Emergency Medicine

16 Critical Care Emergencies SHOCKED PATIENT end in cardiac arrest with pulseless electrical activity. Once shock deteriorates t ...

Critical Care Emergencies 17 SHOCKED PATIENT (i) Hypovolaemic shock (‘insufficient circulatory volume’) (see p. 19): (a) haemorr ...

18 Critical Care Emergencies SHOCKED PATIENT (ii) Look at the skin for sweating, pallor or mottling and feel if it is cold or cl ...

Critical Care Emergencies 19 SHOCKED PATIENT (a) omit fluids if JVP is already raised, and or the patient has pulmonary oedema ( ...

20 Critical Care Emergencies SHOCKED PATIENT (ii) Internal: (a) pancreatitis ‘third spacing’, bowel obstruction. 4 Ask about ext ...

Critical Care Emergencies 21 SHOCKED PATIENT (a) remember that in healthy adults the only signs associated with loss of up to 30 ...

22 Critical Care Emergencies SHOCKED PATIENT (iii) Severe sepsis Sepsis plus either organ dysfunction, or with evidence of hypot ...

Critical Care Emergencies 23 SHOCKED PATIENT MANAGEMENT 1 Commence high-dose oxygen via a face mask. Maintain the oxygen satura- ...

24 Critical Care Emergencies Unconscious Patient The aim is to resuscitate the patient and treat urgent precipitating conditions ...

Critical Care Emergencies 25 UNCONSCIOUS PATIENT (ii) Remove all the clothing, but keep the patient covered and avoid heat loss. ...

26 Critical Care Emergencies UNCONSCIOUS PATIENT (b) watch out for deterioration in the level of consciousness, ultimately with ...

Critical Care Emergencies 27 Anaphylaxis 6 These four lists may seem daunting, but aim to build up a picture of the events as fo ...

28 Critical Care Emergencies ANAPHYLAXIS 2 Respiratory manifestations: (i) Dyspnoea, laryngeal oedema, hoarseness and stridor. ( ...

Critical Care Emergencies 29 Severe Head Injury (ii) Lie the patient flat and or elevate the legs. (iii) Give a bolus of normal ...

30 Critical Care Emergencies SEVERE HEAD INJURY Table 1.1 The Glasgow Coma Scale (GCS) score Score Eye opening Spontaneously 4 T ...

Critical Care Emergencies 31 SEVERE HEAD INJURY (iii) Eye movements and fundoscopy: (a) intact eye movements are one indicator o ...

32 Critical Care Emergencies SEVERE HEAD INJURY MANAGEMENT 1 Clear the airway by sucking out any secretions, remove loose or bro ...

Critical Care Emergencies 33 SEVERE HEAD INJURY (ii) Hypoxia (a) PaO 2 <70 mmHg (9 kPa) breathing air or 100 mmHg (13 kPa) on ...

34 Critical Care Emergencies CRITICAL-CARE AREAS DRUG INFUSION GUIDELINES 11 Criteria for neurosurgical consultation: Refer all ...

Critical Care Emergencies 35 Drug Loading dose Paediatric infusion Dilution Adult dose (70–80 kg) range (< 30 kg) Infusion pu ...