The Advanced Fellowship in Emergency Medicine Revision Course
Advanced Fellowship in Emergency Medicine Revision Course
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    • SAQ 1-Trauma >
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      • SAQ 14 answer
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      • SAQ 15 answer
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SAQ 3 - resp - Model Answer:

1-    Severe Academia                                  - decompensated
        Hypercarbia                                            -Type  2 resp failure and probably Chronic Co2 Retainer
        Metabolic alkalosis                              -Metabolic compensation for Chronic Co2 retaining
        Hypoxia and high A-a gradient      -  Type I respiratory failure secondary to                                                      
                                                                                Infective exacerbation of COPD

2-    Salbutamol    Neb 5 mg repeated doses

                          IV  Bolus 5mcg/kg   and infusion 1-20mcg/kg/min

                          SE: Tachycardia , Tremor hyperlactemia

       Iprotropium Bromide    Neb 500mcg
                            SE:                         tachycardia , tremor

        MgSo3                 IV bolus 10 mml 

                                      SE: Hypotension, Decrease muscle tone

        Aminophylline    SE: Tachyarrhythmia , Seizure and vomiting

3-    Is an advanced Healthcare directive in place advising against NIV

      Indications: Acute resp failure with high risk of abolishing his native   respiratory drive.

        Risk/Complication: Barotrauma , decrease LOC, aspiration

        FiO2 settings: Monitor FIO2 to maintain Resp drive.

        Ongoing specific treatment treatment : Continue Bronchodilator via the circuit, Steroids

4-    Anticipate difficult mechanical ventilation due to auto PEEP

Permissive hypercarbia

Pressure no more thamn35 cm H2O

Slow Insp: Expiratory ratio

Low vent rate < 10

Sedation, paralysis, Continue bronchodilator , tracheal suction, NG tube insertion


Knowledge Required:

COPD Pharmacological Mx and escalation therapy

Ventilation strategies of COPD

Important consideration of NIV
REFUND POLICY: All refunds are considered at the discretion of the AFEM Executive. Refunds of a maximum of 60% of the course fee is payable with valid reasons with a notice period of 8 weeks  prior to the course. Thereafter,   refunds are managed on a case by case basis.  No refunds are offered within 2 weeks of the course date. No course transfers to individuals or other courses are permitted.