Various For Acos In Victoria Australia - See Other Sets

Front 1

What are the 3 types of mechanical rescue?

Back 1

Rapid extraction – should be uncommon. Careful extraction. Assisted extraction.

Front 2

Describe rapid extraction (from mechanical entrapment).

Back 2

Rapid extraction is for when hazards cannot be removed and/or the patient is critically injured and needs immediate management. Rapid extraction should be relatively uncommon.

Front 3

Describe careful extraction (from mechanical entrapment).

Back 3

Carful extraction is for the patient with serious but not life threatening injuries, needing care for painful or potential spine injuries. Use e.g. cervical collar, KED, coordinated Pt handling.

Front 4

Describe assisted extraction (from mechanical entrapment).

Back 4

If the Pt can move without too much difficulty or pain we can assist them as necessary.

Front 5

Snake Envenomation What are the three types of toxin are in snake venoms?

Back 5

Nerve toxin. Muscle toxin. Blood toxin.

Front 6

Snake Envenomation What are the signs & symptoms of nerve toxins?

Back 6

Eye drooping. Disturbed vision. Dilated pupils. Difficulty swallowing. Progressive muscle paralysis – including muscles used for breathing.

Front 7

Snake Envenomation What are the signs & symptoms of muscle toxins?

Back 7

Muscle weakness and/or pain Rhabdomyolysis - muscles break down causing large molecules to be released into the blood. These damage the kidneys. Dark urine (blood) Kidney failure

Front 8

Snake Envenomation What are the signs & symptoms of blood toxins?

Back 8

Bleeding from wounds – reduced clotting Tachycardia Hypotension

Front 9

Snake Envenomation What is rhabdomyolysis?

Back 9

Muscle are broken down by toxins from snake bite. Large molecules are released and trapped by the kidneys. This can lead to kidney failure.

Front 10

What local creatures have a bite that needs pressure immobilisation technique?

Back 10

Snakes Funnel web spiders

Front 11

What kinds of bites and stings do not require pressure immobilisation technique?

Back 11

Scorpions, centipedes beetles Bees, wasps, ants Redback and other spiders – except funnel web.

Front 12

Snake Envenomation Describe the first aid treatment for snake bite.

Back 12

Use crepe or self-adherent bandage. Don’t move limb but remove jewellery and clothing if possible. Lower limb (let gravity help). Short pressure bandage over wound site. Pressure bandage from limb extremity to top of limb – or as far as possible. Splint/immobilise. Don’t allow patient to move/walk.

Front 13

Snake Envenomation What are three things that can happen which would affect patient management?

Back 13

Anaphylaxis – allergic reaction to snake bite proteins. Severe non-cardiac pain. Cardiac arrest/breathing failure/unconsciousness.

Front 14

Snake Envenomation Is it better to get the patient to walk a bit or wait for delayed help to move patient?

Back 14

Wait. Correct first aid should prevent significant deterioration for considerable time.

Front 15

What are the four criteria for assessing perfusion?

Back 15

HR/Pulse (<50 or >100). Blood Pressure (< 100/P). Skin – cool, pale, clammy / sweaty. Conscious state – drowsiness, lethargy or worse.

Front 16

What is the normal human response to loss of blood volume (hypovolaemia)?

Back 16

Increase the heart rate Constrict the blood vessels.

Front 17

What is de-compensated shock?

Back 17

When the body’s normal response to shock maintains perfusion it is called ‘compensated shock’. When this is no longer the case it is ‘de-compensated shock’.

Front 18

What are the three categories of perfusion?

Back 18

Adequate perfusion. Less than adequate perfusion. No perfusion.

Front 19

What does ‘less than adequate perfusion’ suggest?

Back 19

Less than adequate perfusion suggest there is a real medical or trauma emergency. The patient is actual time critical.

Front 20

What are the two types of drug that increase bleeding making it harder to control?

Back 20

Anti-platelet – eg aspirin Anti-coagulant – eg warfarin

Front 21

How does the body respond to a damaged blood vessel? (3 things)

Back 21

Spasm of damaged blood vessel restrict blood flow. Platelets stick to damaged area plugging hole. Clot forms to reinforce plugging.

Front 22

What are the four simple rules/steps to stop bleeding?

