Equipment Flashcards
Indications of a SAMsling
- Suspected pelvic fracture with evidence of haemodynamic compromise
Contraindications of a SAMsling
- Suspected isolated neck of femur fracture
2. Suspected Traumatic hip disclocation
Complication of a SAMsling
- Binder should not be removed due to the risk of haemodynamic instability
- Other methods (e.g. vacuum splint) may be used in small children.
- Apply careful in gross open fractures to minimise pain and further complications.
SAMsling procedure
- Remove all objects from the pts pockets and pelvic area and cut off outer garments.
- Unfold the appropriate size pelvic binder with the inner white surface facing up.
- 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.
- Feed black strap through the buckle, placing the buckle close to midline.
- With assistance, firmly pull black and orange loops in opposite directions. tighten the binder until it is firm (you may not require a click).
- Maintain tension and firmly press the black strap onto the velcro.
Is it recommended to apply the pelvic binder before extricating pt from a vehicle?
No
Is the SAMsling recommended for use in pregnant trauma pt’s?
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.
True or false, do not allow the Pelvic binder to be cut off the Pt?
True
Is it appropriate to provide Analgesia to a pt prior to applying a pelvic binder?
Yes
Indications of a CT-6
Mid shaft femoral fractures
Contraindications of a CT-6
Fracture/dislocation of the knee
Ankle injury
Complications of a CT-6
Latrogenic injury due to poor application technique
CT-6 Procedure
- Assess the injury (Expose the affected limb, assess the limb for distal perfusion, irrigate and dress open fractures as required)
- Assembly
- 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.
- 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.
- Attach ankle hitch (foot strap runs beneath foot, tighten bottom of strap)
- Apply minimal traction (until splint rests in appropriate position)
- Secure leg straps (start with upper inner thigh
- Apply traction (until legs are of equal length)
In the setting of a potential pelvic injury, the CT6 is to be applied first, followed by the SAMsling
False, Pelvic binder is applied first
Open fractures need to be washed out prior to the application of a CT6
True, (minimum of 2L saline)
Indications of a soft cervical collar
Suspicion of a cervical spine or SCI
Contraindications of a soft cervical collar
- Surgical airway
2. Penetrating neck trauma
Complications of a soft cervical collar
- Discomfort
2. Anxiety
Soft Cervical Collar procedure
- Align pt head in neutral or position of greatest comfort
- Measure distance between the base of the chin and the suprasternal notch.
- Select appropriate size.
- Slide the collar under the pt neck. until velcro is visible
Should the ends of a correctly sized soft collar meet or slightly overlap at the back of the pt neck?
Yes
Indications of NIEJ
To facilitate safe Extrication from a confined space
Contraindications of NIEJ
PT is actual time critical and application of NIEJ will delay transport
Complications of NIEJ
- Respiratory effort effected if chest straps too tight
- Groin straps need to be firmly secured to minimise jacket and neck mov’t.
- Cspine hyperextension or hyperflexion with incorrect head padding
- Cspine Mov’t with immobilising head without properly securing torso
NIEJ Procdure
- Explain procedure gain consent
- Prepare NIEJ
- Cspine immobilisation in conjunction with NEIJ. MILS during application of Collar.
- Position NIEJ firmly in armpits but no higher than top of head.
- Position groin straps from back of NEIJ. (make sure they are not twisted
- Raise pt arms to shoulder height, position chest flaps (apply straps green yellow then red).
- Straps should cross the chest, or vertically if pt has breathing difficulty.
- Slide groin pads onto leg strap
- Connect leg straps on buckles and tighten
- Recheck straps are tight.
- attach head pads to prevent hyperextension
- Secure collar strap and forehead strap (inline with eyebrows), tighten each side equally.
- Extricate pt, groi straps may be loosened.
Paediatric Specialised use of NEIJ
Can place blankets either side to assist with pt support
Pregnant specialised use of NEIJ
Chest flaps may be folded inward to expose abdomen, and straps tightened to support
NEIJ used of Hip immobilisation
Invert, chest flaps over pelvic area. Secure head flap around knee, use lumbar support between knees, secure ankles with triangular bandage.
Indications for a NPA
Potential or actual airway obstruction
Contraindications for a NPA
Nil in this setting
Complications for an NPA
- Airway trauma, Epixtaxis
- incorrect size or placement will compromise effectiveness
- Exacerbate a base of skull fracture (NPA displacing in the cranial vault)
- Can stimulate gag reflex in sensitive pt, precipitating Vom or Aspiration.
Procedure for inserting an NPA
- Place pt head in neutral position.
- Identify correct size NPA by measuring from tip of nose to earlobe.
- Lubricate end of NPA.
- Advance NPA (bevel facing septum, until flange rests against the nostril.
Does the NPA protect the pt airway from aspiration
No.
Which nostril is preferred when inserting an NPA
Right nostril is often preferred as its typically larger and straighter then the left.
Indications for an OPA
- Maintain airway patency
2. Bite block for intubated pts
Contraindications for an OPA
- Nil in this setting
Complications for an OPA
- Airway trauma from OPA placement
- Intolerance of OPA requiring removal
- Can cause Vom/aspiration in pt with intact gag reflex.
- Incorrect size or placement can potentially exacerbate airway obstruciton
Indication of Vacuum Splint
- Suspected fractures and dislocations of arms, legs or joints
- Spinal immobilisation or full body splinting where appropriate for infants or small children
Contraindications of Vacuum splint
- Nil in this setting
Complications of Vacuum splint
- vacuum splints may require further extraction of air to maintain rigidity during aeromedical transport
Procedure of vacuum splints
- Apply appropriate dressing to all wounds
- Select appropriate sized splint from limb, correct size will immobilise joints above and below the injury site
- lay splint down, spread beads
- position splint under injured area, so that one strap is above and below injury site.
- support limb and spread beads to provide good mould
- mould splint to ensure optimal coverage
- attach hand pump to valve
- manually pump out air from splint
- Disconnect pump
- secure splint straps
- check distal pulse, recheck pulse and vital signs.
