ILs Osce Flashcards
What is the first step when approaching the scene?
Scene and patient safety - ask if it’s safe to approach
What must you do for scene safety to yourself
Apply gloves or ppe
What must you get if the patient is alert?
Consent - and explain wishes to patient
If not alter act under the doctrine of necessity
When scene is safe what do you do?
Ask about their general appearance, AVPU status - End of bed assessment
What do you do in the primary survey ?
ABC - comfirm primary survey positive or negative and if they are time critical
What can you use for airway management?
OPA, NPA, head chin tilt lift, jaw thrust, suction
What are you doing in the initial management and assessment
ABcDE,
Airway management - opa, npa, head tile chin lift, jaw thrust
Breathing - oxygen applied early, breathing assessed
Circulation - ecg monitoring, heart rate, bp
Expose and examine - any other injuries
Develop working and different diagnosis
Request backup - LUCAS device
Cardiac arrest management - what is the first step
Confirm cardiac arrest and update backup crew
What is the second step in cardiac arrest management
Immediately commence cpr - 30:2
What is going on after commencing cpr - cardiac arrest management?
Effectively managing airway using stepwise approach - HtCL - opa - npa - igel
Once the airway is secure and managed what do you do - cardiac arrest management
Ventilates using bvm
With cardiac arrest management what is important that you get on quickly?
The pads
What also needs to be attached to the monitur during cardiac arrest mangement?
Capnogrophy, establishing ETCO2
Once the airway is set up and the pads are on the chest what is important to do - cardiac arrest management?
Check the rhythm and verbalise what rhythm it is
If the rhythm is shockable, what energy should the defib be set at?
360 joules
When delivering the shock, what must we do?
Remove all the hazards, communicate with the team all of the way through - telling them to stand away from the patient. Also communicate to the person on the chest
Once the shock is delivered when should cpr re commence?
Straight away
What should you do in regards to the rhythm?
Keep checking the rhythm as it will probably change
What do you do in a non-shockable rhythm?
Continue CPR
What also must you be aware of?
Time
What are the six reversible causes?
Hypovlaemia, Hyperkalaemia, Hypoxia, Hyper/Hypothermia, Toxins, Tension pneumothorax, thrombus, Tampanade
When on the arrest, what must you do?
Take the lead
What else is important?
HAVE CONFIDENCE!!!
When looking at reversible causes, with a tension pneumothorax what do we do?
Listen to the chest - is it equal each side?
What rhythms are shockable?
VF
VT
What rhythms are not shockable?
Asystole
PEA
With the rhythm PEA what do you have to check for?
A pulse!!
With the rhythm VT, what do you have to check for?
A pulse
If pulse present do not shock!!
What must you not do if VT has a pulse?
DO NOT SHOCK
In the OSCE how do I verbalise that I’m checking for the reversible cause hypoxia?
Verbalise that
The patients airway is open
Oxygen is being administered
In the OSCE, how do I verbalise that I’m checking for tension pneumothorax?
VERBALISE and DO
Listen to both sides of the chest - checking for equal air entry
How do you check the reversible cause hypothermia?
Verbalise that it’s a warm room
Verbalise and take pts temp
How to you check the reversible cause toxins?
Verbalise and check for any needle marks on the pts arm
Check pupils?
