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62 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What does DR ABC stand for? |
Danger Response (Catastrophic haemorrhage) Airway Breathing Circulation |
Approaching a casualty first steps |
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What are the 4 parts of Response? |
Alert Voice Pain Unresponsive |
AVPU |
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The 3 principles of IEC? |
Preserve life Prevent deterioration Promote recovery |
3 P’s |
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What does SAMPLE stand for? |
Signs and symptoms Allergies Medication Past medical history Last ate/drank Events (leading up to) |
What would you need to know when assessing someone? |
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How to check for disability? |
Alert Voice Pain Unresponsive Then assess the pupil size and check for movement and sensation of all limbs |
AVPU first... |
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Trauma Emergencies what is different about these? |
Catastrophic Haemorrhage before ABC (for circulation check skin colour, pulse rate, cap refill, and blood loss in 5 places external, chest, abdomen, pelvis and long bones) then check for Disability and then E for exposure and environment |
Catastrophic bleed |
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What is the Glasgow Coma Scale? |
This is a score based system that rates eyes opening (out of 4), verbal response (out of 5) and motor response (out of 6). You rank each casualty (the highest they can receive is 15 meaning fully conscious and lowest is 3 which means unconscious). |
What are you rating? |
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Reassessment of medical emergencies, what are the 3 areas? |
Head- airway, consciousness and pupils, establishing Glasgow coma scale Chest- breathing rate/depth, tensions, skin colour/temp and pulse rate/SpO2 Limbs- movement and sensation |
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Trauma Emergencies Reassessment, what are we reassessing? |
Head- ABC, skin colour/temp, bruising, pupils, brain fluid, coma scale and signs of basal skull fracture Neck- is collar the right size? Chest- breathing rate, re-listen to breathing, look for marks (seat belts, contusions and flail segments) Abdomen- look for open wounds, contusions or seat belt marks Pelvis- is blood visible (urethra or post vaginal and does the patient need to wee? Limbs- examine Lower then upper limbs, wounds/fracture evidence and reassess movement/sensation in limbs |
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What is the difference between air inspired and air expired? |
Inspired is 21% oxygen, 0.04% carbon dioxide, 78% nitrogen and is a variable water vapour Expired is 16% oxygen, 4% carbon dioxide, 78% nitrogen and a saturated water vapour |
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What are the average breathing rates for adults, children and infants? |
Adult- 12-20 Child- 20-30 Infant- 30+ |
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What are the average pulse rates per minute for adults, children and infants? |
Adult- 60-80 Children- 100-140 Infants- 140+ |
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Factors that can affect the accuracy of the pulse oximetry? |
Bright sunlight Nail varnish Movement Carbon monoxide poisoning (will show normal levels) Poor tissue perfusion-cold basically |
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Name 5 pulse sites |
Carotid- neck Brachial- top of arm Radial- wrist Femoral- groin area Superficial temporal- the temple |
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For trauma patients we can use the acronym ATMIST, what does it stand for? |
Age Time Mechanism of Injury Injuries Signs and symptoms Treatment given/immediate needs |
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What are the principle functions of respiration? |
1) Extract oxygen from atmosphere to lungs 2) Excrete water vapour and carbon dioxide 3) Maintain the normal acid base status of blood 4) Ventilate the lungs |
There’s 4 |
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What are the organs of the respiratory system? |
Nose Pharynx Larynx Trachea Two bronchi (one in each lung) Bronchioles and smaller air passages Two lungs and pleura Muscles of breathing (intercostal and diaphragm) |
There’s ******* loads |
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An exchange of gases occurs in 2 places where are these? |
External- lungs Internal- tissues |
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What are the two respiratory movements? |
Inspiration (inhaling/breathing in) Expiration (exhalation/breathing out) |
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What are the points of protection? |
Cover exposed wounds with waterproof dressings Ensure protective equipment is correctly maintained Be alert to hazards at operational incidents Approach all patients as if they were infectious Use correct level of PPE Wash off any body fluid splashes to eyes and mouth |
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Recognition of a smoke inhalation injury? |
Scorched hair Blisters Soot around mouth/nose Difficulty breathing (wheezing sounds) Coughing (with black sputum being coughed up) Change in voice or difficulty speaking Note: may not be any symptoms so all patients been in fire must be treated as time critical |
