By Graham Robert Nimmo
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Severe LVF, post-MI. • Post cardiac arrest (unless rapid return of circulation, ventilation and consciousness) usually go to CCU. • GI bleed with haemodynamic instability. • Severe diabetic ketoacidosis • Poisoned patients at risk of airway or haemodynamic compromise. 54 adult medical emergencies handbook | NHS LOTHIAN: UNIVERSITY HOSPITALS DIVISION | 2009/11 Patients with Neurological disease with: • Inability to breathe adequately. • Inability to protect their airway. • These include patients with reduced conscious level or brain-stem dysfunction.
Fill in an OPD Appointment Card with Clinic Name and approximate date of attendance. • In some units the ward secretary or housekeeper will arrange appointments. • Write in the Case Notes: Date of admission (DOA) Date of discharge (DOD) Diagnoses Any other relevant details Relevant Ix, Rx, changes to Rx Follow‑up • The medication on Discharge (see below) should be checked with a more senior member of medical staff. You must complete this accurately. • Leave in the agreed place for checking by a Pharmacist where this service is available.
Tracheal intubation and ventilation, vasoactive drug therapy, invasive haemodynamic monitoring or mechanical circulatory support may be required. • In acute coronary syndromes PCI, thrombolysis, or other interventions may be needed. • Persisting hypotension with impaired organ perfusion despite supplemental oxygen and correction of volume status may necessitate vaso-active drug support. • The drug of first choice is adrenaline (short term) as it has inotropic and vasoconstrictor effects, the latter predominating at higher doses.