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85 Cards in this Set
- Front
- Back
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Recognition of cardiac arrest:
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Lack of spontaneous breathing, Lack of coughing, Lack of movement
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You should get help immediately when:
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There is more than one rescuer - In case of single rescuer: – after making sure that victim is not breathing
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CPR before/after calling for help if alone?
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Go with CPR sequence for 2 minutes before calling:
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Continue CPR until:.Arrival of qualified medical personnel
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There are signs of ROSC,You become exhausted
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differentiation between mild and severe foreign body airway obstruction:
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Can answer you, can cough and breathe = mild. Unable to speak, cannot breath/wheezy breathing, silent attempt to cough = severe
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What to do with a mild airway obstruction:
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Encourage cough
– continue to cheack for deterioration to ineffective ccough or intile obstruction relived |
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What to do with a severe airway obstruction:
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5 back blows – 5 abodminal thrusts if conscious
start CPR if unconscious |
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chances for a successful defibrillation decrease % each min?
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7-10% / min
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The survival rate in cardiac arrest is:
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lower than 5%.
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The survival rate in cardiac arrest is ? when there are AED close by and trained personal:
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30-50%
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ALS includes:
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basic life support functions plus extra:.
-cardiac monitoring, including ECG, cardiac defibrillation. -intravenous therapy (administration of anti-arrhythmic agents + other specific medications and drugs), -use of adjunctive ventilation devices (artificial airway), -and trauma care |
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Common drugs during ALS:
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Epinephrine 1 mg i.v. or intraosseous every 3-5 min, + Amiodarone 300 mg i.v. after 3rd defibrillation
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Reversible causes 4H
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Hypoxia (give oxygen, ). Hypovolemia (give i.v. fluids), Hypo/hyperkalemia/metabolic. Hypothermia (prevention of further heat loss)
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Reversible causes 4T:
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’Thrombosis (coronary or pulmonary), Tamponade cardiac, Toxins. Tension pneumothorax
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Tension pneumothorax - Insert the needle with attached syringe just at:
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the upper border of the 3rd rib
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Symptoms of respiratory insufficiency:
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- DYSPNOEA
- TACHYPNOEA -BRADYPNOEA - USING OF ACCESORY MUSCLES (neck or abdomen muscles) - FLARING OF NOSTRILS ON INHALATION - CYANOSIS OF LIPS, NAILS |
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DYSPNOEA:
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shortness of breath or air hunger
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TACHYPNOEA:
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rapid breathing
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BRADYPNOEA:
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slow breathing rate
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CYANOSIS?
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blue coloration of skin or mucosa due to the poor blood oxygenation in the lungs and therefore low oxygen saturation of the tissues
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Normal breathing rate is:
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12-20 breaths/min.
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HYPOXIA:
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insufficient oxygen level in the body tissues
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Most dangerous airway obstruction places:
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pharynx, larynx and trachea
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Complete airway obstruction is:
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ALWAYS silent!
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Complete obstruction causes:
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the paradoxical chest and abdomen movement, described as ”see-saw” breathing.
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In pregnant women or in very obese patients – what to do in a mild obstruction:
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CHEST THRUSTS are RECCOMENDED instead of abdominal thrusts
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Finger sweep should be done when?
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unconscious patient with severe obstruction
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What to do on a CONSCIOUS INFANT with obstruction?
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5 back blows and 5 chest thrusts
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Normal arterial blood oxygen saturation:
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- 95-100%.
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What to do on a UNCONSCIOUS INFANT with obstruction?
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Start CPR with 5 rescue breaths(15:2)
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HYPOXEMIA?
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Insufficient oxygenation (oxygen content in the blood)
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the rescuer’s expired O2 concentration is:
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only 16-17%
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“room air” – oxygen % ?
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(21% oxygen)
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Assessment of arterial oxygen saturation – most common way?
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Pulse oximetry
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three manoeuvres that may improve the patency of an airway obstructed by the tongue or other upper airway structures:
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head tilt, chin lift, and jaw thrust.
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A =
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airway (open and remove obstructions)
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B =
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breathing (ensure adequate ventilation)
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C =
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circulation (maintain blood flow)
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D =
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disability (assess mental status)
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E =
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exposure
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Signs and symptoms of acute coronary syndrome (ACS):
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Chest pain (Pressure or burning behind the sternum) often radiating to left hand, jaw or back, Shortness of breath, Sweating
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Syncope=
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fainting or passing out
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pulse assessment In breathing unresponsive patient – where?
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carotid artery
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pulse assessment In breathing Responsive patient – where?
