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150 Cards in this Set
- Front
- Back
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Timings of trauma death |
Instantaneous -- 0 to 10 minutes Early -- 2 hours Late -- Days |
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Late symptoms of nerve agent poisoning |
Headaches Increase salivation Dizziness Excessive sweating |
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Danger signs of nerve agent poisoning |
Nausea and vomiting Involuntary urination and defication Muscle spasms Stoppage of breathing |
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Name the three areas of the hazard spectrum |
Trauma and burns Environmental Medical/Toxicological |
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Three types of ops we're deployed into. |
War Ops other than war Ops during peace time |
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Two key elements of framework for acute military care. |
Scene management Casualty management |
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Early symptoms of nerve agent poisoning |
Difficulty breathing Runny nose Pinpointing pupils Tightness of chest |
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Effects of crush injury |
Cardiac arrest Renal failure |
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some causes of injurys |
Blunt trauma Penetrating trauma Climate Chemical |
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Types of entrapment |
Actual Relative |
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Types of shock |
Hypovalemic Anaphylaxis Septic shock Neurogenic shock Cardiogenic shock
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Types of extrication |
Routine Urgent Emergency |
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Principles of care under fire |
Win the fire fight Casualty self aid Apply tourniquet Extract to cover Position for airway support |
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Recognising mild asthma |
Tachycardia <110 bpm wheezing PEFR >50% of predicted raise RR < 25rpm orthopnea |
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Preservation of amputated part. |
Rinse with sterile saline Seal in plastic bag keep cool but do not freeze Never warm amputated limb never place it in water Never place in ice |
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fluid loss stages of hypovalemic shock |
stage 1--less than 15% stage 2--15% to 30% stage 3--30% to 40% stage 4--more than 40% |
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Principles of extrication |
Teamwork Training Preparation Correct equipment Approach |
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Types of drowning |
Near drowning
Dry drowning Fresh water drowning Salt water drowning Secondary drowning |
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How acute poisoning effects the respiratory systems |
Interferes with: Pulmonary respiration Mechanic of cellular respiration Respiratory centers in the medulla |
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Drowning management |
Establish airway CPR if needed 100% oxygen dont perform abdo thrusts remove wet cloths, wrap in blanket check pulse in two sites |
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Definition of open wound |
A break in the continuity of the skin, this includes burns |
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Management of anaphylaxis |
Lay with legs raised assess adrenaline 1,1000 IM evacuate |
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Asthma definition |
Recurring sudden attacks of dyspnea characterized by wheezing and difficulty in expiration. |
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Causes of pneumothorax |
penetrating spontaneous blunt trauma disease |
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Categories of asthma |
Mild severe Life threatening |
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Signs of severe asthma |
Tachycardia >110 Increased wheezing PEFR <50% of predicted cant complete sentences |
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Complications with drowning |
Hypothermia Prolonged immersion |
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Acute poisoning definition |
Any substance which can cause harm or death if taken into the body in sufficient amounts. |
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Signs of haemothorax |
Hypo resonance tachypnea/dyspnea inexplained shock wound cynosis reduced chest movement
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Management of asthma |
Oxygen Salbutamol via o2 driven nebuliser or inhaler serial PEFR prior and after treatment |
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Causes of respiratory arrest |
airway obstruction cardiac arrest damage to respiratory center due to head injury/ stroke/ drugs Tension pneumothorax |
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Types of chest injuries |
pneumathorax haemothorax flail segment rib fracture |
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Internal wounds signs and symptoms |
reduction or BP increase PR swelling rigid areas tenderness |
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Closed wound definition |
Blunt trauma to an area causing damage to underlying soft tissue but no break in the continuity of the skin |
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Types of pneumothorax |
Simple sucking tension |
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Signs of simple/open pneumathorax |
Cynosis Tackycardia dyspnea emphysema obvious wound MOI |
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Fracture definition |
Crack, chip or break in the continuity of the bone |
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Signs of life threatening asthma |
Bradycardia Hypotension cynosis silent chest exhaustion PEFR <33% of predicted |
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Tension pneumothorax definition |
