First Aid

Question 1

Advantages and disadvantages of the recovery position

Answer 1

Advantages: simple, quick, no equipment and postural drainage
Disadvantages: no definitive airway - aspiration may still happen

Question 2

Wound definition

Answer 2

An injury to living tissue caused by a blow, cut or other impact, typically causing skin to become broken

Question 3

Closed Wounds

Answer 3

Contusions, bruises and crush injuries
Damage to blood vessels under the epidermis
pain and swelling
haemorrhagic shock can occur due to internal bleeding

Question 4

Abrasions and Lacerations

Answer 4

Abrasions: caused by friction and often affects the superficial layer but can go deeper, may contain dirt. Consider nerve endings and infection

Laceration: Tearing or splitting of skin due to blunt trauma

Question 5

Incisions and Punctures

Answer 5

Incisions: breaking of skin due to a sharp object, usually clean. Consider depth and structures beneath

Punctures: penetrating wounds due to sharp, narrow objects. Leave object inside

Question 6

Avulsions and Amputations

Answer 6

Avulsions: top layer of skin tearing, more common in elderly or as a result of poor manual handling techniques

Amputations: partial or complete severing of a digit or limb, take missing parts to the hospital

Question 7

Bites and Gunshots

Answer 7

Bites: what has bitten the person? lacerations and bruising

Gunshots: caused by a projectile object moving at speed, entry wound and potential exit wound. Varying amounts of damage

Question 8

What types of haemorrhage cannot be assessed?

Answer 8

bruising
nose bleeds
haemothorax
intercranial

Question 9

Characteristics of capillary haemorrhage

Answer 9

slow and even flow
bright red colour

Question 10

Characteristics of venous haemorrhage

Answer 10

steady and slow flow
Dark red colour

Question 11

Characteristics of arterial haemorrhage

Answer 11

spurting blood
pulsating flow
bright red colour

Question 12

General signs of an internal haemorrhage

Answer 12

SOB, chest pain, dizziness, bruising around navel or sides of abdomen, nausea, vomiting, blood in urine, abdominal pain, signs of shock, bleeding from nose and mouth

Question 13

Signs of a head haemorrhage

Answer 13

weakness on one side, headache, tingling, visual and auditory disturbances, issues with speaking and chewing

Question 14

Signs of bleeding into joints and muscles

Answer 14

reduced range of motion, joint pain and swelling

Question 15

Grey Turner’s Sign

Answer 15

large retroperitoneal haemotoma
blood enters the space behind the posterior reflection fo the abdominal peritoneum

Question 16

Management of haemorrhage: direct pressure

Answer 16

with cloth, tissue or gauze
check for foreign bodies
if blood bleeds through then apply more cloth, tissue or gauze but leave the old one in-situ

Question 17

Management of haemorrhage: elevate limb

Answer 17

raise limbs to reduce blood flow
raise them above the level of the heart

simple plaster/ gauze with conforming bandage wrapped around

Question 18

Management of haemorrhage: dressings

Answer 18

cover wound and edges
hold the dressings at edges - do not touch wound
check distal circulation before and after

Question 19

Management of haemorrhage: foreign objects

Answer 19

if they are small enough then remove them with water

if not, leave them in the wound

protect the area with sterile gauze

Question 20

Management of haemorrhage: haemostatic dressing

Answer 20

thin bandages or gauze that have chemicals that help seal the wound

use to pack wounds

Question 21

Management of haemorrhage: tourniquets

Answer 21

consider in the presence of severe haemorrhage that cannot be relieved by direct or indirect pressure

warn patient of pain and place 2-3 inches above bleeding site

Question 22

Stage 1 of hypovolaemic shock

Answer 22

up to 750ml blood loss
vital signs remain normal

Question 23

Stage 2 of hypovolaemic shock

Answer 23

compensation stage
750-1500ml blood loss
100-120 bpm
RR = 20-30
Reduced BP
Pt will be mildly anxious

Question 24

Stage 3 of hypovolaemic shock

Answer 24

Decompensated stage
1500ml-2000ml
120-140bpm
RR = 30-40
Reduced BP
Pt will be anxious and confused

Question 25

Stage 4 of hypovolaemic shock

Answer 25

irreversible stage
over 2000ml blood loss
pulse rate greater than 140bpm
RR will be above 35
Reduced BP
Pt will be confused and lethargic

Question 26

Symptoms of hypovolaemic shock

Answer 26

pallor, cold peripheries, anxiety, abnormal behaviour, tachycardia, tachypnoea and altered consciousness

Question 27

Name the types of fractures

Answer 27

transverse, open, oblique, comminuted, avulsed, spiral and greenstick

Question 28

Types of force than can cause fractures

Answer 28

Direct - blunt force such as in RTCs
Indirect - bone breaks a distance away from point of impact
Pathological conditions - reduction in calcium - weaker bones

Question 29

What should be considered when asking about the mechanism of injury for a fracture?

Answer 29

How did it happen
establish a mental image of the direction of the force, magnitude and duration
ask pt to demonstrate on the uninjured limb
ask if the patient could mobilise immediately after the injury if it was on the lower limbs

Question 30

Fracture assessment key points (4)

Answer 30

check joint below and above the fracture

inspection: swelling, deformity, wounds, haemorrhage and colour changes
Palpation: injured and surrounding area. assess severity of pain

check the range of movement, motor function and sensation feeling

Question 31

Signs and Symptoms of Fractures
B SLIP DUCT

Answer 31

bruising, swelling, loss of function, irregularities, pain, deformity, unnatural movement, crepitus and tenderness

Question 32

6Ps of a musculoskeletal assessment

Answer 32

Pain or tenderness
Pallor - pale skin or poor capillary refill
Paraesthesia
Pulses - diminished or absent
Paralysis
Pressure - potential for compartment syndrome

Question 33

Advantages of immobilisation

Answer 33

reduces pain
prevents further injury
ensures vascular and neurological supply to affected area
reduces risk of fat embolism
promotes recovery