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21 Cards in this Set
- Front
- Back
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What are the indications and contraindications for the King LT?
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Indications - Unconscious apneic without gag reflex, long transport times, poor compliance with OPA/BVM
Contraindications - Gag reflex, short transport times, caustic ingestion, essophageal trauma, under 4 feet tall |
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What are the steps to placing a King LT?
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-Size King LT based on height
-Check the cuffs work -Hyperoxygenate -Lube the distal end -Open airway with applicable maneuver -Cross finger technique to open mouth -Insert sideways from corner of the mouth -Rotate midline -Inflate balloons with specified air -Ventilate -Confirm placement - chest rise, auscultate, ETCO2 -Secure in place -Hyperoxygenate |
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What are the indications and contraindications to placing an NPA?
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Indications - Unconscious or SEMI conscious with intact GAG reflex
Contraindications - Suspected basillar skull fracture, massive head or facial trauma Complications - nasal bleeding and trauma, nasal blockage |
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What are the steps to placing a NPA?
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-Measure airway from tip of the nose to the earlobe
-Lubricate airway -Use the largest least deviated nostril, usually the right side -Insert with the bevel facing the septum -Advance which gently rotating back and forth -At the halfway point partner to perform jaw thrust -Rest the flange flush with the nare -Ventilate and observe for good chest rise If resistance is felt try gentle manipulation if no good then try the other nostril |
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What are the Indications / Contraindications for inserting an OPA?
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Indications - Unconscious or comatose patient without a gag reflex
Contraindications - Gag reflex, massive trauma to the jaw, trismus |
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How should an OPA be inserted?
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-Measure for the correct size from the corner of the mouth to the earlobe
-Open the airway with the applicable manouvre -Open the mouth with the cross finger technique -Insert with the tip to the roof of the mouth -Rotate as advance until the flange rests against the teeth If children or alternative technique for adults Depress the tongue with a blade and insert past the tongue without needing to rotate |
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What are the Indications / Contraindications for inserting an LMA?
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Indications - Unconscious apneic without gag reflex, long transport times or poor compliance with BVM / OPA, patient is too small to use a King LT
Contraidications - Intact gag reflex, short transport time, esophageal trauma, known caustic ingestion Complications - does not provide as good a seal against aspiration |
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How should an LMA be inserted?
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-Size based on the persons weight
-Test the cuff and then deflate -Hyperoxygenate the patient -Lube the posterior side -Open airway as applicable -Open mouth with crossfinger technique -Insert LMA and adance along the roof of the mouth -Continue to advance until resistance is felt -Inflate the balloon cuff -Ventilate -Confirm placement / effectiveness -Secure in place -Hyperoxygenate |
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How is the Jaw Thrust Maneuver performed?
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To be used whenever there is a mechanism of injury or suspected spinal trauma or whenever the potential for spinal trauma cannot be ruled out.
-Position yourself at the top of the patients head -Put base of thumbs against the zygomatic arches -Hook tips of fingers under the angle of the mandible -While holding the patients head still displace the jaw upward -Open the patients mouth with the tips of thumbs |
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How is the Head tilt chin lift performed?
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-Position yourself at the side of the patient
-Place hand closest to the head on the patients forehead -Place two fingers of other hand on the underside of the patients chin -Apply downward pressure on forehead and pull up on the chin |
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How is a BGL taken?
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-Setup equipment
-Position arm below heart level -Swab finger -Set lancet to long -Lance finger -Squeeze -Wipe off first drop of blood -Collect the second drop of blood on strip -Stop bleeding with gauze and dress with plaster -Check the reading |
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How is suctioning performed?
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Indications - secretions or debris interfering with breathing or ventilation
Complications - hypoxia and resulting cardiac arrhythmias -Ensure the unit is properly assembled and turn on the suction unit -Ensure that there is at least 300 of suction -Measure the cannula from the corner of the mouth to the earlobe -Open the mouth and insert to the predetermined depth without turning the machine on -Turn on the suction and apply in circular mostion as you withdraw -Do not suction for more than 15 seconds |
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How is IV cannulation performed?
