comms skilss Flashcards
SOCRATES
Site Onset Character Radiation Associated symptoms Time/duration Exacerbating/relieving factors Severity
what medications to ask about
prescribed
over the counter
recreational
herbal
assoc symptoms of CHEST PAIN
SOB sweaty/clammy fever nausea cough palpitations dizziness oedema- swelling in lower limbs
social history
smoking alcohol drugs diet/exercise living situation occupation
cardio systemic inquiry
chest pain palpitations SOB fainting swollen ankles
resp systemic inquiry
SOB cough sputum - blood wheeze chest pain
gi systemic inquiry
appetite nausea vomiting - blood indigestion weight loss bowel habit abdo pain
what does ABCDE stand for
airways breathing circulation disability exposure
first step in ABCDE
Airways - are they breathing
if they can talk: airways are OPEN and PATENT
what to do if patient struggling to breathe
15L non re-breather mask 100% O2
SIT THEM UP
what do you want O2 sats to be in healthy people
94% +
how to check o2 sats
pulse oximetry - clip on finger
second stage in ABCDE
Breathing - what is their breathing like pulse oximetry resp rate consent patient and remove top - do mini resp exam if wheezy - neb salbutamol
what to do in ABCDE when patient removes top
check for abnormalities, accessory muscle use sweatiness/generally struggling or not symmetrical chest expansion trachea and JVP percuss and auscultate front and back
what to give for wheeze (asthma/anything)
NEB SABA/LABA
continuous dosage
every 15-30 mins
what does OSHITMAn stand for
oxygen salbutamol hydrocortisone ipratropium theophylline magnesium sulfate Ask for help! Anaesthetist
what to give COPD patient struggling to breathe
15L non rebreather mask
100% o2 then titrate to 88-92%
third stage of ABCDE
Circulation check pulses - radial and peripheral rate, regularity, strength blood pressure low: 90/60 TEMPERATURE cap refill ankles for odema auscultate
hypotension in ABCDE
wide bore cannula - grey
preferably one in each cubial fossa
IV fluids in - saline solution
500ml/15 mins - repeat up to 4 times
blood for testing out
FBC, U&Es, glucose
fourth stage in ABCDE
Disability
glucose
check pupils
check movement in limbs
fifth stage in ABCDE
Exposure expose patient - w consent check for bleeding roll patient to side and check for bum bleeding check for rashes slight GI examination
acute exacerbation of COPD
ISOAP Ipratropium (NEB) Salbutamol (NEB) Oxygen Antibiotics Prednisolone
what does SBARR stand for
situation background assessment recommendation- as in ask for one response review
