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Radiographic Principles > Management of the Acute Patient & Trauma > Flashcards

Management of the Acute Patient & Trauma Flashcards

1
Q

Define an acute patient

A
  • Patient who is having severe symptoms which appear rapidly
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2
Q

State points to be aware of when working with an acute patient

A
  • Patient could be in a lot of pain
  • May have breathing difficulties
  • Unresponsive
  • Uncooperative
  • Limited in ability to move and comply with instructions
  • Condition where normal anatomy is altered
  • Could be attached to monitoring equipment
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3
Q

When working with an acute patient you must that the patient can…

A
  • Identify themselves
  • Communicate with you
  • Sit upright unassisted
  • Take and hold a breath for the duration of the exposure
  • Tolerate the image detector behind their back
  • Be considered an infection risk
  • Be monitored during the examination
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4
Q

When working with an acute patient you must check that the equipment can…

A
  • Be moved out of the FOV
  • Be removed for the duration of the examination
  • Be considered a siginifcant artefact
  • Physically impede the x-ray equipment
  • Be considered as sterile or an infection risk
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5
Q

When monitoring a conscious patient what should be considered

A
  • Listen to their manner and rate of speech
  • Does this explain their mental or emotional state?
  • Make eye contact, verbalise your actions
  • Remember, attending emergency is usually stressful regardless
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6
Q

When monitoring an unconscious patient what should be considered

A
  • Monitor their blood pressure, oxygen saturation, heart rate
  • What is their Pallor like?
  • If they are brought to the department, they should have a medical escort
  • Do you know where the adult and paediatric crash carts are
  • If in doubt get help or call 2222
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7
Q

How can we confidently identify an unresponsive patient?

A
  • All admitted patients should have an identifying wristband on always
  • All patients who have been brought to the hospital unresponsive with no-one to identify them will be assigned a unique ‘unknown’ ID
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8
Q

What is the Glasgow Coma Scale

A
  • Used to determine state of consciousness by assigning a score (3-15)
  • The lower the number assigned, the more likely a brain injury has been sustained
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9
Q

What is the potential problem with the GCS

A

GCS may not be the best idea as patients could come in drunk or on drugs

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10
Q

What is the Golden Hour?

A

This is the first 60 minutes after traumatic injury where rapid investigation and treatment can lead to increased patient outcomes

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11
Q

Describe the triage system

A
  • Immediate / Critical
  • Very Urgent
  • Urgent
  • Standard
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12
Q

What is consent

A
  • Permission or Agreement
  • The principle that an individual gives permission before they receive tests / treatments
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13
Q

Why is consent important

A
  • Ethical Requirement
  • Legal Requirement
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14
Q

What is the consequences when their is failure to obtain consent

A
  • Negligence
  • Sexual Harassment
  • Battery
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15
Q

Who can obtain consent?

A
  • Initially the Referrer
  • Health Professional undertaking the examination
  • Health Professional assisting in the examination
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16
Q

When should you get consent?

A
  • Before the procedure
17
Q

What is valid consent?

A
  • Must be given voluntarily
  • Individual must be appropriately informed
  • Individual must have the capacity to consent
18
Q

State the 3 types of consent

A
  • Implied Consent
  • Expressed Consent
  • Documenting Consent
19
Q

Describe implied consent

A
  • Agreement signed by behaviour
  • Agreement signed by an informed patient
  • Compliance is not implied consent
  • Always try to seek verbal consent prior to undertaking the procedure
20
Q

Describe Expressed Consent

A
  • Required for investigation / treatments which carry significant risks
  • Law does not always require written format as long as the patient is legally competent, volunteers their consent and has been well informed prior to the treatment
21
Q

Describe documenting consent

A

Details of express consent being obtained should be recorded this mean explicity writing on the request card within the patients notes, or on the RIS / Track system

22
Q

How do we obtain consent when a patient is unresponsive

A
  • If no relatives present a decision is made by the emergency doctor
  • Decisions must be made in the best interest of the patient
23
Q

When is rapid imaging used

A

if a person has sustained injuries a patient may be sent for a CT

24
Q

When is mobiles used?

A
  • Used when their is no possible way for the patient to come to the department
25
Q

When is it ok to use mobiles

A
  • If the patient is too unwell to come to the department
  • Patient is being monitored or unstable and unable to be transported
  • Patient is intubated
  • Patient is an infection risk
  • Patient is peri / post arrest
  • Is immunocompromised
  • Just come out of theatre
26
Q

When is it not ok to use mobiles

A
  • Too many members of the public
  • Patient management is not likely to be changed by the provision of imaging
  • Clinical information is not provided or justified
  • The technical limitations of the machine will not produce a diagnostic image
27
Q

Advantages of mobiles

A
  • Patient does no have to. move anywhere
  • Staff may be on hand to assist
  • Monitoring equipment and medication can continue to be used
  • Digital mobile machine can provide image immediately
  • If patient is quarantined the rest of the hospital is not at risk
28
Q

Disadvantages of using mobiles

A
  • Lots of dynamic factors, people in your controlled area
  • Patient may not be able to adopt any valuable position to an image to be taken
  • Staff may leave you on your own
  • Mobile images are less diagnostic accuracy than departmental
  • Exposure of yourself or to others
29
Q

What is the most common mobile examination request?

A
  • Chest x-ray
30
Q

What are clinical indications for a chest radiograph

A
  • Perforation
  • Chest Pain
  • Traumatic Injury
  • Sepsis of unknown origin
  • Decreased Oxygen saturation
  • Assessment of invasive lines and tubes
  • Shortness of breath
31
Q

Who can request an image

A

Anyone who has IR(ME)R 2017 authorisation within their scope of practice

32
Q

What is a major incident?

A

These are incidents or serious situations in which a number of people are threatened with death or severe injury such that special procedures are required for their reception and treatment

32
Q

How do we know a major incident is happening?

A
  • “Major Incident Standby!”
  • “Major Incident Declared!”
  • “Major Incident Cancelled!”
33
Q

What happens once a major incident is declared?

A
  • Ambulance Control Centre will designate 4 appropriate hospitals to receive casualties
  • Order depends on the location of the incident to the hospitals
  • Ambulance Control Centre will alert the hospitals, and Respons Team from the 4th hospital is sent out to assess and coordinate casualties
34
Q

How will the emergency department respond to a major incident

A

They will try clear the waiting room and all bays of all non-life threatening injuries, either treating or sending them home

35
Q

How will radiology respond to a Major incident

A
  • Assign a Lead member of staff
  • Assign a Receptionist role
  • Ensure all stock is ready
36
Q

How can staff decompress from a major incident

A

Discussions around the event that have happened, try to attend them and gain some closure

Radiographic Principles (7 decks)

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