Important Considerations Population / Age Group Pay more attention to these patients (who are generally more vulnerable):• Children• Elderly (>65 years old) • Pregnant women Patient’s condition on arrival • Came by himself? Brought by car? Brought by ambulance? • Upon arrival, patient was walking? On wheelchair? On stretcher? Timing • Why patient comes to […]
Introduction • Elderly tends to present ‘fall’ as a consequence of underlying etiology, while healthy and younger age group tend to present with fall/trauma first as the etiology which may later be complicated by stroke e.g. due to intracranial bleed (ICB) Age group Etiology Consequence Younger age group Fall / Trauma Stroke Elderly Stroke Fall […]
Background • Premorbid ADL status• • Occupation• • Staying with who? • How patient came? Brought by ambulance? Came alone? Trauma details • Date & time of trauma• Witness• How trauma occurred?• • Was patient under alcohol or illicit drug influence? Motor-vehicle accident• Type of vehicle • Patient was the driver / passenger / rider […]
Introduction • A service provided at all government general hospitals in Malaysia which caters to all cases pertaining to , and exploitation of adults and children Important Points Different approach • Triage counter: victim should be brought to a room with privacy without further history taking at the triaging counter• Soft spoken & rapport building […]
Triage Primary triage • Asking presenting complaint • Any evident / potential life-threatening condition / limb or organ injuries • Any high risk medical profile? =====📑If patients fulfill the above criteria, patient will be assigned to higher acuity zones e.g. yellow / red zone (bypassing secondary triage) Secondary triage • Objective assessment: vital signs, brief […]
Components • Tachyarrhythmia• Bradyarrhythmia & heart block• ACS• Cardiac arrest Related Posts • Basic life support• ECG interpretation basics Guidelines Download full guideline from: https://cpr.heart.org/-/media/cpr-files/cpr-guidelines-files/highlights/hghlghts_2020_ecc_guidelines_english.pdf Simulation • Example 1
Adult Bradycardia Algorithm Download algorithm Features of unstable bradycardia • Hypotension?• Signs of shock?• Acutely altered mental status?• Ischaemic chest discomfort?• Acute heart failure? Causes Common causes:• Myocardial ischaemia / infarction• Hypoxia • Drugs e.g. calcium channel blockers, beta blocker, digoxin• Electrolyte imbalance e.g. hyperkalaemia Other causes:• Endocrine related e.g. hypothyroidism• Typhoid • Cushing reflex […]
Introduction Trimodal model of trauma mortality • — death within minutes of injury• — ‘early death’, i.e. death within hours of arrival to hospital• — ‘late death’, i.e. death after 24 hours of trauma (days to weeks post injury) =====Further reading: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3603725/#:~:text=The%20first%20peak%20in%20the,after%20arrival%20to%20the%20hospital. Polytrauma • A clinical syndrome with severe injuries, involving two or more major […]
Risk Factors • History of thromboembolism / Inherited thrombophilia• • • Malignancy• Active inflammation• Pregnancy / COCP / HRT Investigations Blood • D-Dimer : Cardiac USG for massive acute pulmonary embolism : – right ventricle with of right ventricular apex – right ventricular wall– —–• is no longer a reliable sign for pulmonary embolism —–Relevant […]
Preparation Patient’s position: supinePreset: cardiacProbe: Sector probe, B mode Indications / Uses • Cardiac tamponate• Massive acute pulmonary embolism• Estimation of left ventricular ejection fraction 4 Standard Cardiac Views • Parasternal long axis: 2 – 4th left intercostal space just next to sternum • Parasternal short axis (parallel to long axis of left ventricle): rotate […]