Date / / «ay) (a73)) aU) are — = ema Metical mele for - Ernergency Yoom.. \bsb bh sus, aw i — By /De Mohammed Hassania. _ a 7 — _gcineko appli Cation »> gpa chy) — 8. Bea For_non Cacdislogists.. Written by: Gt Ma lal, ee f smilewD Ciaysllaz| Fall history e Vitals 4 Examination x Full history $4, bspoagle “_calsapsl—EbGs Gal h5 blac le. | — x Vitals 2. (4p. 2R_- 2c _ U) _ . pulse + By moritor — 1p :ts pacg fa™ pressure 6p) >. don’t depend. on cnonitoc (al 3) pupil reachive or not? [dileked Fixed in deatht at E equal._on_both siden [not equal —> IcH] 2 pupils _shifled toward side of. Lerioa Stra Ke "> Random Bld S45 ar (RBS) By iéadom device. OTT Repel Rolo (RR) _y Count 2c: “Coma Score_(glaocow) —» Below 8 sIntuboke old cals B chs gl 64) Rule Abesoe = fexcept_in_ hypaglycemic. Como J Cappillary ePillg time (CRT) Uop Curiae output) ° _ = > Head & Neck: pep Joundica, Pallor, Sweatiag » y Examination: _ neck veins Uppec Gmbb_:_clubbi int Chest: mass -echyonasis 3 “Tenderneas_ heac Chest fori wheeze — asthma = —Lerepihabion-»P.e eddeines PEPPER IDDate / / Abdomen: mans , Tendernens , wardinny —_— Newer limb: edemay pulse .Calp munde tenderers ——— = pol car MUI fen febann cca) Facuned History Bp 2 RBs z — Examine System of Complaint — - + pulse : + Loo + Blood eet Qo [bottle «RBS: 7: 200 Cin normal. people) as = upts 250 _in_ diabetic paieats . _ — <2 Sees (sf more: cris — _._ CRT RR +12: 20 + Pocg +94: Loo _Can_narmel. peopl) sie 88. 92 Cin _CopD pabients) ______ Smile(3) ABG vs. VBG arterial Venous Poceg ¢ poop « PH J) eS BY Caw ee bola sate ol CLF reopicakor, problem CML- 4 1asL» Venous chet Disturbed Soot wll) ABG pop alhi. ett —ABG:- wo heh te VE pa #—PH +> 735 7,45 ds acidosis 3s obKalosis —%Paceg—» 35: 45 acidosis 4 + alKalosis _ _ Reap irakney). — x Prog —> 94: Loo or 884 of nein. e “alkalosis x Hcoz —» 22: 28 Bos, _CHetabolie ) cA Heog sl |_Coo. ge ste loLighs dst PH cot y al¥alosis sl acidosis Sct py ol Gig — Lola Cela ___ metabolic si _+eopiratan) __ (Complete _¢ _pactiol. More if PH is _narmol.____ Z 5 alkalosis si acidosis _clfJs\, csly),coya normal pe “igs Normal_pH +> 7, 35: 745 ee iP pH > 7.35 2 1f’s acidosis & Gmpeasated.. = an pH > 7.45: 15 alkalosis & Gmpensoled. ¢ No_)_Campensakion NG =} Onion rw “(ne" oe ) —(cl + Hees)» 12:18 Cask) ID how = __>18_, High HamarDate f/f “ VBG metabolic ea changed) Heoz 5 pH J) csgi 5 — -reapiratory <_Gay kad) Reop- Failure be Sols cayall fo dk.) ole Cog cag = pHs. ZBL! om — PaCeg—5 47 +7 7 Pooy —» 37 +12 = = HCoz —» an ARG: smileDate / / a x Haematemesis ;. vitals. history report asia dso gto dpe + Bleeding per rechin :—» Freah 528 he pT. INR Full lab at - Report paolo jog > Not Fresh, Helena Lb bJL Naemokemenis os JJo.geibll 45 - y Convulsions 4 @_alu. Vikels GL — Sip s9 Os {18 Years old 1d abl __ __§ ulcee ots) ai arya ghuslesarys- If_yes. Seal Dg) Paracehamol. a) or_anti Gh Ls cso) pl aos! 64M 4. Rondtidol _| RantideL 5 Bao foal _ JS a7)oups AE 50 Fy 8 (3x4). adel tabs sobs Pas Jas “Hel lagi sy t599-_NSALDs ELAM fe oe clade - 7 i Bl» decals DLL 5 a1 Whar cphalll Jaap Cobb Bb» Smile© Date vA c =p Renal. Colic = _ ae / ~Sedlt jos couny ohh apa cay + dysucea + Vomiking + History Pa shonenessh al a eine. analists + anki Spaamedic 4 analgesic __—-+ ooh AbBpislysts tM Malle ayy ° anal geaic_ 4aankispanmodic IM 3.7}y 2237 3 px iPbl ekg x analgesic. + Declophen« ER cb s57s0n f Ketolac — y ankspaamedic_:— viscelalgens —— — = odcloc 4 are Gass Lt has Nolugio —_.