MRCEM Resus

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Mrcem fast facts resuscitation :

Mrcem fast facts resuscitation Dr Sajjad Pathan MBBS MHA MRCEM

Approach to assessment:

Approach to assessment Airway & Cervical Spine: Oxygen Support Breathing : Pulse Oximeter Circulation : BP & IV Access Disability: Glucose Exposure : Temperature

Know your rhythms:

Know your rhythms Sinus A Fibrillation A Flutter V Tach V Fibrillation Torsades Des Pontes (Magnesium) Bradycardias (1 Degree, 2 nd Degree Types 1 & 2, 3 rd Degree) : Don’t Treat Bradycardia unless symptomatic or 2 nd Degree type 2 and 3 rd Degree.

Signs of instability:

Signs of instability Altered Sensorium/Dizziness/LOC Chest Pain or S/o Ischemia S/o CHF Hypotension If any signs of Instability  Give Electricity (Shock) For Tachy with Pulse we call it Synchronized Cardioversion For Tachy without Pulse we call it Defibrillation For Brady we call it Pacing

V Tach (Pulseless) & V Fib:

V Tach (Pulseless) & V Fib Start with CPR Adrenaline (10 ml of 1: 10000) just before 3 rd Shock Amiodarone 300 mg IV after third shock Think Hs & Ts Pediatric Patients : Adjust Dose of Drugs / Shocking Voltage /

Asystole & PEA:

Asystole & PEA CPR Adrenaline Think Hs & Ts

Trauma:

Trauma Stages of Hypovolemic Shock

Resuscitation in pregnancy:

Resuscitation in pregnancy Know the Physiological Changes in Pregnancy Left Lateral Position Same as others CPR and Drugs Early Intubation Early OBGY Consult Deliver by CS ( Peri mortem CS) within 4 minutes ideally

RSI:

RSI Know the Drugs and Doses for Induction & Paralysis Induction Agents: Etomidate, Midazolam, Fentanyl, Ketamine, Propofol Paralytic : Depolarising Succinyl Choline

Anaphylaxis:

Anaphylaxis Adrenaline IM 0.3 to 0.5 mg (1:1000) IV can be used only if there is Shock Use Steroids, H1 and H2 Blockers Observe for 4 to 6 hours in ED

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