Immediate Emergency Care (5 Day IEC) Flashcards
1
Q
Which Act of Parliament establishes the principle of ‘Assumed Capacity’?
A
The Mental Capacity Act 2005. It also states that patients should be given practical help with decisions, that a lack of capacity should not be assumed just because of a bad decision and freedoms should not be restricted
2
Q
Capacity can be ‘impaired’ by poor brain function. How do we test for this impairment? (4)
A
Can the individual:
1) Understand information
2) Retain information
3) Weigh up information
4) Communicate
3
Q
What does DNAR stand for?
A
Do Not Attempt Resuscitation
4
Q
In which of the following circumstances are Responders to initiate resuscitation:
A) A close family member states that there is a DNAR
B) A copy of the DNAR is shown to the responder
C) The reason stated on the DNAR does not correspond with circumstances?
A
All of the above. The original DNAR must be available and the stated reason for the DNAR must correspond with the circumstances
5
Q
There are 8 listed:
‘Signs Unequivocally Associated with Death’ can you name 5?
A
1) Decapitation
2) Massive cranial/cerebral destruction
3) Hemicorporectomy (cut in half)
4) Massive Truncal Injury
5) Decomposition/Putrefaction
6) Incineration (95%+)
7) Hypostasis (Coloration caused by blood pooling in the lowest quarter of the body
8) Rigor Mortis
These are the same no matter what the age of the casualty
6
Q
When someone is lying on their back (face up) are they Prone or Supine?
A
Supine
7
Q
When beginning a ‘Primary Survey’ latex gloves must be worn. Which other item of PPE should be considered?
A
Eye protection
Always change gloves between casualties
8
Q
What does the first D stand for in the Primary Survey Acronym DR C ABCDE?
A
Danger.
Posed by People, objects or the environment
9
Q
What does the first R stand for in the Primary Survey Acronym DR C ABCDE?
A
Response
10
Q
When gauging the response of a casualty during a primary survey do we use:
A) The Glasgow Coma Scale or
B) AVPU
A
B) AVPU
11
Q
What does AVPU stand for?
A
Alert
(Responsive to) Voice Commands
(Responsive to) Pain
Unresponsive
A casualty is always deemed as being one of the above
12
Q
What does the first C stand for in the Primary Survey Acronym DR C ABCDE?
A
Catastrophic Bleed, consider use of tourniquet or blast dressing
13
Q
On approach to a casualty you say ‘Hello, Hello’ and get no response (A) you then say ‘Open your Eyes’ and still get no response (V) how do you then attempt to elicit a pain response (P)?
A
Tap or squeeze the shoulders
14
Q
What does A stand for in the Primary Survey Acronym DR C ABCDE?
A
Airway.
Open mouth and look but don’t use fingers to clear (Adult/child may clench teeth, Trismus, and in infants it could trigger vagus nerve with catastrophic results)
15
Q
In what circumstances might we consider the ‘Jaw Thrust’ (CE or Anaesthetist grip) as a manoeuvre to clear the Airway instead of the ‘Head Tilt Chin Lift’ (simultaneously using 3 fingers under chin to lift and 3 fingers on forehead to tilt the head back)
A
Suspected cervical spine injuries
16
Q
What 2 types of adjunct might be used to maintain a clear airway?
A
Nasopharyngeal Airways (NP’s) for altering levels of consciousness and Oropharyngeal Airways (OP’s) for unconscious casualties only
17
Q
How do we now size an OP airway correctly?
A
Angle of the jaw to a point level with the mid incisor (Green currently fits Resusci Annie).
To correctly fit an OP hold the chin to open mouth, point end toward roof of mouth place in gently until resistance then turn, seat resting lip on lips. In children aged 8 and under insert with no turn.
18
Q
How many sizes of OP airway do we carry?
A
4
We currently carry 2 full sets of 4 OP’s in each bag. These can be replenished by LAS
19
Q
How many sizes of NP airway do we carry in each EIC bag?
