Medical Protocols Flashcards
The EMT in the field is expected to follow protocols without deviations unless he or she receives a…
VERBAL ORDER FROM AN ON-LINE MEDICAL CONTROL PHYSICIAN
Personnel may perform only to the level that they are…
LOCALLY CERTIFIED
In protocols WITHOUT a medical control bar, all treatments may be given by_____, and it is unlikely personnel will receive orders for any other treatments if______
STANDING ORDER
MEDICAL CONTROL IS CONTACTED
Non-protocol orders may be requested, with justification by field personnel, or be______
INITIATED BY THE MEDICAL CONTROL PHYSICIAN
Care ordered by the Medical Control Physician not contained in specific protocols shall:
(LONG ANSWER) A, B, C
A. Follow rules promulgated under:
Texas Administrative Code, Title 25, Part 1, Chapter 157 (Emergency Medical care) Texas Health and Safety Code Chapter 773 (EMS and Trauma Systems)
B. BE WITHIN THE SCOPE OF THE EMT’S LOCAL LEVEL OF CERTIFICATION AS DEFINED BY EPFDEMS MEDICAL PROTOCOL SECTION 1- GENERAL #11 (UNIVERSAL PATIENT TREATMENT), AND PROTOCOL SECTION 1- GENERAL #10 (EPFDEMS MEDICATIONS)
C. Be documented in the Medical Control section of the electronic patient care report by EPFDEMS personnel. Med control section will include the Medical control Phy # giving the order, AND THE ORDER
Medical control responsibilities include being ____ to provide medical advice and ____ orders
AVAILABLE
TREATMENT
ROUTINE CAUSES FOR CONTACTING MED CONTROL
When advice, support or direction is needed regarding appropriate patient management and/ disposition_____
THE RIGHT TO CONTACT MED CONTROL IS NEVER DENIED.
ROUTINE CAUSES FOR CONTACTING MED CONTROL
Advanced Life support requiring Med control orders____
BELOW THE BAR
ROUTINE CAUSES FOR CONTACTING MED CONTROL
Pt refusing transport who appears to need med attention; Med Control should be called for____
“Physician ADVICE to PATIENT”
ROUTINE CAUSES FOR CONTACTING MED CONTROL
Physician Bystander____
ACCEPTING RESPONSIBILITY FOR PATIENT CARE
ROUTINE CAUSES FOR CONTACTING MED CONTROL
For Permission to DISCONTINUE_____ (LIFE SAVING)
RESUSCITATION ALREADY BEGUN
Med control must be contacted prior to discontinuing ANY____
ALS TREATMENTS (IV therapy, ECG monitoring, Med administration)
Communication failure- if standard radio contact cannot be initiated with med control____
Call dispatch (or any other recorded line) @ 832-4432
AND
Request a conference call to Med control at UMC
Unable to contract Med control for any reason? (lengthy explanation)
- and
2.
May perform to the LIMITS of their LOCAL LEVEL OF CERTIFICATION
&
1. Paramedics auth to perform protocols below the bar which would normally require on-line med control IF the pt needs immediate therapy to prevent immediate death.
- If actions that require med control are not urgent, they should be deferred until comm is reestablished.