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What are things that can precipitate about asthma attack? |
Cold air Smoking Air pollution Upper respiratory tract infection (URTI) Emotional stress Strenuous exercise |
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Signs of moderate asthma? |
Talk normally <25 breaths per min Hr<110 bpm |
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Signs of severe asthma? |
Can’t say full sentence in one breath Increased wheezing Respiratory rate >25 bpm HR>110bpm Reluctant to move around Use of accessory muscles |
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Signs of severe asthma? |
Can’t say full sentence in one breath Increased wheezing Respiratory rate >25 bpm HR>110bpm Reluctant to move around Use of accessory muscles |
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Signs of life threatening asthma? |
Altered level of consciousness Exhaustion Arrhythmia Hypotension Cyanosis Silent chest Poor respiratory effort SpO2 < 92% |
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What is hyperventilation syndrome and who are more common to it? |
HVS- basically quicker breathing. People more likely to get it include people with: pulmonary embolism, diabetic ketoacidosis, asthma and hypovolaemia Always presume hyperventilation is secondary to hypoxia or other breathing problems until proven otherwise. |
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What is the general treatment for respiratory problems? |
Comfortable position (seating etc) Oxygen therapy Monitor patients respiration’s Record respiration rate, depth and SpO2 in PRF Call for ambulance |
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The 3 basic ways damage occurs when smoke inhalation occurs? |
1) heat causes thermal damage 2) gases cause asphyxiation 3) irritation of lungs/airways |
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What is a normal respiratory rate for an adult? |
Between 10-30 |
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What is respiratory arrest and name 4 occurrences when this can occur. |
Respiratory arrest is when a patient is not breathing but has a pulse. Can occur from gases/smoke inhalation, head/spinal injuries, asphyxia and electrocution. Treatment is to ventilate patient at 10-12 breaths per minute, checking pulse and breath every minute too. |
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Always think JAWS when ventilating a patient, but what does JAWS stand for? |
Jaw thrust- pull face into mask Adjunts- OP and/or 1-2 NPs Work together- two people are better than one Squeeze slowly- squeeze bag over 1 second |
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Causes of airway obstruction? |
Upper- tongue and foreign materials e.g. vomit, gum, blood etc Lower- excessive bronchial secretions, pulmonary bleeding, inhalation of regurgitated stomach content The tongue is the most common cause of airway obstruction! |
Upper and lower |
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Signs of severe airway obstruction and mild airway obstruction? |
Severe- unable to breath, sounds wheezy, coughing is silent, unable to answer are you choking? and may be unconscious Mild- can answer if they are choking and can speak, cough and breath |
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Why is the recovery position used? |
Keeps an open airway Provides drainage Stable position Keeps chest/abdomen clear to allow breathing |
4 points |
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What to do for someone who has a severe airway obstruction? |
5 back blows, check to see if obstruction removed then 5 abdominal thrusts then continue alternating. If unconscious begin basic life support and when doing CPR check mouth to see if object expelled. All patients who have had abdominal thrusts should go to the hospital! |
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NPAs how to size, who can use them and when not to use them? |
6mm generally for women 7mm generally for men Sized by diameter of nostril No under 12’s Don’t use if: suspected skull fracture, any obstruction or excessive bleeding These can be used on adults with gag reflexes |
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What do you do differently if someone has a tracheostomy? |
You put the bvm over the hole and also use the v vac through the hole. |
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What is hypoxia and what are signs of it? |
A lack of oxygen to body’s tissues leading to irreversible cell damage A lack of oxygen can result in the death of brain cells in 3 minutes Signs: rapid breathing, confusion, pale/cold/clammy and cyanosis (later stage sign) Don’t wait for cyanosis to diagnose hypoxia |
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When do we not give oxygen to casualties? And when should cautions be taken? |
Explosive environments
Oxygen increases fire risk Can cause spark with defib Can explode in high temperatures Cylinders shouldn’t be allowed to roll round and fall over COPD patients- can lower or even stop their breathing Therefore monitor any patient and remove oxygen if leaving them unattended |
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Oxygen cylinder litres and durations? |
600 litres Charged to 300 bar 15 litres per min Lasting 40 mins |