A
2 size 7 (mm) adult male and size 6 (mm) adult female. We carry a packet of 2 of each, not replenished by LAS.
To Fit an NP correctly apply lubricant, point curve toward mouth, wiggle slightly on entry to nostril, do not force if wiggle does not work remove. NPs DO NOT need rotating.
20
Q
When are NP Airways contra indicated (not to be used)? (2)
A
1) Where a base of skull fracture suspected
2) Where a casualty is less than 12 years old
21
Q
What does B stand for in the Primary Survey Acronym DR C ABCDE?
A
Breathing
Each intake of breath contains approximately 79% Nitrogen and 21% Oxygen. Each exhaled breath contains 79% Nitrogen, 16% Oxygen and 5% CO2
22
Q
How long should be spent checking for a breath?
A
10 seconds
Assess every 60 seconds
23
Q
In what circumstances would we consider ‘Rescue Breaths’? (2)
A
5 for a child not breathing
5 for and adult drowning victim
24
Q
At what rate of respiration (breaths per minute) would we begin to assist using the ‘Bag and Mask’?
A
<10 breaths per minute
(less than 10).
Count to six with each
25
How many litres per minute should the Oxygen cylinder always be set at?
15 Litres per minute
Remove the grey cover and afix hose to fir tree connection, the reservoir on the bag and mask will inflate itself.
OXYGEN IS CLASSED AS A DRUG and so it’s administration should always be recorded
26
What type of Oxygen cylinder do we carry, ZD or CD?
ZD
300 bar 600 litres giving 40 minutes use at 15 litres per minute. They should be replaced by LAS crews, they carry 6 plus 2 larger ones. But make sure they are not marked CD as they also carry these.
27
In what circumstance is the use of Oxygen still contra indicated?
Highly Flammable Atmospheres.
COPD and Hyper Ventilation are still treated but with close monitoring. It is LAS that have set this protocol for LFB (paraquat has not been available for more than 10 years so is no longer a likely consideration)
28
Which lung has 3 lobes and which has 2 lobes?
The right has 3 the left 2 to make room for the heart
29
What are the 4 signs of Hypoxia? (Insufficient Oxygen)
1) Pale cold and clammy skin
2) Rapid breathing
3) CONFUSION
4) Cyanosis (very late stages)
30
Prior to using the Paediatric Bag and Mask what must be in the Open position?
The pressure relief valve (if it farts it’s open)
31
What is the last sense to be lost and the first to return during altering levels of consciousness?
Hearing
32
If Oxygen is administered to someone who has suffered smoke inhalation, what must follow?
Referral to LAS as carbonaceous deposits in the lungs can provoke the body to produce liquid/mucus that then has a similar effect to pneumonia. The casualty should also be encouraged to clear their nose and throat prior to administration.
33
What is the Hudson Freeflow mask now known as?
High Concentration Oxygen Mask
Delivering 95-98% Oxygen
34
The High Concentration Oxygen Mask is used when casualties are breathing at a rate of 10 breaths a minute or more. What must you remember to do prior to administration?
Fill the reservoir bag by placing a gloved finger over the valve in the mask
35
An adult is considered to be Hyper Ventilating when they are breathing at rate of how many breaths per minute and above?
30 breaths per minute
Hyperventilating is always caused by an underlying condition. The average rate in an adult is 12-20, a child 20-30 and an infant 30+
36
An infant is 0-1 years of age, how is a child classified?
1 to Puberty
37
What does the second C stand for in the Primary Survey Acronym
DR C ABCDE?
Circulation
Adult 60-80 bpm
Child 100-140
Infant 140+
The Chest Compression rate is 100-120 a minute (‘Staying Alive’) for all age groups
38
What are the 3 principles of IEC?
1) Preserve life
2) Prevent Deterioration
3) Promote Recovery
39
What stage of Assessment follows Scene Assessment?
