CCA Year 1 Summer Flashcards
What are the 7Cs
Consent
Confirm
Call
Chaperone
Comfort
Concerns
Clean
Introduce yourself to a patient you would like to chat to
Hello, Im Tamsin Baker. Im a first year medical student from the University of Manchester. I was wondering if I would be able to have a chat with you about why you’ve come in today? This is purely for my learning and I wont be able to provide any kind of clinical advice or diagnosis.
Could I confirm your name and DOB?
What would you like me to call you?
Would you like a chaperone?
Are you comfortable?
Do you have any concerns or questions?
CLEAN
Describe end of bed examination
Alert/Conscious?
Patients colour?
Posture, Breathlessness, sweating, pain?
Patients build?
Any obvious conditions?
Rashes or bruising?
Behaviour?
Respiratory noises?
Smells (eg cig smoke)?
Anything arounf them (eg walking stick)
What do we check for on patients hands
Nail clubbing
Colour
Arthritis
Temp
Tremor
What do we check for under patients eyelid
Inner bottom eyelid (check if pale)
What is peripheral O2 saturation? How measure?
Pulse oximeter on middle or index finger
What is PIPPA stand for
Preparation
Inspection
Palpation
Percussion
Auscultation
What does ICE stand for
Ideas
Concerns
Expectations
How do we assess pain?
(There is an acronym)
SOCRATES
Site
Onset
Character
Radiates
Associated symptoms
Time/duration
Exacerbation
Severity
How do we motivational interview for behaviour change
OARS
Open questions
Affirmations
Reflections
Summaries
Explain steps of a respiratory exam
General end of bed examination
Palpate trachea (check not deviated)
Chest expansion front and back
Percuss front and back on middle finger front and back (getting them to lift arms)
Auscultation (use Stethescope and get patient to breathe in and out each time)
Explain steps of cardiovascular exam
General end of bed examination
Jugular venous pressure (raised in right heart failure) - patient turns head, it is likely not visible
Feel for thrills (palpable murmur):
-aortic valve - 2nd right intercostal space
-pulmonary valve - 2nd left intercostal space
-Tricuspid valve - 4th left intercostal space
-Mitral valve - 5th left intercostal space (under boob - midclavicular)
Apex beat felt at 5th left intercostal space (under boob - midclavicular)
Feel for heaves (pressure)
-vertical to left boob
-under left boob
Auscultate (listening using Steth) heart valves (same areas as thrills)
How to measure blood pressure?
7Cs and explain procedure
Put cuff 2cm above brachial artery (just above elbow)
Find radial pulse (above thumb)
Increase pressure of cuff until this disappears (this is the estimate of systolic pressure - approx 120?)
Deflate cuff and put stethoscope over brachial pulse
Increase pressure to 20-30 above estimated systolic pressure - you should hear nothing at this point
Deflate cuff slowly until you hear tapping sounds (Kortokoff sounds) - this is systolic pressure
Keep deflatingthe cuff until the sounds disappear - this is diastolic pressure
SPHYGMOMANOMETER (bp measurer)
How to operate peak flow monitor
Attach cardboard mouthpiece
Maximal inspiration
Blow out as hard as they can
3 measurements
How to use metered dose inhaler
1)If hasn’t been used in5 days, take cap off, shake, and release a puff into the air
2)Clean
3)Shake inhaler, hold upright, thumb on base, forefinger at top
4)Breathe out
5)Breathe in steadily and inhale medication
6)Hold breathe for 10 seconds
7)Breathe out
How to use inhaler with spacer
Shake inhaler and attach to spacer
Put spacer in between teeth and lips forming tight seal
Tidal volume
Normal breathing
Inspiratory reserve volume
Amount further you can inhale
