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CMT1 Gen Med Jun 2024 > CMT1 Gen Med > Flashcards

CMT1 Gen Med Flashcards

1
Q

What are the 4 S&S of raised ICP?

A

Hypertension & Bradycardia
Reduction in Consciousness
Abnormal resp patterns
Abnormal Posturing

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2
Q

What are the 4 managements of ICP?

A

Primary Survey
Monitor Regularly
Evacuate ASAP
Give Oxygen

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3
Q

What is Shock?

A

A Series of signs and symptoms which occur as a result of reduced tissue perfusion with blood. the result of inadequate delivery of oxygen and nutrients to all parts of the body, skin, kidneys & brain.

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4
Q

What are the types of shock?

A

Hypovolemic
Anaphylactic
Septic
Neurogenic
Cardiogenic

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5
Q

What are the Sign & Symptoms of hypovolaemic shock?

A

Peripherial Vasoconstriction
Tachypnoea
Reduced Pule Pressure
Sweating

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6
Q

What are the 4 stages of shock?

A

Initial
Compensatory
Progressive
Refractory

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7
Q

What are the complications of ET intubation?

A

Hypoxia
Damage to teeth
Spinal Cord injury
Failed intubation

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8
Q

Define surgical cricothyroidotomy

A

Placement of a small cuffed tracheostomy tube, usually size 6 into trachea via an incision in the cricothyroid membrane.

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9
Q

3 Do’s and Don’ts of snake bites/scorpion stings?

A

DO:
Gain IV Access,
Pressure Immobilisation,
Arrange Transfer

DON’T:
Feed
Elevate
Wash

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10
Q

4 Signs & Symptoms of poisoning?

A

Nasal bleeding
Puncture Marks
Drowsiness
Excessive sweating
Pinpoint pupils
Cyanosis

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11
Q

Management of poisoning

A

Initial assessment
Give antidote
Evacuate with poison.

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12
Q

What is the treatment of Hypovolaemic shock?

A

Control any bleeding
Fluid resuscitation
Bolus’s of 250ml crystalloid fluid

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13
Q

General signs and symptoms of shock?

A

-Reduced Blood pressure.
-Increased Pulse and Respiratory rate.
-Pale, Cold & Clammy skin.
-Poor urine output
-Altered level of consciousness (ALOC).
-Anxiety
-Hypoxia
-Death

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14
Q

When would you NOT use an ET tube?

A

Trismus (lock jaw)
Conscious

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15
Q

What difficulties could you come across when wanting to use an ET tube?

A

Facial Trauma
Shape of Trachea
Pre-existing disease

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16
Q

When would a casualty require needle decompression?

A

-Tension Pneumothorax
-Developed open pneumothorax
-MOI

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17
Q

What are the post complications of needle decompression?

A

-Local, pleural infection.
-Local haematoma
-Pneumothorax

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18
Q

Define ET intubation

A

Passing a cuffed endotracheal tube through the vocal cords into the trachea.

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19
Q

What are 4 indications for ET-tube intubation?

A
  • Deeply Unconscious
  • Management of cardiac arrest
  • Potential airway obstruction
  • Chest / Head injuries.
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20
Q

What is Penthrox?

A

Inhaled analgesia. Contains methoxyflurane.

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21
Q

When can you use Penthrox (indications)?

A

Dislocations
Fractures
Burns
Neck Of Femur

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22
Q

When in Penthrox Contra-indicated?

A

Liver Damage
Unconscious
Kidney impairment
difficulty breathing

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23
Q

Acute Severe Asthma?

A
  • PEF 33%-50% best or predicted.
  • RR >25/min
  • HR >110/min
  • Inability to complete sentences in one breath.
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24
Q

Moderate Asthma?

A
  • Increasing Symptoms
  • PEF >50%-75% best or predicted
  • No features of acute severe asthma.
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25
Q

What are the signs of hypothermia?