Primary Survey
PPE - gloves (new for each casualty) and eye protection
40
History Taking follows the Primary Survey. What acronym can be used to remember the questions that need to be asked?
```
S signs and symptoms
A allergies
M medication
P past medical history
L last ate drank
E events leading up to injury/illness
```
41
How long should a Secondary Survey (4th stage of Assessment) typically take?
60-90 seconds. If it’s taking longer check pulse and breathing then carry on
42
Where an individual is breathing at a rate of <10 or >30 we would consider assisting but at what rate?
10-12 respiration’s per minute
43
What is ‘stridor’ and what might it indicate?
A higher pitched noise on inspiration which is indicative of an obstruction in the upper airway
44
If present what does a radial pulse imply?
Profusion of blood is likely to be adequate to vital organs
45
How do we check capillary refill?
Press your thumb to the casualties nail bed, or for a child forehead, for 5 seconds and see if colour returns within 2 seconds
46
What is the Tympanic membrane also known as?
Eardrum
47
What is Hypovolemic shock?
Shock caused by a lack of blood in the system
48
What is Cyanosis?
A bluish discolouration under the skin usually visible around the lips caused by low O2 levels in red blood cells. This is a late sign and indicates the need for immediate treatment
49
The average pulse rate for an adult is 60-80 beats per minute and for a child 100-140. What is the average pulse rate in an infant?
140+ beats per minute
50
Do all Arteries carry blood away from the the heart and all Veins carry blood to the heart (Venus return)?
No, 99% do but the Pulmonary Artery and Pulmonary Vein do the opposite
51
What piece of equipment do we now use to give us a casualties pulse rate?
The Pulse Oxymeter
It measures Oxygen saturation levels IN THE BLOOD
A warning beep will sound when a casualties pulse is <50 beats per minute (Bradycardic - slow), >120 (Tachycardic - fast) or their Oxygen saturation falls below 90%. The black button simply changes the display
52
In what 5 circumstances might the Pulse Oxymeter fail to work?
1) In direct sunlight
2) Carbon monoxide poisoning
3) Poor tissue perfusion eg Cold casualty
4) Shivering/movement
5) Nail Varnish (try turning it around)
Only use it on a finger and functions between 30 and 240 beats per minute
53
When the Pulse Oxymeter is used why should we also take a manual pulse?
To determine whether the pulse is weak, rapid, pounding or missing beats
54
Name 4 of the 9 pulse sites listed in the manual
Carotid - neck running in hollow next to wind pipe
Brachial - inside upper arm
Femoral - inside thigh level with genitalia
Popliteal - inside leg at knee
Posterior tibial - inside heal
Dorsalis Pedis - top of foot above arch
Superficial temporal - head temple
External maxill - jaw
Radial - grove in the wrist, follow line of the thumb
Do not use your thumb to take pulse as there is a pulse in the thumb
55
What are the 4 main elements (components) of blood?
1) Plasma (55%)
2) Red Cells (Erythrocytes which carry oxygen)
3) White Cells (Leukocytes which fight infection)
4) Platelets (Clotting)
56
We now carry a Digital Ear Thermometer (measures Tympanic temperature) normal Core temperature is approximately 37 (36.9) degrees Celsius, what temperature range may indicate hypothermia?
35-36 degrees C - Hypothermia
38-39 - Heat exhaustion
40+ - Heat stroke
57
When taking an adult casualties temperature with the digital ear thermometer what should we do with the ear?
Gently pull it up and back (straight back for infants) to straighten ear canal
Press grey ‘on/recall’ button, wait for beep then place cap on probe, insert probe and press ‘scan’ when beep sounds reading is complete. On/recall button can be pressed to show last 9 readings
58
How do we ask a casualty to score their pain?
On a scale of 0-10 where 10 is the worst pain they have ever felt. To locate the source of the pain try to get the casualty to use 1 finger to point to where the pain is most acute
59
What does the second D stand for in the Primary Survey Acronym
DR C ABCDE?
