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CSB331 OSCE > Equipment > Flashcards

Equipment Flashcards

1
Q

Indications of a SAMsling

A
  1. Suspected pelvic fracture with evidence of haemodynamic compromise
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2
Q

Contraindications of a SAMsling

A
  1. Suspected isolated neck of femur fracture

2. Suspected Traumatic hip disclocation

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3
Q

Complication of a SAMsling

A
  1. Binder should not be removed due to the risk of haemodynamic instability
  2. Other methods (e.g. vacuum splint) may be used in small children.
  3. Apply careful in gross open fractures to minimise pain and further complications.
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4
Q

SAMsling procedure

A
  1. Remove all objects from the pts pockets and pelvic area and cut off outer garments.
  2. Unfold the appropriate size pelvic binder with the inner white surface facing up.
  3. Gently position the binder beneath the pt to the level of the buttocks (GT or pubic symphysis). Ensure pt movement is minimised to prevent clot dislodgement.
  4. Feed black strap through the buckle, placing the buckle close to midline.
  5. With assistance, firmly pull black and orange loops in opposite directions. tighten the binder until it is firm (you may not require a click).
  6. Maintain tension and firmly press the black strap onto the velcro.
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5
Q

Is it recommended to apply the pelvic binder before extricating pt from a vehicle?

A

No

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6
Q

Is the SAMsling recommended for use in pregnant trauma pt’s?

A

If applied correctly (at level of GT), it should be safe from pregnant pts, even late term. It is not officially recommended due to concern of inappropriate placement. But it is suggested to be used case by case if pelvic exsanguination exists and the risk of mortality is high.

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7
Q

True or false, do not allow the Pelvic binder to be cut off the Pt?

A

True

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8
Q

Is it appropriate to provide Analgesia to a pt prior to applying a pelvic binder?

A

Yes

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9
Q

Indications of a CT-6

A

Mid shaft femoral fractures

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10
Q

Contraindications of a CT-6

A

Fracture/dislocation of the knee

Ankle injury

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11
Q

Complications of a CT-6

A

Latrogenic injury due to poor application technique

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12
Q

CT-6 Procedure

A
  1. Assess the injury (Expose the affected limb, assess the limb for distal perfusion, irrigate and dress open fractures as required)
  2. Assembly
  3. Sizing: place next to uninjured leg. ischial cap align the top of the iliac crest with the ankle hitch end approximately 15cm beyond the bottom of the pts foot.
  4. Attach strap: Align 2 straps above the knee and 2 straps below the knee taking care not to strap over the injury or over the knee. Feed the strap under the pt thigh and reattach.
  5. Attach ankle hitch (foot strap runs beneath foot, tighten bottom of strap)
  6. Apply minimal traction (until splint rests in appropriate position)
  7. Secure leg straps (start with upper inner thigh
  8. Apply traction (until legs are of equal length)
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13
Q

In the setting of a potential pelvic injury, the CT6 is to be applied first, followed by the SAMsling

A

False, Pelvic binder is applied first

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14
Q

Open fractures need to be washed out prior to the application of a CT6

A

True, (minimum of 2L saline)

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15
Q

Indications of a soft cervical collar

A

Suspicion of a cervical spine or SCI

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16
Q

Contraindications of a soft cervical collar

A
  1. Surgical airway

2. Penetrating neck trauma

17
Q

Complications of a soft cervical collar

A
  1. Discomfort

2. Anxiety

18
Q

Soft Cervical Collar procedure

A
  1. Align pt head in neutral or position of greatest comfort
  2. Measure distance between the base of the chin and the suprasternal notch.
  3. Select appropriate size.
  4. Slide the collar under the pt neck. until velcro is visible
19
Q

Should the ends of a correctly sized soft collar meet or slightly overlap at the back of the pt neck?