-: a7 Gus — (afd sols Ae adele Jor SX c tis) aah Bla Sol cyte Aodce ue): Bzaeill 2K ada Reo cole Ses al RBS tread pain ae 73 64 DRAWS los Re Ratsad Bp =p Qodey MM _ _ eUsine analysis: [pun ¢ RBCs 2 oxalate _¢ Urabe, uric acich) (4)pus; < too: — Cipro_5See_tabs alu K wp cA bey — Uvamia retacd Bed mes Stans fl Ops teh ashi tid Gt) Cutt - pL | ae Ee Neth oy | Lifes Bs jp0 (2) RBes_ : 4 < too: ek Gai — omega ahi Ps gil Oh ake INR, PT ja ovld-< A, ary de coh. 3 aU, oe WU kd vores : Nawar smile(7) Date / / (3 oxalate _, epimag ap xb ie AB ee pyre eo pyeedhciile on Urake [Uric acids > UroSdlvin > (Bxt) ate pe go abs Ne) cae os Serum sic acide SME Ja Joy aan ea = Colchicine Eline Sb sso —— => Hypotension :. aa2 — —» <8o _: Sunpect shock —» See Shock * Bo: 400 : dexa_amp- 1645 beer. bsip\ ony ad AP S32 Gisin? Stewide 5 T Nak & Plaid in Blood 57 Blood. pressure, —.-i Comp leant + History Poche ybaeate “sb bo>- AOE agadd _ylir if ea crea Ale ps5) Boy gaulsl, a mi Bole Bsy i ab5> one Cis, aging kl ast on Gontwentekis 4 Voraitiag 2 Diohreaolsass_— 6g l#y ab) Cow de Eolally CBC For anemia. _Dyspnoc. — < __avil — 4 dexo_gao93—+ Vanavagal ditack — rel S kr N e Foe pst Orthostatic: e Suspect aloorhion +S} der ¢ doled eu = Suppect internal Hoemorrage <3 C8 Bales dole : Cas5% ‘bu clio) )Date , 7 ® > Hypertension. :_sysholie> ti 7 Loo 659 Joi cil GILG dle Gu tHe jock ‘ial » 160 J alo gi Cabs + ot Cus vslis5 cx) beware clls chao. patient)» White Coot HTN 4 Shess oe Gp 4 g4@ ECG g epigaotric|chest prin oJ Js ahtp ale ss: olarsl + o_ HTN 4 Emergency / Maligaant_/ Caisse = Urgency - _ uw Emenenty 1S Sry HTN ——. 7 — HTN _y ToD “Target Organ DysPunchion a = ¥ Tt t__ * SeiZuceo Canara Chestpain — Pedema paresis Paralysis Ly . = aa bg bea dj Giisng cals wb « r wat nhs CT. Sirke Ich &CL DS, 2 Urg Icgency.: — HTN -oonly abs dol Ou oes > (A) 2oe ooafst; = “Cgiyalas) ELL cd Gpoten 26 od - Vip Cpr dare dyousl Glin hash ys sos paps) Gus — : = SS Gated ale cps av Gandy Gpoten 25 Up a Mali cary GptaBues- ay pbb GL. Ritrodecm pach - (resistant hypeckasinalla) clad JapSe le Ra.) pitas Nat atin Shalini = be (B)___2e6 fads +_Nibrodecm patch 5o_4. “copelen 5a oles > 2 Aa fo53 Glje oS ale Ged 29 Gpoten 3) ners se: DUIS 4a tees] venel Corse.o) ao Vaz pte Cats, Yoslool pid epilake 3 _ abl Idee. See ety Dap Caryn cl Gipasls \ QWiete aces. Aadays Sir top ff Biath on on F341) dae tye ds) A abl, Bw br a Hawar Smile Sea UW UR ene ehh eet enanSFSSPRSBERBBERERBRURBUBUEERUYEEUnWd waa d Date f (@ => Ganhoedritis + _ casrembnt nt abd fo TF 2 Coronavirus may _Prreat on roentritis 5» take Core. +—Complaint :Vorniting Diahreo., alod. paia shistogy: 6 5-iafi —%—-Managements ating @xL)- FM YS — + Colonic_paia 17)» Colona ___(4x4)_ Bel cake. PES Dall pal me athe ib ype) es Gare et pdshopl Chih o Gn Case _ Jyaol Primpran—— { Visceaalgene. amp.| lis flecty eeeruls) __ Motiliun_+ viscecalgens Jab + erp Ep ofl is Tey a le tN gail og alee ohh s baie. — aps ba Side EE) pb wed i Gale i ayo Ge css Lv chow a) dad dang dap toil ipl Hasoar SmileDace / C40) => Insboble Boul s ndromes i seeebat NANG 5 Ue cite ets POAT, Deady pe MG ale lo fo i tele — ar nolin 6 oliay ¢ Gist - —— — i hoe dL ¢ Js «Age Poo ts: bese a Ls 57! x BpR ay fer I. cl + Weight loss 5 D.O of Gacer Calon. “et Vomiting 4 oy Bi Mostly Feed patsonisg —» Colona + GE Gre gllanagements— (eet Ss tail yainide oh Gh ol) : eZ * Antispaomedic_— Colona / gostroreg doo Cand) acu, Fels . digesta [ neodiges\in Chetter in HIN of DM) (3x4 Peal PI Gaus (eeON Sasha cileshn é + Symphomakic TT + ( Vomiting 2 Zles\ 6 laud ¢ IHD Ss es —————metilium —_dlisflabyL__antinal {Stone hex abo wb? Bye Le) BL cas gg 9 HB beh L —- Ao; sloer SLs seedy a vscw cil caleso $lclegay. rt Usps Gua —Jgar eb gs . Gas ee aap NS) 503 sof hd pp ca a Np peo Ki cd 2s wy Cone Scenarios. #. Patient Complaina oP wey Sects_on hand —with no history