Disability
This is a check for Neurological problems. Open the eyes and check that the pupils are equal active and reacting to light.
60
Where one eye is not responsive which side of the brain does that indicate may be effected?
The same side as the eye any other part of the body and it will indicate an issue with the opposite side of the brain. Important to remember when rolling a casualty, roll onto the injured side of the brain.
61
There are 6 stages to the Physical Secondary Survey. They are:
1) Facial Orifices
2) Scalp and Neck
3) Front of the body
4) Back of the body
5) Legs
6) Arms
What are we looking for in stage 1?
Straw Coloured liquid (smells bad and indicates brain injury)or/and blood coming from orifices
62
What is the Epiglottis?
A leaf shaped fibroblastic cartilage that acts as a lid and closes of the larynx (wind pipe) during swallowing.
63
There are 6 stages to the Physical Secondary Survey. They are:
1) Facial Orifices
2) Scalp and Neck
3) Front of the body
4) Back of the body
5) Legs
6) Arms
How do we examine the scalp and neck?
With cupped hands pat gently and check then move till area has been examined.
Allows for better location of any injury and doesn’t spread blood or end up covering gloves
64
Why do we aim to keep the casualties left hand side clear of equipment?
LAS use a Pit Crew approach, this allows us to continue with CPR while they set up in the format they are used to. Place IEC bag at left shoulder and AED at right shoulder.
65
There are 6 stages to the Physical Secondary Survey. They are:
1) Facial Orifices
2) Scalp and Neck
3) Front of the body
4) Back of the body
5) Legs
6) Arms
How do we examine the front and back of the body?
Shoulders, then sternum (if supine) roll blade of hand to check for movement, Ribs hand either side, roll palm on 4 quadrants of the abdomen to check soft and then run hands under hollow in back checking for pooled blood
66
What may the shortening of one leg indicate?
A broken femur. It may be necessary to assist LAS to correct if blood supply to the foot has been compromised
67
There are 6 stages to the Physical Secondary Survey. They are:
1) Facial Orifices
2) Scalp and Neck
3) Front of the body
4) Back of the body
5) Legs
6) Arms
How do we examine the legs and arms?
One at a time hand either side working from the top down (for obvious reasons on the legs). Pat, check, move down. Leave shoes in place if blood is showing as they will give direct pressure. Leave the pelvis, mechanism of injury or ‘Charlie Chaplin’ may be indicator of damage
68
How do we use the bag and mask (BVM) to administer oxygen to someone fitted with a Stoma (breaths through a hole in the throat)
Remove the adult face mask from bag and place over nose and mouth using palm to seal. Fix paediatric mask to bag and seal over stoma. Administer 2 breaths to every 30 compressions
69
What is COPD and why might a sufferers breathing rate be slowed by the administration of high flow Oxygen?
Chronic (long term) Obstructive Pulmonary Disease.
Carbon dioxide levels in the blood are the normal trigger for breathing but in COPD suffers the body has become used to high levels of carbon dioxide and switches to Oxygen levels as the trigger instead. When it detects high Oxygen Concentration it may slow or stop a sufferers breathing. Administer but monitor closely!
70
What is the most common cause of airway obstruction?
The Tongue
71
What does GCS stand for?
Glasgow Coma Scale
Consists of 3 sections which are then added together
3 lowest score
8 or lower head injury
15 highest score
72
Trauma Casualties require a different handover to LAS. The acronym for this is ATMIST what does it stand for?
```
A Age
T Time incident occurred
M Mechanism of injury
I Injuries
S Signs and Symptoms
T Treatment
```
73
When would we consider using the recovery position?
If we needed to leave a casualty or more likely following a feint or seizure
A) Check pockets and remove glasses
B) Lower arm at 90 degrees, straight palm up
C) Upper arm cross chest palm to palm, knuckles to underside cheek
D) Lift upper leg, knee up use as lever
E) Roll toward you controlling head
F) Use free hand to release trapped hand and adjust arms
G) Hand on hip, move upper leg into step position
H) Check pulse and breathing, administer Oxygen
74
What are the 4 benefits of the Recovery Position?
