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FREC > FREC > Flashcards

FREC Flashcards

1
Q

Primary Survey
DRCABCDE

A

Danger
Response (AVPU)
Catastrophic Bleeds
Airway
Breathing (RISEN)
Circulation
Disability
Environment, Expose, Evaluate

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2
Q

AVPU

A

Alert
Voice
Pressure
Unresponsive

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3
Q

Blood on the floor & Four more

A

External bleeding (blood on the floor)

  • Chest
  • Abdomen
  • Pelvis
  • Long Bones
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4
Q

SECONDARY SURVEY

SAMPLE

A

Signs & Symptoms
Allergies
Medication
Past Medical History
Last Oral Intake
Events leading to

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5
Q

Hand over

A

Age
Time
Mechanisms
Injury
Signs (vitals, breathing, circulation..)
Treatments

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6
Q

Vital signs - PEARL

A

Pupils
Equal
And
Reactive
Light

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7
Q

Chest Examination
RISEN

A

Rate (Respir. - goal posts 10-30bpm)
Injuries (cut off tops, full check)
Symmetry (‘W’ checking equal raising)
Effort (muscular contractions trying to get air in, shoulders/abs/intercostals)
Neck (trachial deviation from lung expanding and pushing lung & heart around).

Keep healthy side up.

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8
Q

Primary Survey
CATASTROPHIC BLEED

A

Haemostatic Gauze/dressing
- NOT on head or chest (or armpit)
- apply for 5 minutes so blood can clot
- Then apply a pressure bandage (these can be used when not catastrophic bleed)

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9
Q

Primary Survey
AIRWAY

A
  • Postural drainage 10-15 secs
  • Airways (Nasal & Oral)
  • edge to ear lobe measurement
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10
Q

Primary Survey
BREATHING

A
  • if no movement on diaphragm, they are not breathing
  • 2/3 breaths in 10s is fine.
  • 1 breath in 10s is not enough to sustain life (give breaths only - every 6s).
  • no breaths - CPR

Bag Valve Mask
Oxygen, 15ltrs per min. C grip.

If breathing, checking for pulse
RISEN

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11
Q

SHOCK AND BLEEDING

A

15secs x 4 = bpm
Adults should be 60-100bpm
Lowest happy with 40bpm
Max happy with 120bpm

Capillary refill - push down 5s, should refill in 2s or less.
Sternum and forehead for central. Hands and fingers for extremities.

Don’t move the pelvis/iliac crest

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12
Q

BLOOD

A

Good blood pressure is 120/80

PLASMA - fluid component of blood of which is 90% water
PLATELETS - blood clotting
RED CELLS - transport o2 via haemoglobin
WHITE CELLS - fight infection/bacteria?

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13
Q

BLOOD
Arterial
Venous
Capillary

A

Arterial - bright red oxygenated. Spurts from wound in time with heartbeat

Venous - dark red blood will gush from the wound or pool at site of wound

Capillary - oozing occurs at the site

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14
Q

SHOCK

A

Circulation failure.
Life threatening condition.
Circulatory system fails to provide enough oxygenated blood to the body and as a result, deprives the vital organs of oxygen. If left untreated can cause death.

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15
Q

HYPOVOLAEMIC SHOCK

A

Low volumes of blood/fluids

External bleeds
Internal bleeds
Burns
Severe diarrhoea

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16
Q

COPD

A

88-92% oxygen - finger test

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17
Q

Medical Emergencies

A

Heart Attack (Myocardial Infarction)
Cardiac Arrest
Angina
Asthma
Diebetes
Hypoglycaemic
Hyperglcaemic
Seizures
Anaphylaxis
Head Injuries
Spinal Injuries
Chest Injuries
Open Pneumathorax
Tension Pneumathorax
Abdominal Trauma
Protruding Trauma
Blunt Force Trauma
Abrasion
Gunshot
Contusion
Laceration
Incision
Puncture
Burns - SCALD

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18
Q

Heart Attack

A

M & F feel them differently.

Circulation Failure
(Can lead to cardiac arrest)

  • Sit in W position
  • give 300g of aspirin
  • give oxygen - non return mask
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19
Q

Cardiac Arrest

A

Electrical failure -
Pumping of the heart stops

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20
Q

Angina

A
  • Supply of oxygen is insufficient
  • Normally caused by a narrowing of the arteries
  • usually occurs on exertion or stress

GTN Spray (Glycerin Trinitrate?)
- under the tongue - 2 sprays
Should work within 3-5mins (allow to 8). Dilates arteries.

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21
Q

Asthma

A

Narrowing of lower airways with a build up of mucus, air can get in but not out.

