p.17
Primary Survey (ABCDEFG)
What are the signs of shock evident in Marge?
Tachycardia and hypotension.
p.7
Triage and Assessment Questions
What is the triage category for a patient who has suddenly collapsed with no pulse and no spontaneous respirations?
Triage category 1 (Resuscitation)
p.7
Triage and Assessment Questions
What is the triage category for a patient who has cut his forearm, cannot bend or feel most of his fingers, and has a heavily blood-stained bandage wrapped around his arm?
Triage category 3 (Urgent)
p.34
Disturbances of Function and Form
What is the cause of intracranial (extradural) haemorrhage?
Typically a cranial fracture which cuts an artery or blood vessel bursts spontaneously.
p.22
Assessment of LOC in different age groups
What is the age and gender of the patient in ECG 2?
Elderly female with palpitations.
p.22
Disturbances of Pulse (Tachy-Arrhythmias/Brady-Arrhythmias)
What is the ECG finding in ECG 1?
Sinus rhythm with normal P-wave and QRS complex.
p.9
Cardiovascular Emergencies & Shock
What are the disturbances of BP that constitute a cardiovascular emergency?
Shock, Hypertensive Crisis.
p.24
Disturbances of Function and Form
What is the pathogenesis of myocardial infarction?
Atherosclerosis (& Thrombosis).
p.33
Assessment of LOC in different age groups
What is a contusion in the context of head trauma?
It involves bruising, swelling, and bleeding of the brain following trauma, often leading to some damage and decreased memory and concentration.
p.33
Glasgow Coma Scale (GCS)
What is diffuse axonal injury (DAI)?
It is a high-energy injury where the grey matter of whole areas of the brain have been sheared right off, leading to non-functional brain by day 3 and a GCS of 3, often resulting in brain damage and potential organ donation.
p.22
Assessment of LOC in different age groups
What is the age and gender of the patient in ECG 1?
35-year-old male triathlete.
p.10
Cardiovascular Emergencies & Shock
What are the clinical effects of shock related to CNS?
Impaired consciousness, confusion, unresponsiveness, coma.
p.10
Cardiovascular Emergencies & Shock
What are the clinical effects of shock related to renal function?
Decreased urine output due to hypoxia of brain and decreased filtration in kidney.
p.9
Cardiovascular Emergencies & Shock
What are the disturbances of Pulse that constitute a cardiovascular emergency?
Brady Arrhythmias, Tachy Arrhythmias.
p.18
Primary Survey (ABCDEFG)
What signs of shock are evident in Maggie's case?
Tachycardia, hypotension, and grey, colorless skin.
p.34
Disturbances of Pulse (Tachy-Arrhythmias/Brady-Arrhythmias)
What are the symptoms of subdural haematoma?
Unsteady gait, other abnormalities, and abnormal brain underneath.
p.3
Glasgow Coma Scale (GCS)
What is the AVPU rating and GCS for the febrile 82 year old who is brought into the ED by relatives?
AVPU: U (unresponsive), GCS: To be calculated based on the provided information.
p.26
Cardiovascular Emergencies & Shock
How does the Renin-Angiotensin System respond to heart failure?
It leads to increased vasoconstriction, peripheral vascular resistance, blood pressure, and organ perfusion.
p.35
Primary Survey (ABCDEFG)
What does the primary survey involve?
Assessing Airway, Breathing, Circulation, Disability, and Exposure.
p.4
30-Second Patient Assessment in an Emergency
What vital signs can be approximated from the 30-Second Patient Assessment?
Respiratory rate, pulse, temperature.
p.30
Supportive Treatment in Cardiovascular Emergencies
What is the aim of definitive treatment in cardiovascular emergencies?
Treating the underlying pathology.
p.27
Disturbances of Function and Form
What are the effects of cardiac tamponade on the cardiovascular system?
It puts pressure on the heart, prevents proper ventricular filling, decreases stroke volume (SV) and cardiac output (CO), leading to obstructive shock and possibly cardiac arrest.
p.33
Assessment of LOC in different age groups
What is a concussion?
A head trauma with no structural damage, usually resulting in a brief loss of consciousness.
p.9
Cardiovascular Emergencies & Shock
What are the disturbances of Function and Form that constitute a cardiovascular emergency?
