Emergency Flashcards
What are some common emergency conditions?
- cardiac arrest
- anaphylactic shock (allergy to contrast media, esp those with poor renal function)
- respiratory arrest (COPD, pneumonia, bronchitis, adverse rxtn to contrast media)
Anaphylactic shock minimum amount of contrast material to happen?
as little as 1ml
Signs of anaphylactic shock?
- swelling of lips, tongue, and/or throat
- skin: hives, itchiness, flushing
When is BCLS used?
- most common used in cardiac arrest/ heart attack
- brain death, permanent and irreversible damage within 4 to 6 min w/o circulation
What are the 4 links of chain survival in BCLS?
1) early access to Emergency medical service (EMS)
2) Early CPR
3) Early defibrillation (AED)
4) early advanced cardiac care
Steps of BCLS (6) for adults (TV vol and depth of compressions)
D: danger - wet (move to dry area), metal (place casualty on blanket), flammable gas
R: responsiveness - pat pat and ask if ok
S: shout for help - “call 995 ambulance, get AED”
A: open airway
B: breathing - check pulse and breathing (rise and fall of chest) “no pulse, no breathing, start compressions”
C: compression - 30 chest compressions (5 to 6cm, 100 per min) = allow complete chest recoil
2 breaths -1 sec per breath. TV = 400 to 600ml
what are the chances of survival after collapse using AED? (decrease % per min)
chance of survival decrease 10% per min
What is ST-elevation myocardial infarction (STEMI)?
heart atttack - one of major coronary arteries is blocked
- on ECG shows up as ST_segment elevation
Symptoms of STEMI:
- chest pain or discomfort
- shortness of breath
- dizziness
- nausea/vomitting
- diaphoresis (sweating)
- palpatations
- anxiety/ feeling of impending doom
What is code blue?
to indicate that a patient requires resuscitation, or need immediate medical attention (usually cuz of respiratory or cardiac arrest)
usually code blue team is those who have:
- advanced cardiac life support (ACLS)
- life support for nurses (LSCN)
- or other equal resustraining
What is ROSC in code blue setting?
return of spontaneous circulation
When to introduce drug therapy in cardiac arrest?
- when IV/central access is established
- does not need to be coordinated with shocks
- Should NOT cause significant interruptions in CPR and should NOT delay shocks
(prioritise high quality CPR and early defibrillation)
What is the purpose of the drugs in Cardiac arrest during CPR?
In cardiac arrest:
- drugs help start heart
- preserve coronary and cerebral perfusion
When pulse is present:
- Optimise environment for heart function and CO (vol, pump function and HR)
- optimise coronary circulation
Fire evacuation protocol if you spot the fire (4)
1) rescue people near fire if safe
2) alarm, alert staff
3) call fault reporting centre - inform exact location and extent of fire
4) extinguish with fire extinguisher (Pin
Aim nozzle at base of fire
Squeeze
Sweep side to side)
5) Evacuation of patients:
- ambulant patients: vertical evac to assembly pt
- non-ambulant patients: horizontal, rescue patient to nearest and lowest accessible (safest) ward, if not use stretcher to go one level down
Duties of senior staff (8)
- comm with all staff in charge
- inform receiving ward to receive and to send more wheelchairs - shut all gas supply and door to contain fire
- but also port O2 for patients on O2 therapy - direct ambulant patients exit
- assist jr staff evac non-ambulant patients horizontally
- check rooms for ppl b4 leaving (toilets too) - conduct roll call, and report
duty of receptionist in fire evac protocol?
Grab files:
- staff assignment book
- patient census record, case listing
assist in roll call