Air enters the pleural cavity which leads to collapse lung and circulatory impairment |
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Depth of burns |
superficial-- red, swollen, tender Partial thickness-- blister, raw skin full thickness-- involves all layers of skin |
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Effects of pneumothorax |
compession of lung compression of heart cardiac arrest death |
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Haemothorax definition |
The presence of blood in the chest cavity |
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Flail segment definition |
The breaking of two or more ribs in two or more adjacent places |
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Respiratory arrest definition |
The cessation of breathing |
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Types of open wounds |
Laceration Incision puncture abrasion impalement |
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Pneumothorax definition |
The presence of air or gas in the pleural cavity |
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Contra indication for ENTONOX |
Chest injuries Head injuries Drug/alcohol intoxication Unconscious cold <6' confused |
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Close fracture definition |
Bone fractured without breaking the overlying skin |
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Complicated fracture |
Bone ends cause injury to important structures of the body |
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Comminuted fracture |
Bone has fractured into many pieces |
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methods of pain relief |
Splintage Reassurance Drugs |
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Treatment of fracture |
Dont move unnecessarily treat for shock pain relief splint dress wounds CRT |
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Signs and symptoms of fracture |
Pain deformity reduced sensitivity loss of distal pulse |
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Categories of burns |
Radiation Dry heat Electrical chemical extreme cold scolds |
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Anaphylaxis definition |
An acute allergic reaction which can effect the whole body and be fatal. |
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management of burns |
Fluids evac O2 remove constrictions cool burn for 10 minutes apply clingfilm treat for shock |
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Signs of smoke inhalation |
Burn/soot around mouth/nose singed facial hair swelling stained sputum hoarse voice |
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Why give pain relief |
Duty of care prevent physiological response to pain |
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Signs of flail segment |
Paradoxical breathing Dyspnea cynosis pain wound/bruising |
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Classifications of haemothorax |
massive simple |
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Contra indications for morphine |
ALOC in the PU chest injuries RR<10 hypotension BP<90mmhg Allergy |
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Side effects of morphine |
Drowsiness pupils nausea and vomiting respiration depression fall in BP |
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side effects of entonox |
Nausea Vomiting Dizziness Euphoria |
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4 means of delivery for CBRN |
Bursting munitions aerosol generator spray equipment chemical IED |
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What does the severity of burn depend on? |
depth age of casualty area of burn condition of casualty before incident |
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Classifications of head injuries... |
skull fracture scalp wounds brain injury |
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Signs and symptoms of head injury |
ALOC headache nausea, vomiting dizziness memory loss anxiety |
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Basal skull fracture signs and symptoms |
CSF leaking from nose/ear Bruising over mastoid process Bilateral black eyes |
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Types of brain injuries |
(inner layer)Subdural haematomea (middle layer)Extradural haematoma (outer layer)Subarachnoid haemorrhage |
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signs and symptoms of raised ICP |
hypertension & bradycardia reduction in concious levels abnormal respiratory patterns abnormal posturing |
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Level 1 ICP signs and symptoms |
Decorticate posturing abnormal resp patterns BP rises, pulse lowers pupils constrict but are reactive |
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Level 2 ICP signs and symptoms |
Decereberate posturing BP rises, pulse lowers abnormal resp patterns Pupils become fixed or react to light sluggishly |
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Level 3 ICP signs and symptoms |
Patient becomes flaccid BP drops pulse rapid and irregular unresponsive one or both pupils fixed or constricted ventilation may become ataxic |
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Management of ICP |
primary survey suspect c-spine O2 monitor regularly treat what you see evac asap |
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Definition of a fit |
Fit is a term used to describe an episode relating to a seizure of the brains electrical activity. |
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Types of seizures |
Partial seizure Generalised seizure |
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Causes of a seizure |
Mental illness Battle shock Hyperventilation hypothermia hypoglycaemia grand mal epilepsy |
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Management of a fitting casualty |
History Protect from harm allow fit to subside O2 Identify and treat cause if possible evac |
