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AV CPG's > Adult Assessment > Flashcards

Adult Assessment Flashcards

1
Q

Adequate Perfusion

A

Skin: WPD
HR: 60-100
SBP: > 100
CS: Alert & Oriented

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2
Q

Borderline Perfusion

A

Skin: CPC
HR: 50-100
SBP: 80-100
CS: Alert & Oriented

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3
Q

Inadequate Perfusion

A

Skin: CPC
HR: < 50 or > 100
SBP: 60-80
CS: Alert or Altered

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4
Q

Extremely Poor Perfusion

A

Skin: CPC
HR: < 50 or > 110
SBP: < 60
CS: Altered or Unconscious

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5
Q

No Perfusion

A

Skin: CPC
HR: Nil palp
SBP: Unrecordable
CS: Unconscious

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6
Q

Normal Respiratory

A 
Appearance:      Calm, Quiet
Speech:              Clear, Steady
Sounds:              Quiet
RR:                      12-16
Rhythm:              Regular
WOB:                  Normal
Pulse:                  60-100
Skin:                    Normal            
CS:                      Alert
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7
Q

Mild Respiratory Distress

A

Appearance: Calm or Anxious
Speech: Full Sentence
Sounds: Cough, Mild Wheeze or Basal Crackles
RR: 16-20
Rhythm: Prolonged Expiratory Phase
WOB: Slight ^ Chest Movement
Pulse: 60-100
Skin: Normal
CS: Alert

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8
Q

Moderate Respiratory Distress

A

Appearance: Distressed, Anxious
Speech: Short Sentences
Sounds: Cough, Insp/Exp Wheeze, Mid-Zone Cckl
RR: > 20
Rhythm: Prolonged Expiratory Phase
WOB: Marked +/ - AM use
Pulse: 100-120
Skin: Pale, Sweaty
CS: Alert or Altered

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9
Q

Severe Respiratory Distress

A

Appearance: Exhausted, Fighting to Breath
Speech: Word or None
Sounds: No Cough, I/E Whz, FF Cckl, Stridor, No
RR: > 20 or < 8
Rhythm: Prolonged Expiratory Phase
WOB: Marked +/ - AM use, IC retract, +/ - TT
Pulse: > 120 or < 60 (Late)
Skin: Pale, Sweaty, +/- Cyanosis
CS: Altered/ Unconscious

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10
Q

AVPU

A

Alert
Voice
Pain
Unresponsive

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11
Q

GCS Eyes

A

Spontaneous: 4
To Voice: 3
To Pain: 2
None: 1

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12
Q

GCS Verbal

A

Orientated: 5
Confused: 4
Inappropriate Words: 3
Incomprehensible Sounds: 2
None: 1

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13
Q

GCS Motor

A 
Obeys Commands:                 6
Localises to Pain:                    5
Withdraws to Pain:                  4
Flexion to Pain:                       3
Extension to Pain:                   2
None:                                       1
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14
Q

Adult Trauma TCG VSS

A 
HR:                        < 60 or > 120
RR:                        <10 or > 30
SBP:                      < 90mmHg
SpO2:                   < 90%
GCS >= 16:            < 13
GCS < 15:              < 15
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15
Q

Adult Trauma TCG Specific Injury

A

All Penetrating Injuries.

Blunt Injuries:
- Serious Injury to single body region, needing special
care such that life, limb or life quality is at risk
- Significant injuries > 1 body region

Specific Injuries:

  • Limb amputation or threat
  • Suspected Spinal Cord injury or Spinal #
  • Burns > 20% TBSA or Suspected Resp Tract
  • High Voltage ( > 1000 volts) burns.
  • Serious Crush Injury
  • Major Compound # or Open Dislocation
  • # to >= 2 of Femur/ Tibia/ Humerus
  • # Pelvis
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16
Q

Adult Trauma TCG High Risk

A

Mechanism of Injury:

  • Motor/ Cyclist impact > 30km/h
  • High speed MCA > 60km/h
  • Pedestrian impact
  • Ejection from vehicle
  • Prolonged extrication
  • Fall from > 3m
  • Struck on head by falling object > 3m
  • Explosion.

Co-morbidities:

  • Age < 12 or > 55
  • Pregnant
  • Signficant underlying med injury;
    • Poorly controlled HTN.
    • Obesity
    • Controlled or uncontrolled CCF
    • Symptomatic COPD
    • IHD
    • Chronic Renal Failure or Liver disease
17
Q

MSA Observe

A

Safety:
Scene safety is 1st priority

Appearance:
Neatness, cleanliness, extraocular monement

Behaviour:
Bizarre or inappropriate, threatening or violent, unsual motor activity, impaired gait, agitation

Affect:
Flat, depressed, agitated, hostile, withdrawn

18
Q

MSA Listen

A

Speech:
Rate, volume, quantity, content.

Thought Process:
Vague, jumping btw thoughts

Cognition:
Poorly organised thoughts, poor memory, short attention span, impaired judgement, impaired insight

19
Q

MSA Discuss

A

Thought Content:
Delusions, suicidal thoughts, concerned w/ body functions

Self-harm:
Ask pt whether attempted or plan self-harm/ suicide

Perceptions:
Hallucinations

Environment:
Lack of family/social support, substance abuse, recent stressors

20
Q

Clinical Red Flags VSS

Mandatory Tx

A 
HR:               > 120
RR:               > 30
SBP:             < 90
SpO2:          < 90% / UL norm
GCS:            < 13 / < 15 (age <16)
21
Q

Clinical Reg Flags

Mandatory Tx

A 
Stridor
First Presentation Seizure
Anaphylaxis (incl resolved)
ACS (incl resolved)
Ectopic Pregnancy
Primary Obtetric Issue.
Stroke/ TIA
Sudden Onset Headache
Unable to Walk (unusual)
Post Tonsillectomy Bleeding
22
Q

Clinical Yellow Flags

Advise Hosp or GP < 2hrs

A

Ongoing Pt/ Carer concern

Infection non-responsive to community care

Immunocompromised w/ suspected infection

Surgical procedure within 2/52

Unexplained pain >= 5

Syncope

Abdo pain

AND MUST HAVE:

Capability to attend hosp/GP
Be read Referral Advice Script

23
Q

Ambulation Risk Assessment

High Risk

A

Prerfusion:
- Inadequate or extremely
poor.
- Sig postural changes in BP &/or HR.

Baseline Mobility:
- Poor.

Specific Conditions:

  • Anaphylaxis.
  • Acute Respiratory Presentation.
  • Acute Coronary Syndrome/ STEMI.

ACTION = Extricate supine or sitting (as approp 4 pres).

24
Q

Ambulance Risk Assessment

Increased Risk

A

Perfusion:
- Borderline.

Baseline Mobility:
- Impaired.

Specific Conditions:

  • Drug or alcohol use.
  • Medicine admin (eg. Opioids).
  • Cognitive impairment.
  • Neurological pathology.
  • Hx of falls.
  • New or pre-existing injury.
  • Frail or requires mobility aid.
  • Morbid obesity.

ACTION = Aim to extricate supine or sitting.

25
Q

Ambulation Risk Assessment:

All Patients.

A

Pause & Plan.

Request Manual Handling if required.

Provide redundancy options in case ambulation fails.

In complex egress situations, if risk to patient is acceptable, consider Sit/ Stand/ Walk test & limit walking/ exertion.

AV CPG's (11 decks)

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