Pump Failure, Cardiac Tamponade, Valve dysfunction, Aortic Dissection, Myocardial Ischaemia.
p.7
Triage and Assessment Questions
What is the triage category for a patient who has twisted his ankle but is still able to walk with normal observations?
Triage category 4 (Semi Urgent)
p.12
Supportive Treatment in Cardiovascular Emergencies
What is the immediate compensatory mechanism related to sympathetic stimulation?
Release of Catecholamines
p.12
Cardiovascular Emergencies & Shock
What is the effect of β1 receptors stimulation on the heart?
↑ HR (Chronotropic) and ↑Contractility (Inotropic)
p.13
Cardiovascular Emergencies & Shock
What is Cardiac Reserve?
The maximal percentage that cardiac output can increase above normal.
p.16
Cardiovascular Emergencies & Shock
What signs of shock are evident in Homer's case?
Pale & sweaty, hypotensive, bradycardic.
p.17
Assessment of LOC in different age groups
Why did Marge collapse?
Due to Postural Hypotension leading to hypo-perfusion of the brain.
p.6
30-Second Patient Assessment in an Emergency
Why is communication critical for a coordinated effort and positive patient outcome?
To ensure coordination between doctors, nurses, patients, and families.
p.22
Disturbances of Pulse (Tachy-Arrhythmias/Brady-Arrhythmias)
What is the ECG finding in ECG 2?
Sinus tachycardia with 1:1 P:QRS ratio.
p.7
Triage and Assessment Questions
What is the triage category for a patient who has had a cough for 3 days, seems quietly confused, with low oxygen saturation and elevated pulse and blood pressure?
Triage category 2 (Emergency)
p.32
Disturbances of Function and Form
What are the primary injuries associated with head trauma leading to loss of consciousness?
Concussion, contusion, laceration, diffuse axonal injury.
p.32
Disturbances of Function and Form
What are the secondary injuries associated with head trauma leading to loss of consciousness?
Hypoxia, hypoglycemia, decreased cerebral perfusion, hypotension, hemorrhage, edema.
p.26
Cardiovascular Emergencies & Shock
What is the body's response to heart failure?
Activation of the Renin-Angiotensin System and the Sympathetic System.
p.30
Supportive Treatment in Cardiovascular Emergencies
What is the aim of supportive treatment in cardiovascular emergencies?
To restore/maintain adequate tissue perfusion.
p.5
Pain assessment and management
What are the advantages and disadvantages of parenteral analgesia?
Strong in effect, but more expensive and complicated.
p.24
Disturbances of Function and Form
What are the symptoms of acute myocardial ischaemia?
Crushing chest pain, nausea, vomiting, dyspnoea, radiating pain to shoulders, neck & arm.
p.6
Supportive Treatment in Cardiovascular Emergencies
What is the impact of emergencies on health workers?
Significant impact due to increased workload and stress.
p.10
Cardiovascular Emergencies & Shock
What is the medical definition of shock?
Inadequate perfusion of vital organs (Heart/Brain/Kidneys).
p.16
Cardiovascular Emergencies & Shock
What type of shock is evident in Bart's case?
Hypovolaemic (Haemorrhagic) Shock.
p.25
Disturbances of Pulse (Tachy-Arrhythmias/Brady-Arrhythmias)
What are some signs of weak, thready pulse during examination?
Weak, thready (irregular) pulse.
p.3
Glasgow Coma Scale (GCS)
What is the AVPU rating and GCS for the six month old who suffered a generalized seizure?
AVPU: U (unresponsive), GCS: To be calculated based on the provided information.
p.19
Cardiovascular Emergencies & Shock
What are the symptoms of a hypertensive crisis?
Headache, drowsiness, confusion, vision disorders, nausea, vomiting.
p.29
Cardiovascular Emergencies & Shock
What is considered raised blood pressure?
The range indicating high blood pressure.
p.25
Cardiovascular Emergencies & Shock
What are some potential ECG findings in cardiac examination?
Arrhythmias, changes in serial ECG traces (e.g. ST-elevation, ST-depression, pathological Q waves).
p.26
Cardiovascular Emergencies & Shock
What is the effect of the activation of the Renin-Angiotensin System on preload and cardiac output?
