Emergency

Question 1

What are the 4H’s and 4T’s for reversible cardiac arrest?

Answer 1

4H’s

Hypothermia

Hypoxia

Hypoglycaemia

Hyperkalaemia

4T’s

Toxins

Thrombosis

Tension Pneumothorax

Cardiac Tamponade

Question 2

What qualifies as hyperkalaemia?

Answer 2

Mild: 5.5-6.0

Moderate: 6.1-6.9

Severe: >7

Question 3

What ECG changes are associated with hyperkalaemia?

Answer 3

Peaked T waves

Small or broad P waves

Continued widening of QRS –> sinusoidal wave pattern

Question 4

What is the treatment of hyperkalaemia?

Answer 4

Urgent treatment if > 6.5 mmol/L

1. 10 ml of 10% calcium chloride IV
2. 10 units of short acting insulin with 50 ml of 50% glucose
3. 5mg of salbutamol

Question 5

What effect does calcium chloride have in the treatment of hyperkalaemia?

Answer 5

Stops cardiac membrane excitability in hyperkalaemia