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radial artery
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Alarming parameters: Blood pressure:
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Systolic < 90mmHg - Mean < 60mmHg
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Alarming parameters: Heart rate:
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< 50/min or >120/min
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Alarming parameters: SaO2:
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<90%
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Alarming parameters: Respiratory rate:
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> 25/min (above)
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Symptoms of acute upper airway obstruction:
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Dyspnea - Anxiety and agitation - Gasping inspiration - Persistent cough - Use of accessory respiratory muscles - Nasal flaring - Suprasternal and intercostal tissue retraction – Stridor
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Immediately life-threatening respiratory emergencies (excluding trauma) (APPART):
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Airway compromise
- Pulmonary embolus - Pulmonary edema (acute) - Asthma – acute severe -Respiratory failure – acute or chronic - Tension pneumothorax |
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Tension pneumothorax is what:
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Air in the pleural cavity - Valve mechanism increasing intrapleural pressure and causing mediastinum shift
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Tension pneumothorax causes what:
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Blood inflow into the right atrium compromised decrease in cardiac output, fall in blood pressure, shock or cardiac arrest
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Tension pneumothorax Treatment:
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needle thoracentesis
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Signs of respiratory distress:
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Nasal flaring, Tracheal tugging or deviation (by palpation), Intercostal recession on inspiration, Use of accessory muscles in the neck and abdomen, Tachypnea (High respiratory rate)
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AVPU scale:
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Simple neurological assessment :,
-Alert - Voice-responsive - Pain-responsive –Unresponsive |
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TIA?
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Transient Ischemic Attack (TIA) - neurological dysfunction resolves within 24 h
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Two types of Cerebral stroke:
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HEMORRHAGIC 15% - ISCHEMIC 85%
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Stroke =
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vascular disturbance resulting in focal neurological dysfunction which lasts for more than 24 hours
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Signs and symptoms of stroke:
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Sudden weakness or numbness in face, arm or leg on one side of the body
- Sudden dimness, blurring or loss of vision, particularly in one eye - Loss of speech, troubles with talking or understanding speech - Sudden, severe headache, with no apparent cause - Unexplained dizziness, unsteadiness or a sudden fall, |
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Unconscious patient = double risk – why?
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1. Results of the underlying cause of unconsciousness -
2. Consequences of the unconscious state |
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General condition - Assessment of ventilation:
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- Number of breaths per minute
- Volume of respiration - Signs of ventilatory insufficiency (dyspnoea, cyanosis, usage of auxiliary respiratory muscles) |
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TRIAGE is what?
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System of rapid physical evaluation and
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TRIAGE you look at "RPM" =?
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Respirations: <30/min ,
Perfusion: blanch test nail bed<2secs, Mental status: understands simple commands |
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Triage - Code green =?
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delayed care / can delay up to three hours
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Triage - Code yellow =?
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urgent care / can delay up to one Hour
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Triage - Code red =?
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immediate care / life-threatening
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Triage Code black =?.
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victim is dead / no care required
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Management of unconscious patient:
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1. Approach safely !!! -
2. Control the head, look in the face - 3. Ask a simple question – can you hear me? are you all right? 4. If unconscious cry for help - 5. Make sure that victim is breathing - 6. If not breathing start CPR - 7. If breathing and unconscious assess possibility of spinal trauma 8. If spinal injury possible leave victim as he was, reassess breathing regularly - 9. If spinal trauma unlikely put victim in lateral -- safe position and reassess regularly - 10. Seek professional help |
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Paediatric basic life support:
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Unresponsive
- Shout for help - Open airway - Not breathing normally - 5 rescue breaths - No signs of life - 15 chest compresions - 2 rescue breaths/15 compressions - If alone undertake resuscitation for 1 min before going for assistance |
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REASONS for drugs?
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to alter the disease process - to relieve symptoms
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1% = 100ml + ?g:
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1g in 100 ml
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1% = 100ml + ?g:
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1000 mg in 100 ml
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1% = 1ml + ?g:
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10 mg in 1 ml
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Maximum dose of lidocaine is 7 mg/kg - What volume of 0,5% solution can not be exceeded for wound infiltration in 20 kg child?
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20 kg x 7 mg/kg = 140 mg
(1 % = 1 g / 100 ml - 0,5 % = 500 mg /100 ml - 0,5 % = 5 mg / 1 ml) 140 mg : 5 mg/ml = 28 ml |
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The Six Rights of Drug Administration:
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Right Person - Right Drug - Right Dose - Right Time - Right Route - Right Documentation
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Intramuscular Injection Sites:
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Deltoid - Dorsal gluteal - Vastus lateralis - Rectus femoris
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PRIMARY INTENTION =
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When wound edges are brought together so that they are adjacent to each other (re-approximated)
- Minimizes scarring - Most surgical wounds heal by primary intention healing |
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SECONDARY INTENTION:
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The wound is allowed to granulate
- Surgeon may pack the wound with a gauze or use a drainage system - Granulation results in a broader scar - Healing process can be slow due to presence of drainage from infection |
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TERTIARY INTENTION:
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(Delayed primary closure or secondary suture):
- The wound is initially cleaned, debrided and observed, typically 4 or 5 days before closure. - The wound is purposely left open |
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PURPOSES OF WOUND DRESSING:
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Stem bleeding
- Absorb exudate - Ease pain - Debride the wound - Protection from infection - Promote healing - Reduce psychological stress |
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Comminuted fracture:
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A fracture in which the bone has broken into several pieces.
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Impacted fracture:
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A fracture caused when bone fragments are driven into each other.
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Avulsion fracture:
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A fracture where a fragment of bone is separated from the main mass.
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TYPES OF BONE FRACTURES:
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Open (contamination) and closed
Complete and incomplete - Linear, transverse, oblique, spiral |
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ROSC =?
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Return of spontaneous circulation
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