Clinical Skills Flashcards
what is venepuncture?
vein is punctured in order to obtain appropriate blood samples which can be analysed to aid diagnosis and treatment
how do you clean skin?
with chloraprep in a cross hatch way
where does the bevel sit?
upwards
what do you need to remember before extracting needle?
remove the tourniquet, remember to do in correct order
what is the basis of cannulation?
a venous cannula is flexible tube inserted into a vein, use the needle to pierce the vein and then remove the needle and leave plastic tube in vein
at what angle does the cannula get inserted?
at 30 degrees - look for flashback and then lower the insertion angle
what do you flush the cannula with?
5-10mls of saline
what are vital signs?
temperature, pulse rate, respiratory rate, oxygen sats, blood pressure and ACVPU
what is NEWS?
the national early warning system score
what does a rising new indicate?
deteriorating patient and triggers specific response
what does C mean in ACPVU?
signs of confusion (disorientation and delerium)
what is the fatal range of temperatures?
the usual range is 36-37.2, the fatal is 27-44 and most people will not make it to this score
what is pyrexia and what is hypothermia?
pyrexia is >37.5 and hypo is <35 degrees
what classifies as tachycardia and bradycardia?
tachy >100bpm and brady <60bpm
what are the four aspects of pulse that are looked at?
rate (at least 30 seconds), rhythm (regular or irregular), volume (strength - low could be hypovolaemic due to haemorrhage, bounding - fever) and character
what is the usual respiratory rate for adults and children?
adults - 12-20, and for children it is 22-28, adolescent fall at 18-22
what could bradypnoea and tachypnoea mean?
brady - CNS depression. sedation or opiods and tachy - pain, anxiety, activity and fever
what accessory muscles are used?
abdo on expiration and neck muscles on inspiration
why might a patient use their arms?
to improve thoracic stability and therefore make a tripod to breath easier
what does PEFR measure?
respiratory function at a particular moment in time It is a measure of how much and how fast a patient blows out.
what conditions can PEFR be used in?
CF, asthma, COPD
what does a higher reading show?
the patient is well. In an exacerbation the patient will have a lower reading because their airways are narrowed.
what does a pulse oximentry probe measure?
the percentage of Hb in arterial blood that is oxygen saturated - normally >95% for healthy, for respiratory disease is 88-92% normally
what should be considered for oxygen sats readings?
nail varnish, cold extremities, the amount of ambient light and keeping the probe still to prevent motion artefact
how is blood pressure expressed?
as two values - systolic/diastolic
what is the normal reading for BP?
it is higher in the elderly but usually 120/80mmHg
what stimuli can influence blood pressure?
pain, anxiety, exercise, relaxation
at what speed should you ideally deflate the BP cuff?
2mmHg/second
what might happen in pregnant women or children?
the Korotoff sounds (BP sounds) will continue as a muffling through to phase 4 - this is the diastolic
what should you do if you need to redo a BP?
deflate and wait for 30 seconds before trying again
what must you do with an anxious patient who presents with hypertension?
you should retake the reading a while later to rile out white coat hypertension.
what should you do if it is the first time you have met a patient?
take a bilateral reading