oP allem ts Food_or -antibistic administvakion. ——ovil__Jol 4 —dexo J gurl Wie & nr 9 + Sig ¥ + TelePoot tals 150/300 GS wor de Kell ha ota as Mawar SmileDate ‘if dD =» GERD " shay 2 Heart burn, Epigaatric. Fullnens Pain 5 Check. pain —— al 3 Bio sap poh + Ball Sion woe Soabl te gap - ey: pho Cassel gees acanitl she dalirda __ Ly De_Ecg for ansurance. _ GERD oe d) Cadyaung citack Jsles> 654.42 » ly pene War aldl $164 ao Alcs 65 ihes ae» raven ay odslol— _Sjaphomabic. Relief) 4 cys Ato 4 Aol pe aol — Contrloe Yo _/ ZueCal Yo _IV_amp._- —_hepabic_ cary os) Reydleeh qoufdox ye tee AL gall a Gyll FX aol ara ol cpakae Gi sed - ! —Jsb elaine 2b Gales cig adgaac. Zurlac_/-Conbrlse J Sol ail po FA cit} alepdssxpes)antodine. Jy cvs) cit cals Gost CA ————Symptomabio Ht 4. (apl>eal) ‘pol. ye an seccell A) Symptomatic HE }—9 maalox—syup-_>15_yeos_only LasdLb Js Lops St. JB an dye cle ph — fycll blag es Go pl Th ate GisbLe — _ bso PLL do ce oY bal 8) abel Gal gah. 6902+ Chi ee fy ue Ca Coe ae - c)—pel (paten pump mhibitee)_, [ GERD J Z2e43] Omez¢ Zurcol < Pamblee ¢Contnloc Zena Hepatic _— os - ok Uremic CARD — — — = a Tyxedema a eta Peet a ——— Toxo. gato eee ee — Glasgow —Coma—Scole : a _ a. renpanse -Sintnatina open t bh inking ot benebne 4 _= opens tn_verbel Command, pSpeech Shout» al _— opens to_pain, ee 92. ede ti dP Nae No nt Sy ae ast (N) Best Vecloal reapanse weeds 55 2 aby —Confured 4 coovenahign but aba toa answer Qs. 94 a ___Anappropriake teoponsea, works discernible 93 di, tiny _____ncomprchensilbla_ speech 42 u AAPA RPP RAP PRP AF HPF ARF ARKFRRARRRAAD — None a 7 a (1M) Best Totor response —__ obeys. Commands. far mavement 26 os =, 5 PucposPul. movement bo painful stimulus 5 = Ae _ Withdraws From pain. 9 SL abnormal spantic. lexion (decorkcake) 43 | Bcdeasoe rigid response —_(dlecerebrak) 59 Octo cpaeDate f / (3) —+GCs_ <8 ~»Intubake except in hypaglycemic Coma Eeelnl= ars BLN ol 1. Psychics J+) Histooy x. middle age + — Sernabe City. All vital ore. anton By examination sale ribs oh2 Sal aaa @ ER & Jasin ll SoS che Copel <—s)—— \Layrbais dyD Ye eb3_e ) = A__pyvliadslos, do barao esl (leis, Gab ds aol 3 prychic lementlalan sdk Sudden toss exc Anke alpodee " dS be foo N Oss 2 ul L. Neurolog ccal; Stroke or ICH also; Sign of loberalization / paresis scalp Ea Ia il pupib LAIN pF pcazsl Adsl dle Ly CT Brain 4 Ginpty i Jot _ — 8 Remember ; F tis (PMT: Dont lower Bp. Tl Hepatic ;— —Tonp Pinole Fe TI IW axedk 5! aod fi L, J ¢ abl Jo SEDI ra) Wo Uremic: abl Jeu CAT Creatinine ¢ Uren.) (ule Bbslaais od Vo Wyaedemic_; Rare) ——History—oP Hypothyroidism —Caldnens: ¢ obenity « Goitec TSH Wy 1 el - eek qr loll vat Lojtib col ply seats ogzge ce eltroxin Iv ales a Gradual Coma may be Gunel by. Coy rors. 2 Reap. Fare Smile 2c ANA a— Vpara 2 aNd Klos hstory olesDate 7 7 cy) —~>—Paychic. Patients . Lash> re ae —A-_ Somakic Symptom Disorder Css0s) - —prtvioualy Known_as Somekaform diserbes 2 —[Ceaversion Syadame_is_asulbtype. 2. fachioun Disordess ThaachousenSyndome is “subtype. 3_ Tahengecin, 7 = —- 2 pel bsele Gybos qs Gil ed hg tobe Produchion oP sympa do O- — sh Na+ Bendis ol Gan as jo @ t Somabte_SYmpkom. Disorders (SSDs) i Un intenhicnal 4. No Gain. -o 52 Cohje8! ots yaar ly DL, Shes I cp ailail aaa! aa plas vaveabieghionn 2s Grlynyg Yeo ch sels lus er blather dll Sheers esti dan ll £54 aol GMdin gs Galea os =. ee 4 Tnkenttenal 4 primnany Gosia: . ince | eptte dpdgcbal gage opi cil_Leyguin- 639 Ke gue pad dec Bly iwesigheiles cheote os CIE imposed. on_salP oy oO LS _Fackibous diserdea Mg. p22 Ds yaaa Papas a) Jsblig hs, ele Gassseath ose o> "Mi Sbinactng sotentional 4 2adey Gaia _ yp jes Goze sh Cpye Sl ols ile alls) 2adey Goin raverkigadiens Gps Whos Ceca eal, bad ap de )5> 62 Gus nvachesolesi, : Chey le Gunian ail, aes) gs o> elie gin Oanie. gh (S505) 38 Gell) (ucts) ek okey . Las e. patos cdl go auar Smile yep UV? PRRPRPRaa Date / / (15) = ansfineloosns 2. # not anaphylacke shock» . a CAEN asap ® ChB [pg mer BLL Ne ol cps | Solu carte? 