Emergencies in medicine

20 Emergencies in medicine



Chapter Contents


Definitions 703

Basic life support 704

Adult advanced life support 705

Acute anaphylaxis 706

Severe upper gastrointestinal bleeding 707

Fulminant hepatic failure 708

Febrile neutropenic patient 709

Hot swollen joint 710

Extreme hyponatraemia with a normal extracellular volume 711

Severe acute hyperkalaemia 711

Central chest pain — cardiac cause likely 712

Acute coronary syndrome —management of STEMI 713

Acute coronary syndrome and management in N-STEMI 714

Heimlich manoeuvre for treatment of inhaled foreign bodies 714

Pneumothorax 715

Acute massive pulmonary embolism 716

Acute severe asthma 717

Shock 718

Severe hypercalcaemia 719

Acute adrenal failure 720

Stroke 721

The comatose patient 722

This chapter consists of algorithms which should be used in conjunction with the appropriate chapters to enable emergencies to be dealt with quickly and effectively.


An assessment and initial resuscitation of the critically ill patient should be undertaken (ABCDE):


• Airway — remove any obstructing material and make sure airway is clear.

• Breathing — look, listen and feel for signs of breathing.

• Circulation — check carotid and peripheral pulses and start external chest compression if cardiac arrest.

• Disability — conscious level — Glasgow Coma Scale (see Table 17.1, p. 624).

• Examination/exposure — to allow a full examination to be carried out.

Recent evidence emphasises that maintaining the circulation is the key factor overall. The order of resuscitation should be CAB, i.e. Circulation, Airways, Breathing.



Definitions



• An emergency is something dangerous or serious, such as an accident which happens suddenly or unexpectedly and needs fast action in order to avoid harmful results.

• Urgent cases need attention very soon (Cambridge Advanced Learners Dictionary).


Basic Life Support



image

Fig. 20.1 Basic life support. (out of hospital).


With permission from Resuscitation Council UK http://www.resus.org.uk * Studies have shown that compression alone is as good as compression with rescue breaths. Compression should be at least 5 cm and performed at 100 compressions/min. The heel of one hand is placed over the centre of the chest, and the heel of the second hand is placed over the first, with the fingers interlocked.

Only gold members can continue reading. Log In or Register to continue

Related posts:

  1. Poisoning
  2. Environmental medicine
  3. Critical care
  4. Respiratory disease

Stay updated, free articles. Join our Telegram channel
Tags:
Apr 2, 2017 | Posted by in GENERAL SURGERY | Comments Off on Emergencies in medicine

Full access? Get Clinical Tree
Get Clinical Tree app for offline access