in flight medical care Flashcards
what are the principles of medical care? (5)
assess the situation, do no further harm, stabilise airway, breathing and circulation, give treatment within the scope of your skill level and refer to medical help
roles and responsibilities of cabin crew (7)
looking after your own personal safety, looking after the safety of your work colleagues, pax and by standers, providing basic patient assessment and care, supporting passengers legal rights, privacy and human dignity, liaising with medical care, keep records and reports and checking the equipment and kits
medical situation decision making
the situation is resolved, the situation is contained (eg medicals ready when they land), professional help is needed urgently and must be sorted as quick as possible
medical decision to divert- what we think about
medical diversions are appropriate, no unknown destinations, familiar surroundings, somewhere that has hospitals nearby
specific wording to assist your decision regarding the need to divert…
“we will need to be landing in state scheduled destination state hours/minutes until landing we will request medical assistance to the aircraft, do not specifically ask the medical for a diversion, make decisions with the pilot and communication
scene safety (before dealing with a casualty we must look out for these risks….) 9
fire,water,confined spaces,falling items, chemical spills, extreme conditions,toxic fumes infection, falls from height
personal hygiene
washing your hands then putting on sterile gloves
ppe on board and guidance for using it- facemasks
dealing with suspected infectious diseases and for passengers with an infectious disease
ppe on board and guidance for using it- gloves
for all first aid scenarios
ppe on board guidance for using it- goggles
when dealing with a suspected infectious disease
ppe on board guidance for using it- apron
first aid incidents with bodily fluids
clinical/biohazard waste
waste produced by casualtys is known as clinical waste, it is also known as biohazard and medical waste
clinical waste includes..
solid material-gloves,used dressing and other medical equipment
human waste includes..
blood,urine,feaces and vomit
how is clincal/biohazard waste disposed?
by wearing gloves and places in a sharps box or a biohazard bag or gash bag with a biohazard label
what is upk
universal precaution kit
what does a upk contain
ppe, general cleaning equipment and equipment for dealing with disposal of clinical/biohazard waste
contents of a upk (9)
biohazard disposal kit, biohazard labels, sharps disposal kit, anti bac wipes, anti static wipes, hand sanitiser, disposable gloves, goggles and face mask
contents of biohazard disposal kit (9)
protective gloves and apron, granules for absorbing bodily fluids, scoops and scraper, biohazard bag and ties, disinfectant spray, dry cloth, disinfectant wipes and instructions
sharps injury carry out the following…
encourage bleeding on the injured site, thoroughly wash the area (do not scrub + warm water) , cover the injured area with dressing, seek medical advice and carry out a cabin safety report (include location where the sharp object was found)
whats in a sharps disposal kit
sharps removal tweezers and bin, clinical waste bag and ties, hand wipes and instructions
medical action plan 1st crew member
on finding a medical situation start to deal with it and call for help communicate or press call bell 3 times
medical action plan 2nd crew member
get the assistance of the third crew member and inform on severity and location of the incident- obtain appropriate medical equipment including the aed, wash hands, put on gloves and return to help
medical action plan 3rd crew member
informs the commander, clear brief-including signs and symptoms and treatment, inform if the aed is being used and request an aed is available when landing
if necessary make a pa looking for a medic
a pa should be made for the following
doctor of medicine, midwife, nurse or paramedic
dealing with distressed relatives always ensure that
safety is maintained, they do not interfere with the treatment and explain what is happening
dealing with distressed relatives do…
answer questions- be honest and direct, allow silence between answers, allow touching and allow what is safe
dealing with distressed relatives dont…
exclude from situation, give too much technical info, talk too much and do not lie
moving and handling before lifting…
-check the size of the person, get assistance, if possible talk to them- find out if they can stand, assist them if they needed, if they are conscious explain how you are going to lift them (plan the lift check space is clear)
during lifting…
keep your back straight, keep your feet apart, relax the knees, the upward motion by raising head, lift by straightening your legs
how to lift 1-
a minimum of 3 people do not attempt lift if you feel like you cant
how to lift 2-
one person supports the head and neck to keep airway open
how to lift 3-
use one hand to lift waist band of the clothing and other under the knee, everyone must lift at the same time
DRABCDE
danger, response, airway, breathing, circulation, dysfunction, examination
airway-
absence of breathing (total blockage), foreign objects, fluid, swelling, gurgling, grunting, snoring
breathing
look, listen and feel- look for chest movement, listen for breath sounds, feel for air on cheek assess for 10 secs
breathing observe-
skin colour, rate, depth, regularity and chest movement
circulation
visible signs of bleeding, check pulse, skin temp, capillary refill and signs of shock
dysfunction-
we need to assess the brain function, as this is the first organ that will die without oxygen
AVPU: should be checked every 10 mins!