It leads to increased preload, stroke volume, and cardiac output.
p.7
Triage and Assessment Questions
What is the triage category for a patient who has been vomiting for 3 days, is a known diabetic, and has a blood sugar level of 'HI' with low blood pressure and is semiconscious?
Triage category 2 (Emergency)
p.32
Assessment of LOC in different age groups
What are some common causes of loss of consciousness?
Trauma, drugs, post-ictal, hypoglycemia, SAH (Sub-arachnoid Haemorrhage), systemic.
p.5
Pain assessment and management
What are the components of pain assessment?
Site of pain, circumstances at pain onset, character of pain, intensity of pain, somatic pain, visceral pain, and pain scales.
p.3
Glasgow Coma Scale (GCS)
What is the AVPU rating and GCS for the 24 year old man who is cheerfully intoxicated with alcohol?
AVPU: V (responsive to verbal stimulus), GCS: To be calculated based on the provided information.
p.5
Pain assessment and management
What are the advantages of analgesia?
Relieves pain, improves patient communication, improves patient cooperation, and can improve symptoms like pain-related tachycardia.
p.29
30-Second Patient Assessment in an Emergency
What is considered normal blood pressure for a patient?
The normal range for blood pressure.
p.10
Cardiovascular Emergencies & Shock
What are the two types of shock mentioned in the text?
Hypovolaemic shock and cardiogenic shock.
p.13
Supportive Treatment in Cardiovascular Emergencies
What are the determinants of cardiac output?
Preload, Contractility, Afterload.
p.30
Supportive Treatment in Cardiovascular Emergencies
Give an example of supportive treatment for cardiovascular emergencies related to controlling external bleeding.
Control of external bleeding.
p.27
Disturbances of Function and Form
What is cardiac tamponade?
An emergency condition where fluid accumulates in the pericardium, also known as pericardial effusion.
p.29
30-Second Patient Assessment in an Emergency
How and where should blood pressure be measured?
Methods and location for measuring blood pressure.
p.16
Cardiovascular Emergencies & Shock
What signs of shock are evident in Bart's case?
Pale and sweaty, tachycardic, hypotensive.
p.4
Primary Survey (ABCDEFG)
What are the components of the Primary Survey in a 30-Second Patient Assessment?
Airway, Breathing, Circulation, Disability, Expose.
p.16
Cardiovascular Emergencies & Shock
Can Bart be shocked without a change in blood pressure?
Yes, young, healthy people can compensate for up to 1500mL of blood loss by tachycardia and vasopressin.
p.19
Cardiovascular Emergencies & Shock
What is the management aim for a hypertensive crisis?
To smoothly reduce blood pressure over 24 to 36 hours to 150/90.
p.11
Cardiovascular Emergencies & Shock
What is cardiogenic shock?
It is the inability of the heart to pump adequately, often caused by conditions like AMI, valvular problems, or cardiomyopathy.
p.28
Assessment of CVS Emergencies
What are the components of the appearance assessment in cardiovascular emergencies?
Level of consciousness, sweating, agitation, cyanosis or pallor, external blood loss, and clues to the cause.
p.26
Cardiovascular Emergencies & Shock
What is the effect of the activation of the Sympathetic System on cardiac output?
It leads to increased cardiac output and organ perfusion.
p.28
Assessment of CVS Emergencies
What aspects are included in the history assessment for cardiovascular emergencies?
Nature, onset, progression, associated symptoms, treatment, previous episodes, and significant past history.
p.20
Disturbances of Pulse (Tachy-Arrhythmias/Brady-Arrhythmias)
What does the QRS complex represent in an ECG?
Ventricular Depolarisation.
p.28
Assessment of CVS Emergencies
What does the examination for cardiovascular emergencies involve?
Assessment of appearance, pulse, capillary refill time, blood pressure, heart sounds, evidence of heart failure, and signs of chronic disease.
p.9
Cardiovascular Emergencies & Shock
What are the cases that constitute a cardiovascular emergency?
Disturbance of BP, Disturbance of Pulse, Disturbance of Function and Form.
p.22
Cardiovascular Emergencies & Shock
What is the clinical significance of Sinus Tachycardia?
It leads to increased cardiac output (CO).
p.19
Cardiovascular Emergencies & Shock
What are the risks associated with untreated hypertension?
Increased risk of stroke, coronary artery disease, and aneurysm.
p.18
Cardiovascular Emergencies & Shock
What type of shock is evident in Maggie's case?