A

Severe:
- Not Shivering
- Unresponsive
- Confused
- Slurred Speech
- Slow irregular pulse
- May appear dead

Moderate:
-Feel cold
- Shivering
- Say they feel cold
- Loss of dexterity
- Cold, pale hands & feet

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26
Q

Life threatening Asthma

A
  • PEF <33% best or predicted
  • SP02 <92%
  • Silent chest
  • Cyanosis
  • Poor respiratory effort
  • Arrythmia
  • Exhaustion
  • ALOC
  • Hypotension
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27
Q

How would you recognise an open pneumothorax?

A

Mechanism of injury
Dyspnoea
Tachypnoea
Obvious wound
Emphysema
Cyanosis

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28
Q

What is Dyspnoea?

A

Shortness of breath / Breathlessness

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29
Q

What is the management of open pneumothorax?

A
  • Safety
  • Check, Clear, maintain
  • Apply Russel chest seal
  • 100% 02
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30
Q

What are the complications associated with drowning?

A
  • Hypothermia
  • Prolonged immersion
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31
Q

How long after can secondary drowning occur?

A

up to 72hrs after

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32
Q

When not to give oral fluids?

A
  • Those requiring surgery
  • Risk of vomiting
  • Major abdominal trauma
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33
Q

Why do we gain IV access?

A
  • Fluid resus
  • Administration of drugs
  • Prior to chest drain
  • Prolonged entrapment
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34
Q

When would you gain IO access?

A
  • Other access failed
  • Emergency
  • Major Burns
  • Prolonged shock
  • Overwhelming Sepsis
  • Cardiopulmonary arrest
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35
Q

Contra-indications to IO?

A

Fractures
Infection
Osteoporosis

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36
Q

Contra-indications to FAST IO?

A

Under 12yrs
Sternotomy

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37
Q

What injuries should we take care with when administering fluids?

A
  • Isolated head injury ICP
  • Renal trauma
  • Cardiac Failure
  • Cerebro-vascular incident
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38
Q

What are complications with IV/Cannulation?

A
  • Perforated vein
  • Haematoma
  • Shearing
  • Needle breakage
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39
Q

What is triage?

A

The assignment of treatment and evacuation priorities to the wounded and sick at each echelon of medical care.

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40
Q

What are the indications of nasal gastric intubation?

A
  • Pre/Post abdominal surgery
  • Abdominal injury
  • Intestinal blockage
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41
Q

What are some medical emergencies?

A
  • Airway
  • Breathing
  • Cardiac
  • Nervous system
  • Vascular
  • Diabetes
  • Tropical disease
  • Appendicitis
  • Drowning
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42
Q

What are the five types of drowning?

A
  • Near drowning
  • Freshwater drowning
  • Saltwater drowning
  • Secondary drowning
  • Dry drowning
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43
Q

What is the management of hypoglycaemia?

A
  • Ensure A, B, C stable
  • BM level
  • Recovery position
  • Evacuate
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44
Q

Define diabetic coma?

A

Collapse or acute illness caused by hypo/hyper glycemia.

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45
Q

What % of fentanyl is absorbed through the mucosa membrane?

A

25%

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46
Q

What are the 3 contra-indications of fentanyl?

A
  • P or U on AVPU
  • Respiratory rate below 10
  • Head injury
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47
Q

Define poisoning?

A

Any substance which if taken into the body in sufficient amounts may cause harm or even death

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48
Q

What are the 4 common poisons we encounter in the military?

A
  • Carbon monoxide
  • Opiates
  • Alcohol
  • Toxins
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49
Q

What are the three types of EZ-IO needles?

A

Pink - 15mm - Children
Blue - 25mm - Adults
Yellow - 45mm - Large Adults

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50
Q

What are some complications to EZ-IO / FAST?

A
  • Painful to use
  • Extravasation
  • Compartment syndrome
  • Skin infection
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51
Q

What are four common breathing conditions?

A
  • Asthma
  • Drowning
  • Anaphylaxis
  • Opiate overdose
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52
Q

What is anaphylaxis?

A

An allergic reaction that can be fatal and effects the whole body.

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53
Q

What is the management of anaphylaxis?

A
  • Lay casualty down, legs elevated.
  • Adrenaline 1:1000 Intramuscular
  • Salbutamol 5mg
  • 4mg Chlorphenamine
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54
Q

What is an open wound?

