP

neuroprotective ventilation mannitol/hypertonic saline

features of severe asthma

RR > 25 HR >110 can't complete sentences

how frequent is monitoring in severe attack?

monitor PEFR every 15-30 mins

important formulas in Burns

Lund and Browder Charts to assess amount of burn Parkland formula to guide replacement (4 x wt x %burn = mL of Hartman's in 24 hrs)

how frequently do you give adrenaline and amiodarone in VF/pulseless VT?

adrenaline and amiodarone after 3rd shock repeat adrenaline every cycle

how often to give adrenaline in PEA/asystole?

adrenaline 1mg as soon as IV access obtained repeat adrenaline every other cycle

Emergency Care Flashcards

(54 cards)