FR Medical Protocols Flashcards
What is the purpose of the trauma - primary survey?
To provide an organized and consistent means of evaluating patient status in a prioritized manner, so that life threatening conditions are quickly identified.
The primary survey should not be interrupted except when…
There is complete airway obstruction or partial obstruction without adequate air exchange.
There is cardiac or respiratory arrest.
You are stopping major severe external bleeding.
Anything occurs that may cause harm to the patient if not immediately dealt with.
The primary survey should be repeated when…
The patient’s condition changes, such as change in LOC, a seizure, a change in respiratory rate and quality, vomiting, or change in circulatory status.
The patient is moved.
The Semi-Automatic External Defibrillator (SAED) has an internal microprocessor based detection system that analyzes rhythm for characteristics of ventricular fibrillation (VF, V-fib) and pulseless ventricular tachycardia (VT, V-tac).
If ventricular fibrillation (VF, V-fib) and pulseless ventricular tachycardia (VT, V-tac) are present, the SAED advises the operator to deliver a shock.
SAED pads…
Do not pre-open pad packages. Only open when they will be used.
For infants and children less than 8 years of age or less than 55 lbs, use paediatric pads. (reduced energy defibrillation electrodes)
For children more than 8 years old or bigger than 55 lbs, use adult pads.
Use anterior/posterior placement on children and infants.
Adult pads may be used on children as a last resort.
Avoid placing pads over implanted pacemakers or defibrillators.
There are 5 special situations with SAED…
this was on an exam
Hairy chest - shave the area for pads
Patient is in water or was in water - take them out of the water and dry area for the pad
Pacemakers - Make sure the SAED pad is more than one inch away from the pacemaker
Medical patches - Remove all medical patches before applying SAED pads
Hypothermic/cold water drowning - If the patient is hypothermic, minimize the shocks to one.
Left Ventricle Assist Device
There are at least 3 people living in Calgary with this device. It is a battery operated pump.
DO NOT do chest compressions on this patient.
DO NOT attempt to operate the LVAD unless under the direct guidance of either the patient or caregiver.
Patient is to be transported to Foothills Medical Centre only.
Bring the patient’s power supply.
Home/Public AED Use… (This was on an exam)
If CFD crews encounter a cardiac arrest scene at which another AED is already being used, the newly arriving CFD crews shall not use that machine.
Simultaneously with patient assessment, the CFD Life Pak 1000 should be attached to the patient, and the other machine should be removed.
Suctioning…
If gurgling is heard, immediate suctioning is needed…
Suctioning should be limited to less than 15-20 seconds.
Harness Suspension Syndrome…
HSS is a state of cardio vascular collapse. It is caused by the pooling of blood in the lower extremities, as a result of occlusion of the veins by the harness. By moving their legs or flexing their muscles, rescuers and patients can improve the circulation of venous blood returning from their legs to their heart.
Symptoms include:
Faintness, difficulty breathing, sweating, paleness, dizziness, nausea, and unconsciousness.
Treatment:
Provide high flow oxygen. Encourage the patient to keep moving their legs or flexing their muscles while the rescue is being performed.
NEVER lay the patient down in a horizontal position (recovery position) after the rescue. A horizontal position increases the likelihood of the right ventricle being overloaded and can, therefore, result in heart failure.
Keep the patient in a sitting, squatting, or crouching position.
Helmets…
Full face motorcycle helmets impede your ability to assess and manage the airway; they must be removed in order to assess, evaluate, and maintain the patient’s airway.
All open face helmets, such as football helmets, are best left in place with the face guard removed.
Crime scene…
If crews are dispatched to a medical call where there is a death or possible crime, it is imperitive that all possible precautions are taken to preserve thr scene.
If crews must cut ropes or similar devices to provide care, do not cut or undo any knots.
