-
Paraldhyde resp depression?
time to act? duration?
- no resp depres
- 10-15 min to act
- lasts 2-4 hrs
-
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
-
Thiopentone dose, role? is it an antiepileptic med?
= 4-8mg/kg, general anesthetic, no antiepiletic properties
-
What should be on your respiratory checklist for stablization
ETT, humidification, ventilation parameters, CXR, A/VBG
-
What should be on your Cardiovascular checklist for stablization
Circulatory status, hepatic size, use of inotropes, ECG, CXR
-
What should be on your neurological checklist for stablization
GCS, Pupils, Use of sedation, Analgesia and paralysis, imaging, neuroprotection for raise ICP
-
What should be on your Gastrological checklist for stablization
Nutrition, gastro-protection, ileus/gastric decompression with NG/OG
-
What should be on your Renal/fluids checklist for stablization
urine output, fluid balance, U&C, need for renal support
-
What should be on your hepatic checklist for stablization
LFTs
-
What should be on your biochem checklist for stablization
electrolytes, Bm, Ca2+, Mg 2+
-
What should be on your Haematology checklist for stablization
Hb, Clotting, blood group
-
What should be on your infection checklist for stablization
temp, wcc, cultures, crp, specific pcr, abx in use/used
-
What should be on your skin+joint checklist for stablization
Skin, mouth + eye care, rashes, passive movements
-
What should be on your Drugs checklist for stablization
All current IV and enteral meds + allergies + drug levels
-
What should be on your Lines and tubes checklist for stablization
- access for monitering
- bloods sampling and IV drugs
- Security of catheter and drains
-
What should be on your family checklist for stablization
communication, concerns, support
-
how long does it take to get oneg blood, ABO typed blood, Full crossmatched
- o - 0min
- abo - 10-15min
- full 45-60
-
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
-
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
-
managment of haemoperitoneum
why
- conservative
- haemorrhage is often self limiting
- there is more chance of preserving the spleen
- the mortality and morbidity is are generaly lower
-
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.
-
Pathopysiology of drowning
- subermsion
- vlountry apnoea
- acidosis adn hypoxia
- involuntary breath
- layngeal spasm
- involuntry aspiration
-
affect of temperatures on heart rythem
arrythmias are more common, at temps below 30 C VF may be refractory to dc cardioversion.
-
as part of assessment of a drowning patient
a full trauma assessment must be completed
-
ix in drowning
- bllod gas
- blood glucose
- UEC
- coags
- blood + sputum culture
- cxr
- cspine
-
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
|
|