ALL circumstances which there is a failure of comm devices or other COMM equipment failure shall be reviewed BY
THE MED DIRECTOR
EPFD Personnel involved will NOTIFY____ as soon as practical after the inability to____
FIRE ADMINISTRATION
CONTACT MEDICAL CONTROL
ALL skills listed under ECA/EMT-Basic and EMT-Advanced may be performed by____ without______
STANDING ORDER
CONTACTING MEDICAL CONTROL
EMT-B skills that don’t require contacting Med control:
- Vital signs- including pulse ox and BGL
Spinal motion restriction that doesn’t require med control
4 Items
a. Rigid cervical collars
b. Backboards
c. extrication devices/ vests (KEDS)
d. cervical immobilization devices after patient is secured to backboard
Oxygen related items that can be used without contacting medical control
a. stable
b. Unstable/acute
a. Stable/ non-acute o2- 1-4 LPM via NC
b. unstable/acute o2- 8-15 LPM via Non-rebreather, BVM, or BAG VALVE TUBE of intubated pt’s at 100%
Lower flow rates of (?) may be used as long as bag remains x% full during______
8-10 LPM
50% full
Patient’s MAXIMUM Ventilatory effort
Positioning and suctioning for airway control don’t require
Contacting med control
Insertion of OPA or NPA airways don’t
Require contacting med control
Insertion of SUPRAGLOTTIC airway in medical or trauma or Cardiac arrest PT’s doesn’t
Require contacting med control
BVM or demand-valve for PPV doesn’t
Require contacting med control
Rapid PT extrication doesn’t
Require contacting med control
DOESN’T REQUIRE CONTACTING MED CONTROL
Application of____ to ISOLATED fractures of_____ or_____
Tractions splints
FEMUR
Tibia/Fibula
DOESN’T REQUIRE CONTACTING MED CONTROL
Electrical defibrillation with_____
Automated External Defibrillator (AED)
Stabilize and splint bone fractures and joint dislocations using (4 items)
- Board splints
- Wire or “ladder splints”
- Pliable metal or “SAM” splints
- Field-expedient means: Pillows or blankets, etc
DOESN’T REQUIRE CONTACTING MED CONTROL
Six meds/actions that don’t require med control
2(actions)
4 (meds)
- CPR
- Childbirth
- Admin of aspirin
- Oral Glucose
- Epi auto injector
- Admin of nebulized albuterol
Request for ambulance=
Considered a patient
Calls to 9-1-1 are not always intended to be an_______, although an ambulance may be dispatched (_______)
AMBULANCE REQUEST
Minor MVCs
If someone is not a legal adult (under the age of 18) they=
ARE a PATIENT
A person is NOT ALERT and ORIENTED to person, time, place, and event=
THEY ARE A PATIENT
Someone is a patient if they are under reasonable_____ of_____ or______ known or unknown.
SUSPICION
ALCOHOL
DRUG SUBSTANCE
If someone has signs or symptoms of an active medical illness or injury they=
ARE A PATIENT
If someone has a medical or psychological event=
THEY ARE A PATIENT
If someone suffers a trauma event (including a minor fall)
They are a patient
All patients MUST have a completed (2 items)
Patient Care Record
and/or
Patient refusal
If the involved party IS NOT a patient other responding Fire and Medical units will be____ and both_____ and ______ will need not be completed.
Cancelled
Patient Care RECORDS
Refusal FORMS
If there is any___, complete a_______ and/or______
DOUBT
Patient Care RECORD
REFUSAL
Level III patients___ attended by any EMT level crew member locally certified under the EPFDEMS Med director
May be
Level I and II patients____ attended by a Locally Certified EMT-Paramedic
MUST BE
If NO locally certified paramedic is available for any reason, the______ crew member will attend all level I or Level II patients
Highest locally certified
Although each individual is held responsible for his or her actions, the_________, is responsible for all patient care,_______ of who attends the patient
Highest locally certified crew member
REGARDLESS
A Physician on-scene can either be a ____ or a _____ in providing optimal care for a patient
Help
Hindrance
It is important to be______ (to an on-scene Physician)
Cordial
Who mediates disputes when there is an on-scene physician
Med control
When an ALS unit is dispatched under Medical direction a____
Physician/patient relationship is established.
The Pre-hospital provider on the scene is responsible for the management of the patient and acts as the
AGENT of the physician providing med control
Usual places for patient’s private physician (not in a public place ex. mall)
Physician’s office
Patient’s home
or Nursing home
If a private physician is on-scene and ASSUMES responsibility for pt care the Pre-hospital provider should____ to their orders_____ those orders_____ with the established protocols
DEFER
UNLESS
CONFLICT
You must request Private Physician to____ his or her____, with printed_____, _____, and ______ number
document orders name signature DEA
The on-scene Physician’s orders will be FORWARDED TO (for what reason)
EPFDEMS Admin for attachment to Pt’s med record
On-line Med control Physician will be notified of the______ of the patient’s private physician
PARTICIPATION
If private physician’s orders conflict they shall be____
placed in communication with Med control
If med control and Private physician don’t agree the private Doc must either (two things)
Continue to provide direct pt care and accompany pt to the hospital
OR
Defer all remaining care to Med control
Med control or on-line med control shall assume responsibility for the pt at anytime when______
The pt’s private physician is not in attendance
Usual places for by-stander physician
Public place( MVA, mall, etc) Pt's home where a by stander or neighbor identifies themselves as a Doc
If a Doc is present and has satisfactorily ID’d themselves as a licensed Physician, and expressed they want to assume responsibility… (you should do what?)
