Interventions Flashcards
Intra-osseous landmark - proximal tibia
Approximately 2cm medial to the tibial tuberosity, or approximately 3cm below the patella and
approximately 2cm medial, along the flat aspect of the tibia
Child - 2 fingers below the patella and 1 finger medial
Intraosseous access - distal tibia landmarks
Adult - 3 finger breadths above the tip of the medial malleolus
Child - 2 finger breadths above the tip of the medial malleolus
Needle decompression landmarks
Primary - 2nd intercostal space mid clavicular line
Secondary- 5th intercostal space mid axilla line
Distal femur IO landmark
1cm proximal to patella
1-2cm medial to midline
What is Sellick’s manoeuvre?
Cricoid pressure
Adult IO sites
Proximal tibia
Proximal humerus
Distal tibia
Paediatric IO sites
Distal femur
Proximal tibia
Distal tibia
Proximal humerus
IO contraindications
Overlying skin infection
Fracture of the target bone
Prosthesis or plates
Unable to landmark
IO needle sizes
Red - 15mm
Blue - 25mm
Yellow - 45mm
IO insertion process
- Consent?
- prep kit
- landmark
- clean
- push into skin until testing against bone
- check 5mm line visable
- drill until loss of resistance
- secure with io fix
- aspirate for bone marrow
- flush 5-10ml saline
Pacing procedure
3 lead monitoring
Pads on
Sedation
Press pacer
Rate 70
Demand mode
Start at 30m/amps
Increase until electrical capture
Increase until mechanical capture
Increase by 10m/amps
Needle decompressions should be performed in any patient with a suspected Tension showing signs of decompensation. What are these signs according to the FPHC consensus statement?
Hypoxia
Cardiovascular compromise with loss of radial pulse
Reduced conscious level
Contraindications to femoral traction
- # NOF
- Distal femur fracture
- Disrupted knee injury
- Ankle fracture
Indications for pre-hospital surgical amputation
1) Immediate and real risk to patients life due to a scene safety emergency
2) A deteriorating patient physically trapped by limb where they will almost certainly die during the time of extrication
3) The patient is deceased and they are blocking access to potentially live casualties.
