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43 Cards in this Set

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  • Back
Basic Emergency Routine and Protocols
A.Personal Safety
B.Use Universal Precautions
C. Confidence, competence, compassion
Personal Safety
Survey the scene
Environmental Dangers
Personal Dangers
Universal Precautions
PPE (Personal Protective Equipment)
a. Double latex gloves
b. Eye protection
c. Face Mask
d. Gown (could be anything)
* Wash hands after
* cover your mucous membranes and any open wounds
Confidence, competence, compassion
Introduce yourself
Get consent
Ask pt. name
Smoothly but swiftly
Turn over to paramedics
Emergency history taking mnemonic
A SAMPLE

Age (gender, race)

Symptoms (brief OMPQRT)
Allergies
Meds (Include OTC)
Previous (other) Illness
Last Meal
Events prior to emergency
Legal mnemonic to keep you out of trouble
RISKS

Recording
Informing
Solve problems
Keep up (cont. edu)
Stay in communication w. pt.
Informed Consent
All risks and benefits disclosed to the pt

Usually written

Pt and Dr sign consent form
Expressed Consent
Emergencies only

Verbal permission

No signature or consent form required
Implied Consent
Emergencies only

unconscious adults or mentally incompetent people

minor unaccompanied by adult

assumes patient would give consent and can't respond
Minors consent
Under 18

Consent from parent or legal guardian
Refusal of Care
Patient refuses care and is mentally competent

Expain all risks

Calm them down, ask again

Still refuse sign something

Mentally ill or substance abuser = Grey area → call police
Before getting involved (6)
1.Survey the scene
2. PPE
3.Shake/ Shout/ Introduce yourself/ Get consent
4.If no response, call 911.
5.Support / stabalize c-sp
6.Plug major blood loss
ABC DE of Life
Airway
Breathing
Circulation

Disability (level of consc)
Expose and Examine
Airway Obstruction (causes)
tongue (most common)

Laryngeal edema (upper airway swollen shut CAN'T CLEAR!)

Foreign body
Head tilt/ Chin lift maneuver
superior hand is on their forehead

inferior hand is under the chin

Tilt / lift
How many minutes before brain damage from lack of O2?
4-6 min

then hypoxia
Breathing key criteria (is the patient breathing?)
Look (at chest)

Listen (for sounds)

Feel (your cheek to their mouth for air)

-Check the skin, change in color bluish/purple, sclera (eye), and mucus membrane color
Circulation key criteria (is blood flowing?)
- Check carotid pulse (on your side)

- In child check brachial pulse
A Carotid pulse represents a presence of a minimum of __ mmHg systolic
60
A femoral pulse represents a presence of a minimum of __ mmHg systolic
70
A brachial pulse represents a presence of a minimum of __ mmHg systolic
70
A radial pulse represents a presence of a minimum of __ mmHg systolic
80
Disability (Level of Consciousness/ LOC)mnemonic
AVPU

Alert
Voice Stimulation
Pain Stimulation
Unresponsive

More letters = worse pt. is
Alert criteria (by 4)
1.Person (What is your name?)
2.Place (Where are you?)
3.Time (What time is it?)
4.Situation (What happened)

Confused = all right answers but still not fully there
Voice Stimulation criteria
becomes partially or fully alert

Can move fingers, toes or blink eyes on command
Pain Stimulation criteria
sternal rub or shake and shout gets a response

moan or groan
Most life threatening fractures
1. femur ... 2 L bld internally

2. Posterior clavicle ... cuts subclavian artery
Emergency pulse protocal
15 sec X 4

60 - 100 normal

3 fingers - no thumb
Café Coronary
dentures + large bites of food + alcohol= choking obstruction of upper airway in a conscious person
palpatory blood pressure protocal
- taken when too noisy

- Palpate return of pulse as the air bladder is released.

- gives systolic only

- note as ---/P
Epiglottis in children
treacheostomy or swelling of upper airway

intubation to treat
American Heart Association ... four links in their chain of survival
a.Early access to the emergency response system
b.Early CPR
c.Early Defibrillation
d.Early advanced care
Chest pain with no muscular death
angina pectoris

occurs if the cardiac artery has temporary vasospasm
heart stops completely
cardiac arrest
When the heart may transmit dysfunctional neurological signals resulting in fibrillations
Cardiac failure
General difficulty with the heart
cardiac compromise
when 1 or more of the cardiac arteries are occluded and can’t deliver blood to the cardiac muscle
Heart attack = MI (myocardial infaraction)
Contraindications to CPR
-Patient has no pulse
-Obvious mortal wounds
-Decapitation
-Rigor mortis
-Obvious signs of death
Complications of CPR
-Rib fractures
-Sternal fractures
-Costochondral separation
-Lung and heart contusions
-Pneumothorax
-Liver lacerations
When to terminate CPR
-Patient is resuscitated
-Pulse returns
-Medics arrives and take over
-Patient is declared dead by EEG
-Your are 100% tired
Adult CPR motions

(after survey > look, listen, and feel)
- deliver 2 good breaths
- check pulse (carotid) look for signs of circulation
- 15 smooth compressions (@ 1/3 depth, 100 cpm)
- retilt pt’s head
- total of 4 cycles
- no pulse, continue CPR breathing every 5 sec
CPR Recovery position
- get person off their back
- roll to side, take top knee up, one hand under their face.
- With air in stomach they will probably vomit.
Child CPR Motions (age 1-8 years old)

(after survey > look, listen, and feel)
- 2 breaths
- check carotid pulse
- If pulse but no breathing perform rescue breathing 1 breath every 3 seconds
- no pulse do chest compressions 5:1
- may be arm compressions
- recheck breathing, and pulse
- 911