management Flashcards
status epilepticus
check BM and toxicology
open and secure airway 2222
lorazepam IV, buccal midazolam, PR diazepam
after 5 mins and then can repeat after 10 mins
ICU review and phenytoin infusion
treat cause eg alcohol, overdose, pregnancy
head injury
immobolise c spine.
check for csf leak > tetanus toxin and neurosurgeons
NICE guidelines for CT head criteria
addisonian crisis
Hydrocortisone IV
fluids
correct any U&E imbalance
long term steroid regimen
phaeochromocytoma
ICU
alpha blockade IV
once bp controlled > long acting alpha blockade anf can add beta1 blocker
elective surgery 4-6 weeks later
acute asthma attack
warn ICU if severe or life threatening
PEFR
Salbutamol nebs 5mg and high flow o2
ipratropium bromide nebs
IV magnesium sulphate
not responding > ICU, intubation, IV aminophyllline
give pred 40mg 7 days, gp follow up, check inhaler technique, 4 week resp follow up
sepsis
blood cultures
o2
VBG for lactate
catheter
broad spec ABX
IV fluids
PE
wells score, CTPA, D-Dimer
o2, morphine
DOAC (rivaroxiban)
VTE 3 months
massive PE
iv unfractionated heparin and thrombolysis (alteplase)
VTE 3-6 months
Acute COPD exacerbation
Sputum
Nebulised salbutamol, neb ipratropium bromide
o2 15L unless known co2 retainer > venturi 24-28% aim for 88-92% sats
IV hydrocortisone, abx trust guidelines,
ITU, IV aminopphylline
oral pred 40mg 7 days
acute HF
Troponin, BNP
15L o2
morphine
GTN
Furosemide
acute coronary syndrome
morphine, metoclopramide, o2, aspirin, clopidogrel
STEMI
NSTEMI
STEMI
ACS treatment plus
<12 hour symptoms and can have PCI<2 hours - PCI
<12hour symptoms cannot make PCI in 2 hours - Thrombolysis with PCI after if necessary
>12 hours since symptoms started angiography and possible PCI
NSTEMI
ACS treatment plus
Fondaparinux
Discharge MI drugs
aspirin, clopidogrel, ACEi, Statin, Beta blocker
pneumothorax
primary
<2cm discharge and review in OPD
>2cm or breathless aspirate then consider discharge and review in outpatients if not sucessful then chest drain and admit
secondary
<1cm admit high flow o2 observe 24hr
1-2cm aspirate sucess - admit high flow o2 and observe 24hr not sucess then chest drain and admit
>2cm chest drain and admit
if bilateral chest drain