Assessment Flashcards
1
Q
- What are the co-morbidities for TCG?
A
Systemic illness limiting normal activity/constant threat to life: PISCOC - Poorly controlled hypertension - Ischaemic heart disease - Symptomatic COPD - CCF - Controlled/uncontrolled - Obesity - Chronic renal failure/liver disease Pregnant Age <12 or >55
2
Q
- What are the specific injuries meeting Potential major trauma criteria?
A
- All penetrating injuries (except isolated superficial limb)
- Blunt injuries: serious injury to single body region requiring specialised care or life/limb/QoL may be at risk; significant injuries to more than one body region
- Limb amputation/limb threatening injury
- Suspected spinal cord injury or spinal fracture
- Burns >20% TBSA ( >10% if ≤15) or suspected resp tract burns
- High voltage >1000v burns
- Serious crush injury
- Major compound fracture or open dislocation
- Fracture to 2 or more of femur/tibia/humerus
- Fractured pelvis
3
Q
- What are the High Risk criteria for major trauma?
A
4 Car:
- Motor/cyclist impact >30kph
- High speed MCA >60kph
- Pedestrian impact
- Ejection from vehicle
4 Other:
- Prolonged extrication
- Fall from heigh >3m
- Struck on head falling object >3m
- Explosion
And co-morbidities: Age <12 or >55, pregnant, or significant underlying medical condition
4
Q
- What are the High Risk Mental health symptoms?
A
- Attempted suicide or self-harm
- Intentional overdose/poisoning
- Substance intoxication to the point unable to complete MSA
- Section 351
- Requires sedation
- Pt in dangerous social situation - Family violence
- Acute psychosis/mania/confusional state
- Any red flags
5
Q
- What are the signs the Mental health patient requires a specialist mental health assessment, possibly via Tele PROMPT?
A
- Currently under care of mental health service
- Recent d/c <28days from psychiatric inpatient
- Unwillingness to accept help
- Current suicidal ideation/prev attempt
- Pt lacks social/emotional support options
- Evidence of not coping
6
Q
- When should women be considered at risk of ectopic pregancy?
A
Women of reproductive age with any combination of pain in abdo/pelvis/shoulder tip/rectum, PV bleeding or dizziness/syncope
7
Q
- What are the conditions under immunocompromised in Yellow flags?
A
- Chemotherapy/radiotherapy for cancer
- Organ transplant
- HIV/AIDS
- Rheumatoid arthritis therapies (other than NSAIDS)
8
Q
- What are the Red Flag abnormal vital signs?
A
HR >120 RR >30 SBP <90 SpO2 <90% (unless chronic hypoxaemia) GCS <13 (<15 if age ≤15)
9
Q
- What are the specific Red Flag conditions?
SAFE AS PUPS
A
SAFE AS PUPS
- Stridor
- Anaphylaxis
- First presentation seizure
- Ectopic pregnancy
- Acute Coronary Syndrome (even if resolved)
- Stroke/TIA
- Primary obstetric issue
- Unable to walk (when usually able to)
- Post-tonsillectomy bleeding up to 14 days post-op
- Sudden onset headache
10
Q
- What are the Yellow Flags? OASIS PI
A
- Ongoing patient or carer concern
- Abdominal pain
- Surgical procedure within past 14 days
- Infection not responding to community based care (oral antibiotics)
- Syncope (asymptomatic, normal vital signs, normal ECG)
- Pain (e.g. ≥5) - significant unexplained
- Immunocompromised with suspected infection
Pt must have capability to attend hospital/GP and be read Referral Advice Script
11
Q
- What are the four elements of Decision-making capacity?
A
- Understand the info relevant to the decision and the effect of the decision
- Retain that information to the extent necessary to make the decision
- Use or weigh that info as part of the process of making the decision
- Communicate the decision
12
Q
- Define perfusion:
A
Ability of CV system to provide tissues with adequate oxygenated blood supply to meet functional demands and to effectively remove associated metabolic waste products.
13
Q
- What are the transport considerations for trauma maternity pts?
A
All maternity pt who meet TCG criteria, or any pt>24 weeks gestation with any trauma or potential harm to unborn child should be transported to RMH if within 45mins. If >45mins Tx to nearest alternative highest level of trauma service. Pregnant women must not be taken to the Alfred hospital unless in cardiac arrest and it is closest.
14
Q
- MSA points:
A
- Observe: SABA - Safety, Appearance, Behaviour, Affect
- Listen: STC - Speech, Thought Process, Cognition
- Discuss: PETS - Perception, Environment, Thought Content, Self-harm
15
Q
- What are the components of valid consent?
A
- Voluntary: cannot pressure or coerce a decision
- Informed: results of assessment/implications, diagnostic uncertainty, care pathways, recommended course of action, consequences
- Relevant: consent is relevant to a specific context/procedure
