General Standards of Care Flashcards
As per the BLS typically warrant a cardiac monitor
- VSA (that are not obviously dead)
- Unconscious or altered LOC
- Collapse or syncope
- Suspected cardiac ischemia
- SOB
- CVA
- Overdose
- Major or mutli-system trauma
- Electrocution
- Submersion injury
- Hypothermia, heat exhaustion or heat illness
- Abnormal vital signs as per the ALS PCS
- If requested by sending facility staff
Reassess vital signs every ??? minutes
30 (minimum)
When giving O2, attempt to maintain the patient’s oxygen saturation at what level?
92-96%
If pulse ox. isn’t working, administer high concentration o2 to what patients?
- Confirmed or suspected carbon monoxide or cyanide toxicity or noxious gas exposure
- Upper airway burns
- Scuba-diving related disorders
- Ongoing cardiopulmonary arrest
- Complete airway obstruction
- Sickle cell anemia w/ suspected vaso-occlusive crisis
AND - age specific hypotension
- Respiratory distress
- Cyanosis, ashen colour, pallor
- Altered LOC
- Abnormal pregnancy or labour
For what patients should you continuously administer high concentration O2
- Confirmed or suspected carbon monoxide or cyanide toxicity or noxious gas exposure
- Upper airway burns
- Scuba-diving related disorders
- Ongoing cardiopulmonary arrest
- Complete airway obstruction
- Sickle cell anemia w/ suspected vaso-occlusive crisis
For COPD patients on o2, how often should you reassess vitals?
Every 10 minutes
In patients with COPD, what oxygen saturation should you aim for?
88-92%
If pulse ox. equipment doesn’t work with a COPD patient, what should you do?
Administer o2 by nasal cannula with oxygen flow at 2lpm above the patient’s home oxygen levels. Or 2 lpm if pt is not on home o2
How do you increase oxygen flow for COPD patients
Increase o2 by increments of 2 lpm above starting level approx. every 2-3 minutes if the patient’s status deteriorates or the patient indicates they feel worse.
What are some CPR resuscitation interventions
- Chest compressions
- Defibrillation
- Artificial ventilation
- Insertion of an OPA, NPA, or SGA
- Endotracheal intubation
- Transcutaneous pacing
- Advanced resuscitation drugs
What are signs of obvious death
- Decapitation, transection, visible decomposition, putrefaction
OR - Absence of vital signs AND
- Grossly charred body
- Open head or torse wound with gross outpouring of cranial or visceral contents
- Gross rigor mortis
- Dependent lividity
What are the physiological criteria under the Field Trauma Triage Standard (FTTS)
- Patient does not follow commands
- Systolic BP <90mmHg
- Respiratory rate <10 or ≥ 30 breaths per minute OR need for ventilatory support
- In infants <1 yrs old, <20 breaths per minute
What are the anatomical criteria under the Field Trauma Triage Standard (FTTS)
- Any penetrating injuries to head, neck, torso and extremities proximal to elbow or knee
- Chest wall instability or deformity
- Two or more proximal long-bone fractures
- Crushed, de-gloved, mangled, or pulseless extremity
- Amputation proximal to wrist or ankle
- Pelvic fractures
- Open or depressed skull fracture
- Paralysis
What are the mechanism of injury criteria under the Field Trauma Triage Standard (FTTS)
- Falls
- Adult: falls ≥ 6m (or 2 story)
- Children (age<15): falls ≥ 3m, or 2 to 3 times the height of the child - High risk auto crash
- Intrusion ≥0.3m occupant site, ≥0.5m any site
- Ejection (complete or partial)
- Death in the same passenger compartment
- Vehicle telemetry data consistent with high risk injury - Pedestrian or bicyclist thrown, run over, or struck with significant impact (≥30mk/hr) by an automobile
- Motorcycle crash ≥30km/hr
What are the special criteria under the Field Trauma Triage Standard (FTTS)
- Age
- Risk of injury/death increases after age 55
- SBP <110 may represent shock after age 65 - Anticoagulation and bleeding disorders
- Burns
- With trauma mechanism: triage to LTH - Pregnancy ≥20 weeks
