Feedback - Practical Flashcards
Learning Point x 3
Call for backup earlier
A patient stops breathing suddenly. Response?
Primary survey again.
R - Response - 4, 5 6 GCS
A - Check airway - No soiled? Move on
B - Check breathing - Count rate - Too low ?
- Insert OPA / i-gel -> Get BVM attached and provide up to 10 per min breaths if needed.
C - Check circulation. If no radial pulse -> begin compression’s.
- > Charge and check ect.
Learning point x 2
Going too fast. Slow…it…down. You have all the time in the world.
Learning point x 1
You dont have to consult for fluids in asthma
Learning point x 1
When providing a neb -> Always have the patient postured upright.
On-road observation - Mucus influenza patient
When dealing with a patient with propensity for respiratory decline. Use capnography if possible
On-road observation - Mucus influenza patient
If you have a patient with significant mucus in the upper respiratory tract…you should consider suction even if they are conscious. You saw this done in resus by the doctors.
On-road observation - Mucus influenza patient
A patient with severe mucus in the upper respiratory tract is a severe aspiration risk. This is the key thing you are worried about.
On-road observation - Mucus influenza patient
When doing a notification ‘paint the picture’ of how sick the patient is, desribing the respiratory presentation in detail if nessecary.
On-road observation - Mucus influenza patient
posture upright immediately in respiratory patients.
On-road observation - Mucus influenza patient
You panicked with you saw 80 sats and rising respiratory rate.
you needed to LOOK at the patient. Is he stable? At this stage yes. Next step. troubleshoot the sats probe and try different fingers to get a good pleth wave.
If nessecary - > consider a primary survey. If passed. Continue.
A patient with a siezure in a shopping centre. Passes primary survey…next step? GCS 14
Extricate. Get on a bed and in an ambulance for assessment.
Any patient who is disorientated, post ictal is?
GCS 14. Confused.
Never use what size cannula?
Size 24.
You go for cannulation on a patient. It fails. Your aim is to give ondansatron. Next step?
IM. Dont mess around anymore with it.
You come to a patient with no radial pulse, sitting on the couch, currently GCS 15. Do what?
Put them on the ground. Feet Up - POSTURE patient!!
When someone is GCS 15 -> has NO RADIAL pulse and has already been postured, what should you do next?
Oxygen because the patient is in a ‘shocked state’
Why must you ALWAYS make sure the monitor is on at the start of any scenario?
Because they will pin you with a declining patient that you ‘didnt notice’ where as if you have a monitor on, you will be prompted that the monitor is beeping. This is your clue for declining/arresting patients.
What should always be a part of your primary survey>
- Doing an auscultation/breathing assessment. You often miss this.
How should you correctly do a paerdiatric arrest compression, you damn idiot?
With only one arm at a time.
You have a patient who is maintaining an airway, breathing at an adequate rate, and is unconcious with a head injury. How should you manage their breathing/airway?
The least invasive method.
Do MANUAL jaw thrust with head tilt. Do not poke the bear by putting in an airway device even with a low GCS unless airway is an issue and airway device indicated. If nessecary, think about going naso first.
You are doing compressions, the person on the airway wants to do an advanced airway, do you stop?
No. Keep going. Doesnt affect an advanced/any airway management.
Doing a scenario, and you are not attending…you are the supporting clinican. What do you do?>
SHUT UP. Do NOT make ANY sort of clinical decision, or suggest anything. Just take obs and report them. If you see somthing important, communicate it to your attending clinican and make sure they hear you/good communication/attention.
When managing a paed airway should you go no OPA?
No. Just go for advance airway.