1) Patient is stable and lateral
2) Vomit or other fluids can drain
3) Tongue will fall foreword
4) Chest is off floor which aids breathing
Not used if staying with casualty, airway can be maintained and the patient doesn’t vomit
75
What can we use to clear obstructions from the mouth (eg Vomit)?
The V-Vac used in conjunction with postural drainage (roll)
Remove red cap! Top clip can adjust grip size. Stow closed and white plastic section to clinical waste, wash the rest.
76
In a case of suspected Choking what 2 good questions should you ask?
‘Are you choking?’
‘Can you cough?’
77
For and adult choking victim how many back blows should be administered before attempting abdominal thrusts?
5
Support chest, heel of palm hard between shoulder blades x 5
Step behind. Both arms around upper abdomen. Make a fist, thumb in, grasp with other hand, place between belly button and ribs. Pull sharply inward and upward x 5. Alternate with back blows.
78
When abdominal thrusts have been used to remove an obstruction what must you ensure?
Patient transported to hospital due to possible internal injuries caused
79
How are abdominal thrusts delivered to a choking infant?
They aren’t! Use to fingers to press on the centre of the chest lying side on, head and neck supported in other hand
For back slaps support head and neck in left hand, baby pointing down leg, length ways astride forearm, lateral slap between shoulder blades. Alternating sets of 5
80
Why might someone suffering Hypothermia (35-36-)attempt to remove their clothes and someone suffering heat stroke (40+) try to wrap up?
The hypothalamus, a small area of the brain that regulates body temperature, is not functioning correctly
81
Can water be given to a patient suffering Heat Stroke (which is the most serious heat related condition occurring at 40 degrees C+)?
No
Heat exhaustion (38-39 degrees) small sips. Use the cap of the bottle
82
Should clothing be removed from individuals suffering hypothermia?
Only if they are wet
An individual will not be declared dead unless their body temperature has been raised to at least 34 degrees as body may shut down in lower temperatures.
83
What is Sepsis?
Blood poisoning which can lead to Septic Shock often following an infection.
84
Can you name one sign or symptom of SEPSIS to correspond with each letter of the word?
```
S Shivering
E Extreme pain
P Pale skin
S Sleeping difficulty’s
I I feel I’m going to die
S Short of breath
```
85
What is Angina?
A furring up or narrowing of the Arteries. Normally treated with GTN spray.
Has similar symptoms to Heart attack. O2, reassurance and ambulance. Try to dissuade from over doing GTN spray as lowers the blood pressure and may lead to fainting
86
How do we treat a casualty that has fainted?
Lie down and raise legs
87
What is the posh name for a Heart Attack?
MI or Myocardial Infarction
Caused by a blockage in one of the 3 coronary arteries (CAD) that serve THE 4 CHAMBERS OF THE HEART. Areas of the heart muscle starved of 02 begin to die. Usually complain of Crushing chest pain moving to left shoulder and arm and very pale and clammy. 02 reassurance and ambulance.
88
What is a Silent MI?
Some people can suffer a Heart Attack without displaying the classic signs. This is known as a Silent MI (Myocardial Infarction).
Diabetics and Women may just feel generally unwell or complain of a dull ache in the back
89
What is Anaphylactic Shock?
A severe allergic reaction.
A reaction to almost anything that causes Swelling, rashes, hives, itchy ness. Initially treated with an Epi Pen (Epinephrine - US name for synthetic adrenaline) and then hi dose anti histamines in hospital
90
How is an Epi pen administered?
In to large muscle. Normally side of the thigh to avoid blood vessels, clenched and delivered from 10cms (avoid placing thumb over end!).
91
What are the 3 basic causes of shock?
1) Pump failure, heart problem
2) Low fluid problem
3) Poor vessel function
92
There are 7 types of burn and 5 are treated with cold Running water for 10 minutes; Friction, Scalds, Dry Heat, Electrical and Radiation what are the other 2 and how are they treated?