A

Where there is a disruption in the continuity of the skin.

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55
Q

What is a closed wound?

A

Trauma has caused damage to the underlying tissue and not broken the skin.

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56
Q

What is a fracture?

A

Chip, crack or break in the continuity of a bone.

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57
Q

What are the signs and symptoms of a fracture?

A
  • Tenderness/pain at site
  • Deformity
  • Inability of movement
  • Possible reduced sensitivity
  • Possible loss of distal pulse
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58
Q

What are internal haemorrhage signs and symptoms?

A
  • Increase pulse rate
  • Swelling over site
  • Tenderness
  • Rigid areas
  • Hypo resonance
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59
Q

Typical blood loss for Fractured rib?

A

150ml per rib

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60
Q

Typical blood loss for closed femoral fracture

A

1.5litres

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61
Q

Typical blood loss Haemothorax?

A

Up to 2litres per lung

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62
Q

Typical blood loss for Closed Tibial fracture?

A

500ml

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63
Q

Typical blood loss for fractured pelvis?

A

3litres +

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64
Q

Typical volume of a fist sized clot?

A

500ml

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65
Q

What causes a tension pneumothorax?

A
  • Blunt chest trauma
  • penetrating chest trauma
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66
Q

What is a Haemothorax?

A

Presence of blood in the chest cavity (up to 2l per lung)

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67
Q

What is flail chest?

A

Breaking of two or more ribs in two or more adjacent places

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68
Q

Define asthma?

A

Recurring sudden attacks of difficult breathing characterised by wheezing and difficulty in expiration.

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69
Q

What are the three categories of Asthma?

A

Acute moderate, Severe & Life threatening

70
Q

What is the treatment of Asthma?

A
  • 02
  • Salbutamol Nebuliser with 02
  • Salbutamol inhaler 1-2 puffs
71
Q

What are the symptoms of a head injury?

A
  • Headache
  • Aggression
  • Dizziness
  • Headache
  • Nausea / Vomiting
72
Q

Name4 Signs and symptoms of basal skull fracture?

A
  • ‘Raccoon eyes’
  • Bleeding from the ear
  • Battle signs
  • Rhinorrhoea (runny nose)
  • Otorrhea (ear drainage)
73
Q

What are the triage priorities?

A

T1 - Immediate - 1hr - RED
T2 - Urgent - 2hrs - YELLOW
T3 - Delayed - 4hrs - GREEN
T4 - Expectant - BLUE

DEAD - BLACK

74
Q

What are the timings of trauma death?

A

Instantaneously - Seconds
Early - Minutes to hours
Late - hours to day and a week

75
Q

What are the causes of injury?

A

Blunt trauma - RTC, Fall, Blast, crush.
Penetrating trauma - GSW, Shrapnel, knife.
Climate - Hot and Cold

76
Q

Wallace rule of 9’s % TBSA

A

Head & Neck - 9%
Chest and Abdomen - 18%
Back - 18%
Arm & hand - 9%
Leg and foot - 18%
Genitals - 1%

77
Q

What are 5 Initial managements of burns?

A
  • Check <C>ABCDE</C>
  • Rinse with cold water >10min
  • Entonox/ High concentration 02
  • Remove constrictions
  • Remove Hot/wet clothing not adhering to skin.
78
Q

What are 5 further/later managements of burns?

A
  • Cling film dressing
  • Treat for shock
  • Place extremities in Burns bag
  • Leave facial burns uncovered
  • Encourage mobility
79
Q

3 do NOT’s of burn management?

A
  • Apply creams/ointments/lotions
  • Pop blisters
  • Cut away skin
80
Q

What are the signs & symptoms of smoke inhalation?

A
  • Hoarse voice
  • Soot around nose or mouth
  • Stained sputum (spit)
  • Signed nasal & facial hair
  • Breathing difficulties
  • Redness, swelling or actual burning of the tongue
  • (Casualty has been in confined space.)
81
Q

What are the two sites for EZ - IO?

A

Tibial Plateau
Humeral Head

82
Q

What are the additional causes of impact injuries? (RTC)

A

Lap Belt
Diagonal Belt
Airbag

83
Q

What are the blast injury phases?

