IACSS

Question 1

Name the 7 movements for handwashing

5 strokes for each

Answer 1

• palm to palm
• palm to palm with fingers interlocked
• back of hand in between fingers on each hand
• nails/ fingers rotational rubbing
• rotational washing of thumb
• scratching centre of palm
• wrists
  turn off tap with forearm after rinsing fingertips to elbow

Question 2

Vital Signs Process

Before starting, what questions should you ask your patient?

Answer 2

after the 3 I’s….

Ask the patient that within the last 30 minutes if they have:
eaten a large meal or had a hot or cold drink
had a hot bath
smoked a cigarette
undertaken vigorous exercise or exerted themselves.

Enquire if they are taking any blood pressure lowering medications.

Ask the patient if they are wearing a hearing aid or if they have any ear infections.

Enquire about presence of an arterio-venous fistula in the arm, any operations on arms, axillae or breasts, any pain, swelling or weakness in the arm.

Question 3

firstly im just going to take your temperature (need thermometer and disposable cover)
ill just place this in your ear and it wont be uncomfortable

Answer 3

place in ear and press button

Question 4

secondly im going to just take your heart and breathing rate

Answer 4

took a reading in 15 seconds using watch and x4

Question 5

Now im going to take your blood pressure which will just involve me tightening a cuff on your arm twice, deflating it each time. It won’t hurt but may be a bit uncomfortable’

Answer 5

stethoscope on brachial artery, pump about 20 mmHg above estimate

Question 6

finally, I need to measure the amount of O2 in your blood by attaching a probe onto end of finger- this is painless and will produce a reading within a few seconds.

Answer 6

place probe on finger, thank patient

Question 7

What equipment is needed for venepuncture?

Answer 7

 Apron
 Gloves
 Tourniquet
 Wipes x3
 Butterfly needle
 Barrel
 Purple (FBC) and yellow vacutainers (U+E)
 Aerobic (blue) and anaerobic (purple) microbiology bottles
 Cotton wool
 Tape
 (Make sure there is a sharps bin nearby before you start)

Question 8

What do you say to the patient before beginning?

Answer 8

3 I’s then

‘I’ve been asked to take a small blood sample from you today, all that will involve is one small needle to the inside of your elbow and will feel like a sharp scratch, there may be light bruising or bleeding but that’s perfectly normal’
am I okay to go ahead?
Finally before we begin do you have any allergies I need to be aware of?

Question 9

Describe to process of venepuncture

Answer 9

1- tear two pieces of tape and Sit patiently comfortably with pillow, palpate and put on tourniquet, clean area of use
2- clean aerobic and anaerobic bottles
3- connect barrel to needle and insert
4- see flashback then tape it
5- attach aerobic bottle
6- attach anaerobic bottle
7- yellow U+E
8- purple FBC
9- invert the bottles to mix and release tourniquet
10- pick up cotton wool and remove needle, tape wool down
11- label correctly at bedside, add bottles to write blood request form

aerobic/anaerobic= black
U+E= green form
FBC= red form

Question 10

what do you ask before cannulation

Answer 10

3I’S then

I’ve been asked to put a cannula in your hand today, all that will involve is one small needle to the back of your hand, this will then allow us to put a small plastic tube into your hand so we can give you the drugs and fluids we need to. It will be a sharp scratch when we put the needle in but besides that no pain, there may be light bruising or bleeding but this is perfectly normal’

Am I okay to continue?

before I start can I just check if you have any allergies I need to be aware of

Question 11

equipment for cannulation

Answer 11

	Tourniquet
	1 wipe
	Cannula 
	Bung 
	Gauze
	Dressing sticker
	Syringe and saline
	(Make sure there is a sharps bin ready before you start)

Question 12

equoess of cannulation

Answer 12

1- prepare saline
2- tourniquet and choose vein
3- clean area
4- insert needle until flashback, slightly withdraw needle and push cannula fully in
5- release tourniquet
6- release needle and put on bung
7- secure with dressing 
8- flush with saline 
9 - label with name DOB and signature

Question 13

equipment needed for making up drugs

Answer 13

	Drug chart
	2 wipes
	1 needle
	3 syringes
	3 saline bottles
	1 drug (placebo)
	(Make sure there is a sharps bin ready before you start)

Question 14

what do you say before administering drugs

Answer 14

‘I’ve been asked to put some drugs through your cannula today to hopefully make you feel a bit better. Firstly, I will flush the cannula with some saline to make sure it is working, I will then put the drugs through before flushing it with some more saline to make sure it has all gone through. It will not hurt but you may feel a bit of cold going up your arm. Stop me at any time if you are in pain or discomfort.’

and ask about allergies/ 3 I’s

Question 15

process of making up drugs

Answer 15

1- check drugs chart and expiry date
2- prepare saline flushes
3- open all the equipment non touch
4- remove cap and wipe bung of drug
5- put needle on a saline inject into vial then allow to fill with air
6- mix
7- inject air back in 
8- invert vial and remove the mixed drug
9- remove syringe and needle in sharps
10- place back in the packaging of syringe
11- clean bung of cannula
12- recheck patient name etc.
13- flush
14- drug (tell examiner normally over minutes)
15- second flush
16- say drugs chart would be filled in

17- tell patient ‘let myself or one of my colleagues know if you have any reaction to the drug for example; SOB/wheeze/itching/skin flush/tongue or lips or throat swelling’

Question 16

Equipment for setting up an infusion

Answer 16

	Prescribed fluid chart
	IV drip stand
	IV Infusion set
	Saline bag
	1 syringe
	1 saline bottle
	1 wipe

Question 17

what do you say before setting up an infusion

Answer 17

 Ask about allergies, broken skin or rashes.

 Inform patient ‘I’ve been asked to set up a drip for you today to put some saline fluid through your cannula today to hopefully make you feel a bit better and make sure you stay hydrated. Firstly, I will flush the cannula with some saline to make sure it is working, I will then set the drip up which will stay attached to your hand. It will not hurt but you may feel a bit of cold going up your arm. Stop me at any time if you are in pain or discomfort.’

Question 18

process of setting up an infusion

Answer 18

1- check drugs chart and expiry date
2- remove seal of entry point
3- spike bag with giving set and hang up
4- squeeze entry chamber to half full
5- expel air bubbles with clamp into drip box
6- clean cannula bung and add saline flush
7- connect drip to cannula and set to 3 drops a min
8- Fill in the fluid chart (In exam just say you would do this).

9)Thank patient and tell patient ‘Are you ok? let myself or one of my colleagues know if you have any problems’