4+( Dexa 4 ovil__) 4 Farcolin- “de et abil eS adienaline aes gl ba ss15- of lage. edema <3.9)9-4 = Co Ju) = S cab Js fd Shock Mls 9} Glee bpil Sg —— = Haemoglolsin dot CF 9 fav HL poe — P:R 5 yar ule Cede) _ ue tht DB a ah Ferroglebia Cosy eons pe aa’ Hts Led oS cBe cold ly, Conan, ) Dyspren ac sleds Cerys o2) 2 (GAD Bc Jad oy oe YA cabs Js He JIGst 7 FP? Cre stenaria: patient. Complaiarony. of Teehycardio. ohio very mild dyspnea History of psychic. element yah ah = LL, Apter vitals, Ask about chest_paia.. — = \p_yYes or (Na 8, Diabekic patient) —» Eq. = \p_No. Hr <150_: Avil 4 Neck rubbisg = a — cla) Boys EcG__cpioins) | HR 5450. ECG Se 09 Soturation J\.9 CBC Por anemic. cal 4 _Op-maok_-<— @ check for psychic elemeat Tie Headache _/ Cough &3Fo->3 foal s7lbgcssleay a2 2 OSe - Oo ECG ¢ Perens (HT) J Wiley abd-@ nda oy Sehrain 605 ailhana! “ete oulinds ® 92.5 ary —Copd tly ax mde Paton) 9 B52 dd5 (Pang) cde vgSashn CopD Corse Cog drive Leon al arly be Ste 94 - Gul aby Moos Wenge bS2 Bs2)9 By» hj 09 Saturntion_gly_- goa fL 4 ad acute “attack “oP asthe ues CopD Cip250 cols G6 S058 +—Soburation So bye S2 Surly oy 2 als Saburackion Ng Opto!) normal aie aw jlor Farcolia alo uols oil ceyyale ___-. 4rala) cB o909-8 Gee 02 Ge “Stine Salutorte. 4p Og maak Cusith Faccslin| adrovt) 2; U8 by bho Chik p54 law mane Glehing op Satuaation —_gvb f _af Sahwation rises rapidly —> 5) pF Ofidg aT Jesh clk oak Gosia) -Ablan Geles CopD alco leo _§ CopD Gpazacsh} shea P CP 9A C8 Grtde ia Qo Ae.) absb 653} G2 (0) Yate entry } Vypecrtoonance by peremasion / [a / pale, alin : _y Bronco | breathing «— Tost speciPretawbt) "Smile \aigh pitched + Gop bekween inspiration & expiration.Date f/f (418) => Hypectheemia (Lever), 38,5' Bylyp Aaya cLS4| Cphctiadyssile cig 6 I Toauel ob dest peelgan J injectemol viol 155 p05 38,5 degre od Comet yb wo dsb € Glin Jolt ac Viol 03) => Hyped Cemia. / HypoglyCemic Coma_:- RBS dal® Code Jl GUE (1 Salis Uby GUN bis abr» Jolt Cas cals pad ate JL G5 fons Bt) 559 plac 4 dUGols ale mere hypoglycenic_ encephalopathy <_\, Coma tis Gyan Gut So cl (s) ys Suptg dona yb Jit) = 20, © “eal Coma. 4 aera Gk dyke kt u, als. cast mass smile Ly Rebound Vypedycemia —> abUil fy)bat bs=Date f/f / (49) =>} Pecglycemia +. WRBS__> 200 ia normal» « RBS >280 in diabehic Pog Sees boing 4. alias ER fplo cay asl Epigaateic poio_- anal i545» IF. RBS 250: : Zoo a Bb asi 9 dig Ghul Uriae. alps Not e kta VBG 2 Urea _¢ Creabiaina 3 Cound - 4 dle -, Gey ) Bun. 25 Xurea Ne) Bun—= Creckinina - Osmolarity 1 equation_=. QNo t Siucane , Bun 28 Cu \ycemia) ee Vi ye : : DKA ONK Simple hypera} canth. i ane Mireaioe _aCetone : 42 —_|4.No_acetone > By exclusion in urine | |, RBS_,> Geo > 4 aL YW SEI Metalic acidosis! dpb Ged4l Ge |, deal RBS G ds —Heox—< 15. > @ osmalacihy alate. = Bay S.C py) sol =|. 