Clinical Skills Flashcards
1
Q
5 times one should wash hands?
A
- Before touching a patient
- After touching a patient
- Before aseptic procedure
- After body fluid exposure risk
- After touching patient surroundings
2
Q
How long should hand washing take?
A
40-60 seconds
3
Q
What does ABHR not work against?
A
Spores
4
Q
Soiled (used) dressings are an example of?
A
Healthcare waste
5
Q
Delivery of healthcare in both clinical and non clinical settings produces what type of waste?
A
Special waste
6
Q
Three types of waste?
A
Healthcare, special, domestic
7
Q
Trivial waste is put in which coloured bin?
A
Black
8
Q
Low risk waste is put in which coloured bin?
A
Orange
9
Q
High risk waste is put in which coloured bin?
A
Yellow
10
Q
Special waste is put in which coloured bin?
A
Red
11
Q
Are pharmaceutical glasses put in a sharps bin? Yes or no?
A
Yes
12
Q
Large yellow bin is used for what?
A
Couch paper
13
Q
Steps taken in a needle stick injury?
A
- Bleed it
- Wash it
- Cover it
- Report it
14
Q
How long should you “Look, listen and feel” for?
A
Up to 10 seconds
15
Q
How should you approach casualty?
A
From feet
16
Q
Cyanosis, gasping, strider and panic are signs of what?
A
Airway obstruction
17
Q
Head tilt/chin lift is used to do what?
A
Open the airway.
18
Q
Vomit, food or blood could be obstructing what?
A
The airway.
19
Q
What should you assess when feeling a pulse?
A
Rate, rhythm, volume.
20
Q
Normal pulse rate?
A
60-80 beats per minute.
21
Q
Bradycardia?
A
less than 50 beats per minute.
22
Q
Tachycardia?
A
more than 100 beats per minute.
23
Q
Why should you feel for carotid pulse on one side?
A
ensure no constriction of blood flow to brain.
24
Q
What does FiO2 men?
A
Fraction of inspired oxygen
25
What is the FiO2 of expired air?
16%
26
How many back blows are given when a person is choking?
5
27
How many abdominal thrusts are given when a person is choking?
5
28
Maximum number of rotations of back blows/abdominal thrusts when a person is choking?
3
29
Where should your clenched fist be placed when someone is choking?
Between the umbilicus and xiphisternum.
30
What age group is choking most commonly found in?
Under 5
31
What is cyanosis?
Blue discolouration of skin du to poor circulation.
32
Where is cyanosis most commonly detected?
In lips and under tongue.
33
Where is another location one can find a large calibre artery in an emergency?
Femoral artery.
34
What is success rate of bystander CPR?
13%
35
How deep should chest compressions be?
5-6cm
36
Rate of chest compressions in CPR?
100-120 per minute.
37
Ratio of compressions to rescue breaths?
30:2
38
Why must no one touch the casualty when AED analyses heart rhythm?
Can only analyse correctly when no one is touching the casualty.
39
What should you do before delivering a shock?
Remove supplemental oxygen.
40
Where should the AED pads be placed?
1. To the right of sternum.
| 2. Left mid-axillary line.
41
When should a secondary survey be carried out?
1. When the casualty is conscious.
| 2. When the casualty is unconscious but you have assessed that they have a pulse and are breathing.
42
How much air should be given per rescue breath?
1. 10ml per kilogram.
43
How often should one switch with another person when performing CPR?
Every two minutes to prevent fatigue.
44
How do you perform a secondary survey?
1. Get further history if possible.
2. Initial assessment - look for external clues i.e. GTN, insulin and adrenaline pens. Medical alert bracelet may give information on patient's medical history i.e. epilepsy, diabetes, allergies, adrenal failure.
3. Head to toe examination including a capillary refill test.
45
How to perform a capillary refill test?
Press on toe or finger nail for 5 seconds. Colour should return in less than 2 seconds.
46
What to do if an object is in a wound?
Leave it in place. Apply firm pressure to either side of object.
47
What is shock?
Hypoperfusion of tissue, resulting in an inadequate blood supply to tissue.
48
What are the causes of shock?
1. Cardiogenic.
2. Hypovolemic.
3. Anaphylactic.
4. Septic.
5. Neurogenic.
49
What are the clinical signs of shock?
Cold, clammy, pale skin, Loss of blood.