Cold burn treated by applying WARM running water for 10 minutes
Chemical burn treated by applying cold running water for 20 minutes
93
What are the 3 classifications of burn?
Superficial - 25% coverage Hospitalise
Partial Thickness - 1% + coverage Hospitalise
Full Thickness - Hospitalise
As a rule of thumb the area of the casualties palm is ruffly equal to 1% of the bodies surface area. This can be subtracted or added using Wallace’s rule of 9’s to estimate area effected. Circumferential burns (wrap around) also require Hospitalisation
94
Can the burns pack be used in conjunction with water and cling film?
No. Use one or the other
Never wrap a burn with cling film only cover and complete cooling first.
95
Why is caution needed when tilting a babies head backward for O2 administration?
In an adult/child there are rings of cartilage that prevent the neck overextending and kinking/closing the airway. These are not formed in an infant.
96
A baby normally has a pulse of 140 or more when would we commence full CPR?
60 beats per minute or less
97
What does TIA stand for?
Transient Ischaemic Attack.
A short form of Stroke the effects of which are almost immediately reversed. Seek medical advice
98
Patients in an RTC should be treated as if they have what type of injury until cleared by LAS?
Spinal
99
What are the 3 sources for an external bleed?
Capillary - small blood vessels (oozes)
Arterial - high pressure, bright red (pumps)
Venous - lower pressure, dark red (flows)
100
What item of equipment do we carry that allows us to apply indirect pressure mechanically in the event of a catastrophic haemorrhage (bleed)?
Tourniquet
Remove clothing and use on single bone site (Femur - upper leg / Humerus - upper arm) tighten until bleed stops (turn windlass and secure to triangular plastic clip) Note time applied on label and PRF
101
How do we treat someone suffering a diabetic emergency?
With a sweet drink
It will help if they are hypo (excess insulin in blood) and won’t make them worse if they are hyper
102
What does MOI stand for?
Mechanism of Injury
When treating Trauma understanding the MOI is key to understanding what damage has been done and where.
103
For what reason would we remove a crash helmet following an RTC involving a motorcyclist?
In order to maintain an air way.
The helmet should be kept with the casualty on transportation to hospital
104
A lateral impact in an RTC may result in what 3 types of injury?
Pelvis, Chest and Spine
105
What is the most common facial fracture?
Broken nose
The bones in the face are a natural ‘crumple zone’ designed to protect the face.
106
What is Tension Pneumothorax?
This is a LIFE THREATENING CONDITION. The progressive build-up of air within the pleural space which can only travel one way and causes the lung to collapse
107
Should long boards be used for the transportation of casualties?
No, just the extrication
108
What are the 3 factors which can affect bone strength?
1) Age
2) Nutrition
3) Disease
109
Why should we try to remember the phrase;
| ‘LUMP TO THE LEFT’?
When dealing with a pregnant casualty who is lying supine (on her back) we need to put something under her right buttock to change her angle by 15-30 Degrees. Otherwise baby will put pressure on her Venus return reducing it by up to 40%
THE SAME APPLIES DURING CPR
110
The BLAST dressing can be used with amputations and large wounds (includes a plastic cover for abdominal wounds).
What colour package does it come in?
Brown
It is NA (non adherent - doesn’t stick) and should be wrapped below and above the wound not over unless it’s an amputation in which case once round and the figure of 8.
111
The OLAES Modular bandage comes with a plastic cup built in to aid the application of direct pressure.
What colour package does it come in?
Green
It has a small plastic cover and 3 meters of packing which can be used in ‘Cavernous’ wounds. Pack until just proud of skins surface. Cup on wound, Round once then ensure edges enclosed.
112
What does Oedema mean?
A build up of fluids in body tissue and cavities.