Blue inhaler - reliever (2 puffs, max 10 puffs. Repeat after 10mins if no improvement)

Brown inhaler - steroidal, strengthener (AM & PM)

22
Q

Diebetes

A

Type 1 - can’t cure
Type 2 - diet etc.
Gestational - pancreas not producing enough insulin for mum and baby

Normal values: 4-8mmol

Never give anyone insulin

23
Q

Hypoglycaemic

A

Low Blood Sugar

Give jelly babies, coke, jam around gums (or sugar jel on the truck)

24
Q

Hyperglycemic

A
  • Increased thirst &/or hunger
  • frequent urination
  • headache
  • blurred vision
  • fatigue
  • ketone breathe
  • takes days for patient to go into a coma
    No emergency treatment for this.
25
Q

Seizures

A

Tonic Phase - stiff and fall
Clonic Phase - shaking/convulsions

  • Time it
  • protect their head
  • talk to them
  • call 999 if you don’t know them or first time them having one
  • call 999 if goes over a known amount of time they normally last for
26
Q

Anaphylaxis

A

Dilates blood vessels, water fills these expanded holes. Loss of blood flow. Wheeze on breathe in.

Pens - from 10cm away, hold in for 3-5secs

27
Q

Head injuries

A

Concussion
Compression
Skull fracture

28
Q

Concussion Head Injury

A

Brain hits the skull and has a wobble

Side effects - instant
Temporary loss of consciousness (999)
Nausea
Vomiting
Mild headache
Tiredness

Treatment
48-72hrs rest to recover
- can sleep if usual sleep time, but must be checked every 10mins for whole sleep

29
Q

Compression Head Injury

A
  • build up of pressure
  • internal bleed - pressure on brain
  • compression normally take a few days
  • severe headache / migraine
  • lowered levels of response
  • change in behaviour
  • brain will compress optic nerve - PEARL, effects pupils
  • wouldn’t lie them flat
30
Q

Skull Fracture head injury

A
  • split in the skull
  • blunt impact
  • maybe indentation of the skull
  • blood goes to area of least resistance
  • racoon eyes / blackened eyes (FRT impact)
  • battle bruising - behind the ear (REAR impact)
  • blood from ears and eyes
    Releasing pressure, don’t stop it
    Colours: watery or straw coloured
31
Q

Spinal Injuries

A

Broken neck normally kills you

Extrication boards / long boards
Manual Inline Stabilisation (MILS)

32
Q

Chest Injuries

A

Flail Chest
Open Pneumothorax
Tension Pneumothorax

33
Q

Chest Injury: Flail Chest

A

Broken ribs/floating

Paradoxical breathing
- ribs go in and out opposite to chest
- pressure bandage to reduce movement outwards. Lie them on injured side to reduce movement

34
Q

Open Pneumothorax

A
  • Sucking chest wound
  • Penetrating injury to the chest cavity
  • which fills the plural cavity with gas and air
35
Q

Tension Pneumothorax
Chest Injury

A
  • Is when the hole is covered & puts tension on the gas in the cavity as the lungs start to re inflate
  • Russell chest seal is used as a one way valve over the opening, allowing air out and blood out and just air in.
36
Q

Abdominal Trauma
———-
Protruding Trauma

A

Do not remove items eg. Knives

—————

  • do not put back in
  • keep clean and cover (cling film)
37
Q

Abrasion

A

Irrigate with water, wipe around then dressing

38
Q

Gunshot

A
  • exit wound bigger - pack it
    (Lightly if bullet near exit & still in)
39
Q

Contusion

A

Bruise
Cold compress - ice pack for 10mins

40
Q

Laceration

A

Messy cut

41
Q

Incision

A

Clean cut

42
Q

Puncture

A

Hole
Pack if need to - normal dressing

43
Q

Depth of Burns
SCALD

A

Size
Cause
Age
Location
Depth

44
Q

SCALD - S

A

Size
9% for arms, legs
18% for front, back
1% for groin

45
Q

SCALD - C

A

Cause
Chemicals, electrical
Medical attention

46
Q

SCALD - A

A

Age
Young & Old seek medical attention no matter what. Thinner skin.

47
Q

SCALD - L

A

Location
Face, hands, feet, genitals
Must get medical attention

48
Q

SCALD - D

A

Depth:
Superficial - over 5%

Partial thickness - goes through to the dermal layer (blister, yellow) over 1%

Full thickness - goes through to the subcutaneous layer (fatty)

49
Q

Burns - treatments

A

Water - any tepid water - 20mins
Remove jewellery while cooling burnt skin
Layering with cling film, top layer & bottom layer, so if swelling it can expand and blood flow not be restricted

50
Q

CPR - Adult

A

Adult 18+
30x compressions
2x breaths
100-120per min

FREC (1 decks)

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