A
  • Primary
  • Secondary
  • Tertiary
  • Quaternary
84
Q

Define the rate of tachycardia?

A

More than 100bpm (>)

85
Q

Define the rate of bradycardia?

A

Less than 60bpm (<)

86
Q

What are the 5 burn categories?

A
  • Thermal
  • Electrical
  • Chemical
  • Radiation
  • Friction
87
Q

What are the 3 burn depths?

A
  • Superficial
  • Partial thickness
  • Full thickness
88
Q

What is hypoglycaemia?

A

Low blood sugar < 4mmols

89
Q

What are the 4 signs and symptoms of hypoglycaemia?

A
  • Sweating
  • Tachycardia
  • Irritable
  • History
  • Anxiety
  • ALOC
90
Q

What is respiratory arrest?

A

Cessation of breathing

91
Q

What are the typical causes of respiratory arrest?

A
  • Airway obstruction
  • Damaged respiratory centre
  • Trauma
  • Drugs
92
Q

How would you recognise a haemothorax?

A
  • MOI
  • Hypo-resonance
  • Tachypnoea/Dyspnoea
  • Obvious wound
  • Unequal chest movement
  • Pain on palpation
  • Cyanosis
93
Q

How would you recognise a flail chest?

A
  • Paradoxical movement
  • Cyanosis
  • Obvious wound
  • Tachypnoea / Dyspnoea
94
Q

What are the 6 priorities of extrication?

A
  1. Safety & Scene management
  2. Stability and initial access
  3. Glass management
  4. Space creation
  5. Full access for treatment
  6. Immobilisation and Extrication.
95
Q

What are the principles of extraction?

A
  • Teamwork
  • Training
  • Preparation
  • Correct equipment
96
Q

What are the indications for a surgical cricothyroidotomy?

A
  • Severe facial trauma
  • Upper airway burns
  • Upper airway obstruction
  • Trismus
97
Q

What are the potential complications of surgical cricothyroidotomy?

A
  • Asphyxia
  • Bleeding
  • Aspiration of blood
  • Laceration of trachea
  • False passage to tissues
98
Q

What are the effects of a tension pneumothorax?

A
  • Compression of the lung
  • Mediastinal shift
  • Cardiac arrest
  • Death
99
Q

What are the Signs & Symptoms of a tension pneumothorax?

A
  • Hyperresonance
  • Cyanosis
  • Distended neck veins
  • ALOC
100
Q

What difficulties can you face when inserting a surgical airway?

A
  • Casualty Movement
  • Poor neck anatomy
  • Light (enough to see)
  • Correct equipment
  • Position of operator
101
Q

What is a needle thoracentesis?

A

Insertion of a wide bore cannula through the 2nd intercostal space in the mid clavicular line, on affected side to alleviate a life threatening tension pneumothorax.

102
Q

What are the three treatment aims for the mother in emergency childbirth?

A
  • Pain relief
  • Prevent trauma
  • Prevent infection
103
Q

What are the 3 treatment aims for the baby in emergency childbirth?

A
  • Prepare resus
  • Prevent trauma
  • Regulate body temp
104
Q

What are the contra-indications of naloxone?

A

known hypersensitivity

105
Q

What are the side effects of fentanyl?

A
  • Dizziness
  • Drowsiness
  • Nausea
  • Vomiting
  • Constipation
  • Abdominal pain
  • Headache
106
Q

What is Entonox made up of?

A

50% Oxygen / 50% Nitrous oxide

107
Q

When would you use Entonox?

A

Prior to applying traction or splints

108
Q

What are the contra-indications of Entonox?

A
  • Chest injuries
  • Severe Head injuries
  • Diving injuries
  • Intoxication
109
Q

What are the two types of entrapment?

A

Actual & Relative

110
Q

What are the 3 levels of extraction?

A

ROUTINE: 30+ mins (planned)
URGENT: -30 mins (planned)
EMERGNCY: Immediate (hasty)

111
Q

Class 1 fluid loss?

A

<750ml (15%)

112
Q

Class 2 fluid loss?

