ABCDE
ABCDE stands for?
Airway Breathing Circulation Disability Exposure
Trauma primary survey is done in how much time?
Within 5 minutes
Normal respiratory rate in adults
10-20 breaths/minute
3 classical signs of shock
CRT > 3s,
Fast and weak pulse,
Cold and clammy extremites
AVPU stands for
Alert, Verbal response, Pain response, Unresponsive
First and best way to know if someone's airway is open
Maneuver used to open airway in trauma
Jaw thrust
2 scenarios when oxygen must be given in ABCDE assessment
1) Respiratory rate above 20
2) Respiratory rate below 10 (with assisted respiration)
3) Signs of respiratory distress
Treatment of hypovolemic shock
2 large bore cannulas, IV fluids (3 L stat in adults, 20ml/kg in children; given over 30 minutes)
3 things to assess for in disability (ABCDE approach)
Level of consciousness, Pupils, Glucose levels
One sign of acute asthmatic attack
Wheezing
Difficulty in breathing
Increased respiratory rate
Increased breathing effort
HEENT in trauma secondary survey stands for
Head, Ears, Eyes, Nose, Throat
In organophosphate poisoning, the airway may be compromised with secretions affecting breathing. Which drug is used to reduce the secretions from the airway, and what dose to give (adults and children)
Atropine (4mg in adults - may be repeated, 0.1mg/kg in children)
A 20-year-old woman presents with shock, abdominal pain, missed menstrual cycle and vaginal bleeding
What is the likely cause, and the immediate care?
Ectopic pregnancy (ruptured);
2 large bore cannulas, IV fluids (3L stat), escalate care to theater for Ex-lap
A pregnant woman (7 months gestation) starts convulsing in the antenatal queue. What is the drug to give and its dose.
Loading dose (IV + IM): * 4 g IV (dilute to a 20% solution and give 20 ml slowly over 20 minutes)
AND *10 g IM (intramuscular): 5 g (10 ml of 50% solution) with 1 ml of 2% lidocaine in upper outer quadrant of each buttock. Magnesium can cause low blood pressure; monitor carefully. IF unable to give IV, give 10 g IM injection only (as above, 5 g in each buttock).
If seizures/convulsions recur: after 15 minutes give an additional 2 g (10 ml of 20%) IV over 20 minutes. If transport delayed, continue treatment: Give 5 g of 50% solution IM with 1 ml of 2% lidocaine every four hours in alternate buttocks.
Most important step concerning management of a patient who has been found in a burning house and has burnt nostril hairs
Escalation of care/ Handover to a facility where advanced airway interventions can be done
In trauma, most bleeding may come from (mention 3 areas)
Pelvis, Femur fracture, abdominal
Drug used for opioid poisoning, its dose and what to consider while giving it
Naloxone; 100mcg; patient must be reassessed after one hour to see if more is needed because naloxone wears off after one hour, and the opioid effect may be prolonged
Formula for estimating weight in children to calculate fluids (age one year to 5 years)
2*(age + 4)
Burns can cause dehydration with signs of AMS. What is the formula used to calculate the fluids to give in burn patients
4 ml fluid X weight in kilograms X total burn surface area.
Half should be given over the first 8 hours, and half over the next 16 hours.
Pediatric consideration in ABCDE approach
short neck, large head, detoriorate quickly
Logroll maneuver should be done when suspecting... and must be done with at least how many people... positioned at what part of the victim's body?
Spinal injury,
3 people: one on the head, another on the shoulders, and the third around the waist.
Normal respiratory rate in children
Less than 2 months - 40 to 60 breaths/minute;
2 months to 12 months - 25 t0 50 breaths/minute
1 year to 5 years - 20 to 40 breaths/minute
25-year-old female, P3+0 has just delivered a live baby boy by SVD. You are called that the mother is bleeding per vaginal and has fallen down because she was dizzy. As you come, what will you tell the husband to be doing?
Uterine massage
3 things to consider when taking care of a very violent patient
Protect the patient from harming self or others.
Ensure that staff have a clear exit path (do not place the patient between staff and the door).
Remove potential weapons and unsafe objects.
Call for help from colleagues, family members, and security if needed.
Speak in a calm, soft, non-threatening tone. Explain what is happening at each stage of care. Do not confront or judge.
Consider other causes: check glucose and vital signs including temperature and oxygen saturation. Treat abnormalities. Arrange for safe handover/transport to advanced provider.