Resus Flashcards
(24 cards)
Airway checklist
SSAAMM
S:suction
S: situated (pt positioning)
A: airway
A: adjuncts -> bougie, LMA
M: meds -> induction, pressors, infusions for post
M: monitors: cardiopulmonary and etco2
When not to do classic rsi?
When patient will have decreased safe apnoea time or needs to maintain high maintenance ventilation. Need to bag or ventilate via other means e.g. BiPAP or OptiFlow while waiting for paralytic to set in.
Number one risk factor for sudden cardiac death?
Severe LV dysfunction
RF for sudden cardiac death?
Brugada pattern?
Down slopping ST elevation in V1-3
2 ECG findings in benign early repolarization
-Notch-like J wave on qrs downslope
Flowed by upsloping st segment elevation
Also needs in younger/athletic pts, esp males
Conditions that cause PEA
Etiologies of shock, causes of same
Receptors, dose, of
Norepinephrine
Epinephrine
Phenylephrine
Vasopressin
Dobutamine
Isoproterenol
Type of shock to consider when failing to respond to pressors. What med to give empirically
Addison’s crisis. Give Hydrocortisone 100 mg IV
Why can bradycardia occur in abdo hemorrhage?
Increased vagal tone in response to hemoperitoneum (can happen 30% (?) of the time)
What is a damage control resus in hemm shock?
2g txa over 20 mins
MHP for blood
What is abc score for MHP?
2 or more points means likely to need MHP. Sp = about 70, sens 80-90%. Stands for assessment of blood consumption
Complications of MHP?
Hypocalemica! Citrate in blood prods binds calcium
Hypothermia
Hyperkalemia
What is the calcium target in MHP?
Above 0.9, use calcium chloride (preferred) but gluconate works too
What are two units of blood based definitions of MHP
More than 10 units in 24 hrs
4 units in 4 hours with ongoing bleeding
Anaphylaxis diagnostic criteria
Anaphylaxis standard cocktail for adults
Epi 0.5 mg IM q5min prn
Assess airway and intervene prn
IVF for hypotension
Dexamethasone 10 mg po/IV
Cetirizine 10mg po
Famotidine 20 mg
Ventolin for brochospasm
Anaphylaxis observation time
4-6 hours after last dose of epi
Dose of pediatric epi in anaphylaxis
0.01 mg/kg (max 0.5 mg)
Anaphylaxis rescue therapy? When to do it?
IV epi infusion, consider when given 3 doses of IM epi or when pt has significant hypotension/impending CV collapse
When do symptoms occur after exposure in anaphylaxis
Often immediately, almost always in the first 60 mins
When to give IV glucagon in anaphylaxis and why
If hypertension refractory after epinephrin and fluids, beta blockers are a risk factor for severe prolonged anaphylaxis.
Antihistamine in anaphylaxis
Everyone should get H1 (cetirizine), in severe cases or bad pruritis, also give an H2
