FREC Flashcards
Primary Survey
DRCABCDE
Danger
Response (AVPU)
Catastrophic Bleeds
Airway
Breathing (RISEN)
Circulation
Disability
Environment, Expose, Evaluate
AVPU
Alert
Voice
Pressure
Unresponsive
Blood on the floor & Four more
External bleeding (blood on the floor)
- Chest
- Abdomen
- Pelvis
- Long Bones
SECONDARY SURVEY
SAMPLE
Signs & Symptoms
Allergies
Medication
Past Medical History
Last Oral Intake
Events leading to
Hand over
Age
Time
Mechanisms
Injury
Signs (vitals, breathing, circulation..)
Treatments
Vital signs - PEARL
Pupils
Equal
And
Reactive
Light
Chest Examination
RISEN
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.
Primary Survey
CATASTROPHIC BLEED
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)
Primary Survey
AIRWAY
- Postural drainage 10-15 secs
- Airways (Nasal & Oral)
- edge to ear lobe measurement
Primary Survey
BREATHING
- 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
SHOCK AND BLEEDING
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
BLOOD
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?
BLOOD
Arterial
Venous
Capillary
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
SHOCK
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.
HYPOVOLAEMIC SHOCK
Low volumes of blood/fluids
External bleeds
Internal bleeds
Burns
Severe diarrhoea
COPD
88-92% oxygen - finger test
Medical Emergencies
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
Heart Attack
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
Cardiac Arrest
Electrical failure -
Pumping of the heart stops
Angina
- 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.
Asthma
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)
Diebetes
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
Hypoglycaemic
Low Blood Sugar
Give jelly babies, coke, jam around gums (or sugar jel on the truck)
Hyperglycemic
- 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.