Distributive (Septic) Shock caused by bacterial infection from dog faeces, endo/exo toxin, systemic cytokine release, and loss of vasomotor tone.
p.34
Disturbances of Pulse (Tachy-Arrhythmias/Brady-Arrhythmias)
How does subdural haematoma typically occur?
Mostly in old people with low force trauma, leading to slow venous bleed.
p.34
Supportive Treatment in Cardiovascular Emergencies
What is the prognosis for intracranial (extradural) haemorrhage?
Good prognosis with surgery, but may result in death without surgery.
p.28
Assessment of CVS Emergencies
What are the aims of assessing cardiovascular emergencies?
To determine the cause and severity.
p.13
Triage and Assessment Questions
How do we recognize and assess shock?
By identifying obvious causes and signs of inadequate tissue perfusion.
p.16
Cardiovascular Emergencies & Shock
Why might a myocardial infarction have caused Homer to be shocked?
Myocardial infarction disrupts heart contraction & conduction, leading to decreased heart rate and cardiac output.
p.23
Disturbances of Function and Form
What is the characteristic of ECG in ventricular fibrillation?
No visible P-wave, no P:QRS relationship, no recognizable QRS complexes.
p.29
Cardiovascular Emergencies & Shock
What are the components of direct cardiovascular monitoring?
Components include BP, Pulse, and ECG.
p.23
Disturbances of Function and Form
What is the characteristic of ECG in complete heart block?
P-wave present, no P:QRS relationship, inverted QRS complexes, ST-depression.
p.25
Supportive Treatment in Cardiovascular Emergencies
Why is it important to measure cardiac markers at different times?
To indicate cardiomyopathy, typically infarction.
p.13
Cardiovascular Emergencies & Shock
What is the third stage of shock?
Irreversible Shock, where no treatment is sufficient, and the patient is in a vicious cycle leading to death.
p.28
Assessment of CVS Emergencies
How is capillary refill time assessed peripherally?
By pressing down on the nail bed for 5 seconds and then releasing, and watching for the return of normal color. Normal is less than 2 seconds, abnormal is 2 seconds or greater.
p.21
Cardiovascular Emergencies & Shock
What is the formula to calculate heart rate on ECG?
300 divided by the number of large squares between QRS Complexes.
p.14
Cardiovascular Emergencies & Shock
What are the characteristics of Grade 1 shock?
<15% Blood Loss (750mL), Mild resting Tachycardia, Normal BP Maintained
p.14
Cardiovascular Emergencies & Shock
What are the characteristics of Grade 3 shock?
30 - 40% Blood Loss (1500 - 2000mL), Severe Resting Tachycardia, Hypotension, Compensatory Mechanisms Beginning to Fail (e.g. Low Urine Output)
p.20
Disturbances of Pulse (Tachy-Arrhythmias/Brady-Arrhythmias)
What are the first and second heart sounds called?
1. Lubb (AV Valve Closure) 2. Dupp (Semilunar Valve Closure).
p.6
Pain assessment and management
What is the importance of regional blocks in early management?
Prevention of morbidity & complications, minimization of suffering.
p.33
Assessment of LOC in different age groups
What is a laceration in the context of head trauma?
An incised wound of brain tissue, usually resulting in severe damage and a poor prognosis.
p.34
Cardiovascular Emergencies & Shock
What are the vascular causes of altered level of consciousness (LOC)?
Ischaemic stroke and haemorrhage.
p.3
Glasgow Coma Scale (GCS)
What is the AVPU rating and GCS for the 16 year old female who fell from a third floor balcony?
AVPU: P (painful stimulus), GCS: To be calculated based on the provided information.
p.19
Cardiovascular Emergencies & Shock
What is a hypertensive crisis also known as?
Malignant or accelerated hypertension.
p.12
Cardiovascular Emergencies & Shock
What is the effect of α1 receptors stimulation in vessels?
Arteriolar Vasoconstriction, ↑ Total Peripheral Resistance, and ↑BP
p.3
Assessment of LOC in different age groups
How useful do you think the AVPU and GCS scales are in infants? Why?
To be answered based on the provided information.
p.18
Supportive Treatment in Cardiovascular Emergencies
What is the initial treatment for Maggie's condition?