Back 22

Apply direct pressure Apply dressing – thick, dry, sterile pad Bandage to maintain the pressure on the dressing Elevate injured part

Front 23

If you detect hypotension in a trauma patient and there is no obvious blood loss, what must you suspect?

Back 23

Internal bleeding – possibly abdominal (and there may be swelling)

Front 24

What must we assume if there is vaginal bleeding in the first few months of pregnancy?

Back 24

An ectopic pregnancy – until proven otherwise.

Front 25

Why must we keep a bleeding patient warm?

Back 25

Hypothermia causes increased bleeding time.

Front 26

What are three classifications of upper airway obstruction?

Back 26

Introduced – eg food Medical – eg anaphylaxis causing neck swelling Trauma – eg damage to face/throat by gunshot, MVA etc

Front 27

What are the two types of lower airway disease?

Back 27

Bronchiole disease Alveoli disease

Front 28

What is the basic care for any patient with breathing difficulties? (Asthma, COPD, chest infection, heart failure)

Back 28

Rest and Reassurance !NO EXERTION! Position patient upright Oxygen @ 8 lpm If ACS then IPPV Asthma patient also gets Salbutamol and maybe Atrovent

Front 29

Name 3 common diseases that present in the alveoli.

Back 29

Emphysema Pneumonia Acute pulmonary oedema

Front 30

Give 3 ways of clearing an introduced airway obstruction.

Back 30

Coughing Back blows Chest thrusts

Front 31

What are the six components of the respiratory system?

Back 31

Control system Upper airway Middle airway Lower airway Mechanical structures Protective mechanisms

Front 32

What do we do for a patient with Altered Conscious State from respiratory failure?

Back 32

High concentration oxygen from bag/valve/mask. IPPV if unconscious. Do not continue to administer Salbutamol since, if the patient’s breathing can’t supply enough air to the lungs, it can’t supply drugs via a nebuliser.

Front 33

What is the approximate weight of a small child? (Formula)

Back 33

(Age x 2) + 8 Kg

Front 34

What is the approximate weight of a large child? (Formula)

Back 34

Age x 3.3 Kg

Front 35

Patient Assessment When should vital signs be taken?

Back 35

As early as practicable in patient assessment. Before any drugs are administered. Every 5 to 15 minutes depending on how stable patient is.

Front 36

Patient Assessment What are the four groups of vital signs?

Back 36

Perfusions Status Assessment Respiratory Status Assessment Conscious Status Assessment = GCS Others: BGL, Temperature

Front 37

Patient Assessment What does a GCS of 3 mean?

Back 37

Either dead or deeply unconscious.

Front 38

Patient Assessment What are the three parts of the GCS?

Back 38

Eye opening. Verbal response. Motor response.

Front 39

Patient Assessment How do you assess motor response for the GCS?

Back 39

Hold both extended fore fingers in front of Pt and ask Pt to grip them. (6) Press knuckle into sternum. Does patient push hand away? (5) Press pen across nail bed. Does Pt pull away? (4) Does Pt twist arms up towards chest/brain? (3) Does arm stiffen & stretch out away from brain? (2) Check both arms – score best side. No response at all = 1.

Front 40

Patient Assessment What responses can you expect from nail bed pressure?

Back 40

Withdrawal. Abnormal flexion – arms twist up towards chest. Abnormal extension – arms stiffen & stretch out away from brain. Check both sides – score best side.

Front 41

Patient Assessment What are the standard questions for the GCS?

Back 41

Can you open your eyes for me? Can you reach up and squeeze my fingers with your hands? Can you tell me your name? Where are we? Can you tell me what time and day it is?

Front 42

Patient Assessment How do we assess pupil reactions?

Back 42

Get Pt to close eyes. Pupils should dilate. Get Pt to open eyes and pupils should constrict – you may need to shine a torch near their eyes if there’s not much light.

Front 43

Patient Assessment What score do we give an uncooperative Pt in GCS?

Back 43

We score what we see and what we hear – we don’t make assumptions. If we think a Pt is deliberately not complying, we make a note of it. If we think there is any other reason for a low score, we make a note – eg not an English speaker or deaf.

Front 44

Patient Assessment What can Pt pupil size tell us?