A

750ml - 1500ml (15-30%)

113
Q

Class 3 fluid loss?

A

1500ml - 2000ml (30-40%)

114
Q

Class 4 fluid loss?

A

> 2000ml (>40%)

115
Q

What are 4 trauma chest injuries?

A
  • Open pneumothorax
  • Tension pneumothorax
  • (Massive) Haemothorax
  • Flail chest
116
Q

What is a pneumothorax?

A

Air or gas in the pleural cavity

117
Q

What can cause a pneumothorax?

A
  • Trauma
  • Penetrating
  • Blunt
  • Disease
  • Spontaneous
118
Q

What are the 5 limitation to CUF?

A
  • Hostile forces and enemy fire
  • Equipment limited
  • Time
  • Limited visibility
  • Comms difficulty
119
Q

What does HITMANN stand for?

A

Head to Toe / Hygiene
Infection
Tubes
Medication
Analgesia
Nutrition & Hydration
Notes and Nursing

120
Q

What is CSCATTT & what is it used for?

A

C ommand and control
S afety
C omms
A ssess
T riage
T reatment
T ransport

Scene management.

121
Q

What does METHANE stand for?

A

M ajor incident declared / my C/S
E xact location
T ype of incident
H azards identified
A ccess and egress
N umber & Serveries of Casualties
E mergency services required

122
Q

What are the collision types?

A
  • Frontal
  • Rear end
  • Lateral / Side
  • Rotational
  • Rollover
123
Q

What are the 3 types of Pneumothorax?

A
  • Simple
  • Open/sucking
  • Tension
124
Q

What are 4 types of fracture?

A
  • Closed/Simple
  • Open
  • Complicated
  • Comminuted
125
Q

What is a closed fracture?

A

The bone is fractured, without a break in the overlying skin.

126
Q

What is a hazard?

A

Something that has the potential to cause harm

127
Q

What are the 3 types of bleeding?

A
  • Arterial
  • Venous
  • Capillary
128
Q

What is the Parkland formula?

A

Body weight x % of burn x 4ml

129
Q

What are the hazard spectrum(s)?

A

Trauma / Burns
Environment
Medical / Toxicological

130
Q

What are the categories in the operational spectrum?

A

ODP - Operations during peacetime.
OOTW - Operations other than war.

War -

131
Q

Name some of the technical rescue skills?

A

Rope rescue
Water rescue
Search rescue
Confined space rescue
Heavy rescue

132
Q

Name some tools / devices used for extrication?

A
  • Telford extraction device
  • Cervical Collar
  • Scoop stretcher
  • Recue board
  • Xtract2 stretcher
  • MIBS stretcher
133
Q

What defines a major incident?

A

When the number of casualties temporarily overwhelms the available medical and logistical capabilities.

134
Q

What are the levels of command in a major incident?

A

Gold
Silver
Bronze

135
Q

What drug is used to reverse an opioid overdose?

A

Naloxone hydrochloride.

136
Q

How many doses can you give naloxone and how long to wait between doses?

A

1st - 400mg
2nd - 800mg
3rd - 800mg

1 minute apart.

137
Q

Give 3 reasons why you would insert an NPA?

A
  • Cannot tolerate OPA
  • Trismus
  • Jaw injury
138
Q

What is Hyperglycaemia?

A

Abnormally high blood sugar levels >8mmol

139
Q

When might eyes be bilaterally fixed?

A
  • Dead
  • Hypoxia
  • Hypovolaemic
  • Atropine / Ecstasy OD
140
Q

When might eyes be unilaterally fixed?

A

Brain injury
Stroke

141
Q

What are some causes of anaphylaxis?

A
  • Drugs / medication
  • Blood Transfusion
  • Food ingestion
  • Bites & Stings
142
Q

Name some immobilisation equipment?

A
  • Triangular Bandage
  • Splints (SAM / Frac immobiliser)
  • Cervical Collars
  • Long Board
  • Fracture Straps
143
Q

What is a compressible haemorrhage controlled by?

A
  • CAT (tourniquet).
  • Pressure points.
  • ECB.
  • Elevation.
  • Celox.
144
Q

What is a non-compressible haemorrhage controlled by?

