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GAP1 > Assessments > Flashcards

Assessments Flashcards

1
Q

Perfusion definition

A

The ability of the cardiovascular system to provide tissues with an adequate oxygenated blood supply to meet their functional demands at the time, and to effectively remove the associated metabolic waste products

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2
Q

Adequate perfusion

A

Warm/pink/dry
Pulse 60-100
BP >100
Alert and oriented

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3
Q

Borderline perfusion

A

Cool/pale/clammy
Pulse 50-100
BP 80-100
Alert and oriented

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4
Q

Inadequate perfusion

A

Cool/pale/clammy
Pulse <50, >100
BP 60-80
Alert and oriented or altered conscious state

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5
Q

Extremely poor perfusion

A

Cool/pale/clammy
Pulse <50, >110
BP <60
Altered conscious state or unconscious

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6
Q

When assessing the pattern of injury, the patient can be considered to have a significant blunt head injury in the setting of blunt head trauma with and of the following:

A 
>5 minutes LOC 
Head # or skull #
Emesis >1
Neurological deficit 
Seizure activity
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7
Q

Normal respiratory status

A 
Calm, quiet 
Clear steady sentences 
Usually quiet, no wheeze
12-16
Regular even cycles
Normal chest wall movement 
Pulse 60-100
Warm/pink/dry
Alert and oriented
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8
Q

Mild respiratory distress

A

Calm or mildly anxious
Full sentences
Able to cough. Asthma: mild exploratory wheeze. LVF: may be fine crackles at the bases
16-20
Asthma: slightly prolonged expiratory phase
Slight increase in normal Chest wall movement
Pulse 60-100
Warm/pink/dry
Alert and oriented

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9
Q

Moderate respiratory distress

A 
Distressed or anxious 
Short phrases only
Able to cough. Asthma: expiratory +/- inspiratory wheeze. LVF: crackles at bases to midzone
>20
Asthma: prolonged expiratory phase
Marked chest wall movement +/- accessory muscle use 
Pulse 100-120
Pale and sweaty 
May be altered conscious state
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10
Q

severe respiratory distress

A

Distressed,anxious, fighting to breath, exhausted, catatonic
Words only or unable to speak
Unable to cough. Asthma: expiratory and inspiratory, may be no sound. LVF: full field crackles, possible wheeze. FBAO: inspiratory stridor
>20 or bradypnoea (<8)
Asthma:prolonged exploratory phase
Marked chest movement with accessory muscle use, intercostal retraction +/- tracheal tug
Pulse: >120, bradycardia late sign
Pale and sweaty +/- cyanosis
Altered conscious state or unconscious

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11
Q

Trauma time critical - actual

A 
HR  <60 or >120
RR <10 or >30
BP <90
O2 <90
GCS <13
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12
Q

Trauma time critical guidelines - potential

A

All penetrating injuries (except isolated superficial limb injuries)
Blunt injuries
-serious injury to a single body region such that specialised care or intervention may be required or such that life, limb or long term quality of life may be at risk
-significant blunt injuries involving more than one body region
Specific injuries
-limb amputation
-suspected SCI or spinal #
-burns >20% tbsa or ?respiratory tract burns
-high voltage burn injury
-serious crush injury
-major compound # or open dislocation
-# to 2 or more of femur/tibia/humerus
-# pelvis

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13
Q

Trauma time critical guidelines - emergent

A 
Mechanism 
 -motor cyclist impact >30km/he
 -high speed MCA >60km/he
 -pedestrian impact 
 -ejection from vehicle 
 -prolonged extrication 
 -fall from height >3m 
 -struck on head by object falling >3m
 -explosion 
And comorbidities
 -age >55
 -pregnant 
 -significant underlying medical condition
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14
Q

Medical time critical guidelines - actual

A

Moderate or severe respiratory distress

Oxygen saturation <90% RA/<93% supplemental o2

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15
Q

Medical time critical guidelines - emergent

A
  • ACS
  • acute stroke
  • severe sepsis including meningococcal disease
  • possible AAA
  • undiagnosed severe pain
  • need for possible hyperbaric treatment
  • hypothermia/hyperthermia
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16
Q

Critical illnesses requiring 100% O2

A 
SpO2 <85%
Cardiac arrest
Major trauma / head injury 
Carbon monoxide
Shock
Severe sepsis
Anaphylaxis 
Decompression illness
Status epilepticus
17
Q

sepsis criteria

A 
2 or more of the following:
Temp >38 or <36
HR >90
BP <90
RR >20
18
Q

anaphylaxis criteria

A

sudden onset of symptoms (minutes to hours)
two or more of R.A.S.H with or without confirmed antigen exposure
R = respiratory distress
A = abdominal symptoms
S = skin/mucosal symptoms
H = hypotension (or altered conscious state)
OR
isolated hypotension (<90) following exposure to known antigen

19
Q

modifying factors for hypovolaemia fluid administration

A

SCI, 500ml bolus
chest injury, rx TPT
penetrating trunk injury, accept carotid pulse & tx
uncontrolled external haemorrhage
GI haemorrhage, consider lesser volumes and accept BP of 80-100

20
Q

Newborn values

A 
<24hours 
Weight 3.5kgs
HR 110-170
BP >60
RR 25-60
21
Q

Small infant values

A 
<3 months old 
weight 6kgs 
HR 110-170
BP >60
RR 25-60
22
Q

Large infant values

A 
3-12 months
Weight 8kgs
HR 105-165
BP >65
RR 25-55
23
Q

Small child values

A 
1-4 years 
Weight 
         - 1 year = 10kg 
         - >1 year old = age x 2+8 =weight 
HR 85-150
BP 70
RR 20-40
24
Q

Medium child values

A 
5-11 years 
Weight
       - 5-9years = age x 2 +8 = weight
       - 10-11 years= age x 3.3 = weight
HR 70-135
BP >80
RR 16-34
25
Q

Large child values

A 
12-16 years 
Weight 
        - 10-14 years= age x 3.3 = weight 
HR 60-120
BP >95
RR 14-26
26
Q

Signs to confirm meningococcal septicaemia (meningeal&sepsis)

A 
-Purpuric rash 
Septicaemia signs:
-fever, right, joint &amp;a muscle pain 
-cold hands&amp;feet
-tachycardia, hypotension 
-tachypnoea 
Meningeal signs:
-headache, photophobia, neck stiffness 
-nausea&amp;vomiting 
-altered conscious state
27
Q

Simple pneumothorax

A
  • unequal breath sounds in spontaneously ventilating pt
  • low spO2 on room air
  • subcutaneous emphysema
28
Q

Tension pneumothorax

A
  • increased peak inspiratory pressure
  • decreased EtCO2
  • poor perfusion
  • increased JVP
  • altered conscious state
  • tracheal shift
  • low spo2 on supplemental o2 (late)
29
Q

If any of the following present spinal immobilisation should be provided

A
  • Age >55
  • History of bone disease
  • Unconscious or altered conscious state or LOC
  • drug or alcohol affected
  • significant distracting injury
  • spinal column pain/bony tenderness
  • neurological deficit or changes

GAP1 (4 decks)

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