Antibiotics and checking lactic acid level.
p.15
Triage and Assessment Questions
What is the volume of distribution for glucose in the body?
Large, as none effectively remains in blood.
p.24
Disturbances of Function and Form
What are the symptoms of myocardial infarction?
Arrhythmias (palpitations), syncope, crushing chest pain, dyspnoea (shortness of breath), nausea, vomiting, sweating, possible shock.
p.25
Supportive Treatment in Cardiovascular Emergencies
What may be observed in imaging during cardiac examination?
Obstruction on coronary angiogram.
p.13
Cardiovascular Emergencies & Shock
What is the second stage of shock?
Progressive Shock, where the patient is no longer able to compensate, showing signs of hypotension and hypoperfusion, but still reversible with treatment.
p.8
Triage and Assessment Questions
What is the Triage Category for a 38-year-old male with an inversion injury to the ankle?
Category 4 - Sprained Ankle.
p.29
Cardiovascular Emergencies & Shock
What does a chest XR help detect?
CV abnormalities and their effects such as pulmonary edema.
p.8
Triage and Assessment Questions
What is the Triage Category for a 2-year-old female with febrile convulsion?
Category 3 - Febrile Convulsion implies an Active Infection.
p.14
Supportive Treatment in Cardiovascular Emergencies
What is the aim of Fluid Resuscitation?
To bring the patient up to Class I
p.5
30-Second Patient Assessment in an Emergency
What is the next priority after prolonging life, if the patient is in pain?
Assess the patient's pain status and give analgesia.
p.32
Assessment of LOC in different age groups
What are some uncommon causes of loss of consciousness?
Infection, endocrine, metabolic, tumour, vascular, paralysis, hypothermia.
p.5
Pain assessment and management
What are the different pain scales used for assessing pain?
Categorical scales, verbal descriptors, numeric scales, visual analogue scale, and picture-based pain scale for specific groups.
p.19
Cardiovascular Emergencies & Shock
What are the common conditions that can cause secondary hypertension?
Conditions affecting kidneys, arteries, heart, and endocrine system.
p.17
Cardiovascular Emergencies & Shock
What type of shock does Marge likely have?
Distributive (Anaphylactic) Shock.
p.4
30-Second Patient Assessment in an Emergency
What are the observations included in the 'LOOKING' part of the 30-Second Patient Assessment?
General appearance, neck, chest, pulse, skin.
p.32
Supportive Treatment in Cardiovascular Emergencies
What are all treatments focused on in head trauma?
Preventing secondary injury.
p.17
Primary Survey (ABCDEFG)
What are the signs of shock evident in Lisa?
Tachycardia and hypotension.
p.35
Triage and Assessment Questions
What is the National Triage Scale?
The standardized triage guidelines for Australian Hospitals.
p.13
Cardiovascular Emergencies & Shock
What is the first stage of shock?
Nonprogressive (Compensated) Shock, characterized by the beginnings of shock and adequate compensation without hypotension or hypoperfusion.
p.1
Glasgow Coma Scale (GCS)
What are the different levels of response for motor function in GCS?
Varies from obeying commands/localising painful stimulus to no response, scored out of 6.
p.11
Cardiovascular Emergencies & Shock
What is distributive shock?
It involves an increased size of circuit or capacitance due to altered vascular tone, and can manifest as septic shock or anaphylactic shock.
p.2
Primary Survey (ABCDEFG)
What is the impact of hypotension in head trauma in the primary survey?
25% increase in mortality after 5 minutes of hypotension.
p.21
Cardiovascular Emergencies & Shock
What is the definition of Tachycardia on ECG?
Heart rate greater than 100bpm.
p.21
Cardiovascular Emergencies & Shock
What is the definition of Bradycardia on ECG?
Heart rate less than 60bpm.
p.20
Disturbances of Pulse (Tachy-Arrhythmias/Brady-Arrhythmias)
What is the S-wave in the cardiac cycle?
Isovolumetric Contraction.
p.21
Cardiovascular Emergencies & Shock
What does missed beats indicate on ECG?
Second-degree heart block.
p.26
Cardiovascular Emergencies & Shock
What is heart failure?
When the heart cannot maintain adequate cardiac output to perfuse the organs of the body.
p.10
Cardiovascular Emergencies & Shock
What are the components of the cardiovascular system that can lead to shock?
