ACUTE ON-FIELD CARE Flashcards
you are being called because there’s an unconscious person in the hallway just outside the AT clinic. upon approach what are your steps?
assume c-sp and distance obvs of area
check for safety hazards
remove anything surrounding the person
if there are bystanders ask them what happened
- approach patient, introduce yourself, state qualifications, ask for consent to help out
contact EMS immediately
is a person who is unconscious and IS BREATHING (w/ no other life-threatening things to account for) what should you do with this person until EMS arrives?
put them into the recovery position on their left side
for how long should you be checking to establish breathing and circulation?
10 sec
if you were to use a suction device for a patient who has vomited, what are your measurements before you use it?
corner of mouth to earlobe
before putting an OPA in an unconscious patient, what must you check first?
gag reflex - flicker the eyelid and if there’s no movement, you may proceed
measurements - corner of mouth to corner of same side earlobe
for what kind of patients can you use an NPA for? what must you do first before inserting it into the nostrils
unconscious and responsive unconscious adults
must lubricate first and measure - nostrils to same side earlobe
it shouldn’t produce a gag reflex unless the the apparatus is too long
DO NOT USE FOR ANYONE WITH SUSPECTED HEAD TRAUMA
for a patient who is not breathing but has a pulse - what is the most appropriate course of action?
rescue breaths
1 breath/ 5 sec - up to 2 mins
what are the flow rates for each assistive breathing tool?
what also must you consider before administering oxygen?
(updated as of 2019):
nasal cannula (for person who can breath on their own) : 4 lpm
Resuscitation mask (unconscious patient): 6+ lpm
BVM (conscious or unconscious patients): 15 + lpm
NRB (conscious patients ONLY): 15 + lpm
regional specifications on administering oxygen (may need a physicians clearance to do or may face litigation)
explain the protocol for obstructed airway management for a conscious patient
encourage coughing
if no sounds are coming out - proceed with back blows and abdominal thrusts
if you got a preggo lady or bigger person - chest thrusts at tall kneeling height
explain the protocol for obstructed airway management for a unconscious patient
30 compressions and check airway for obstruction (no pulse check or breathing)
dislodge object until they can breathe on their own
if there is hemorrhaging, how can you tell what vessels have been affected?
venous blood:
dark red
capillary:
reddish
arterial:
bright red and is coming out in spurts
if direct pressure on a wound doesn’t stop hemorrhaging, what other options do you have?
go to pressure points (11 pressure points):
dorsalis pedis (wounds for feet) popliteal (wounds for lower leg) femoral (wound of thigh) femoral triangle radial and ulnar (wound of hand) brachial axillary subclavian (upper arm wounds) **carotid (DO NOT PUT PRESSURE ON THIS - COULD CAUSE CARDIAC ARREST)* fascial (wound under eyes) temporal (wounds of the temple and scalp)
internal hemorrhaging - what are the typical signs?
mng?
distention or “pressure build up” at area of discomfort
vitals: low BP
weakness (especially on affected side)
tx for shock
an athlete comes to you super dehydrated and feeling a weakness and wooziness - they look pale, skin is cool and clammy - you suspect them in shock, but what type of shock?
hypovolemic - because they’re dehydrated, not enough water in the plasma to get blood to the extremities
associated with also low BP
s/s of respiratory shock
decrease in ability to breathe - may be secondary to injury that impedes breathing
what type of shock is likely to have occurred when there’s enough blood vessel dilation to cause syncope
psychogenic shock
normal human body temp
36.8- 37 C
s/s of shock
how to mng?
pale, cool, clammy skin weak, rapid pulse pupils may be dilated shallow- rapid breathing rate low BP restlessness/excitement
maintain body temp comfort patient elevate legs (**depends on the injury)
for a dark-skinned person, where would you look to see if there are indications from their skin as what is going on?
inside mouth and tongue
if they are in shock:
skin around mouth, nose and tongue would have a gray-ish cast)
if a dark-skinned person is going through shock due to a hemorrhage, what could indicate that?
inside of mouth and tongue - becomes light gray
if a dark-skinned person has a fever what other skin indications can reveal that?
the tips of their ears would be flushed with red
when is compression for an acute injury contraindicated?
acute lower leg compartment syndrome
you run down to the field to an athlete who’s gone down holding his arm - you arrive on the scene and suspect a humeral fracture, what are your next steps?
what must you also be concerned about with a humeral fracture?
get someone to bring the splint and call EMS as you stabilize the arm in the position found
check PMS before splinting
splint
check PMS after
tx for shock if necessary
additional concerns: laceration or damage to the radial nn - patient presents with a wrist drop
when fitting a crutch on an athlete, what are the key points for proper crutch fittings?
- foot of crutch is ~ 6 inches lateral of shoe and ~2inches up
- arm pad below armpit should be 1 inch below the armpit
- athlete should be holding the crutches such that the elbow is bent at 30 degrees of flexion
where would you measure for adjusting the height of a cane?
crease of the wrist
if the first dose of nitroglycerin is administered and there is no change in the patient’s perception of chest pain - what is another option?
recommended to get 160 - 325 mg of aspirin (only done once)
what must you do first in order to assist in the administration of nitroglycerin?
take their BP (anything below 100 systolic is contraindicated) - this for EVERY ROUND OF NITRO GIVEN
have them semi-reclined or seated on the floor (just in case their BP goes too low)
max dosage for nitroglycerin
3 doses within a 30 minute period (5 min in between dosages)
precautions for usage of an epi-pen
pregnancy (can induce labour)
the person who has already had 3 doses of nitroglycerin has another episode of chest pain - mng?
check BP and administer another 3 doses (considered a new episode)
what are the rules of nines?
estimates the amount of body surface that has been burned (when communicating with advanced medical personnel) - measured in %
which regions and their numerical values are considered in the rule of nines for adults
head - 9% arms - 9 % each trunk - 18 % legs - 18 % each lady/man parts - 1%
*palm is considered 1%
which regions and their numerical values are considered in the rule of nines for children?
head - 18 %
trunk - 18 %
arms - 9 % each
legs 14 % each
when transporting a patient on a stretcher, what should you be leading with?
patient’s feet first (unless going up a hill or up stairs)
what to look for a suspected electrical burn?
typically has an entry and exit wound - cover burns with non-stick sterile dressing and tx for shock