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Emergencies in OPD/Clinics
Dr.Pankaj Dubey
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Patient come with symptoms
Chest pain
Shortness of breath/Cough
Ghabravan
Abdominal pain/Vomitting /Diarrhoea
Backpain
Headache
Fever Weakness
Overdose,Poisoning,Cardiac arrest
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You could find-Vital sign are VITAL
High Blood pressure/Low B.P
Sugar- High or low
Irregular pulse
Weakness
Altered mental state(A/V/P/U)
Fever- think of Rash and Neck stiffness.
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Ask about
History of angina.
Blood pressure.
Old ECG/CXR
Stones-Gall bladder,Kidney.
Alcohol.
Smoke.
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Take AMPLE history
A= Allergies- Penicillin, Suplha, Food,Contrast
M=Medications taken
P=PMHx
L=Last meal
E=Events- ?What happened
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The G.P bag
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The Drug kit
Angina :Nitro-glycerine (sublingual tablet or aerosol spray), Aspirin 300mg
Acute asthma- Asthalin Inhaler/Nebulizer every 15 min,Derriphyline-
1amp/infusion,Efcorlin 100mg (or Tab.Wysolone 40mg)
Allergic reaction: Adrenaline: 1 in 1000 ampoule- adult give 0.5ml IM,Avil or
injectable Phenergan.
Hypoglycaemia :Oral glucose (solution,tablet, gel or powder),25%D,50D
Seizures: Midazolam (injectable) Rectal Dizepam
High Fever/Pain:Paracetamol- 1gm IV- Perfalgan/Melidens or Febrinil 2 ampoules
Antibiotic: Ceftriaxone 2gm, Augmentin 1.2 gm, Azithromycin 500mg,Metrogyl
500mg ,anti-malarial.
NVD :ORS:NS,Electral,Perinorm,Loperamide
PSYCHOSIS :Largactil for Psychotic patient.
Nausea/Vomitting- Stemetil,Phenergan
!! Oxygen with positive-pressure administration capability !!
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Who do you not want to manage inyour clinic
Drowsy ones. Can't speak ones.
Those who need repeated measurements.
Unstable- what you do does not work orpatient worsens again.
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The real expenditureMinimum Emergency equipment and supplies:
Pulse oximeter,Thermometer
Blood glucose measurement device.
Spacer device with mask for inhaled bronchodilators.
Single use sterile syringes and needles,Gloves.
Laedral - Pocket mask with oxygen port, viral and
bacterial barrier, low resistance one way valve and
pre inflated cuff.
1 bag NS and IV cannula and IV infusion set.
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Inhaler and spacer device
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Oxygen saturation monitor
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Ambu bag
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Non rebreather mask(O2)
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Oro-pharyngeal airway
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Thank you
Any Questions ?