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Definition of poisoning |
Any substance that in sufficient amounts can cause harm. |
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Types of poisons |
Opiate Toxins Alcohol Prescribed meds carbon monoxide |
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signs of a poisoning |
Puncture marks drowsiness sweating nasal bleeds smell of alcohol tachycardic |
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Management of poisoning |
Primary survey Give antidote if possible evacuate and take evidence with you |
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For bites and stings make sure to record... |
When and where bitten any symptoms BP and GCS/AVPU |
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Management or bites and stings |
Pressure immobilisation splint limp O2 Gain IV access arrange transfer |
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Definition of hypoglycaema |
Abnormally low blood sugar |
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Physiological response to airway burn |
Potential problems include upper airway oedema
Inflammatory response in the lungs Tissue hypoxia |
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Treatment of smoke inhalation |
Maintain airway and give humidified oxygen
Bronchospasm may occur and is treated withnebulised salbutamol Urgent evacuation |
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Components of the brain |
Cerebrum
Midbrain Pons Medulla Oblongata Cerebellum Spinal Cord |
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Causes of unconsciousness |
Faint Infection Epilepsy Drug/ alcohol ingestion Poisoning Head Injury Hypo/hyperthermia Hypoglycaema |
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methods for assessing the Levels of conciousness |
AVPU PERL GCS |
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Bilaterally fixed and dilated pupils |
Dead Hypoxia Hypovalemic shock Atropine and ecstasy |
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Unilaterally fixed and dilated pupil |
Brain injury Stroke |
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Bilaterally pinpoint pupils |
opiate overdose |
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Irregular pupils |
stigmatism Trauma history of eye operation |
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Management of hypoglycaema |
Ascertain levels of consciousness
Ensure ABC stable Ascertain blood glucose levels Recovery position Initial assessment and primary survey Rapid evacuation |
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Definition of a diabetic coma |
collapse or acute illness caused by hyper/hypoglycaema. |
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Immobilisation types |
Triangular bandages
Fracture straps and bandages Slings Splints Cervical collars Spinal board |
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Aims of splinting |
Immobilize pain relief elevate support |
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How often do you monitor a patient in continuous care? |
monitor every 15 minutes for the first 2 hours. If stable monitor every 30 minutes for the next 4 hours. |
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10 principles of continuous care |
Maintaining a safeenvironment
Communication Food and Drink Toileting Dressings Personal hygiene Controlling bodytemperature Maintaining dignity Pressure areas Dying |
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What does HITMAN stand for? |
Head to toe Infection Tubes Medication Analgesia Nutrition and hydration |
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Analgesia, 3 P's |
Physical Psychological Pharmological |
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Types of advanced airway |
Endotracheal intubation Surgical cricothyroidotomy |
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Indications for receiving an advanced airway |
Not able to clear/maintain airway using simple techniques. protect airway from obstruction. Control oxygenation and ventilation. |
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ET intubation definition |
The passing of a cuffed ET tube through the vocal chords into the trachea. |
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Contra indications of ET intubation |
Conciouos patient Trismus |
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Potential complications of ET intubation |
Hypoxia Failed intubation Damage to teeth/ mouth/ larynx laryngeal spasm oesophangeal intubation Intubation of right bronchus |
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Surgical crycothyroidotomy definition |
The placement of a small cuffed tracheostomytube into the trachea via an incision in the cricothyroid membrane |
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FMED 826 |
Field medical card |
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Indications on ET intubation |
Deeply unconscious cardiac arrest management pre-emt airway obstruction management of head/chest injuries Resuscitation casualty transfer |
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Indications for a cricothyroidotomy |
trauma/burns to face or neck conscious casualty total upper airway obstruction |
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difficulties with cricothyriodotomy |
Neck anatomy--short neck casualty movement position of operator light and correct equipment essential |
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complications with cricothyroidotomy |
Damage to carotid artery bleeding asphyxia laseration of trachea/eosophagus aspiration of blood |
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Definition of Thoracentesis |
Inserion of a cannula/tube into the pleural cavity for the removal of air or blood that may have accumulated causing pressure and hypoxia. |
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Types of thoracentesis |
Tube Needle |
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Needle thoracentesis definition |
