4HS, 4TS, HOTT PRINCIPLES Flashcards
What are the 4 Hs
Hypoxia
Hypovolvemia
Hyperkalemia / hypokalaemia and hypoglycaemia
Hypothermia/ hyperthermia
What are the 4Ts
Toxins
Tension pneumothorax
Tamponade
Thrombus
How do I treat hypoxia
Secure an advanced airway ensuring that patient is on 15L of o2.
How do I treat hypovolemia ?
For non catastrophic bleeds IV fluids is not indicated.
For catastrophic bleeds
- up to 2L fluids
- rapid movement
- dependant on mechanism pelvic binder.
- blast dressings , torniquets or pressure.
-TXA
How do we treat hypo/hyperthermia ?
Hypothermia - remove wet clothing, wrap patient up, foil blanket and warm them, get onto ambulance with heating.
Adrenaline every 6-10 mins for temp 30-35.
Below 30 don’t give drugs.
Hyperthermia -
Cool pt
Remove clothing
Cool environment - open windows doors
How do we treat hypo/hyperkalemia
Diagnosis is challenging
Look for fistula
Pt history - DKA or high potassium, frailty or eating disorders, gastric disease rapid transfer
Take a blood sugar correct with drugs
How to identify and treat toxins?
Look for drug paraphernalia, track marks, history.
If opioid is suspected give narcan.
How to identify and treat TpTX
Can be challenging
Look for chest trauma (not cause by CPR) or bruising
History of asthma or COPD
Decreased air entry when bagging/check for advanced airway.
Perform needle decompression however can be dislodged due to CPR.
How to identify and treat cardiac Tamponade
May be ECG changes like a narrow QRS complex
No treatment paramedics can do can call for senior support or rapid transfer
How to identify and treat thrombus
Pulmonary - challenging in an arrest - gain history - ask about recent travel / surgery. Ask about calf / check the calf’s.
Cardiac -
Did they have chest pain before hand?
Did they complain of headache/ have signs of stroke.
Rapid transfer