Pump, circuit (loss of vasomotor tone), and fluid (e.g. hemorrhage/fluid loss/dehydration).
p.24
Disturbances of Function and Form
What are the risk factors for myocardial ischaemia?
Hypertension, hyperlipidaemia, high cholesterol, smoking, obesity, diabetes, age, systemic inflammatory state.
p.26
Cardiovascular Emergencies & Shock
How does the Sympathetic System respond to heart failure?
It leads to increased vasoconstriction, heart rate, contractility, and cardiac output, ultimately affecting organ perfusion.
p.35
Triage and Assessment Questions
What is the purpose of triage?
To establish priorities of care among groups of patients.
p.17
Disturbances of Function and Form
How might Lisa's tension pneumothorax cause her to be shocked?
By compressing venous return to the chest and heart, and shifting the mediastinum, leading to decreased cardiac output and shock.
p.11
Cardiovascular Emergencies & Shock
What are the causes of hypovolaemic shock?
Causes include blood loss, haemorrhage, fluid loss from various sources, and conditions like heat stroke.
p.27
Disturbances of Function and Form
What is mitral regurgitation?
It is where the mitral valve doesn't close properly during systole, leading to the regurgitation of blood from the left ventricle into the left atrium.
p.15
Cardiovascular Emergencies & Shock
What is the treatment for cardiogenic shock?
Angioplasty/Reperfusion, inotropes, and possibly transplant.
p.14
30-Second Patient Assessment in an Emergency
What is the assessment of Blood Loss for Grade III shock?
30 - 40% volume, <2l, Agitated, lethargic, Pulse 120, BP 80/60 (BP Falling), Minimal urine output, Treatment: 2L IV Fluid & 2 Units of Blood
p.35
30-Second Patient Assessment in an Emergency
What is the definition of 'Emergency'?
A medical condition requiring immediate treatment.
p.5
Pain assessment and management
What are the advantages and disadvantages of oral analgesia?
Cheap and easy, but weak in effect.
p.29
Cardiovascular Emergencies & Shock
What is considered low blood pressure?
The range indicating low blood pressure.
p.12
Supportive Treatment in Cardiovascular Emergencies
What is the delayed compensatory mechanism related to Angiotensin and Vasopressin (ADH)?
Constrict Peripheral Arteries, Minimize Urine Output, and Increase Circulating Fluid Volume
p.2
Primary Survey (ABCDEFG)
What does ABCDEFG stand for in the primary survey?
Airway, Breathing, Circulation, Disability, Exposure, Glucose.
p.15
Supportive Treatment in Cardiovascular Emergencies
Why is glucose not suitable for pressure fluid resuscitation?
Because it is actively taken into cells and has a large volume of distribution.
p.17
Cardiovascular Emergencies & Shock
What type of shock does Lisa likely have?
Obstructive Shock (Tension Pneumothorax).
p.27
Disturbances of Function and Form
What is the treatment for cardiac tamponade?
Pericardiocentesis, which involves using a chest tube to drain the fluid.
p.29
Cardiovascular Emergencies & Shock
What are the components of indirect cardiovascular monitoring?
Components include O2 sats, urine output, and GCS.
p.29
Cardiovascular Emergencies & Shock
What does an ECG help detect?
Rhythm abnormalities and diagnose other conditions.
p.25
Supportive Treatment in Cardiovascular Emergencies
What are some treatments for the conditions observed during examination?
Nitrates (vasodilators), thrombolytics, surgery (angioplasty/stent).
p.15
Primary Survey (ABCDEFG)
What is the first step in treating hypovolaemic shock?
Recognize severity of the loss and estimate how much has been lost.
p.11
Cardiovascular Emergencies & Shock
What are the characteristics of septic shock?
Septic shock involves immune response to liberated endotoxin, leading to cascade of cytokine effects, hypotension, fever or hypothermia, and decreased peripheral resistance.
p.11
Cardiovascular Emergencies & Shock
What are the characteristics of anaphylactic shock?
Anaphylactic shock is an acute allergic reaction involving release of vasoactive mediators, loss of vasomotor tone, hypotension, urticarial rash, severe bronchospasm, and rapidly aggressive systemic oedema.
p.20
Disturbances of Pulse (Tachy-Arrhythmias/Brady-Arrhythmias)
When blood enters the right atrium from the vena cava, is this diastole or systole?