A

Yes

20
Q

Indications of NIEJ

A

To facilitate safe Extrication from a confined space

21
Q

Contraindications of NIEJ

A

PT is actual time critical and application of NIEJ will delay transport

22
Q

Complications of NIEJ

A
  1. Respiratory effort effected if chest straps too tight
  2. Groin straps need to be firmly secured to minimise jacket and neck mov’t.
  3. Cspine hyperextension or hyperflexion with incorrect head padding
  4. Cspine Mov’t with immobilising head without properly securing torso
23
Q

NIEJ Procdure

A
  1. Explain procedure gain consent
  2. Prepare NIEJ
  3. Cspine immobilisation in conjunction with NEIJ. MILS during application of Collar.
  4. Position NIEJ firmly in armpits but no higher than top of head.
  5. Position groin straps from back of NEIJ. (make sure they are not twisted
  6. Raise pt arms to shoulder height, position chest flaps (apply straps green yellow then red).
  7. Straps should cross the chest, or vertically if pt has breathing difficulty.
  8. Slide groin pads onto leg strap
  9. Connect leg straps on buckles and tighten
  10. Recheck straps are tight.
  11. attach head pads to prevent hyperextension
  12. Secure collar strap and forehead strap (inline with eyebrows), tighten each side equally.
  13. Extricate pt, groi straps may be loosened.
24
Q

Paediatric Specialised use of NEIJ

A

Can place blankets either side to assist with pt support

25
Q

Pregnant specialised use of NEIJ

A

Chest flaps may be folded inward to expose abdomen, and straps tightened to support

26
Q

NEIJ used of Hip immobilisation

A

Invert, chest flaps over pelvic area. Secure head flap around knee, use lumbar support between knees, secure ankles with triangular bandage.

27
Q

Indications for a NPA

A

Potential or actual airway obstruction

28
Q

Contraindications for a NPA

A

Nil in this setting

29
Q

Complications for an NPA

A
  1. Airway trauma, Epixtaxis
  2. incorrect size or placement will compromise effectiveness
  3. Exacerbate a base of skull fracture (NPA displacing in the cranial vault)
  4. Can stimulate gag reflex in sensitive pt, precipitating Vom or Aspiration.
30
Q

Procedure for inserting an NPA

A
  1. Place pt head in neutral position.
  2. Identify correct size NPA by measuring from tip of nose to earlobe.
  3. Lubricate end of NPA.
  4. Advance NPA (bevel facing septum, until flange rests against the nostril.
31
Q

Does the NPA protect the pt airway from aspiration

A

No.

32
Q

Which nostril is preferred when inserting an NPA

A

Right nostril is often preferred as its typically larger and straighter then the left.

33
Q

Indications for an OPA

A
  1. Maintain airway patency

2. Bite block for intubated pts

34
Q

Contraindications for an OPA

A
  1. Nil in this setting
35
Q

Complications for an OPA

A
  1. Airway trauma from OPA placement
  2. Intolerance of OPA requiring removal
  3. Can cause Vom/aspiration in pt with intact gag reflex.
  4. Incorrect size or placement can potentially exacerbate airway obstruciton
36
Q

Indication of Vacuum Splint

A
  1. Suspected fractures and dislocations of arms, legs or joints
  2. Spinal immobilisation or full body splinting where appropriate for infants or small children
37
Q

Contraindications of Vacuum splint

A
  1. Nil in this setting
38
Q

Complications of Vacuum splint

A
  1. vacuum splints may require further extraction of air to maintain rigidity during aeromedical transport
39
Q

Procedure of vacuum splints

A
  1. Apply appropriate dressing to all wounds
  2. Select appropriate sized splint from limb, correct size will immobilise joints above and below the injury site
  3. lay splint down, spread beads
  4. position splint under injured area, so that one strap is above and below injury site.
  5. support limb and spread beads to provide good mould
  6. mould splint to ensure optimal coverage
  7. attach hand pump to valve
  8. manually pump out air from splint
  9. Disconnect pump
  10. secure splint straps
  11. check distal pulse, recheck pulse and vital signs.

CSB331 OSCE (3 decks)

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