NRSV Study Guide for Mark 11:1-11

Peggers Super Summary: Medical Emergencies
Introduction:
Overview:
Assessment
Examination
Investigations
Core Medical Emergencies
o MI
o PE
o Asthma/COPD
o Shock
o Pulmonary Oedema
o Status Epilepticus
o DKA
Assessment:
1. Airway – chin lift + suction +/Secure with guadel
2. Breathing – oxygen + RR + Sats
3. Circulation – iv access + fluids + BP
+ HR + Fluid Balance
4. Disability – AVPU and Glucose
DEFGHI
Don’t Ever the Fucking Forget the
Glucose you Hopeless Idiot
5. Expose – Examine body abdomen,
legs
6. History – BG + HPC + Current
Management
Examination:
1. General
a. GCS/AVPU
b. Observations/Temperature
c. JACCO
2. CVS
a. BP
b. HR note is
regular/irregular/bounding/
thready
c. JVP
d. HS I+II+0 Added?
3. RS
a. RR + Sats
b. Cyanosis
c. Symmetrical chest expansion
d. Trachea Central
e. Resonant chest
f. BS +/- Added sounds
g. Peripheral Oedema
4. ABDO
a. Distension
b. Bruising
c. Soft and Non Tender
d. Organomegaly
e. BS
f. PR
5. NEURO
a. Tone
b. Weakness
c. Reflexes
d. Plantars
e. CN –
i. Facial Droop
ii. PEARL
iii. Eye movement
iv. Tongue movement
v. Facial touch + “Faces”
Investigations:
SIMPLE
Urine Dipstick + MSU/CSU
Sputum Sample
BMs
ECG
BLOODS
FBC/U&Es/CRP/LFTS/Bone/TNI
ABGs
Cultures
IMAGING
CXR
AXR
US
COMPLEX
CT
MRI
Peggers Super Summary: Medical Emergencies
Core Medical Emergencies:
MYOCARDIAL INFARCTION
Non-STEMI (GONAD HBC)
1. Go to Oxygen
2. Nitrates – GTN/ISMN/Succal
Buscard/Nitrate infusion
3. Aspirin
4. Diamorphine
5. Heparin 1mg/Kg BD
6. B Blocker
7. Clopidogrel
STEMI (GONADS)
1. Go to Oxygen
2. Nitrates – GTN/ISMN/Nitrate infusion
3. Aspirin
4. Diamorphine
5. Streptokinase
PULMONARY EMBOLISM
1. Oxygen
2. Morphine
3. Clexane 1.5mg/Kg OD
4. Fluids if BP<90systoli
5. Teds
ASTHMA/COPD
1. Oxygen (PEAK FLOW)
2. Salbutamol 5mg (back to back)
3. Ipratropium Bromide 500micrgQDS
4. Prednisolone 40mg OD 5 days or
hydrocortisone 100mg iv
5. Magnesium infusion
6. ITU
7. Aminophylline
SHOCK
1. Cardiogenic
Oxygen
Diamorphine
CAUSES –
MI/PE/Arrythmias
2. Septic
Oxygen
IV Colloids + Catheterise
Septic Screen
ABx
3. Hypovolaemic
Oxygen
IV Colloids/Blood
Catheterise
Find site of bleeding
Correct Clotting (Vit
k/FFP/Platelets)
4. Anaphylactic
?Airway Swelling
Oxygen
Adrenaline 0.5mg IM
IV Access
o Chlorphenamine
10mg iv
o Hydrocortisone
200mg iv
If Wheezy Mx as Asthmatic
FLASH PULMONARY OEDEMA
1. Oxygen
2. IV Frusemide 80mg
3. Diamorphine
4. GTN
5. CAUSES – MI/Fluid
Overload/Arrhythmias
STATUS EPILEPTICUS
1. Oxygen + Suction
2. Diazepam PR
3. Lorazepam IV
4. Phenytoin Infusion
5. Toxicology Screen
6. Thiamine given in alcoholics
7. Glucose to be given unless Glucose
known to be normal
DKA
1. Fluid Replacement
2. Insulin Sliding Scale
3. K Suplimentation
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