Medical Emergencies Revision Flashcards Preview

CMS: Oncology, Palliative Care, Medical Emergencies, Anaesthesia and Autoimmunity > Medical Emergencies Revision > Flashcards

Flashcards in Medical Emergencies Revision Deck (10)
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1
Q

List the contents of the emergency drug box:

A
  • glyceryl trinitrate (GTN) spray (400mcg/dose)
  • salbutamol aerosol inhaler (100mcg/actuation)
  • adrenaline injection (1:1000, 1mg/ml)
  • aspirin dispersible (300mg)
  • glucagon injection (1mg)
  • oral glucose solution/gel/tablets/powder
  • midazolam (10mg/ml) - buccal or intranasal
  • oxygen
2
Q

Hows best to prepare for medical emergencies?

A
  • take full medical history
  • once identified potential risk, ask more in-depth questions
  • checking if pt has emergency medication with them, leave it close to their hand
  • be familiar with location of emergency drug box and resus trolley
  • modify or delay treatment if required
3
Q

What defines acute severe asthma?

How should this be treated?

A

Acute severe asthma: any one of -

  • PEFR 33-50% of best or predicted
  • respiratory ate >24
  • HR > 110bpm
  • inability to complete sentences in 1 breath

Treatment:

  • salbutamol inhaler - 2-10 puffs per 10-20 mins then reassess
  • use a spacer is possible
  • oxygen
  • 999
4
Q

Define life threatening asthma:

How is this treated?

A

Life threatening asthma: severe asthma as well as one of the following:

  • PEF <33%
  • SpO2 <92% –> hypoxic
  • Normal PaCO2
  • silent chest
  • cyanosis
  • poor respiratory effort
  • arrhythmias
  • exhaustion/ deteriorating GCS

Treatment: get pt to hospital immediately, in meantime treat as for acute severe asthma

5
Q

Symptoms of anaphylaxis:

Treatment:

A

Anaphylaxis: sudden onset and rapid progression

  • life threatening problem to airway/breathing/circulation
  • skin changes
  • +/- exposure to known allergen

Treatment:

  • 999
  • oxygen
  • IM adrenaline 500mcg, repeat every 5 mins if required
6
Q

Signs of epilepsy:

Treatment:

A

Epilepsy: sudden onset, may not get aura

  • life threatening problem to airway and cerebral damage
  • maintain ABCDE approach post ictal

Treatment:

  • 999 if needed
  • oxygen, airway control
  • after 5 mins, administer midazolam 10mg/ml (buccal or intranasal)
7
Q

Signs of cardiac pain?

Treatment?

A

Cardiac pain:

  • collapse often without any warning
  • faintness, dizziness, nausea/vomiting
  • breathlessness and blueness (cyanosis)
  • have a sense of impending doom
  • pale, cold and clammy skin
  • a rapid, weak irregular pulse

Treatment:

  • 999
  • oxygen
  • GTN spray - 2 puffs sublingually, repeat after 5 mins
  • aspirin 300 mcg - chew and swirl around mouth (may be allergic!)
  • reassure and keep calm
  • sit in W position
8
Q

How to treat hypoglycaemia?

A

Hypoglycaemia - 4 = floor

  • sugary drinks
  • glucose gel - 2 tubes
  • glucagon 1mg IM –> hospital
  • seek medical advice

replenish sugar levels when blood glucose normalised

9
Q

List signs of syncope:

Treatment?

A

Syncope: inadequate cerebral perfusion results in loss of consciousness with low BP caused by vagal overactivity

  • dizzy, faint, light-headed
  • slow pulse rate
  • low BP
  • pallor and sweating
  • nausea and vomiting
  • loss of consciousness

Treatment:

  • ABCDE
  • lay pt flat as soon as possible and raise legs to improve venous return
  • loosen any tight clothing, oxygen 15L/min, raise legs
  • always check signs of life –> CPR if unresponsive
10
Q

What may cause adrenal insufficiency?

How should you treat this?

A

Adrenal insufficiency:

  • may follow long term administration of oral corticosteroids and can persist for years after stopping therapy
  • if a pt collapses during dental treatment other cuases should be explored and managed before diagnosis adrenal insufficiency

Treat as for shock!