Insertion of a wide bore cannula through the 2nd intercostal space, mid clavicular line, on the effected side to alleviate a life threating tension pneumothorax |
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indications of needle thoracentesis |
open pneumothorax MOI Tension pneumothorax |
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Complications of needle thoracentesis |
Local haematoma Local/pleural infection pneumothorax |
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Tube thoracentesis definition |
The insertion of a chest drain tube through the 5th intercostal space, slightly anterior to the mid axillary line on the affected side to remove air or blood |
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Indications of a tube thoracentesis |
Massive haemothorax pneumothorax haemothorax |
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Complications of a tube thoracentesis |
Kinked tubes backflow incorrect placement local/pleural infection haematoma damage to organs dislodged chest tube
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Indication of IV access |
to administer drugs fluid resuscitation maintenance fluids prolonged entrapment |
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Early complications with IV access |
Perforation of the vein haematoma needle breaking shearing damage to other structures extravasation |
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Late complications of IV |
Thrombophlebitis Local infection Systemic infection |
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Venepuncture - indications
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To obtain a blood sample for diagnostic purposes
To monitor levels of blood components |
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where can you gain IV access |
Median cubital vein
Cephalic vein Basilic vein Metacarpal veins |
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IO access – indications |
Two or more failed attempts at IV access If the casualty’s condition does not lend itself to IV access Cardiorespiratory arrest Profound shock Major burns Overwhelming sepsis Status epilepticus |
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contra indication for IO |
Fracture infection osteoperosis FAST: under 12 |
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sites for IO |
tibial plateau sternum humeral head |
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Catheterisation Definition |
The passing of a urethral catheter into the bladder via the supra pubic or urethral route for diagnostic or therapeutic reasons |
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Indications for catheterisation
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Monitoring of fluid balance
Unable to pass urine Abdominal/ pelvis injuries Head injuries Post anaesthetic Unmanageable incontinence |
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Contra-Indications for catheterisation
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Major pelvic fracture
Urethral bleeding |
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Complication of catheterisation |
Damage to urethra Ureteric catheterisation Local urinary tract infection |
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Nasogastric IntubationDefinition
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The passing of a nasogastric tube via the nasal passage down the oesophagus into the stomach
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Indications to nasogatric intubate |
Prior to intubation to decompress stomach Abdominal injury Suspected intestinal obstruction Suspected peritonitis Pre or post abdominal surgery |
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Contra-Indications of nasogastric intubation
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suspected fractured base of skull
Nasal trauma Intestinal perforation Abnormal oesophageal tract |
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Complications of nasogastric intubation
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Passing the tube into the trachea
Coiling of the NG tube Induce vomiting Damage to nasal passage Intra cranial placement basal skull fracture |
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3 main pressure points to stem a bleed |
Brachial Subclavian Femoral |
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Define shock |
Signs and symptoms due to poor tissue perfusion with blood |
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How much blood is lost in a fractured rib |
150ml |
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How much blood is lost in a closed Femoral fracture? |
1.5L |
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How much blood is lost through a fist sized blood clot? |
500ml |
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How much blood is lost through a closed tibia fracture? |
500ml |
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Duration of the average pregnancy |
38-42 weeks |
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First stage of labour |
Onset of labour, rhythmic and painful contractions to the full dilation of the cervix |
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Second stage of childbirth |
Full dilation to complete delivery of the baby. |
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Third stage of childbirth |
Birth of baby to the complete expulsion of the placenta and membranes. |
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Treatment aims for the mother during childbirth |
Prevent infections Prevent trauma Relieve pain |
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Treatment aims for the baby during childbirth |
Resuscitate Maintain body heat Prevent trauma |
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3 ways rtc's cause injuries |
Vehicle hitting object. Unrestrained occupant hitting insides of the vehicle. Vital organs hitting wall of cavity or each other. |