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%’s of masks (bvm and high concentration mask) and when are both used? |
Bvm delivers 85% of oxygen when connected to the cylinder (and 21% when not) used in unbreathing casualties or if less than 10 bpm High concentration mask is 95-98% oxygen and used on casualties breathing (conscious or unconscious) Both are exchanged one for one with ambulance service |
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Oxygen is a drug, what do we need to handover to LAS when talking about oxygen? |
Length of time oxygen has been used The flow rate (15L per min) % of O2 patient has received SpO2 levels before/after oxygen administration Any change in conditions as result of oxygen used (This should be recorded on patient form under ‘treatment given’)
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Name the 4 chambers of the heart |
Right atrium Left atrium Right ventricle Left ventricle |
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What are the roles of arteries and veins? |
Arteries carry blood away from the heart while veins carry blood into the heart |
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Name the 4 valves located in the heart |
Aortic Mitral Pulmonary Tricuspid |
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What is the SA Node? |
Basically a natural pacemaker |
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Role of AC Node? |
Is the step after the SA Node and has a delay of 0.1 seconds to allow the atria to finish contracting before the ventricles start. Also a back up for SA Node. |
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What factors can affect HR? |
Gender Age Exercise Temperature Circulating chemicals Autonomic nervous system Baroreceptor reflex Emotional states Position |
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Name the 5 types of blood vessel? |
Arteries Veins Arterioles Venules Capillaries |
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What are the principle functions of blood? |
Carry oxygen from lungs to tissues and CO2 from tissues to lungs Carry nutrients from alimentary tract to tissues Carry waste to excretory organs (principally the kidneys) Give off heat by muscular activity Protect body from infection (white blood cells) Clotting factors (platelets) |
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What are the 4 elements of blood? |
Plasma- straw coloured fluid in which cells are suspended Erythrocytes (red cells)- carry O2 Leukocytes (white cells)- fight infection Platelets- promote clotting |
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What is Coronary Artery Disease (CAD) and what can treat this? |
Furring of arteries resulting in less blood flow and this can be treated by glycerol trinitrate (GTN) |
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What is acute coronary syndrome (ACS)? |
Death of the heart muscle (normally by one or more blockage) caused by angina or heart attack |
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Heart attack (MI) what is it, what are symptoms and how can it be treated? |
Blockage of heart muscle that deprived blood flow which results in part of the muscle to die. Symptoms are: chest pain, pain in left side body, nausea/vomiting/hiccups, sweating profusely, feeling of impending doom, pain not influenced by coughing Treatment: oxygen, call ambulance, semi recumbent position, reassurance, assist in taking medication (aspirin), keep patient still and monitor vital signs and be prepared for CPR Not all patients having MI will experience chest pains and some will mistake it for indigestion |
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What is Cardiac tamponade? |
Penetrating wound to the heart which reduces cardiac output until it can’t beat anymore (due to fluid) Signs include: blunt/penetrating trauma to chest, signs of hypovolemic shock, tachycardia and may have distended neck veins This is a time critical life threatening emergency which requires surgical intervention |
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What is a pulmonary embolism (PE)? |
Sudden blockage in a lung artery usually by blockage from leg This can cause damage to lung due to lack of blood flow to lung tissue Causes low oxygen levels in blood and damages other organs due to this |
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What does FAST stand for? |
Facial weakness Arms Speech Time |
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When can you stop CPR? |
Medical expert takes over or tells you to Exhaustion Defib analysis Significant improvement in casualty |
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Mechanisms of injuries (MOI) name 4 different types? |
Mechanical energy- from motion or stored energy in an object Chemical energy- explosive or acid Electrical energy- high voltage or lightening strike Barometric energy- sudden changes in pressure from diving/flying |
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Depths of compressions for CPR for adults, children and infants? |
Adult- 5-6cm Child- 5-4cm 1/3 of chest Infant 4-3cm 1/3 of chest |
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When are rescue breaths given? |
Infant-5 before CPR wherever possible Child- same as infant Adult- 5 if adult has drowned |
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