Bedside tests

Last Updated on April 16, 2019 by FRCEM IntermediateSome tests that can be done at the bed side ECG Urinalysis Blood Ketone (b-hydroxybutyrate) Analysis Blood Glucose monitoring Blood Gas analysis (PH, electrolytes, lactate ) Faecal Occult Blood Pregnancy tests Ultrasound – FAST/eFAST Drug Screening tests Temperature

Arterial Blood Gas Sample

Last Updated on April 20, 2019 by FRCEM IntermediateIndications Evaluate the adequacy of ventilation, acid–base status, and oxygenation. Evaluate the patient’s response to therapy and/or diagnostic evaluation (e.g. oxygen delivery). Monitor severity and progression of a known disease process. Test Before ABG The Allen test is a good and valid […]

Opioid toxicity

Last Updated on April 20, 2019 by FRCEM IntermediateClinical Features miosis CNS depression respiratory depression complications of hypoxia: seizures, dysrrhythmia, brain injury Investigations 12 lead ECG, BSL, Monitoring Respiratory Rate (RR) Oxygen Saturations (SpO2) Heart Rate (HR) Non-Invasive Blood Pressure (NIBP) Sedation Score (AVPU) should be documented with a minimum […]

Syncope

Last Updated on April 16, 2019 by FRCEM IntermediateCauses of Syncope   Neurally – mediated reflex syncopal syndromes – Vasovagal (emotional reactions) or Valsalva (micturition, cough, straining etc) Orthostatic – orthostatic drop of >20mm systolic blood pressure or >10 mm diastolic blood pressure volume depletion from dehydration or haemorrhage or […]

Tricyclic Antidepressant Toxicity

Last Updated on February 25, 2019 by FRCEM IntermediateOverview: TCAs are weak bases (pKa 8.5) that can cause life-threatening sodium channel toxicity Ingestion of 15 mg/kg tricyclic antidepressants would be expected to result in serious, potentially life-threatening Examinations CVS – dry mucous membranes, tachycardia, hypertension -> hypotension -> cardiovascular collapse […]

STD

Last Updated on February 25, 2019 by FRCEM IntermediateChlamydia infection Doxycycline 100 mg bd for 7 days OR azithromycin 1 g stat Gonorrhea – Neisseria gonorrhoeae Ceftriaxone 500 mg intramuscularly PLUS azithromycin 1 g orally Pelvic inflammatory disease oral ofloxacin 400 mg bd and metronidazole 400 mg bd for 14 […]

DKA – Adult

Last Updated on February 25, 2019 by FRCEM IntermediateTreatment: Use of normal saline (0.9% NaCl). The ABCD recommend 1L in the first hour, 2L in the next 2-4 hours and then 1L 4-6 hourly, with a reduced rate in those who are elderly or have cardiac disease. Once the blood […]