Back 44

1 dilated pupil probably = brain injury/stroke 2 dilated pupils can mean hypoxia/drugs/cardiac arrest. 2 constricted pupils can mean narcotic drug overdose

Front 45

Patient Assessment What are the 6 parts of the RSA?

Back 45

Rate Rhythm Effort Appearance – anxious? Frightened? Panicking? Speech – sentences? Count to 10? Noises

Front 46

Patient Assessment What are the 4 parts of the PSA?

Back 46

Skin: w-p-d or c-p-c HR/Pulse: 60 – 100 OK (<50 or >100 NOT OK) BP: >= 100 OK (<100 NOT OK) Conscious state: Alert or ACS. Irritable etc?

Front 47

Patient Assessment What term must we use when there isn’t a measurable blood pressure?

Back 47

‘Unrecordable’ – we don’t say there isn’t a blood pressure.

Front 48

Patient Assessment What is it important to check in any Pt with ACS?

Back 48

Must check blood glucose level. Hypoglycaemia can affect the brain & conscious state very quickly. Glucose is the only energy source used by the brain.

Front 49

Patient Assessment What do we ask if a patient says s/he has been vomiting?

Back 49

Was the vomit food? Did it seem to have blood in it? How many times?

Front 50

Patient Assessment What is actual time criticality based on?

Back 50

Vital sign abnormalities.

Front 51

Patient Assessment What does Actual time critical mean?

Back 51

At the time the vital sign survey was taken the patient was in actual physiological distress.

Front 52

Patient Assessment What does Potential time critical mean?

Back 52

At the time the vital sign survey was taken the patient was not in actual physiological distress BUT there was a mechanism of injury or illness known to have a potential to deteriorate to actual physiological distress. R! Potential Mechanism

Front 53

Patient Assessment What does Emergent time critical mean?

Back 53

At the time the vital sign survey was taken the patient was not in actual physiological distress BUT the patient has a pattern of actual injury/illness which is known to have a high probability of deteriorating to actual physiological distress. R! Emergent Pattern

Front 54

What are the symptoms of shock?

Back 54

Skin – pale, cold, clammy Tachycardia Shallow rapid breathing Nausea and vomiting Dizziness Anxiety etc

Front 55

What are the three levels in the hierarchy of dangers (risk avoidance)?

Back 55

Remove the danger (hazard). Remove Pt from danger (hazard). PPE to protect from danger (hazard).

Front 56

What do the following symptoms suggest? Skin – pale, cold, clammy – Tachycardia – Shallow rapid breathing - Nausea and vomiting Dizziness - Anxiety - etc

Back 56

Shock.

Front 57

Patient Assessment What extra factors are required to make mechanism of injury time critical?

Back 57

Pregnancy or Age over 55 or Underlying illness or Child

Front 58

Patient Assessment What are the major mechanisms that make an injury potential time critical?

Back 58

Car occupants involved in crash over 60 km/h. Pedestrian impact. Ejection from vehicle. Fall from > 3 metres or 2 times a child’s height Struck on head by falling object from > 3 metres Cyclist/motorcyclist impact > 30 km/h Explosion. Prolonged extrication (>30 mins) Plus: pregnant, >55, child, underlying illness

Front 59

Under what circumstances do we start chest compressions on a child?

Back 59

Pulse absent or Pulse < 40 in a child (1 – 14 inc.) Pulse < 60 in an infant (<1 yr)

Front 60

Symptoms: Cold, pale & clammy skin – tachycardia - shallow, rapid breathing – nausea & vomiting – dizziness – anxiety - etc

Back 60

Shock

Front 61

Symptoms: Hypotension with no obvious blood loss – what must you suspect?

Back 61

Internal bleeding, possible abdominal – possible swelling.

Front 62

Symptoms: Vaginal bleeding in the first few months of pregnancy?

Back 62

We must assume it’s an ectopic pregnancy until proven otherwise.

Front 63

Symptoms: Increased bleeding from wounds (reduced clotting) – tachycardia - hypotension

Back 63

Snake envenomation with blood toxins.

Front 64

Symptoms: Muscle weakness &/ pain – dark urine (blood) – kidney failure - rhabdomyosis

Back 64

Snake envenomation with muscle toxins