Basic Life Support Flashcards
What are the steps in the Primary Survey for Wound Care?
- Expose and Examine
- Cover with sterile dressing
- Control major hemorrhage
- Stabilize injured limb
- Assess distal circulation
- Continue with assessment and treatment
What are the 5 steps (in order) of controlling major hemorrhage?
- Direct Pressure
- Positioning the part (elevation should only be done if it doesn’t aggravate other injuries or conditions.
- Positioning the patient (at rest and supine of other injuries permit)
- Pressure points
- Tourniquet
What could absence of distal circulation indicate?
A limb threatening injury or condition. Should be considered RTC.
When can cold be applied to a wound?
At the end of the primary survey, considering a distal pulse is not impaired. Distal pulse should be checked and compared with uninjured limb.
What are the steps for wound care in the secondary survey?
- Bandage major wounds (if not already done)
- Clean and dress minor wounds
- Apply cold if required
- Elevate, if appropriate
What should be done with embedded objects when treating wounds?
Embedded objects should be stabilized in place.
When should limbs be immobilized when treating wounds?
If there are large wounds, or wounds over joints.
What should be done for Fractures in the Primary Survey?
- Expose and Examine
- Control major hemorrhage
- Stabilize fractured limbs
- Check distal pulse
- Realign grossly deformed or pulseless limbs
What Protocols would be used for fractures?
Entonox, if appropriate.
What should be done in the treatment section for fractures?
- Check distal circulation
- Apply cold, if appropriate
- Apply traction, if appropriate
- Realign angulated long-bone fractures, if appropriate
- Immobilize the joints above and below the injury site.
- Reassess distal circulation, sensation and function.
- Reapply cold, if appropriate
- Elevate, if appropriate
What types of fractures would indicate the use of traction?
Suspected lower-limb fractures between the mid-shaft femur, and the mid-shaft tibia/fibula.
What are the steps for applying a traction splint?
- Assess distal circulation, sensation and function
- Apply cold, if appropriate
- Ensure Pt is supine, with injured leg in line with body
- Place splint beside injured leg
- Secure thigh strap.
- Apply ankle harness above the malleoli
- Apply traction
- Ensure adequate padding
- Stabilize limb by applying 3 zap straps
- Reassess distal circulation, sensation and function.
How much traction should be applied to an adult closed fracture?
10% of body weight, up to 15lbs
How much traction should be applied to an adult open fracture?
5lbs MAX
How much traction should be applied to an adult joint fracture?
5lbs MAX
How much traction should be applied to an infant/child closed fracture?
7.5 lbs max
What should be done for non RTC spinal management in the Primary survey?
Stabilize head and neck
What are the steps for spinal immobilization?
- Apply hard collar
- Adjust and re-align if required
- Place a blanket between legs, and secure with zap strap
- Apply clam shell
- Secure patients body
- Apply padding
- Secure Pt head
When would a patient be treated for a spinal injury?
When a spinal is expected because of mechanism of injury, or for an unconscious Pt where trauma cannot be reasonably ruled out.
What should be done for burns in the primary survey?
- Expose and examine
- Initiate cooling
- High flow O2
- Calculate BSA
How should major burns be cooled in the primary survey?
Cool major burns with water for a total of 10 minutes
How should chemical burns be cooled in the primary survey?
Flush chemical burns with water for a minimum of 20 minutes to stop burning, and remove source of burns.
What should be done for burns in the secondary survey?
- Dress wounds
2. Apply cold and entonox if appropriate.
How are burns dressed in the secondary survey?
Cover wounds with dry, sterile, non-stick dressing. Bandage as required.
When should cold not be used when treating burns?
Cold therapy should not be used on major burns.
Cold should not be applied if distal circulation is impaired. Compare with uninjured limb.
What are some indications of hypothermia?
Suspected hypothermia because of MoI, history, presentation of the patient or the rectal temperature .
What should be done for hypothermia in the primary survey?
- Assess and maintain ABC’s
- Ventilate non-breating, severely hypothermic Pt at a rate of 8-10 breaths per minute.
- Take up to 60 seconds to determine pulslessness in a severely hypothermic Pt
- Remove wet and cold clothing - cover with blankets
- Oxygen
- RTC
- Take temperature
What would constitute Mild hypothermia?
30º to 35º
How should patients with mild hypothermia be actively re-warmed?
Mild activity (if appropriate)
Preheat interior of ambulance to 30º
Use hot packs wrapped in towels
Warm blankets
What would constitute Severe Hypothermia?
Below 30º
How should Pt with severe hypothermia be treated?
Insulate to prevent further heat loss
Heat ambulance to 30º
Avoid rough handling
Do not actively re-warm
Why should O2 be applied with caution to severely hypothermic Pt?
Because of it’s cooling effects
What should be done in the protocol component for Hypothermia?
Maintain BLS and transport to hospital.
How should temperature be taken for hypothermic Pt?
Rectal
What are findings of an unstable Congestive Heart Failure or Pulmonary Edema Pt?
- Altered LOC
- Difficulty maintaining Airway
- Respiratory Distress
- Accessory muscle use
- Noisy respirations
- Weak, rapid or absent radial pulse
- Peripheral Edema
- Cool, Clammy skin
- Jugular vein distention
What are some critical interventions for unstable congestive heart failure or pulmonary edema pt?
- Semi-sit if conscious
- Supine if hypotensive
- Assist ventilations if altered LOC
What is congestive heart failure or pulmonary edema?
When the heart is unable to pump enough, causing excess fluid in the lungs.
What are findings of an unstable patient with chest or abdominal trauma/injuries?
- May have altered LOC
- Difficulty maintaining airway
- Accessory muscle use
- Weak, rapid or absent radial pulse
- Life threatening injuries
- Pale, cool or clammy skin
What are some critical interventions for unstable chest trauma or abdominal injury or patients?
- Seal open chest wounds
- Stabilize flail chest
- Position patient
- Assist ventilations if necessary
What are findings of an unstable patient with Electrical contact?
- May have altered LOC
- Difficulty maintaining airway
- Respirations may require assistance
- Irregular or absent radial pulse
- Muscle spasms
What are some critical interventions for Pt with electrical contact?
- Expose injuries
- Cool burns asap
What are findings of an unstable patient with Heat Stroke?
- Fainting spells or unconscious
- Irregular or panting respirations
- Weak radial pulse
- Hot, dry, red or ashen skin
- Sweating
What are some critical interventions for a Pt with Heat Stroke?
- Remove clothes
- Cool rapidly
What are findings of a stable near downing Pt?
- Conscious
- Stable C-Spine
- Able to maintain airway, breathing
- Strong radial pulse
What are findings of an un-stable near downing Pt?
- Altered LOC or unconscious
- Possible C-Spine injury
- Difficulty maintaining airway
- Shortness of breath, noisy or absent respirations
- Weak, rapid, absent radial pulse
- Cyanosis, seizures, chest pain
What are some critical interventions for an un-stable near downing Pt?
- If respirations below 10, assist with BVM asap
- Non-humidified O2
- Avoid rough handling
- Maintain body temperature