A med control physician should be contacted
Med control is ultimately responsible for the patient unless and/or until (someone does what?)
The intervening Physician appropriately assumes responsibility of the patient
First thing
needed to ID an on scene physician
- Must verbally state that they are a MD or DO currently licensed to practice in Texas
Second thing that must be done for on scene physician to be ID’d
(one of the following three things)
- Visually ID’d by on-scene EMT
- Pic ID (driver’s license) with name confirmed by On line med control or dispatch
- Wallet copy of the medical licensure
Med control has three options when working with an intervenor physician
- Managing case exclusively
- Working with intervenor physician
- Allowing intervenor to assume complete control
If intervenor takes control all of their orders should be
Repeated to Med control for record keeping purposes
Intervenor documentation should be done where? (two options) 1. or 2. with what info?
On Patient Care Record
OR
On a 8 1/2 by 11 paper with Phy’s printed name, sig, and DEA #
Intervenor’s orders will be forwarded to____ for______ to________
EPFDEMS Admin
attachment
Patient’s med records
If Intervenor decides not to accompany pt to hospital it has to be______
approved by on-line physician
Fire personnel will not___ from authorized_____ and Medical procedures
Deviate
Local SCOPE of practice
Absence of vital signs___ authorize EMT to ____ that the patient has expired
Does not
Asssume
Only a____, _______, ________, or ______ is legally authorized to pronounce death
LICENSED PHYSICIAN
DULY Authorized REGISTERED NURSE
Judge
Medical Examiner
In certain circumstances, however, death is obvious, and resuscitation efforts would be______and_____
FUTILE
INAPPROPRIATE
6 Things that are criteria for OBVIOUS DOS
Decomposition Decapitation Hemi-Section Incineration Rigor Mortis Dependent Lividity
OBVIOUS DOS
Victims in_____ secondary to________(signs of brain and heart destruction), and with NO SIGNS OF LIFE noted by bystanders or pre-hospital care workers, including absence of pulse and respirations
Cardiac arrest
OBVIOUS MORTAL INJURIES
OBVIOUS DOS
Extenuating circumstances- 4 examples
HAZMAT incident
Mass casualty incident
Prolonged extrication
Drowning victims under water for longer than one hour
Victims who were under water should be resuscitated IF
They were underwater for an undetermined amount of time OR LESS than ONE HOUR
If the first EPFDEMS unit makes pt contact and determines that it’s an obvious DOS criteria is present they will….
Cancel responding units
Once resuscitation has been started by ANYONE it may not be discontinued without….
Order from Med Control physician
Determined that obvious DOS (in absence of duly registered nurse or Physician), and death appears to be natural with no extenuating circumstances or signs of foul play____ (request one of two agencies/people)
Notify dispatcher to request the appropriate law enforcement agency OR Medical examiner to be dispatched to scene.
Leave the body and scene_____, complete_______ noting obvious death criteria met.
“as-is”
Patient Care Record
Advise the family members that _____ ___ and/or the ___ ___ have been notified and will respond. Don’t give an ETA.
Law enforcement
Medical Examiner
Fire unit may go ___ __ ______ and leave the scene
back in service
Fire comm will notify ___ _________ that the EPFD is leaving the scene a police response is still required to respond.
Law Enforcement
Any question regarding the circumstances of _____ or any signs of ___ ___exist, crews shall remain on scene, out of service, to protect evidence until the arrival of PD.
