Lesson 1 Flashcards
Three parts to the Golden Hour
To Be in and operating room within 60 minutes
Major trauma patients cannot be stabilized in the field
Efficient use of time requiring the use of priority action approach
Role of the attendant (4)
Provide care
Positively affect outcome
Record and report
Decision-RTW or medical aid
Four parts to the priority action approach
Scene assessment
Primary Survey
Critical interventions and transport decision
Secondary survey
6 parts scene Assessment
What happened? (Mechanism of injury)
Is the area safe? (hazards)
Number of injured?
what do I see?
Is patient responsive?
Do I need C-spine control?
RTC
Rapid transport category
8 RTC mechanisms
Freefall from 20 feet or 6.5 m
Severe deceleration in an MVA (if anyone was killed or ejected, where the airbags deployed)
Pedestrian or cyclist struck at a speed higher than 20 mph or 30 km/h
Severe crush injuries (pinned more than 40 minutes)
Smoke or toxic gas inhalation, or carbon monoxide poisoning
Decompression illness
Near-drowning
Electrical injury
Define Primary Survey
Rapid examination of the patient to discover any immediate life- or limb threatening injuries
Based on the ABC’s
Describe Primary Survey ABC’s
Airway assessment with C-spine control
Breathing assessment
Circulation assessment
The initial part of the primary survey is to determine what
If the patient is in cardiac arrest
Cardiac arrest determined by three parts
Not responsive and
Not breathing or having only occasional gasps and
No carotid pulse
- basically no ABC’s
If cardiac arrest is determined
Chest compressions or AED immediately
Determining cardiac arrest in four steps (ABC’s)
Attempt to communicate with patient-any response?
No response-open airway and check for breathing
No breathing or only occasional gasps-check for carotid pulse
Assess breathing and pulse for 10 seconds
Checking for breathing
Trauma and non-trauma methods
Trauma-using C-spine control and a jaw thrust
No trauma-head-tilt chin-lift
Airway assessment
Airway must be opened
Look, listen and feel for breathing
Aligning the head six parts
Take C-spine control with elbows braced
Explain what is going to be done
Tell patient to report any pain or resistance
Apply a gentle pull in line with the head
Gently realigned to anatomical then neutral
Stop if it resistance is met
breathing Assessment 3 parts
Rate
Quality
Need for interventions
Shortness of breath aka
Dyspnea
Circulatory assessment 4 parts
Determine if the heart is beating
Check for shock
Check for-
Massive external bleeding
Obvious fractures
Determine need for critical interventions
What is blood pressure
The pressure of blood against the walls of the arteries
What are the ABC reassessments
Clear airway
Rate and quality of breathing
I radial pulse, obvious signs of shock
ABC reassessments occur
Every 5 minutes on an RTC patient
Every 10 minutes on a non-RTC patient
Time to complete the primary survey
Not longer than two minutes
- however can only be interrupted or extended for critical interventions
Three parts to a secondary survey
Vital signs
History taking
Head to toe examination
Time to complete as secondary survey
Not longer than 10 minutes
- for an RTC patient, secondary survey will be done enroute to the hospital
Vital signs
In-depth measurement of the body functions to help determine the overall condition of the patient
Vital signs not required when
If the patient will be returning to work
Vital sign reassessments occur
Every 10 minutes for RTC patients
Every 30 minutes for non-RTC patients
Vital signs: list of six
Time Respiration Pulse Level of consciousness Pupils Skin
What is normal respiration
Between 12 and 20 per minute
What is normal pulse
Between 60 to 80 per minute
Glasgow coma score 3 parts
Eye opening 4
Verbal response 5
Motor response 6
Total of 15
History taking 4 parts
Chief complaint
Allergies
Medications
Past medical history
PPQRRST mnemonic for investigating pain
P pain P provoke Q Quality of pain R radiating R relieve the pain S severity 1 to 10 T timing
Medication questions five parts
Name of drug Dose Frequency Purpose Compliance
Head to toe examination three parts
Physical examination
Neurological examination
Motor and sensory
Record all findings
Physical examination investigates two parts
All injuries
Limbs circulation
First rule of first aid
Protect yourself first! (ensure that the scene is safe)
You are allowed to let go of C-spine under what condition
In cardiac arrest for chest compressions or AED (said Earl Lowe)
Define agonal respiration
They appear to be breathing but not breathing effectively
In determining cardiac arrest, assessment of breathing and pulse should not exceed how many seconds
10 seconds
In 90% of unconscious airway blockages, the blockages are caused by what
The tongue
A carotid pulse only means the blood pressure is in what range
Between 60 and 90
Purpose of the rapid body survey (RBS)
To look for major bleeding or other gross deformity
