1. Paraldhyde resp depression?
    time to act? duration?
    • no resp depres
    • 10-15 min to act
    • lasts 2-4 hrs
  2. Phenytoin, dose, rate of infusion, measure phenytolin levels when. possible side effects, should moniter what? use if already on oral phytoin? peak action? 
    20mg/kg, 1mg/kg/hr, 60-90 min post infusion, hypotension and dysrhythmias, moniter ECG and BP. no resp effect, not if on oral eqivilent, peak action within 1 hr
  3. Thiopentone dose, role? is it an antiepileptic med?
     = 4-8mg/kg, general anesthetic, no antiepiletic properties
  4. What should be on your respiratory checklist for stablization
    ETT, humidification, ventilation parameters, CXR, A/VBG
  5. What should be on your Cardiovascular checklist for stablization
    Circulatory status, hepatic size, use of inotropes, ECG, CXR
  6. What should be on your neurological checklist for stablization
    GCS, Pupils, Use of sedation, Analgesia and paralysis, imaging, neuroprotection for raise ICP
  7. What should be on your Gastrological checklist for stablization
    Nutrition, gastro-protection, ileus/gastric decompression with NG/OG
  8. What should be on your Renal/fluids checklist for stablization
    urine output, fluid balance, U&C, need for renal support
  9. What should be on your hepatic checklist for stablization
  10. What should be on your biochem checklist for stablization
    electrolytes, Bm, Ca2+, Mg 2+
  11. What should be on your Haematology checklist for stablization
    Hb, Clotting, blood group
  12. What should be on your infection checklist for stablization
    temp, wcc, cultures, crp, specific pcr, abx in use/used
  13. What should be on your skin+joint checklist for stablization
    Skin, mouth  + eye care, rashes, passive movements
  14. What should be on your Drugs checklist for stablization
    All current IV and enteral meds + allergies + drug levels
  15. What should be on your Lines and tubes checklist for stablization
    • access for monitering
    • bloods sampling and IV drugs
    • Security of catheter and drains
  16. What should be on your family checklist for stablization
    communication, concerns, support
  17. how long does it take to get oneg blood, ABO typed blood, Full crossmatched
    • o - 0min
    • abo - 10-15min
    • full 45-60
  18. before placement of hard collar it is good practice to inspect and assess the following in the soon to be obscured neck region
    Distended veins, tracheal deviation, wounds, crepitus - indicating laryngeal fracture, subcutaneous emphysema
  19. Reasons a child is at higher risk of injury
    • More horizontal diaphram causing the liver and spleen to lie lower and more anteriorly
    • Less rib protection
    • Thinner abdominal wall
    • Bladder position abdominal rather than pelvic and therefore more exsposed when full
  20. managment of haemoperitoneum
    • conservative
    • haemorrhage is often self limiting
    • there is more chance of preserving the spleen
    • the mortality and morbidity is are generaly lower
  21. head injury is either primary or secondary, describe both and what can be done about them
    • primary ie at the time diffuse or focal nothing to be done
    • secondary is as a result of another body system, so need to stabilise respiratory or circulatory system.
  22. Pathopysiology of drowning
    • subermsion
    • vlountry apnoea
    • acidosis adn hypoxia
    • involuntary breath
    • layngeal spasm
    • involuntry aspiration
  23. affect of temperatures on heart rythem
    arrythmias are more common, at temps below 30 C VF may be refractory to dc cardioversion.
  24. as part of assessment of a drowning patient
    a full trauma assessment must be completed
  25. ix in drowning
    • bllod gas
    • blood glucose
    • UEC
    • coags
    • blood + sputum culture
    • cxr
    • cspine
  26. Vicitms are leikely to have a poorer outcome if they
    • have spent more than 10 min below water
    • takes more than 10 min to give them basic life support
    • their core body temp has fallen below 33 c
    • they have a GCS less than 5
    • they are younger than 3
    • they have persisitent apnoea or need prolonged CPR
    • pH is less then 7.1
    • the water in which they were immersed was warmer than 10 deg
Card Set
low importance APLS