Atrial Diastole, Ventricular Diastole.
p.21
Disturbances of Pulse (Tachy-Arrhythmias/Brady-Arrhythmias)
What does upright or inverted T-Waves indicate on ECG?
Cardiovascular Emergencies & Shock
p.12
Disturbances of Function and Form
What is the effect of Frank Starling Mechanism on stroke volume?
↑Preload → ↑Stroke Volume
p.1
Glasgow Coma Scale (GCS)
What are the different levels of response for eyes opening in GCS?
4. Spontaneous, 3. Voice, 2. Pain, 1. Not.
p.30
Supportive Treatment in Cardiovascular Emergencies
When would you use central venous access?
For very ill patients in the ICU.
p.4
30-Second Patient Assessment in an Emergency
What does normal skin color indicate in the 30-Second Patient Assessment?
Unlikely anaemia, jaundice, cyanosis, shock.
p.8
Triage and Assessment Questions
What is the Triage Category for a 23-year-old female needing a repeat script for OCP?
Category 5 - Repeat Script.
p.30
Supportive Treatment in Cardiovascular Emergencies
What are inotropic agents used for in cardiovascular emergencies?
To modify the force or energy of muscular contractions.
p.27
Disturbances of Function and Form
What are the effects of aortic valve stenosis on the cardiovascular system?
It increases left ventricular afterload, leading to left ventricular hypertrophy and eventually dilation, causing systolic function deterioration and congestive heart failure, syncope, and angina.
p.30
Supportive Treatment in Cardiovascular Emergencies
When would you use diuretics in cardiovascular emergencies?
If there is pulmonary edema.
p.2
Primary Survey (ABCDEFG)
What is the importance of assessing pupillary size and reactivity in the primary survey?
To assess level of consciousness and monitor for changes.
p.14
Cardiovascular Emergencies & Shock
What are the characteristics of Grade 4 shock?
40 - 50% Blood Loss (2000 - 2500mL), Severe Hypotension, End Organ Failure & Death
p.14
30-Second Patient Assessment in an Emergency
What is the assessment of Blood Loss for Grade I shock?
<15% volume, <750 ml, Mild symptoms, Normal signs (Pulse, BP), Normal urine output, Treatment: Cup of Tea, Biscuit
p.28
Assessment of CVS Emergencies
What are the methods of assessment for cardiovascular emergencies?
ABC: 30-second exam, stabilizing, and in-depth assessment including appearance, history, examination, monitoring, and investigation.
p.13
30-Second Patient Assessment in an Emergency
What are the signs of inadequate tissue perfusion?
Cold, sweaty skin; decreased renal perfusion leading to decreased urine output; decreased cerebral perfusion leading to confusion, anxiety, agitation; decreased myocardial perfusion leading to ischemia and hypotension.
p.16
Cardiovascular Emergencies & Shock
If Homer has a heart that is not pumping properly, which direction will his Starling curve move?
His Starling curve will shift downwards (i.e., stroke volume & CO will be less at any given end-diastolic volume).
p.8
Triage and Assessment Questions
What is the Triage Category for a 67-year-old male with VF Arrest?
Category 1 - Cardiac Arrest.
p.27
Disturbances of Function and Form
What is aortic valve stenosis?
It is the abnormal narrowing of the aortic valve opening, leading to inadequate pumping of blood through the narrow orifice.
p.20
Disturbances of Pulse (Tachy-Arrhythmias/Brady-Arrhythmias)
What does the T wave represent in an ECG?
Ventricular Repolarisation.
p.8
Triage and Assessment Questions
What is the Triage Category for a 12-year-old male with acute asthma and low oxygen saturation?
Category 2 - Acute Severe Asthma.
p.14
30-Second Patient Assessment in an Emergency
What is the assessment of Blood Loss for Grade II shock?
15 - 30% volume, <1.5l, Anxious, Pulse 100 - 120 (Tachycardia), BP normal, Decreased urine output, Treatment: 2L IV fluid
p.11
Cardiovascular Emergencies & Shock
What are the possible causes of cardiogenic shock?
Possible causes include AMI, valvular problems, and cardiomyopathy.
p.25
Supportive Treatment in Cardiovascular Emergencies
What cardiac enzymes may be raised in examination?