50
What is an open (compound) fracture?
Broken bone tears the skin.
51
What is a closed fracture?
Broken bone does not tear the skin.
52
What are the clinical signs of a fracture?
Swelling or bruising over bone. Loss of function in injured area. Pain that gets worse when area is moved.
53
What does AMPLE stand for in history taking?
1. Allergies.
2. Medications.
3. Past illnesses/Pregnancy.
4. Last meal.
5. Events/environment related to injury.
54
What do AVPU and GCS assess?
Conscious level.
55
What does AVPU stand for?
1. Alert.
2. Response to voice.
3. Response to pain.
4. Unresponsive.
56
What is the problem with AVPU?
1. No objective method of recording and comparing responses over time.
2. No objective method of handing over to other medical personnel.
57
What is the main principle behind GCS?
The greater the stimulus which one has to apply to elicit a response correlates with a lower level of consciousness.
58
What are the three different components of GCS?
1. Eye opening response.
2. Verbal response.
3. Motor response.
59
What are the three technique one can assess a casualty's eyes and verbal response with?
1. Passive Observation.
2. Active observation.
3. Active pressure stimulus.
60
What does passive observation involve?
Standing and watching for a short time.
61
What does active observation involve?
Talking to the patient .
62
What does active pressure stimulus involve?
1. Applying pressure to the finger over nail tip.
| 2. Only done if no response to voice.
63
What does the motor response involve?
1. Active response.
64
How should one carry out an obeying a command test?
1. Ask person to perform a simple 2 step task.
2. Keep in mind their injury i.e. if they have a stroke on one side of body they will not be able to squeeze fingers with hand.
3 Use the best motor response.
65
How should one assess localising to pain and other parts of motor response?
1. Apply a central painful stimulus i.e. a trapezium pinch.
2. Apply with increase intensity up to 10 seconds.
3. If this gives no response apply pressure to supraorbital notch.
4. Positive result is a movement of hand towards pain, above the level of clavicle and tries to push hand away.
66
Difference between normal and abnormal flexion?
1. Abnormal = elbow bends more slowly and arm comes across body.
67
What is a coma?
1. Prolonged unconsciousness.
2. GCS of less than 8.
3. In this case, one will not be able to open his own airways.
68
How can AVPU be correlated to GCS?
1. A = 15.
2. V = 12-14.
3. P = 7-9.
4. U = 3-7.
69
What does a person scoring P or U correlate with?
Severe brain brain injury.
70
Why is tympanic temperature used?
Close proximity to internal carotid artery.
71
What should you do when measuring respiratory rate?
Palpate the radial artery.
72
What is used to measure peripheral oxygen saturation (SpO2)?
Pulse oximeter.
73
What can reduce SpO2 reading?
1. Excess movements.
2. Poor tissue perfusion.
3. Hypothermia.
74
What can increase SpO2 reading?
1. Dark skin pigmentation.
| 2. Increase bilirubin/carboxyhaemoglobin.
75
What should you check for on the Test Strip container when measuring blood glucose?
1. Test strip expiry date.
76
How should the glucose test strip be entered into the meter?
Silver bar facing upwards towards the meter.
77
What are you testing for in a urine analysis?
1. Protein.
2. Glucose.
3. Ketone.
4. Blood.
5. Leukocyte.
6. Nitrites
7. pH.
8. Specific gravity.
78
Why is it important that the urine sample is a mid-stream analysis?
1. Ensure it is as free of contamination as possible.
| 2. First bit of urine may be contaminated with bacteria from skin.
79
What should a doctor advise a patient to do before micturition?
1. Clean their external genitalia.
| 2. Wash their hands.
80
What specifically should a male do before micturition in urine analysis?
Retract foreskin.
81
What specifically should a female do before micturition in urine analysis?
Separate labia.
82
When should analysis with dipstick be used?
Within an hour of urination.
83
What is the normal temperature range?
36.5 to 37.5 degrees celsius.
84
What is the normal SpO2?
95-100%
85
What is the normal blood glucose concentration?
4.4-6.1mmol/L.
86
What is normal respiratory rate?
12-18 breaths minute.
87
Why should one perform a urine analysis?
1. Check overall health.
2. Check for diabetes.
3. Check for UTIs.
4. Abdominal pain (could be pregnancy).
