General Flashcards
What is a Status 1?
Obstructed airway or airway needing intervention to prevent obstruction.
Severe stridor.
Severe respiratory distress.
Severe shock.
Multi-system trauma.
Cardiac arrest or post cardiac arrest.
Cardiogenic shock.
ST elevation myocardial infarction.
Dysrhythmia causing severe cardiovascular compromise.
GCS of less than or equal to 9.
What is Status 2?
Moderate stridor.
Moderate respiratory distress.
Moderate shock.
Two or more fractures (including closed fractures) involving the shaft of the femur, the tibia or the humerus.
Fractures or dislocations with clear signs of limb ischaemia.
Note: there may be abnormal sensation or movement distal to the injury but there must be signs of limb ischaemia for the patient to be status two.
Isolated spinal cord injury.
Dysrhythmia causing moderate cardiovascular compromise.
Myocardial ischaemia with clinically significant symptoms, or signs on 12 lead ECG, which persist following treatment with nitrates.
Note: the patient is status two if opiates are administered for the pain of myocardial ischaemia.
GCS of 10-13.
What is Status 3?
Mild stridor.
Mild respiratory distress.
Dysrhythmia causing mild cardiovascular compromise.
Myocardial ischaemia with symptoms, or signs on 12 lead ECG, that have resolved following treatment with nitrates.
Note: the patient is status two if the signs or symptoms return and further administration of nitrates is required.
Isolated fracture of one long bone. This includes the shaft of the femur and compound fractures, provided there are no signs of limb ischaemia.
Dislocations of joints without clear signs of distal limb ischaemia.
Spinal pain without signs or symptoms of spinal cord injury.
Loss of consciousness with normal or near normal (GCS 14 or 15) recovery.
Transient ischaemic attack.
What is Status 4?
Isolated minor fractures.
Strains and sprains.
Lacerations where bleeding has been controlled.
Fever without systemic signs of sepsis.
Headache with normal neurological findings.
Verification of Death
To verify death using clinical criteria there must be:
No signs of breathing for one minute, and
No palpable central pulse, and
No audible heart sounds, and
Pupils that are dilated and unreactive to light.
After ten minutes, all the above examinations must be repeated and at this time the cardiac rhythm must be asystole.
Document this as the time death has been verified.
A patient may be dead but may not be in asystole at the second examination after ten minutes.
For example:
There may be slow broad complexes. If this is the case, wait until asystole is present before verifying death.
A patient with a pacemaker may have electrical activity generated by the pacemaker for many hours after death.
In this setting it is appropriate to verify death despite electrical activity on the ECG, provided all the other clinical criteria are met.
R40 structure
Comms from (callsign) requesting R40 to (hospital).
- Transfer to receiving hospital -
Wellington hospital from (callsign) are you receiving?
Coming to you from (location) with a (status _) patient (MOI and working diagnosis).
Haemodynamics, interventions, and required additional support.
ETA
