Managments Flashcards
When attending an elderly fall - what are the assessments required
Fast
12 lead ECG
Postral drop
Head to toe ( trauma )
Mobility test
When attending an elderly fall what history questions are important
- mechanism of injury ( intrinsic/ extrinsic
- duration on floor ( long lie)
- LOC
- Prior, during the fall, after fall
What are the symptoms of symptomatic bradycardia
2) treatment plan
1) bradycardia causing poor precision - (HR 40-), BP(less 90), confusion, HF
2) O2 (94%+), pads, cannulate, atropine (600mcg -5 mins), fluids (100mmgh maintain)
3) if unrespetive to treatment plan = prealert
How would you manage a fracture
- Early pain relief ( enternox)
- Assess neurovascular compromise
- Longer lasting analgesia ( parcemol/ morphine
- Vacuum splint
What is the assessment pathway for patient with asthma
Rapid primary survey ( Determine LT features)
- RR + HR + ISIFS ( give nebs + hydrocortisone)
- if GHOST is present ( Adrenaline 1:1000 + 02 then nebs + hydrocortisone)
Full set of OBS + 12 lead ECG
- if pt not receptive to treatment = pre alert
What is the basic management plan for an arrythmia ( Brady / svt)
S - support abc
T- 12 lead
O - oxygen ( if needed)
P - pads
P - pre alert
I- IV + fluid( if needed)
*“T**- tamper ( atropine / vagas monover)
How would you manage a adult cardiac arrest
Confirm cardiac arrest via ( ABC Approach
- confirm absence of ADRT, LPA, DNAR, RESPECT forms or irreversible conditions
- put on pads ( respond to rhythm)
- 30:2 - 5 rounds
How do you manage an active seizure ( A-E approach)
A- airway (look + clear - suction + secure (OPA/ npa)
B- rr ( 15L 02 ) - sat not reliable when active seizures - prolonged + tolerating OPA = ? pop in igel ( ETCO2)
C - pulse and cap refill ( BP+ 12 lead when possible)
D- GCS ( give time for them to respond) + BM + TEMP + rashes + head injury assessment
T- time seizure = drugs
How do you manage a patient post seizure ( postictal states)
-Manage ABC
- Placement in recovery position
- History ( DDEMSIPL)
-
What is the management for patient with an active seizure basics
- Managed ABC
- protect the head, and airway from aspirations
- ask about DEMSIPL
- look for signs ( ? Epilepsy / ? PNES)
- 5 minutes + give benzo
- iv access
- 10 minutes in = if still seizuring ( move to ambo
- at 15 mins in/ 10 mins after first dosage = give second benzo
How do you manage a patient in status epilepticus ( seizures)
Status = 5 minutes + seizure/ 3+ seizures with an hour
- address ABC concerns
- protect head
- history = DDEMSIPL
- follow care plan or ( give first benzo ( midazolam buccal)
- 10 mins after give second bezo ( IV diazapam)
- 3rd benzo only 25 mins after 2nd dosage
Move to hospital 5 mins after first benzo = pre - alert. === Get ready with BVM ( Respiratory depression)
What is classified as SEVERE hypoglycemia
- what is the management plan for such PTS
1) PT with a reduced GCS - 8 OR LESS
- correct ABCS
- Give IV glucose / if not possible then Glucagon.
- reassess after 10 mins
- sugars still low = IV glucose or if no access = IO
- Recheck after 15 mins - no change = convay with PRE-ALERT = CONSIDER 3RD DOSAGE
What is classified as a PT with mild - moderate hypoglycemic attack
2) treatment plan
3) backup treatment plan
4) backup backup treatment plan
- PT with suger below 4.0/3.0 who is conscious and can swallow
- give fast acting glucose = glucose 40% or 2 biscuits or pure fruit juice ( this can be given up to 3 times)
- not effictive giv GLUCAGON ( consider PT tho - poor stores)
- after 30 minutes give iv glucose
- once above 4.0 give long acting carbs ( bread or meal)
- make sure to replenish store if giving glucagon = more toast or more food
What is the management plan for PT with sepsis
Early NEWS2 score
- cannulate
- O2 ( if signs of shock or below normal)
- benzopencillin + paracetamol(reduced temp/pain)if needed
- provide fluids ( dilute acidic products, increase volume)
** Pre alert**
What is the management plan for hyperventilation
- who should be convayed
Confirm it is hyperventilation not respiratory, metabolic or cardiac in origin
Management = reassurance, breathing and or distraction technique, in nose out mouth
**Transfer if **under 16 or first episode, known hyperventlator and non resolved or reaccuring,
What is the management for a patient with a suspected stroke
- general history + ONSET TIME
- complete full set of OBS including BM + °C
- complete a FAST TEST
-if FAST+ call stroke nurse regardless of onset time - complete 12 interracial nerves
How do you complete a neuro assessment for patient suspects of a stroke
Face - eyebrows, close eyes then do trigeminal, puff up cheeks, big smile
Arms - squeeze, pull push, hold up, push on them, ?rebound + legs
Speech - hippopotamus, memory recollection
Eyes - vision peripheral, read something, accdomidate, pupils, pearl, big h
Dyscolkinesia, f2n, rebound, Romberg’s, tandom gate
