Osce Questions Flashcards
When giving glucose through IV in a hypo patient what is the initial dose?
10 grams of glucose
In the glucose fluid bag, what is the concentration?
50 grams in 500ml
What is the volume and dosage when giving glucose fluids?
100ml, 10 grams in 100ml
What is the max dose of the glucose fluids?
300 ml, 30 grams of glucose
What is the dose interval for the glucose fluids?
5 minutes
For less severe asthma attacks in adults what is the treatment options?
- Encourage patient to take puffs on their own inhaler
- if symptoms are not controlled by maximum inhaler use, then start nebulised salbutamol whilst transferring to ED
Can some patients with less severe asthma attacks be appropriate for alternative pathways?
Yes such as urgent care, asthma review (GP).
In a more severe asthma attack what actions can we take?
- Encourage patient to use own inhaler
- if no effect, use salbutamol through a nebuliser
- Try iprotropium bromide
What is the treatment for severe asthma
- Adminster high levels O2
- Administer nebulised salbutamol
- if no improvement administer ipratropium bromide
- Adminster steroids (hydrocortisone or prednisolone)
- Continuous salbutamol nébulisation may be administered unless clinically significant side effects occur
What is the treatment for life threatening asthma?
+ Give early consideration and low threshold to activate enhanced care support
+ Continuous salbutamol nebulisers
+ if no improvement administer ipratropium bromide
+ If there’s no improvement administer a single dose of IV magnesium (don’t think we carry)
+ if pt continues to deteriorate Adminster 1 in 1000 adrenaline
+ Adminster steroids (hydrocortisone)
+ assess for bilateral tension pneumothorax
+ Pre alert
What is the care bundle for a STEMI?
Aspirin
GTN
Analgesia (morphine + entonox)
Two pain scores (before and after treatment)
Pre alert PPCI
What are the treatments we can give for COPD?
- Bronchodilators like salbutamol and ipratropium bromide and limit oxygen driver to 6 litres for 6 minutes
- Steroids such as hydrocortisone or prednisolone
- Oxygen but be cautious of hypoxic drive
- consider non invasive ventilations if not responding to treatment
Define hypoxic drive
The primary drive to breathe shifts from carbon dioxide levels to low oxygen levels. This means the body relies more on oxygen receptors to regulate breathing instead of the usual carbon dioxide receptors.
What does hydrocortisone do (steroid)
Reduces inflammation, pain, and swelling by calming down the body’s immune response.
What are differentials to croup
Epiglottitis
What is the management of meningitis
Benpen - drug for suspected meningitis and/ or with the presence of a rash
Look at the rash
Urgent transfer
Contact hospital as notifiable disease
Contact DC?
What are the symptoms for meningitis
Neck stiffness
Headache
Rash - late sign
Other tests - pain during
