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Additional info for Acute medicine
Call for help if the patient does not improve Adverse features of tachyarrhythmias • • • • • Systolic BP <90 mmHg. Heart rate >150 bpm. Chest pain. Heart failure. Drowsiness or confusion. MMC Core Curriculum 23 AM_C01 12/15/10 10:16 Page 24 ACUTE MEDICINE: PACES STATIONS AND ACUTE SCENARIOS Fig. 10 Echocardiogram of a ventricular septal defect following MI (a) and the flow across the defect (b). LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle. Management of a tachyarrhythmia associated with adverse features should include the following.
2, but otherwise concentrate on the following. • What is she wearing? This may have some relevance as to at what time the collapse occurred. • Signs of injury: in particular look at the pressure areas for signs that she has been immobile for a period. Specifically consider whether she has a fractured hip by looking for a short, externally rotated leg. • Temperature: is she hypothermic? Use a low-reading thermometer and take a rectal temperature. • Cardiovascular: check heart rate and rhythm, peripheral perfusion and BP.
Remember that in nonbacterial pneumonia the respiratory signs are commonly unimpressive.