7320, — irl) 50. JD pd5~\ ps5 abl foe | 4 —___— . Joh ¥ obo 165, 3H) Symptoms ion Siac symptoms | Ok Eley is imit_dles —— — ops Do boi Che pod 5 HV boos ode SD) 5) alnp: o 292-90 pds 84, tha Boo dds CEN ACE p Se Cpa} JIB 4 Set eee KT SLD oy 5 r oy 99 a eel ia el eon wb 2 dslsl = Seo GQ Fett glcteDate f / (de) = => Epistaxis. :_ Fi pr < INR ¢ CBC come) a A aos ‘S00 <3. Dicynone +Kapron amps <—- A Ce al UIs way argedal so Be TL a Sa gcteby Zurcol Jagat 2 Sheas, pote clerk dal4h «vit K doo 2: I Cas ye ol Qe Sie Gab Sse bagel oaks takin Js\ af eb) ‘ IV sisly as, 41 & Kapron 9 ‘Di | as! I | - ; (Aocms pe i epistass Gale gd aallaly x cle cbse Gbs— = euhS dle as ody pyle Sou dds ae eM gh g F tad SeLdes sans eyrleis Yaipy + po “ost, cat ols 14,4) co) 3. i | => ees atkacks. of Syacope Sabin Cesk) BS ta Ce=d3> Ch) Gus 95) a 9 SN g A Sa} Bay - = Mawar SmileDate f / (20) amp Shock, ‘Suspect iP Bp. <¢ 802/60 —__ —— Sheek nadequae tissua_perfurioa ______ — aecbic___, Aneabic MT lactic_acid. (Metabolic acidosis) ~— lacke acidosis id Lace ¢ LDH —-:—shock as Jus dsl ARG) 2 a a Signs: _“Techycardin—__“Techypnen ‘ — — Hypotension ved pal a — Sweating ~ Cold exhremetien __-dligurea “Ty peo :-___ Hypo Kalemic _ Cardiogenic — Neuregenic Povey es Septic at =: Shock CS2hES oe Lp, Creat, Urea, CBs (ewe fo J JE colo Qe TNR, OT, Burl, 6 cs dae Boot 9 2piak Gaulo_(2) » Op make O9 Wank (3) Fog anne ser, Ecq. 4) joe. ansea »V.0.p—(anvrea ia AKL) _¢—_rinary Gthdee(5) Gila Blood in urine at | oats cot 4s to cin Sea Med cg bS CH Als Gully shots sol, sl Shots oo Loulll Jala 2 IIe Shock ol ge « Tnotrapes ~Suat Geis) 25 Jpgd tod gle 4 Gud Gains coe ibs 3 s3I> = X Levo Syl ge Jpqulac Gumbo _<&_[Levo phrine] Sig ERE Se a == ais) xX bidto popare 43s Aid JX bE S- Ju2e =e ewilbste ‘ona aoslis ee — Nawar SmileDae f/f / caw OMbde + 20 suspected Cardiegente_shock += (Congested neck veins, \L. edema, ebnormal Beg, —— History of Gediac diseare or Surg al — — Imobropes <= GF cfu aso cr : doze wl Shock JI ey winrctecyang vomiting 4 Diahrren, Diurthice Lay» peritonitis ,Buen ash 7 fo 5 Trouma , Totecnal haemanage Blood m_ucine. —» External hoemorcage » aj oie «die Erolp Band Burn __9| “Trauma _cpsyos _ alll Anal, Gyo pase dsl gece lla abou, ——— Lys ol fa) 5 clisoSe 6 sl Ll eNB+_In_Hypovelemic “shock, Urea: Ceeabininemnoy beth So Don’t _yash soto diolysis_, 1s relative inceane. thn yg Gyr Saybllbcsl Wall ye % Cardiogenic Pulmonary Embolism —Pulmonacy edema ervey TAT: —__-Tamponade — —Pneumathorax ois Cardiomyopathy P - Faetheta — : _Sunpected by: History, Examination, ECG . Echo, Chest Kevaay 2 CSAS woh pom ode CCongenked neck veins)__avecdilated IVC _~- Uo, UB (Gage agg) «Cruces on, 4 EE erominabell & Se aged wer Jabd. Pain aver liver T Sraile eel seer: Als clea slh ne PRRPPDate f / (93) ai Anaphylactic; (ye ccnp thchi i 4 a - = + History of: insect bit, antibiotic adeinislobo- sac food --2 27 Shock ¢— enerahized VD_4— Histamine reléare | management :— avil 4 Dexa 4 Shock JEM je s +% Adrenaline amp. in ant. 4 of thigh CIM) await, BP ob —» Gahcula —> | odenali onp-IM ee olpal 7 Ga cb % gal ob Li doy a¢—Neurogenic : aofaliicen 1 IY ati ~ shock + Severe pain + verbelocal trauma + histoy of V. Dee Lode “nlakufen 7 el _Parcsis__+ Poralysis _> Stroke... Any neuro. Genplaiat AnkiGaglacts Elias 4 neuo Elye olbl x Septic: By Exclusion 4. Motul leucecytic Count fo e Septic Shock _most_propobly resist tt Copp ola 1758 Suspect iP +-—_gangrene _., Soretheot , Fever 5 neck Spadm i Jaundice, History oP: pneumonia , Cancer, - ns, Oo. _-___hospibal_admission.(nssse-t) management’ + Blood culture + Antilatics 4 Shock J Gste _ Cspp las xtra ~ Broad spechum for Sdays Pane _2_ TQ Gatil blood. Cuthure results. appeas. _ Vancomydia_ for IRSA oe eee ——Cephalasporin + 2nd (Cefaxitin)./ Bed CCePlrioxene) far Mase Comial a *Amingg) siden + Streptomycia NanComycia neomycin For Nosecmial —* Pipratillin 2 Tazobackam (pipratnZ) For eee Nosocomial: ©O- Tlehonidazole 5 ametZoli.. 