Emergencies At Phc
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EMERGENCIES @ PHC
WHAT IS DONE @PHC? -FIRST AID -INTIAL LINE OF TREATMENT -EMERGENCY DRUGS KIT -IMMEDIATE REFERENCE -CPR
BASIC ITEMS AVAILABLE @ PHC FOR E-CARE -IV FLUIDS,SYRINGES,NEEDLES, -INJ.ATROPINE,ADRENALINE,STEROID, AVIL,DERIPHYLLINE,PARACETAMOL, NSAIDS,DIAZEPAM,ADRENOCHROME, CALCIUM GLUCONATE, 25% DEXTROSE, LASIX, TT, PERINORM, RANITIDINE, , -TAB. NITRATE(SL), DEPIN(SL)
WHAT IS REQUIRED FROM US IN E-CARE? -DEDICATION -BASIC MEDICAL KNOWLEDGE -CONFIDENCE -QUICK EXAMINATION -WISE DECISION -ASSURANCE OF PATIENT AND RELATIVES -SKILL TO BREAK NEWS -FOLLOW UP
TREATMENT PROTOCOL @ PHC,(ANY COMMENTS!) - INJ.DERIPHYLLINE 1 ampoule i.m. - INJ.HYDROCORTISONE 200mg/DECADRAN 1CC i.m.stat AFTER A WHILECHECK FOR RR, BREATH SOUNDS, PNEUMOTHORAX -IF IMPROVED, DISCHARGE WITH ORAL BRONCHODILATORS, ONE COURSE OF ORAL ANTIBIOTICS IF COPD EXACERBATION SUSPECTED. COUNSELLING ABOUT DISEASE &INHALER TECHNIQUES, - IF NO IMPROVEMENT, GET IV ACCESS FOLLOWED BY INJ.DERIPHYLLINE AND AMINOPHYLLINE - INJ.LASIX 20-40MG i.v.stat IF P.EDEMA SUSPECTED EXPLAIN THE PROGRESS AND REFER IMMEDIATELY TO HIGHER CENTRES
TREATMENT OF INSECT BITE • ASSESS CLINICAL STATUS, RECORD
VITALS • CONFIRM INSECT BITE ,CLEAN THE AREA OF BITE • GIVE INJ. AVIL 1 CC + HYROCORTISONE 1CC I.M. STAT • SEND WITH TWO TAB. AVIL WITH ANALGESICS IF NECESSARY
TREATMENT OF CHEST PAIN
•CONFIRM WHETHER CARDIAC/PLEURITIC/REFLUX FROM DESCRIPTION OF PAIN •ELICIT SIMILAR /RELEVANT HISTORY •IF CONVINCED OF WHAT SOURCE, GO AHEAD •ECG , A GOOD DIAGNOSTIC TOOL •RECORD VITALS,GIVE INJ.RANTAC FOR REFLUX, SL NITRATE FOR ANGINA, INJ.NSAIDS FOR PLERITIC OBSERVE FOR A WHILE AND DISCHARGE
TREATMENT OF SNAKE BITE • RECORD VITALS,ASSESS THE SITE •MAKE THE VICTIM INACTIVE TO PREVENT SYSTEMIC SPREAD •AVOID MOUTH SUCTION TO PREVENT CONTAMINATION BY ORAL FLORA •LYMPHATIC OCCLUSIVE CONSTRICTION BAND PROXIMALLY WITHIN 30 MIN SPLINT IF POSSIBLE •INJ.TT ,IF NEEDED START ON ANTIBIOTICS TO PREVENT CELLULITIS •REFER TO HIGHER CENTRE
FUNDAMENTALS OF POISONING MANAGEMENT •SUPPORTIVE CARE •KEEP VITALS STABLE •PREVENTION OF FURTHER ABSORPTION by gastric lavage, dilution method,inducing emesis, activated charcoal/tea sediment
ENHANCEMENT OF POISON ELIMATION bydiuresis,chelation ADMINISTRATION OF ANTIDOTE
REFERENCES •HARRISON’S PRINCIPLE OF INTERNAL MEDICINE •THE WASHINGTON’S MANUAL OF MEDICAL THERAPEAUTICS