alert, verbal (give direct commands),pain, unresponsive- squeeze my hand and release
pupils- dilation:
indicate hypoxia, drugs or alcohol, brain injury or eye meds
pupils- constriction:
indicates brain injury, disease, or narcotics
pupils-unequal:
indicates brain injury
pupils-mishaped:
brain injury or eye injury
examination: unconscious
head to toe exam
sample: conscious
signs and symptoms, allergies, medication, past medical history, last food or liquid intake, extra (eg medical cards)
causes of shock:
heart fails to work, causing the pressure of the circulating blood to be reduced, volume of fluid circulating around the body (bleeding, vomiting, burns), nervous system affected cannot control the size of blood cells
signs/symptoms of shock (prancer)
pale cold clammy skin, shallow breathing, thirst, yawning, vomiting, disorientated
treatment of shock
DRABCDE, administer oxygen, loosen tight clothes lay flat elevate legs, treat the cause, keep warm, nothing to eat or drink, inform commander and seek medical
basic airway management: causes
obstruction in the tongue, fluid, debris, swelling or constriction
head tilt/chin lift
non spinal injurys, use one hand on the forehead, place your fingers under the chin pull the chin upwards (upper and lower teeth together)
jaw thrust
spinal injurys, grasp angels of jaw bone, pull the jaw forwards open the mouth slightly
oxygen administer: keeping the commander informed
amount of oxygen used, regular updates to the commander and improvement of the casualty- this assist with the commander planning ahead
oxygen administration-
ensure its set to high flo, explain, turn oxy bottle on, verify oxygen is flowing (flow indicator, green, place mask over mouth and nose, secure oxy bottle, monitor the guage be prepared to swap bottles, inform commander: number of bottles used , never leave unattended
where is the pocket mask located?
in the fak (yellow pouch) all things in yellow pouch are basic life support
basic life support: danger
ensure the safety of yourself, patient and others
basic life support: response
gently shake by shoulders “are you alright”
basic life support: airway
head/tilt chin lift, or jaw thrust
basic life support: breathing
chest movement, breath sounds, feeling for air on your cheek assess for 10 seconds
adult basic life support chain- 1
check responsive, open airway (head tilt/chin lift), check breathing (look listen and feel), assess breathing 10 seconds,
adult basic life support chain-2
breathing present (check for continued normal breathing and circulation), no breathing cpr- chest compressions 30!-aed switch on- breath x2: continue with aed and cpr 100-120 compressions per minute (30:2 ratio)
resusication in pregnancy:
incline her 10-15 degrees to left, place padding under right hip- takes pressure off major vein
regurgitations during cpr
quickly turn them away from you, ensure head is turned towards the floor + mouth open, turn them on them back when over and continue cpr
DNR-
do not resuscitate
paediatric (infant:under the age of 1 child: 1-puberty)basic life support- response
stimulate for response (no not shake child) - rubbing finger on the sole of foot
paediatric life support- breathing
head tilt chin, jaw thrust (if spinal injury), place head in neutral position, do not push soft tissue head in “neutral position” an infant in a “sniffing” position
breathing
looking for chest movement, check for breath on cheek and breathing sounds- assess for 10 secs if not breathing 5 rescue breaths, if there are no breaths then move onto cpr
child chest compressions:
“sniffing position” compress the centre of chest (4cm for infant, 5cm for a child) avoid compressing the upper abdomen, find angel where lowest ribs join- give 30 compression (2 ventilations) (1 3rd into the chest) then repeat 100-120 per minute use 2 fingers for infant 1 hand for child
cpr considerations: sending for help
for adult: go and send for help after you have checked response
for child: perform cpr 1 min after sending help
continue bls until…
medical professional, casualty shows signs of regaining consciousness and you become exhausted
adults breath-
12-20 per min
face shield aed case
this is a plastic sheet with a one way valve- apply sheet to patients mouth nose pinch nose and commence mouth to mouth
adult pulse race
60-100 beats per min
capillary refill adult
2 seconds, hold skin for 5 seconds
the aed case contains…
spare set of adult pads, paediatrics pads, razor, tough cut scissors, face shield, manufactures manual
prior to use of aed
remove case, switch it on, remove clothing and chest exposed
medical action plan aed-
2nd crew get equipment and get the aed and switch it on, once it is set up it will analyse and say if shock is needed, then secnond crew will get a shock button
aed after intial shock-
1st and 2nd crew member must swap chest compressions (over head compression) this should happen every shock which is every 5 cycles ( 2 mins)
taking pulse radial- arm
to be used on conscious and over 1 year
taking pulse carotid- neck
to be used on unconscious from 1 year
taking pulse brachial-
to be used on conscious and unconscious under 1 year
what is the normal pulse rate for adults-
60-100 beats per minute
pocket masks
this is a mouth to mouth ventilation device, some masks have a hole for the tube of the oxygen bottle
what happens after 30 compression
2 rescue breaths
how many compressions per minute
100-120 compression per minute
compression depth for adults:
5-6cms
what position is the oxygen mask for a baby?
pointing down
if the aed does not detect anything…
it will not shock and you have to continue cpr
if the aed does detect something…
it will shock
scene safety with a aed- before pressing shock button…
oxygen should not be flowing near it (place it behind you), no one should touch the patient, before shocking shout “stand clear shocking now” then press the button
normal breaths for adults
12-20
