Everyday Skills Flashcards
NPA
Indications
To maintain an airway with a basic adjunct when an OPA cannot be used.
NPA
Contraindications
- Significant nasal or mid-facial trauma.
- Epistaxis
NPA
Precautions
- 3rd trimester pregnancy.
- Patients prone to epistaxis.
- Never force an NPA if resistance is felt.
- Use with caution in suspected skeletal fractures, e.g. base of skull fractures.
- Insertion may cause mild bleeding.
OPA
Indications
To rapidly assist in maintaining the airway patency of an unconscious patient.
OPA
Precautions
- The placement of an OPA MUST NOT interrupt effective compressions in Cardiac Arrest.
- If the patient gags during the insertion of the oropharyngeal airway, remove immediately and be prepared to suction.
- Paediatrics <6 years: insertion should be performed without twisting and should follow the natural curvature of the airway to prevent damage to the oropharynx.
- Suspicion of traumatic injury: ensure spinal alignment and immobilisation of head and neck (jaw thrust method)
Modified Valsalva Manoevure
Indications
To terminate SVT/narrow complex tachycardia by increasing intrathoracic pressure to stimulate vagal nerve response.
Modified Valsalva Manoevure
Contraindications
- Recent or current acute myocardial infarction
- Severe coronary artery disease
- Haemodynamic instability (i.e. systolic BP below 90mmHg)
- Known glaucoma or retinal myopathy
Modified Valsalva Manoevure
Precautions
- The following side effects might be experienced by the patient when performing the Valsalva Manoeuvre:
- Dizziness, Hypotension, Syncope, Tinnitus, Headache
- If patient is on the stretcher, procedure is only to be performed while stretcher is locked into ambulance or lowered to ground height.
Spinal immobilsation
Indication
Immobilisation of patients with suspected spinal injury.
Spinal immobilisation
Precautions
- Do not readjust the torso straps after the head has been secured. This causes movement of the immobilisation device in relation to the torso.
- Do not secure the arms inside the spider straps. This causes the straps to be too tight or loose. If the arms need to be secured an additional strap or bandage should be used.
- Do not secure the base plate of the head blocks or the towel rolls to the Ferno 50/E stretcher. The head and chin straps should be used to keep the blocks in place.
- Prolonged immobilisation on the extrication board can increase the risk of pressure ulcers. Bony prominences should be sufficiently padded.
- Should additional padding be required to support the head, this should be placed underneath the head block base plate.
- In the restless/claustrophobic patient, continuous inline immobilisation might be needed instead of a C-Spine collar and/or head blocks.
- Ensure adequate assistance is utilised when lifting patient.
- Note:
- Safe work load of the extraction board: 220kg
- Safe work load of the scoop stretcher: 159kg
Pelvic splints
Indications
Haemodynamically compromised trauma patients meeting the pelvic binder decision tool criteria
Should be considered an immediate and urgent intervention in symptomatic cases
Pelvic splints
Contraindications
- Patients under 23kg
- Isolated hip fractures
- Fall from standing
Pelvic splints
Precautions
- Elevate male genitalia out of the groin area to prevent compression injury.
- For use on adults and children >23kg (7-8 years of age).
- Pregnant patients; be vigilant to ensure correct placement (i.e. not inadvertently placed too high)
- Not for use on any other fractures.
- Approximately 40% of all pelvic binders are misplaced, often too high
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