WHAT IS DONE @PHC? -FIRST AID -INTIAL LINE OF TREATMENT -EMERGENCY DRUGS KIT -IMMEDIATE REFERENCE -CPR
BASIC ITEMS AVAILABLE @ PHC FOR E-CARE -IV FLUIDS,SYRINGES,NEEDLES, -INJ.ATROPINE,ADRENALINE,STEROID, AVIL,DERIPHYLLINE,PARACETAMOL, NSAIDS,DIAZEPAM,ADRENOCHROME, CALCIUM GLUCONATE, 25% DEXTROSE, LASIX, TT, PERINORM, RANITIDINE, , -TAB. NITRATE(SL), DEPIN(SL)
WHAT IS REQUIRED FROM US IN E-CARE? -DEDICATION -BASIC MEDICAL KNOWLEDGE -CONFIDENCE -QUICK EXAMINATION -WISE DECISION -ASSURANCE OF PATIENT AND RELATIVES -SKILL TO BREAK NEWS -FOLLOW UP
TREATMENT PROTOCOL @ PHC,(ANY COMMENTS!) - INJ.DERIPHYLLINE 1 ampoule i.m. - INJ.HYDROCORTISONE 200mg/DECADRAN 1CC i.m.stat AFTER A WHILECHECK FOR RR, BREATH SOUNDS, PNEUMOTHORAX -IF IMPROVED, DISCHARGE WITH ORAL BRONCHODILATORS, ONE COURSE OF ORAL ANTIBIOTICS IF COPD EXACERBATION SUSPECTED. COUNSELLING ABOUT DISEASE &INHALER TECHNIQUES, - IF NO IMPROVEMENT, GET IV ACCESS FOLLOWED BY INJ.DERIPHYLLINE AND AMINOPHYLLINE - INJ.LASIX 20-40MG i.v.stat IF P.EDEMA SUSPECTED EXPLAIN THE PROGRESS AND REFER IMMEDIATELY TO HIGHER CENTRES
TREATMENT OF INSECT BITE • ASSESS CLINICAL STATUS, RECORD
VITALS • CONFIRM INSECT BITE ,CLEAN THE AREA OF BITE • GIVE INJ. AVIL 1 CC + HYROCORTISONE 1CC I.M. STAT • SEND WITH TWO TAB. AVIL WITH ANALGESICS IF NECESSARY
TREATMENT OF CHEST PAIN
•CONFIRM WHETHER CARDIAC/PLEURITIC/REFLUX FROM DESCRIPTION OF PAIN •ELICIT SIMILAR /RELEVANT HISTORY •IF CONVINCED OF WHAT SOURCE, GO AHEAD •ECG , A GOOD DIAGNOSTIC TOOL •RECORD VITALS,GIVE INJ.RANTAC FOR REFLUX, SL NITRATE FOR ANGINA, INJ.NSAIDS FOR PLERITIC OBSERVE FOR A WHILE AND DISCHARGE
TREATMENT OF SNAKE BITE • RECORD VITALS,ASSESS THE SITE •MAKE THE VICTIM INACTIVE TO PREVENT SYSTEMIC SPREAD •AVOID MOUTH SUCTION TO PREVENT CONTAMINATION BY ORAL FLORA •LYMPHATIC OCCLUSIVE CONSTRICTION BAND PROXIMALLY WITHIN 30 MIN SPLINT IF POSSIBLE •INJ.TT ,IF NEEDED START ON ANTIBIOTICS TO PREVENT CELLULITIS •REFER TO HIGHER CENTRE
FUNDAMENTALS OF POISONING MANAGEMENT •SUPPORTIVE CARE •KEEP VITALS STABLE •PREVENTION OF FURTHER ABSORPTION by gastric lavage, dilution method,inducing emesis, activated charcoal/tea sediment
ENHANCEMENT OF POISON ELIMATION bydiuresis,chelation ADMINISTRATION OF ANTIDOTE
REFERENCES •HARRISON’S PRINCIPLE OF INTERNAL MEDICINE •THE WASHINGTON’S MANUAL OF MEDICAL THERAPEAUTICS
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