General management for emergency cases (ONCALL) - Details

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Rule of HOs during oncall: 1. Always inform your MOs no matter how they would respond for any pt with issues or probs. 2. Never proceed with you own management/tx if you are unsure about it. 3. Always check and know vital sign pt during the event.

Rule of HOs during oncall: 1. Always inform your ______ no matter how they would respond for any pt with issues or probs. 2. Never proceed with you own _______ if you are unsure about it. 3. Always check and know_____ pt during the event.

If patient desaturated, unable to maintain spo2 >95%; 1. PE: always ascultate lungs first. 2. IX: Repeat ABG STAT. CXR if necessary. 3. Put pt on oxygen support /upgrade. 4. If pt is in impending respiratory collapse, prepare for intubation.

If patient desaturated, unable to maintain spo2 >95%; 1. PE: always _________ first. 2. IX: Repeat _______ STAT. ______ if necessary. 3. Put pt on ____ support /upgrade. 4. If pt is in impending respiratory collapse, prepare for _________.

If patient is hypoglycemia & symptomatic: 1. Consider IV D50% 50cc STAT. 2. Repeat DXT (ix) after 1 hour. If still low, can repeat (1). 3. if normal, maintain with IVD D10% with hourly DXT (ix) monitoring.

If patient is hypoglycemia & symptomatic: 1. Consider IV _______ ______cc STAT. 2. Repeat ________ (ix) after 1 hour. If still low, can repeat (1). 3. if normal, maintain with ________ with hourly ______(ix) monitoring.

If patient is hypoglycemia & asx: 1. If pt can tolerate orally, encourage orally. 2. If pt cant tolerate orally, give IVD D50% 50cc and repeat DXT (ix) after 1 hour. 3. Remember to withold first any OHA or insulin regime during the hypoglycemic attack.

If patient is hypoglycemia & asx: 1. If pt can tolerate orally, encourage ________. 2. If pt cant tolerate orally, give IVD ______ ______cc and repeat _____ (ix) after 1 hour. 3. Remember to withold first any ______ or ______ regime during the hypoglycemic attack.

If pt is hyperglycemia; 1. Check if pt is postmeal or not. if yes, repeat DXT after 1 hour. 2. Consider insulin regime if indicated. 3. If highly suspicious of HHS/DKA (esp in pt with ongoing infection), send for ABG, urine ketone. blood ketone if available.

If pt is hyperglycemia; 1. Check if pt is post____ or not. if yes, repeat DXT after ____ hour. 2. Consider ______ if indicated. 3. If highly suspicious of _____/______ (esp in pt with ongoing infection), send for ______, ________. _________ if available.

If pt collapse or drop in GCS; 1. check for vital sign. Correct if needed. 2. ALWAYS check for blood glucose level. 3. Assess pt by ABCDE, follow by BLS control. If pt had no pulse, immediate CPR. put on cardiac monitoring. prepare for crash intubation.

If pt collapse or drop in GCS; 1. check for _______. Correct if needed. 2. ALWAYS check for _______. 3. Assess pt by ABCDE, follow by BLS control. If pt had no pulse, immediate ____. put on ________. prepare for crash _______.

If pt is hypotensive; 1. Always repeat BP manually. 2. Check for pt's hydration, any sign of intravascular volume loss - GI loss, bleeding. 3. If suspected cardiac probs, do ECG (ix). 4. Some MO allow for HO to order fluid resus/challenge first (run 1 pint of NS/Hartmann), some MO need HO to inform first.

If pt is hypotensive; 1. Always repeat ________ manually. 2. Check for pt's ________, any sign of intravascular volume loss - GI loss, bleeding. 3. If suspected cardiac probs, do _______ (ix). 4. Some MO allow for HO to order fluid resus/challenge first (run 1 pint of NS/Hartmann), some MO need HO to inform first.

If pt is hypertensive; 1. Always repeat BP manually. 2. Check and watch out any sx of intracranial bleed. 3. Review back pt's medications. 4. Adjustment or any adding up antihypertensive medication, always need with MO consultation.

If pt is hypertensive; 1. Always repeat _______ manually. 2. Check and watch out any sx of ___________. 3. Review back pt's __________. 4. Adjustment or any adding up _______, always need with MO consultation.

If pt is tachy/brady; 1. Always check for any associated sx (eg: chest pain, palpitations) 2. Do ECG STAT to rule out acute emergency conditions. 3. Check medications that can cause tachy/brady. 4. Check pt's hydration, temperature. 5. If pt post op - check for any sign of bleed or sepsis. 6. Be careful in dengue pt with tachycardia - as it is sign of compensated.

If pt is tachy/brady; 1. Always check for any associated sx (eg: _____,______) 2. Do ________ STAT to rule out acute emergency conditions. 3. Check _______ that can cause tachy/brady. 4. Check pt's ________, _________. 5. If pt post op - check for any sign of ______ or ______. 6. Be careful in dengue pt with tachycardia - as it is sign of compensated.

If pt has low urine output; 1. Normal urine output, adult <1cc/kg/hr, children <0.5cc/kg/hr. 2. Always flush the CBD and check for any blockage. 3. Check BP and hydration status status as hypoperfusion can lead to low urine output. 4. Check for any sign of profuse bleed or sepsis. 5. Can allow fluid resus if indicated and permisible.

If pt has low urine output; 1. Normal urine output, adult <1cc/kg/hr, children <0.5cc/kg/hr. 2. Always flush the _____ and check for any ______. 3. Check ___ and _______ status as hypoperfusion can lead to low urine output. 4. Check for any sign of profuse ______ or sepsis. 5. Can allow __________ if indicated and permisible.

What to do if patient desaturated, unable to maintain spo2 >95%?

What to do if patient is hypoglycemia & symptomatic?

What to do if patient is hypoglycemia & asx?

What to do if pt is hyperglycemia?

What to do if pt collapse or drop in GCS?

What to do if pt is hypotensive?

What to do if pt is hypertensive?

What to do if pt is tachy/brady?

If pt has low urine output?

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