A
  • Urgent Evacuation
  • Blood Transfusion
  • Surgery
145
Q

Name 5 types of haemorrhage control?

A
  • Direct Pressure
  • Elevation
  • Splinting
  • Indirect pressure
  • Haemostatic agents
146
Q

What are the 4 steps of continuous care?

A
  • Monitor
  • Reassess
  • Documenting
  • Caring
147
Q

What are the 4 signs of acute severe asthma?

A

RR >25/min
HR >110/min
Cannot complete sentences
Reduced PEFR >33% - 50% of predicted

148
Q

What are 9 signs of life threatening Asthma?

A
  • Silent Chest
  • Cyanosis
  • Exhaustion
  • Arrythmia
  • SP02 <92
  • Poor respiratory effort
  • ALOC
  • Hypotension
  • PEFR of <33% predicted.
149
Q

What are the 3 classifications of head injuries?

A
  • Skull fractures
  • Brain injuries
  • Scalp wounds
150
Q

What is a complicated fracture?

A

Bone ends cause injury to important structures

151
Q

what is a comminuted fracture?

A

Bone has fractured into many pieces.

152
Q

What is the treatment for smoke inhalation?

A
  • Maintain Airway
  • Humidified 02
  • Nebulised Salbutamol
  • Urgent evacuation
153
Q

Three types of brain injuries?

A
  • Subdural Haematoma
  • Extradural Haematoma
  • Subarachnoid Haemorrhage
154
Q

What are the evacuation priorities of burns?

A

T1 - Airway Burn
T1 - >25% burns

T2 - 12-25% Burns
T2 - Chemical / Electrical Burns

T3 - <12% Burns

155
Q

What are the types of posturing during raised ICP?

A

Decorticate (Arms in)
Decerebrate (Arms out)

156
Q

What are the 3 levels of raised ICP?

A

Level 1 - Decorticate
Level 2 - Decerebrate
Level 3 - Flaccid

157
Q

What are the 3 common pressure points?

A
  • Subclavian
  • Femoral
  • Brachial
158
Q

What are the 7 types of open wound?

A
  • Laceration
  • Impalement
  • Puncture
  • Abrasion
  • Burn
  • GSW (velocity)
  • Incision
159
Q

What are 2 types of closed wounds?

A
  • Fractures
  • Non-Compressible Haemorrhage
160
Q

What are two types of seizures?

A
  • Centralised
  • Partial
161
Q

What are the 4 aims of splintage?

A
  • Support
  • Immobilise
  • Elevate
  • Relieve Pain
162
Q

What exposures should we consider when packaging?

A
  • Safety
  • Tactical
  • Climate
163
Q

What are the three methods of assessing consciousness?

A
  • AVPU
  • PERLA
  • GCS
164
Q

What are some typical causes of seizures?

A
  • Brain Tumour
  • Stroke
  • High fever
  • Lack of sleep
  • Head trauma
  • Drugs / Intoxication
  • Mental illness.
165
Q

What can be done to manage a seizing casualty?

A
  • Obtain history
  • Protect patient
  • Primary survey
  • Oxygen
  • Evacuation
166
Q

What are the 3 P’s of pain relief?

A
  • Physiological
  • Pharmacological
  • Psychological
167
Q

How often should you take Obs in prolonged field care?

A

Under direction from the MO, or…

  • Every 15 Mins for the first 2 hours
  • If stable; Every 30mins for the next 4 hours.
168
Q

10 principles of continuous care?

A
  • Maintaining Dignity
  • Controlling Body Temperature
  • Pressure Areas
  • Personal Hygiene
  • Safe environment
  • Toileting
  • Food & Drink
  • Dressing Changes
  • Communication
  • Death / Dying
169
Q

What is catheterisation?

A

Passing a urethral catheter into the bladder.

170
Q

Why would you catheterise a patient?

A
  • Monitoring fluid balance
  • Unable to pass urine
  • Abdominal / Pelvic injury
  • Post aesthetic
  • Unmanageable incontinence
171
Q
A

CMT1 Gen Med Jun 2024 (1 decks)

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