Clinical Management Flashcards
What vital signs and symptoms do we need to check as part of any good clinical assessment?
Pulse, blood pressure, resp rate, work of breathing, GCS, ECG, 12 lead ECG, BGL, SpO2%
What are the steps in basic clinical assessment?
- baseline obs
- ECG (3 or 12 lead as appropriate)
- pupil size and response
- physical examination anterior then posterior
- neurovascular assessment when fractures are found
- Estimation of burn surface area and depth
- ongoing review of all of the above
What do I need to verbalise in terms of vascular access and Fluid administration?
- device size selected relevant to case
- appropriate insertion technique
- patency established and monitored
- line must be secured to prevent dislodgement
- fluid volume appropriate to case
What do I need to do in terms of drug administration?
- RIGHT DRUG
- RIGHT ROUTE
- RIGHT DOSE
- CHECK WITH PARTNER and CHECK with self
What do I need to do in terms of basic TRAUMA Mx?
- management of fractures
- management of non-life threatening bleeds
- Appropriate management of burns
- Appropriate management of penetrating trauma
What do I need to do in terms of PAIN control?
- appropriately assess pain
- provide effective analgesia (think ICP if will be uncontrollable pain)
- meds, ice, heat, immobilisation
SPINAL CARE?
- MILS
2. correct application of stabilisation device (collar, OSS, spinal board, vacuum matt, improvised
Chest needle decompression?
- identify the need for the procedure (decreased breath sounds, history, tachy, hypotensive
- uses correct landmarks and insertion technique
- monitors patency and effectiveness post procedure
Behavioural disturbance?
- minimal pressure applied to torso if physically restraining
- apply restraint net effectively
Envenomation?
- pressure immobilisation bandage
2. immobilises limb
Communication and documentation?
- Seeks patient consent prior to procedure
- Early SITREP given and resources requested
- provides relevant patient information to other clinicians
- initiates consult with appropriate information
- information recorded during management of the patient
- all patient and case information accurately documented on PCR
Clinical Decision making?
- take the right equipment to the job
- Looks at clinical signs and symptoms to determine diagnosis
- if time critical, identify and manage immediately
- Considers the differential diagnosis
- demonstrates good clinical judgement
- assessment and management priorities managed well
SAFE WORK PRACTICES
- scene hazards identified and risks removed or mitigated
- safe use and immediate disposal of sharps
- safe application of manual handling (think more hands, or spine board stretcher bridge)
- Use of PPE
Problem Solving
- ability to work through problems
2. identifies and uses other resources to solve problems
SCENE LEADERSHIP AND TEAMWORK
- communicate with all on scene
- ask partner to do things and be specific and not too much to do
- Use all clinicians on scene and or the patient
- Provide support to other clinicians
- CALM approach to case and management