5 Antifungal He smileDate / 7 (ayy mp Acute Urine ‘Retention ;- poh ¥ : ae, —Acuke urine Retention Rrurea_oP Acute rencl. failue Renal Colic 4 Suprapubic pain/ -Teadernens — — ~No pain, Tendecness => ame ci said biel 3 alo Ssh may be: | No Urine oPlec Gthetecitation. | uren, & Creachinian fo i oon peek SOM hi seg (. us Jeatli Pes ale 292g] incontinence, ocak Cesctinkabesnes code state Eee Ie he an = Over Garrection ‘Loin AKL aLLnd sb £ en aot wis jap llles abl Jets _ I fst a — | For pales Give ae —_ a yas pahcadtiaadactan | q 1 Searle ade uk faly— aos) sale gl alo at a med Chaemaburia) seit + Renal: “calc eogd See SE, tone Ort. 4 nthe 15, CMDS C959 ules Solo Ufine analysis wd tf Fo bn G, Recal_txjucy Ses BUS PP: please Gmmect on; | INK, WE ly Pes, bladder, pros 7 . a “date SI} as Noma PT-slot2 “we on oe tc Sa oo ois hoo | = eer} Con: Mexetan)—— i > JSS) Shee—alcten Oi) cjLegb | If IWR ZB IE diagnosis * a CoP adi GAET JX Goyer od) olan gba sill B, WN ale Boy 7 WAY (ga Gay ade Di ck WG Jao, smileDae f/f 5) ==> Tyosttis & ebb « Babel CAC Ge ———— TN A yo CMe hz ce Aa Tot lll chest. or abd. pain Gahitin Myositis 90 CthesbM + Chest oc obd. pain GL) BLL skal myositis Loy dp so 3 ep PB 4 ods: dog Caad / pb all Gu 9d) ay 792-Alz_ ol) ga) LOgbe 1y0 2d CKb yo ilbnin Bye ‘ management. “ . : Declophea amp. : aa ays cto Fi1- Declophen 5o tobs (3x1) 2 caoelgeric» B+ Thyolgea__20 babs (3x1) «eodpal) tools Rus Valtarenorclfen gh 21 ASS, Gary ax clo, ae Wepicel orclgesic » tle oy pci cll il dees Cy cled ee exp Acute plurisy —> stitching pain 10 chest. T by Cough Shrataig sys iio! may be. rePerred, 40 Shoulder or epigaatrium. fever, Dyspnea , Dry Cough) dy EcG og cheat x. 3 6 UGe gla, 23 7 pp SNe) Kops —______—_—_— Macwar SmileDate f/f / (26) =. Palmonary Edema ; hd IU & fics fied bIT). (abt col 44, x Types: Hypo, Normo , Hupectense Pulmonay edema. NBL Blase wl ost x Signs 2 pale, Sweaty 4 Cough. Teritoble ( 5 slaceay) x On_examinedion + iad » Yon ftintion sale x Management: (le bi10¥ og maok —__laoik IV in Garnuln i Catheber asses euery do mins [Bp ¢ Uop ¢ auscult Beast) _ Cyplan ak “odkiinstrstion 3 £2o0 SE pan bon Jl (4) Bo Bo mins . Bo _ 3e mins Yo VE no improve > (2) Yo _ mins. Yo do mins, Yo So wins, fo May Dev einsa Lala Ma lle mg AGH oblate V2$B5 Ho Dgel 2 Gy Basins) ow etl Mo ch Gan acl os SPM coal \anix 994 Hifpo— —Gs-S 5 bsp sy es idee) Jig carlos he aio 4 — oral lanix orl Cash) ly (40 eclude TIL) ¢ECG chest x.eny Jave( Stal) Gu cayllUb + cla) Jlarl Boy cram x x_Bp <150_,*patient nok orthopedic. Se ainushlds Stable altel + Crepitstions Slat to fode (9yapte 5 smileDate f/f / (27) La Ip the patient: was. seveccly dishessed Bp >200 Use Tridik —, Boluo Then 9m x Sacer Jt psie dal La Leh oA Shack Mics Jase cu gILsI slor& cola) g_ Stable jul 5 dal dls doth cad patch 5 Gapoten ll sor SIL <—( for HTN) —Tridil ty + War he yposip Hc BT 3 _ casa cuits ory ars cole looix tLe] — x Cone Scenarios Patient Came to FR_Comphins oP. dyspnea sheadache. ________on examinohion ; TP Be ¢ Gepitahion —___ = ; qphistory 2 Chronic rend diseans dialysis. pulmoaagy edeme. _& Jp2aNelameoverlood_LJlé 02 — Hee rine daa fA gle) dle ch IP fea 525 manage ca_pulmn. edema_+,(epilake) renal alloc IP Nog 4 CII —sbigett digs Jer olyah $Me oe ees Mie ssh ole Full labo a 3 glee (2) > pleural_Efpuaion ghee ao - (No Ceoitahion Silent chest. 