First Aid Flashcards
What is the law in terms of first aid?
Under the VSA 1966, unqualified members of the public can perform first aid ONLY as an interim measure to:
- preserve life and
- alleviate suffering
RVNs may administer first to prevent deterioration and alleviate suffering
What should you do in a first aid situation?
Don’t panic
ABC! Airway Breathing Circulation
Maintain airway
-check for obstructions, extend neck, pull out tongue, remove collar and harness
Check Breathing
- palpate and observe chest
- hold something light in front of nose to see
- if not breathing, start artificial respiration
Control haemorrhage and check circulation
- palpate heartbeat on lateral chest wall caudal to elbow between ribs 3-7 (easier on LHS).
-check pulses, MM and CRT
- If no pulse, start CPR
Contact VS asap!
What Is triage?
Prioritising cases into :
- Those that are likely to live, regardless of treatment
- Those that are likely to die, regardless of treatment
- Those for whom immediate care may result in a positive outcome.
When arriving at the scene of an emergency, what should you do?
- Assess the situation - what are the risks to you and the casualty?
- Assess the casualty
- is it conscious? ABCs. CPR or recovery position - Contact vet ASAP
- Assess the injuries
Give some examples of a life-threatening emergency
Cardiac Arrest Airway obstruction Severe haemorrhage Collapse with dyspnoea Severe burns, dehydration GDV(gastric dilation and volvulus) Sudden onset neurological problems
Give some examples of a serious or urgent emergency
Unconscious Fractures Bleeding (mild) Wounds Spinal injury Eye injuries
Give some examples of minor emergencies
Minor burns, stings FBs (e.g. in paw) diarrhoea lameness skin reaction
What should your conversation with an owner include when receiving a phone call about a potential emergency?
Introduce yourself and practise
ASAP confirm if life threatening
Provide clear directions to the practise and alternative transport methods
Obtain ETA and owners contact info
If not an emergency, obtain:
- patient details
- nature of problem
- first noticed
- on any meds
- previous history of anything similar?
- any other changes
- demeanour of patient
What should the nurse do during resuscitation in the vet practise?
Liase with the vet RE cardiac compression and artificial respiration
Monitor and record throughout emergency and stabilisation.
What is your crash plan?
A - airway
C - circulation R - respiration A - abdomen - signs of internal bleeding, pain S - spine - stable? limbs functioning? H - head - bleeding/ trauma?
P - pelvis - stability, fractures?
L - limbs - fractures? Bleeding?
A - arteries and veins -bleeding elsewhere?
N - nerves - signs of control problems
If you don’t have access to equipment, what 2 methods can be used to oxygenate a patient in respiratory distress?
- Chest compressions
- only to be used when no injury to chest wall.
- lateral recumbency, extend head and neck and pull tongue and front legs forward.
- palm at middle point of chest (top of chest dome)
- compress about 1/3rd way down and try to get chest to spring back.
- compress chest and release every 0.5-1 second - Mouth to Nose
- use face mask
- pull tongue forward and close jaw
- place hands around mouth, support head and seal lips
- place mouth over patients nostrils and blow, inflating the lungs do not overinflate- stop when feel tension
- respire patient every 1 second
What is the procedure for oxygenating a patient in respiratory distress in practise?
Intubate using ET tube (can use a very small one to by pass an obstruction - may need to use tracheostomy) Attach to anaesthetic circuit to provide 100% O2 IPPV bagging (Intermittent Positive Pressure Ventilation) - every 5 seconds until spontaneous ventilation occurs. \+/- respiratory stimulant drugs e.g. doxapram
Describe the method for cardiac compressions
Place in right lateral recumbency
Support lower chest with padding - allows u to apply more force.
Place hands over lower 1/3rd of the chest, just caudal to the elbow (flat part of the chest).
Compress at 0.5-1 second intervals
In small species use fingertips
What is CPR?
How do you carry it out (not in practise)?
Cardiopulmonary resuscitation
- carrying out cardiac massage and artificial respiration simultaneously
- ideal to have 2 people doing 5 compressions to 3 breaths
If on own, cardiac compressions for 15 and then inflate chest twice.
Check HR & RR every 2 cycles
Continue for at least 20-30 minutes or until help arrives
Maintain observations and keep patient warm
Describe how you would carry out CPR in practise?
Intubate patient on 100% o2 - 1 breath every 3-5s (10-12 breaths per minute)- Ambu bag if no anaesthetic machine available.
Cardiac compressions 1-2 compressions per second
Administer drugs under direction of vet
Defibrillator
What is shock?
Circulatory collapse causing inadequate tissue perfusion leading to inadequate supply of O2 to cells
What are the types of shock?
Hypovolaemic
Cardiogenic
Distributive (sepsis)
Obstructive
What can cause shock?
Severe haemorrhage, infection, dehydration, medical condition or some poisons
What are the signs of shock?
Pale MM Prolonged CRT Rapid, shallow respiration Rapid, weak pulse Cold extremities Dilated pupils Dull Depressed Convulsions/ collapse
What first aid can be given to a patient in shock?
Gently warm patient - environmental heat rather than direct - insulate
Control the haemorrhage
Reduce stress
Monitor vital signs - Constant observation
Get vet ASAP
IVFT -according to need (get IV access early as once in shock, its difficult to get a vein)
What are the signs of haemorrhage?
Pale MM Prolonged CRT Rapid, weak pulse Altered breathing pattern Subnormal body temperature Inability to stand/weakness
Describe the 5 types of haemorrhage?
Arterial - bright red oxygenated spurting blood in time with pulse rate
Venous - dark red/purple deoxygenated flowing blood
Capillary - red, oozing blood from pin points
External - outside bleeding from an orifice
Internal - in a body cavity
What does the body do to save itself from haemorrhage?
Elastic recoil
Reduced blood pressure
Back pressure
Blood clotting (needs platelets and clotting factors. Fibrin forms the mesh)
How can you control haemorrhage?
And In practise?
Direct Digital Pressure - your hand on it
Pressure Bandage - care if FB, can use belly bandage(temporary measure)
Pressure Points - on arteries
Arrest haemorrhage and notify VS Keep patient warm and quiet TPR and observe! May need IV access, blood replacement, prep theatre Tourniquet - VS only!
What are open and closed fractures?
Open is when there is a skin and tissue wound also
Closed when there is no open surface wound
What are simple and compound fractures?
No complications (e.g. soft tissue, nerves) = simple Compound = complications
What are overriding and avulsed fractures?
Overriding = body naturally splints the fracture, shrinks muscles and pulls the bones along side each other
Avulsed means there is a bit missing or broken off
What are a) transverse b) oblique c) spiral d) comminuted or multiple e) segmental f) impacted g) torus h) greenstick fractures?
a) straight across break
b) diagonal break
c) twisting round the bone
d) crushed and lots of little bits
e) floating bit
f) bone driven in to each other
g) damage to epiphysis
h) not complete - more of a bend
