Medication
What is ondansetron used to treat?
Nausea and vomiting
What is the role of the circulation nurse in the resus room?
Monitoring, IV access, medication preparation and administration, defibrillation, assists with arterial line/CVC insertion.
What should we check prior to commencing IV potassium replacement?
Check the serum potassium level - doctors make mistakes! Get into the habit of checking bloods prior to replacement.
What acronym is used to help nursing staff perform an initial patient assessment? What does it stand for?
Signs and symptoms
Allergies
Medications
Past medical history
Last oral intake
Events leading up to incident/injury
What are the 5 moments of hand hygiene?
Before touching a patient
Before a procedure
After a procedure or body fluid exposure risk
After touching a patient
After touching a patients surroundings
What medication is given for severe hypoglycaemia when the patient is unable to swallow and does not have IV access?
IM glucagon
What is the name of the piece of equipment that sits on top of the circulation trolley in the resus room?
Defibrillator
How many electrodes are used to obtain a 12-lead ECG?
10 leads! It is called a "12-lead" ECG because it shows us 12 different electrical views of the heart.
What is the assessment tool used in the ED to help identify a stroke (CVA)?
Recognition of Stroke in the Emergency Room (ROSIER)
What PPE are you required to wear when entering a droplet precaution cubicle?
Surgical mask, eye protection, gown and gloves.
Complete this paediatric medication calculation...
A child weighing 12kg is prescribed paracetamol liquid 15mg/kg PO.
Available stock concentration is 240mg/5mL.
1. What is the dose in milligrams?
2. What volume is to be administered?
1. 15mg x 12kg = 180mg
2. 180mg ÷ 240mg x 5mL = 3.75mL
When is the acronym COACHED used, and what does it stand for?
It is used during a cardiac arrest during a pulse check.
Compressions continue
Oxygen away
All others clear
Charging...
Hands off!
Evaluate rhythm
Deliver shock / dump charge
Name three indications for indwelling catheter insertion in the ED.
- Urinary retention
- Fractured neck-of-femur
- Fluid balance monitoring
- Bladder washout / irrigation
What may a wheeze indicate when auscultating a patients lungs?
Narrowing or tightening of the airways. Usually heard in exacerbation of asthma/COPD.
What number do you dial to call a CRT?
#870
What changes would you expect to see following IV furosemide administration?
Increased urine output
Improvement to shortness of breath and lung sounds.
What is the name of the two shockable rhythms?
Ventricular Tachycardia (VT)
Ventricular Fibrillation (VF)
What injury may require a collar & cuff?
Clavicular and humerus fracture.
You are caring for a patient with acute appendicitis. They are currently fasting for emergency theatre.
PMHx: HTN, T2DM, hypercholestrolemia. Meds: Perindopril, metformin and atorvastatin.
You last saw them 1-hour ago and their vital signs were stable.
You attend their bedside and they appear diaphoretic and difficult to rouse. What do you do next?
1. Call a CRT (difficult to rouse = sedation score 3!)
2. Check a full set of vital signs including a BGL - these are symptoms of hypoglycaemia!
A patient is placed under a legal order because there are concerns about their welfare and safety. What is the name of this order?
Section 56
Why is aspirin administered to a patient experiencing a myocardial infarction (MI)?
BONUS 50 POINTS: How is aspirin administered during an MI?
Antiplatelet action - it stops the clot from growing any larger.
BONUS - it is either chewed or dissolved in water.
Name three of the Hs and Ts of cardiac arrest.
BONUS 50 POINTS: What do these tell us?
Hypovolemia
Hypoxia
Hypothermia
Hypo/Hyperkalaemia
Tension pneumothorax
Tamponade
Toxins
Thrombosis
BONUS: These are the eight reversible causes of cardiac arrest.
What is Cushing's triad used to assess?
BONUS 50 POINTS: Name the three criteria.
Raised intracranial pressure
BONUS: widening pulse pressure, bradycardia, irregular respirations
What would you do if these were your patients vital signs (two answers!):
RR 26, SPO2 95% on RA, HR 126 in sinus rhythm, BP 92/52 manually, T 36.6, SS 0, GCS 15, pain score 5/10 to lower leg cellulitis
BONUS 50 POINTS if you get both answers correct!
Call a CRT - the patient has x3 vital signs in the RED zone which meets CRT criteria!
Activate a CODE SEPSIS - the patient meets qSOFA criteria (tachypnoea, hypotension and source of infection).
What does APINCH stand for, and what is it used for?
BONUS 50 POINTS: Name one medication for letter A or P (not including potassium)
BONUS: It is used to identify high-risk medications