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-Choose fluid and examine the bag for the 3C's and E
-Ensure the the fluid is correct for the patients condition -Choose the drip set appropriate for the patient -Fill the drip chamber by squeezing it -Flush or bleed the tubing to remove air bubbles -Tear tape strips and have op site available -Palpate a suitable vein - should be springy when palpated -Apply the touriquet above the IV site - 15-25 cm -Clean the area circular motion inside to out -Choose cannula -Break seal but do not advance -Examine the cannula for imperfections -Use other hand to hold traction on the vein -Insert cannula as low as can depending on the depth of the vein 15-45 -Observe for flashback once have advance a little further and then move the cannula into the vein -Tamponade the cannula to prevent blood leaking out withdraw the stylet -Dispose of sharps -Remove the tourniquet -Attach the IV line -Open the line to ensure flow -Secure the cannula and protect the site -Secure the IV tubing and adjust the flow rate as required -Document |
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What are some complications of IV cannulation?
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Infiltration, Irritation of the vein, Catherter shear causing embolism, hit an artery, nerve or ligament damage, allergic reaction, circulatory overload (pulmonary edema), Air embolus, Vasovagal reactions
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How is Subcutaneous Medication Administration performed?
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-Go through the 6 rights of medication and 3C's and E
-Assemble my equipment, mix meds if needed - 23-25 guage needle 5/8's - 1inch and 1ml syringe -Clense the area for administration -Pinch the skin surounding the area -Insert at 45 angle -Pull back on the plunger to aspirate for blood -Inject the medication and dispose of the needle in the sharps container -Rub the area with a circular motion to disperse the medication -Document |
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How is Intramuscular Medication Administration performed?
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-Go through the 6 rights of medication and 3C's and E
-Assemble my equipment, mix meds if needed - 19-21 guage needle 1-1.5 inch's and 3ml syringe -Clense the area for administration (Deltoid, vastus lateralis muscle, gluteal area, rectus femoris) -Advise patient of discomfort -Stretch the skin over the clensed area advise pt of the stick -Insert needle at 90 degree angle -Pull back on the plunger to aspirate for blood -Inject the medication and dispose of the needle in the sharps container -Rub the area with a circular motion to disperse the medication -Document |
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How is Sublingual Medication Administration performed?
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-Determine the need for the medication
-Go through the 6 rights of medication and 3C's and E -Get patient to rinse mouth with some water if the membranes are dry -Explain procedure asking pt to lift tongue -Place tablet or spray dose under the tongue or get the patient to do so -Advise patient not to chew or swallow but to let it disolve slowly -Document |
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How is Oral Medication Administration performed?
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-Determine the need for the medication
-Go through the 6 rights of medication and 3C's and E -Get patient to rinse mouth with some water if mouth is dry -Explain procedure asking pt to open mouth and put in the medication or allow us to do so -Place tablet or spray dose in the mouth or get the patient to do so -Advise patient to chew and swallow the medication -Document |
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How is Nebulized Medication administered?
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-Determine the need for the medication
-Go through the 6 rights of medication and 3C's and E -Add the medication to the bowl of the nedbulizer -Connect the bowl to the mask and connect this to the oxygen tubing -Set the flow rate to 6l per minute to produce a steady mist -Instruct the patient on how to breathe the medication in. -Have them breath as deeply as possible and hold breath for 3-5 seconds before exhaling. -Coach as needed. -Document Ensure if this is a B2 agonist that cardiac monitoring is performed |
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How is 4 Lead Placement performed?
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White electrode - Right lateral deltoid or right arm
Black electrode - Left lateral deltoid or left arm Red - Left leg, inferior to the knee not on bony prominance Green - Right leg, inferior to the knee not on bony prominance Ensure that this skin is clean and dry, wipe and shave as neccessary Ensure that the leads are placed in the same anatomical position bilaterally Ensure the patient is still before printing a strip Patient should ideally be supine or seated Ensure patient is not chilled as shivering will produce artifact Ensure that the monitor is set to the correct lead Print a six second strip |
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How is 12 Lead Placement performed?
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White electrode - Right lateral deltoid or right arm
Black electrode - Left lateral deltoid or left arm Red - Left leg, inferior to the knee not on bony prominance Green - Right leg, inferior to the knee not on bony prominance Use the angle of loui to get the 1st intercostal space and work down to the 4th, the fifth is usually in line just below the nipple. V1 - Fourth Intercostal space at right sternal border v2 - Fourth Intercostal space at left sternal border v3 - Equidistant between V2 and V4 v4 - Fifth intercostal space in left midclavicular line v5 - Anterior axillary line (same h plane as v4) Equidistant between v4 and v6 v6 - Midaxilliary line (same plane as v4) Ensure that this skin is clean and dry, wipe and shave as neccessary Ensure that the leads are placed in the same anatomical position bilaterally Ensure the patient is still before printing a strip Patient should ideally be supine or seated Ensure patient is not chilled as shivering will produce artifact Print a strip |