4 ca) eh) wa a cad CSE ball 4 EN Gr dE pl dled Sa BSRESSREARERDRLERDHEEEEEELauy esa? |Date f / (28) => Hypo Kalemia Ckty 3,5 34,5) us in ileus 2 Generabszed Fakigue— fh BoB Bats Potessium syeup- «3 —+_ Kt ampules - Potassium sup thee 3 Jegit L355 G2 F Byedaol f— [Boo & SB Gio Ga dole loo Sd) - Wl de KM Ges, acca os af arses 9 => Hyperkalemia tebe (GP KF 7 tt, urgeat_chial ysis) 19: Diabekicn CHyperalyceeia’) ART or chronic Rene Failure > tpn Gigos Diokysis- Vex 5% deo XA wai B-%. Ban % do (9) cone sbi tocapatt it B_<@) () Protect _heact by 4 x Loox 5% \, = at Jah too cm glucose 5% x, hour - Stable ol a1 allr’s Jogulac Ganula_& o35 — Ivy GH dgusl_iobn Stable Gad = (Q) 10 __X 590 _X 5 eds) oe do Soa Cm glucose S/o (3),»_ 3: Farcolin A. 09 GLY kt ess WG casckl 2k aby Ip_reaistant 2 8 Resin No? Danix NED alysis sos ly baile: Renin 3,291 ___ Stool cs ¥" Jum Leastons | gmapPrpPRRRnAhA SmileOl baRllTRiES) Vt) S1Bhp- Date ==> NB : / _ (29) % ee ful Varicoceele +: Suopect Jenks. Skhne. + US. - Urine An By i * Pay ‘padi eat_Complains of ileua. Gastritis & Cachebtic cake cece Note ¥ 2 cots Sle coud _ Chee 25 aK Lene sesladuey » PH < 6,8 or > 7,8 _5 Incompatible te Life * CAT Jenca ayh Salt chyba Sof Jogo bial) Gu qa dorsalis pedis CB pulse Cl yao} _« US > Bright 5 cilifes 5 Display — _ 4 Ethayenosis with no_hisory of trauma > fly INR 2 Fi jot Base — | abel tk Jaiaeces 2 id, diabelic,hypectensive. ~ freee —with — paia., , Constipadion Colaselude) Since Leueek _on examinckion, GCs +15 15 @p: 13alFo— Temp. 37 -_— = Bi “WR 1 Bo RR +20 —_—_—_— — a ‘abdomen ¢ “distendedl_» Rigid = Gordo inated: a ereck _dane 5 — lett alge bl aed _ Na, kK yet gh Yale patient @ ye eacs ol( so)! = ‘ c “To Xo Conn - — - Hi cite css ER Calaigiton con Anni, sls sd Le oles dry mragpnent c3,l. 6oh.6 — bas +e 90) J Cone folds coy — Ly No Brecthing —> 92 mask 4 Club pymayas) atten Ly —pulsless ~ + -Cppr _ - L,Hypokeasien —>_Cannula_4 Iv Selubion _ —_— Ly Hypothermia 4 a0 Poadg Spl og Ly Hypecthermia _, __ apelin eb a L,— Convulsions _—>___ Single 2 Short__-> Nathiag —_—— . _ repebitive_¢ long —> nenvil_amp- __ “ose InM_ook. hes das WN ascoyle Gusts fo cs fon BBC e PP 2 asl ce AULs exp Coe Cay _Primpran__<— adult aakemetic le co ce %QLe a Cockgan, Be. child “al Binns, A, AlKolis Cotes 2 Acids bau Bas pate —ablarly Eo — 7 te Cy “ys . _ Pp ——ph-—> lb pel su nap, Peroxide > opal PAs tates - Rncoescésl all celsl et ay “Thea according 4p Poison: ni Organophosphalea By cl Cll iS - (CA)—> Atropine C1v Joel 2] Clothes : arab yc 5h Gal penilly Pini pupil % secretion: & Urine x» Cheal _ _ eye Goole © ane pak Gb Sd a COeoenauaaadaywet 4 th di 1 1 ele i iisie ce a Pe / 1 (a) [2 Carbon monaxide : Se csblnerbis Ghe —________ Og manok (Loo, 02) + rb laayralrs & BD, Bentediazepines : stable cllis carte tool Mele ays arexate — J gual hy Oe ch Opeid_. dolly. a aelasd a 819-8 G48 Sahn pol isoszse bod teil aa x Pinpoiet_pupil except _in tramadol; elas — Convulsions» hyperglycemia Sf wae — Zsyb] sl GU Naloxone ss Ga dob ely eal J ste Cig ty tuithdramal sh cb Jpn 652 33 —— TS], Kole ( Viesi oF) _ arenes Sipe hd age - Jog Soa M Boy = fy oS Sirah chs Vpn 45) ee Se pee eee — E Fg Gil bap 1 ta 7 _ eaeee dome Tal Colye| Gurohtae = Oi al 600mg ole acetyl. cystine) aol pen odie he bo oh dar 4—(dHo.mg_ LK) —<—— ab _Primpeaa- Jactl<— es lasyto an lobow ratios Cob Bey B aby > —— abl Bays poe vb»: Bb cabie de bISl chien cl ol 3] dle —— xkont mholed ak. —— : onal autos Dero» oni cho el ah oN oe bin food de bss Mines ileDate / ta, / (32) debe Gute Ja Edgz U6], Anti depressants. 1. ON mp Na —» Na. IbiCarhonake 8,4%lo ampovle IV. — Fo Vial ueohe 1s oon J—8o Vial isohesm ob fi), Digitalis an_levoxin_ = Seeds prey soy \, & je Chalegeston op 2 i Caz], OShsr|5 cyyall 3° No vomit : Benzene ~» Bredthisy management: = SolucorkeP amp eee fa —Corresives; No _ Vornicting — 4 Ontiemelic Close + GALI WH Botulism: bak GEL aE ea ey! LS, U5], spake Bike: “Tournicat aM cnn ot Sagal Soca Ada ye pros g slat) peas o| ansurance WG tue dhsy Cel BLN Gojs 5 Zine phosphide Gives p™) . Ae ste Gla eget y a) pln pis cay ops She 5 ss GEL Way(33) Date c ECG et Bp ~ Chest pain 2 Epiqastric pain ¢ Disbehe pains ECG