Pregnant casualties will normally be intubated early because of this and the greater likelihood of gastric flux
113
What percentage of her circulating volume (blood) can a pregnant woman lose before showing signs of hypovolaemia?
35%
Her circulating volume increases by up to 50% and 25% goes to the placenta
114
What are the 4 signs of respiratory distress in a child?
1. Recession - skin and sternum can be drawn in during breathing
2. Accessory muscle use (eg head bobbing in infants)
3. Flared Nostrils
4. Grunting
115
How do we check a child’s response to painful stimulus (AVPU)?
Rub finger across heel
116
What does ACS stand for?
Acute Coronary Syndrome
This CAN be caused by unstable angina or heart attack(MI)
117
Where are intercostal muscles located?
Between the ribs
118
At what rate is CPR administered to children?
15:2
119
What are Agonal respiration’s?
Irregular gasps usually in a dying patient
120
What does AED stand for?
Automated External Defibrillator
Remember the DEFIB is only to be used on patients that are not breathing other wise the ZOLL will advise FFs to continue CPR
121
What is the minimum aged for a child in order to use the ZOLL AED?
8 (or 25kg)
The ‘Child’ button is only pressed when you are prompted by the machine to do so
122
What are the two instructions that must be given prior to a shock being delivered?
‘STAND CLEAR’
And
‘OXYGEN AWAY’
123
It takes 4 people to carry out a 40 degree casualty roll correctly (1 Head / 2 Shoulder Waist / 3 Wrist Thigh / 4 Waist Ankle) arms crossing.
Prior to the Instruction ‘READY, BRACE, ROLL’ what question should be asked by the person at the Head?
‘Anyone NOT ready?’
124
When dealing with a puncture wound expose and leave objects in.
What is the difference between a LACERATION and an INCISION?
A laceration is a jagged cut an incision is a clean cut
125
In the event of dealing with a gunshot wound what is the most important question?
WHERE IS THE GUN?!!!
126
How might we be able to identify a ‘Venus’ bleed (from a vein not artery)?
The blood will be dark (not bright) in colour as it is deoxygenated
127
What is the difference between a ligament and a tendon?
A ligament attaches bone to bone
| A tendon attaches muscle to bone
128
When treating a Sprain we use the Acronym
```
P Protect
R Raise
I
C Compress
E Elevate
```
What does the I stand for?
Ice
129
Bone can be seen in an OPEN fracture and not in a CLOSED fracture. But what is a COMPLICATED fracture?
A COMPLICATED fracture is open but also includes structures surrounding the fracture. There may be damage to the veins, arteries or nerves, and there may also be injury to the lining of the bone
130
What does AED stand for?
Automatic External Defibrillator
131
The ZOLL AED delivers a shock of 120-150-200 jules to an adult and 50-70-85 to a child. How do we get a replacement battery?
By ordering on POMs
132
What is the daily check for the ZOLL AED?
It self tests so we just check that there is a ✔️in the viewing window
133
Ideally the AED is set up on the casualties left side and the IEC pack placed at their right shoulder. Why is this?
LAS operate a ‘pit crew’ system and this positioning fits best with that
134
The ZOLL AED is not normally removed from its case during operation. Is our first action to switch it on or apply the pads?
Apply the pads first. Puck centred between nipples and second pad on the ribs one hand width below the armpit
135
Which of the following are contained in the ‘Rescue Accessory Kit’ which is stored in the AED case:
1) Cloth
2) Gloves
3) Tough Cut Scissors
4) Gallant razor
5) Face shield
6) Cleansing Wipe
7) Cuddly toy?
All except the cuddly toy
136
Which of the following need to be considered when using an AED?
1) Medical patches (GTN)
2) Water
3) Metal objects/surfaces
4) 02
5) Pace makers
6) Age
7) Pregnancy
8) Body hair
All except Pregnancy and Pace Maker - continue as normal. All the others require some kind of action
137
At what Age (or weight) do we press the ‘Child Selection Button’ WHEN PROMPTED?
8 or under (<25kg)
