MyCpdZw - Protocols Details

ELECTROCUTION

Electrocution is death or serious injury caused by electric shock, electric current passing through the body.

Diagnosis

Take full history of type of injury, ?self inflicted/ foul play/ abuse,

Look for entry/ exit wounds, associated injuries, fractures, burns, necrosis etc.

Use PARADOXICAL TRIAGE – i.e. Treat the apparently dead before the living.

Management

1. ABC’s, resuscitate as indicated (Resuscitation might need to be long & “aggressive”),

2. Cervical spine protection as indicated,

3. IV access,

4. IV fluids as indicated,

5. FBC, U&E’s, CK,

6. Urinalysis for myoglobinuria,

7. ECG,

8. Monitor as appropriate,

9. Treat arrhythmias as indicated,

10. Analgesia,

11. Catheterise to monitor urine output (aim for 1 ml/kg/hr in face of potential myoglobinuria),

12. Tetanus prophylaxis as indicated,

13. Admit for observation/ monitoring if:

· High voltage/monitoring if:

· High voltage (>600V),

· Chest pain,

· Arrhythmias,

· ECG changes (ST changes, transient arrhythmias, BBB, Heart block, VF, Asystole),

· Loss of consciousness,

· Neurovascular injury or

· Burns,

14. Only discharge if brief, low voltage with no ECG changes & normal tests period of observation. Advise that arrhythmias may occur in the next 2/52.

Recent Protocols

COVID 19

COVID 19 is a disease caused by the most recently discovered coronavirus which is a large family of corona viruses causing illnesses. In humans it causes Respiratory infections for example Severe Acute Respiratory Disease (SARs) PRESENTATION Fever 77-98% Cough 46-82% Myalgia/Fatigue 11-52% Shortness of breath 3-31% Incubation period 14 days, most people develop symptoms between 5-6ays from exposure Stage1 (Early infection). Stage 2. Stage 3(Hyperinflation phase) Viral response---------------------------Pulmonary Phase----------------------Host Response *Anyone presenting with flu like symptoms should be assumed to be a COVID 19 case until proven otherwise*

WARFARIN OVERDOSE/ TOXICITY

Overdose of the oral anticoagulant warfarin (Coumadin), or drug interactions with warfarin, can lead to toxicity. Similarly, toxicity can result from exposure to superwarfarins, which are long-acting anticoagulants used in rodenticides. ... Warfarin is the most common oral anticoagulant in current use

SUICIDAL IDEATION

Suicidal ideation, also known as suicidal thoughts, is thinking about or having an unusual preoccupation with suicide.

SPINAL CORD INJURY

Emergency signs and symptoms of a spinal cord injury after an accident may include: Extreme back pain or pressure in your neck, head or back. Weakness, incoordination or paralysis in any part of your body. Numbness, tingling or loss of sensation in your hands, fingers, feet or toes. Loss of bladder or bowel control.