SA Gaal @- Risk factors :. > Pain refered to left shoulder —> Dyspnea —7 old patient > cli) c's wlls tp = Hn > ce oybly Stable angino. Cayo — piel Je" able dl one el ¥5 UL. edema Ky yd hardale > Dabpe di sliellicnad By cp olga? > “Tachycardia, AB dees _%y Wypoxta 7 ~ or <15o___ Jas Gui _ 5 Haemoptysis — Suspect Pulm. embolisme— (4) JI J6 yp productive Cough : te Gaouner of. Chest Paia2 — STEMI Stable oa STENT > angio unstable a Pulmonacy_emloolisen —» Rorktic Dissection peri Carditis - _, Ruphire 2 sephagus Basi i =) (Myocardial: Infarction (HE) ee = @tos ECG dadi_pon cll) al ho Gy pl Bsall Care % 3) Ly ST elevation > _STEML 4) ——-L, ST_deprension____»_ Non STEMI. cl sti 4) 4.2 2155 bo) das aslo a LA 5h Ad mca Cly 4) PK Ld Ws tole) algtdy M1 one dl, wich zl ‘ = Gtk i dpapde oblis sar O62 ol agk ; J -Aspasidl ieRSIMaT 2 plavix isl girls orbs vor 3 ator sbolyals_/. 4. Dinitra Bo LL og ©) prbbess epllendite cat os at Wt05 B Ghaniob t cmile _ Cpasole Hypeleasive st - Hypotension aay i = lta Date / / (yy Sw Shy og cel SG ML nS gh mon) Carcliac enzymen Gosh 4 Cok MB, Troponin) -ECG juss [2] Angina. 1 Stoble ¢ unstable Mon specific Findiy MEM sand clic ECG Jase Gb « (Stoble) “a_i cae oSeo Ce Me cael Saas o Liiclo QI Dinita celpi A ale sty Po oss 6S Cardioc en2. cat ¢c53 3) PEI canes Gin ou ost SAB +—C ils A azcpN el sk AK facto bis 4 —— Chest pain, Hypotension plochyCarcha., Hypoxia 8 pinion Embolism_: SIE ce ys Gola ata stu fasta ECG Joop oo Urea, Creatinine , D dimer goad ve) [FRY axis deviedion hepaciaIv Jy) 3 pS ah ansls Sd anveckd T inves == not Th 1 to avoid heamatunia.. LU a ay yu) —— | + p_ pulmonale = a 2may be_only Sinus Tadys TA) Rortic. Dissechion +_ chest pain a Hypotensive in_one arm bap M ows = Mipsis or ote 4 a tt Ech, a2 we Jia Rae Cae * I OQ ee at te faces SmileDate 4 fs (35) [5] periCardihs 1 ECG. 1ST segment i. spate = 4+ Fever Esta — 4 Chronic. Renal failure Tues. mg cane) caune| a aie esophagus i Rowe Rare Rove — esl & co 8 Glas joke S\ asce ah ole ono es -Baly? Ray al Sl - awarDate / o¢ CBleckro CardioGram) (Bag t=) eek) Joab GILLY (ous — Vals gars ott co (say “# SAN PRE bundle C AN Se 4)JIIIIIII aby bes Conall Seeks Rigiseheclal er _ ih > el nde EY on —lebake Lt] ayes. yal dest JL 23) Ge 95, Dap 9 *Ain arm 3 Might cede \epabes. Sh CH ty it Vitis 6 leads _ Mas th Rt inkechstel reat Va: 4th Ub intercaste Na 5th tt midclavicwar sanboetween No Q vy Vs: 5th Ub —midaxillaey — &®: inbetween VaR NG - : Chest electrodes _ SUE \ j - a Nawar SmileGD aasie boSils Sst lly \ GIL, ye ave electode Cel» Cave wave) fod lade ste g)g Cave wave) fad Vat GU AVPe WLD a chk iva coy lead owl ad oles (o2F poells ave HEX) _ AVL 6 TL SUE Gacy be lead jusl = CdLatle pasty ve SIGH) ____ - AVR. +: Gah acing in Lead el Conalleasl ave LOR) Recording 8, Graphing at _4ve_wave — asi “held sal yas cs HEM J x 32777, ae” ave “ye wave. ee “Ayatd ols “ube aul) * eee, Ne we oe Bipclar wave — er (ld ce (S25—as. ae * es eee ae ave Mawar NW= — ‘ ‘ ® = = ye - => Naming—of waves + “i _— + wae: is “petal Gentraction ~* QRS + yeateicylac Gatvaction = R ST Seqment . \ Fr seamnot 7 3 "+ Tane _- Repalasization — wove, f / + Twave tn pthc Zeus gh Sa { Is ~Pwave ¢To 2 > ‘@ 6 LR A@ esto Se Blels [Pr intend. | Y. ver cca) ein she ows : Ry a Gsa) wke SS tk 5 Si Rag Cal cole Jb > ECG Interpritihon + Sill «ECG iz ll —, 4 Asseo Connechon_&Standeszotion Sepslldzp dos) s 2 Heact Rake_8 Rythm —CRequlac_or_ Areigulac) 3 Cardiac axis 4_ Analysis oP waves_, Segments & woteevals 1 @ Cardiac —chombre_enlarqemement. LQ Dis Conduction: Bundle Branch Block __L5@©_ Ischemia _& Myecacdiol infaccttan.— Ls @_Dysrythmia af = TTT EEEE EBT | Tort) er smile