Troponin I & T levels, creatine kinase-MB.
p.11
Cardiovascular Emergencies & Shock
What is hypovolaemic shock?
It occurs when there is not enough blood volume, often due to haemorrhagic or fluid loss such as from gastrointestinal fluids or metabolic conditions.
p.1
30-Second Patient Assessment in an Emergency
What does AVPU stand for in the context of assessment of LOC?
Alert, Voice, Pain, Unresponsive.
p.2
Primary Survey (ABCDEFG)
What is the formula for cerebral perfusion pressure in the primary survey?
Blood Pressure - Intracranial Pressure.
p.28
Assessment of CVS Emergencies
What may potentially interfere with the assessment of capillary refill time?
Cold ambient temperature leading to peripheral vasoconstriction to conserve heat.
p.27
Disturbances of Function and Form
What are the effects of mitral regurgitation on the cardiovascular system?
It leads to a decrease in ejection fraction and stroke volume, causing congestive heart failure, dyspnea, pulmonary edema, and cardiovascular collapse.
p.27
Disturbances of Function and Form
What is aortic dissection?
It is a tear in the wall of the aorta where blood flows between the layers of the wall, forcing the layers of the wall apart.
p.8
Triage and Assessment Questions
What is the Triage Category for an 18-year-old female involved in a high-speed MVA and unconscious?
Category 1 - Acute Trauma.
p.14
Supportive Treatment in Cardiovascular Emergencies
Why is Arterial Pressure the last thing to fall following Haemorrhage?
Because it is maintained by Vasomotor Constriction for a while, and shock can be present before any change in BP.
p.14
30-Second Patient Assessment in an Emergency
What is the assessment of Blood Loss for Grade IV shock?
>40% volume, >2l, Drowsy, Unconscious, Pulse 140, Very low BP (40), None urine output, Treatment: IV Fluid, Blood, Surgery
p.1
Glasgow Coma Scale (GCS)
What are the different levels of response for speech in GCS?
5. Oriented, 4. Confused Speech, 3. Inappropriate Speech, 2. Incomprehensible/Incoherent, 1. None.
p.30
Supportive Treatment in Cardiovascular Emergencies
What are the different types of fluids used in intravenous fluids for cardiovascular emergencies?
Crystalloids, colloids, blood & blood products.
p.2
Primary Survey (ABCDEFG)
What is the significance of maintaining adequate ventilation in the primary survey?
To prevent a secondary hypoxic brain injury.
p.2
Primary Survey (ABCDEFG)
What should be examined in the exposure stage of the primary survey?
The whole patient, including the back.
p.15
Supportive Treatment in Cardiovascular Emergencies
What is the volume of distribution for colloid in the body?
3.5L, and all of that remains in circulation.
p.23
Cardiovascular Emergencies & Shock
What is the impact of complete heart block on cardiac output?
Cardiac output will be reduced due to disordered contraction of Atria & Ventricles.
p.29
Primary Survey (ABCDEFG)
What should be known once the assessment is complete?
The cause and severity of the problem, and the degree of urgency.
p.11
Cardiovascular Emergencies & Shock
What is obstructive shock?
It involves blockage to outflow, such as from conditions like massive PE, cardiac tamponade, or tension pneumothorax.
p.21
Cardiovascular Emergencies & Shock
What does a long PR Interval indicate on ECG?
First-degree heart block.
p.30
Supportive Treatment in Cardiovascular Emergencies
What are chronotropic agents used for in cardiovascular emergencies?
To modify the heart rate.
p.8
Triage and Assessment Questions
What is the Triage Category for a 26-year-old pregnant female with lower abdominal pain and vaginal bleeding?
Category 3 - Acute Abdominal Pain.
p.14
Cardiovascular Emergencies & Shock
What are the characteristics of Grade 2 shock?
15 - 30% Blood Loss (750 - 1500mL), Moderate Resting Tachycardia, Extended Capillary Refill time, Normal BP Maintained
p.21
Cardiovascular Emergencies & Shock
What is the key characteristic of Atrial Fibrillation on ECG?
Irregularly Irregular P-Waves at 300/min.
p.21
Cardiovascular Emergencies & Shock
What does ST-Segment distribution tell about on ECG?
Which of the coronaries are blocked/damaged.