death
foul play
In order to terminate resuscitation efforts (age) patient must be
An Adult. >18
ALS length of care to terminate resuscitation (unwitnessed)
20 min
ALS length of care to terminate resuscitation (witnessed)
30 min
You can term resuscitation when this criteria is met? (Five items/actions)
A. observable rise and fall of chest
B. Auscultation of breath sounds
C. Absence of gastric sounds
D. Capnography
IV or IO access
EtCO2 of less than ______ with ______ chest compressions
In order to term resuscitation
20 mm hg
HIGH QUALITY
Termination of Resuscitation will not be done for (2 items)
Minors
Visibly pregnant patients
Termination of resuscitation will NOT occur with- Cardiac arrest associated with other circumstances (5 items)
Overdose Hypothermia Toxicological exposure Electrocution Airway obstruction
Termination of resuscitation will not happen if (law enforcement related)
Patient is a victim of a crime
In Law enforcement custody
Termination of resuscitation will not occur when (2 items) Public places
In a crowded place (excluding nursing homes and extended care facilities)
If it would place personnel in danger
Termination of resuscitation will not be done if family
Does not accept termination
Avoid using euphemisms such as “Passed away”, “No longer with us”. Use terms such as….
Death, dying, or dead.
Avoid saying “I’m sorry” Use phrases like…
“You have my sympathy”
Chapter 672 of TEXAS ADMIN CODE (TAC), natural death act allows responding health care professionals to______ or ________
Withhold or discontinue the resuscitation of certain patients.
DNR=
Do NOT Resuscitate
DNR Identification devices State-approved_____ or_____ containing DNR symbol (______)
bracelet
necklace
any state
Number of Qualified relatives
Two persons if available
People who are QUALIFIED RELATIVES: 4 total
Patient’s spouse
Majority of pt’s adult kids
Patient’s parents
Patient’s nearest living relative
DPAHC
Durable Power of Attorney for Health Care
Proxy-
Person authorized to make treatment decisions for the patient.
If patient has ONE of the following CPR and other life sustaining measures SHOULD NOT be initiated a b c d e
Single page with texas DNR in upper left hand corner if from Texas Patient is correctly id'd on the form All required sections are completed All required sigs are present Duplicate copies ARE considered valid
Presences of a state-approved, signed Out-of-Hospital DNR form,___ _____ = valid
Any state
DNR bracelet or necklace description
A
B
C
A. White plastic/ stainless steel with “Texas” or Texas shape with word “STOP” and words “DO NOT RESUSCITATE
B. Stainless steel 1” diameter disk on a 16” to 18” length of SS chain with “DO NOT RESUSCITATE” on it
C. Items will NOT be honored if not being worn by patient
Living wills and Power of Attorney are/are not considered valid DNRs?
ARE NOT
If there is any doubt of the validity DNR?
Life sustaining measures should be initiated until the discovery of a valid DNR or until pt is transferred to a higher level of care.
If patient with a DNR needs palliative care (define) what should you do?
Palliative- provide comfort
Follow standard protocols as directed by Med Control
____ stopping the resuscitation, rescuers should make clear to qualified relatives, proxy, or legal guardian(s) on scene that they are about to discontinue resuscitation efforts because of the DNR.
Before
If in Resp or Cardiac arrest, and resuscitation has_____ _____ ____ ______, and evidence is found of a state-issued Out-of-hospital-DNR order, the resuscitation should be_______
HAS ALREADY BEEN STARTED
DISCONTINUED
If there is_________, the DNR order is considered________ and resuscitation should continue.
OBJECTION
REVOKED
The discontinuation of resuscitation measures in the presence of a State-issued Out-of-Hospital DNR order ____ ______ require a _________ _______ order
DOES NOT
MEDICAL CONTROL
If a patient covered by a State-issued Out-Of-Hospital DNR order is_________, the Personnel transporting should make a ___________ ________ to bring the ________ form with the patient.
Don’t compromise the patient to secure the form.
Transported
REASONABLE EFFORT
ORIGINAL
If a patient covered by a State-issued Out-Of-Hospital DNR Order is being transported, and develops Cardiac or Respiratory Arrest_____ transport, personnel should______ life sustaining measures and _______ transport to the Emergency Department of the receiving hospital.
DURING
WITHHOLD
CONTINUE
DO NOT honor a DNR if (4 reasons)
Alterations to the form (something is marked through)
Patient is pregnant
You cannot conclusively match patient name to the form
There are unnatural or suspicious circumstances
ANY DNR order may be______ at ____time by the patient, legal guardian, proxy, or qualified relatives.
Revoked
ANY
The revocation will involve _________ of wishes to responding Health Care Professionals,______ of the form, and____ of all or any DNR identification devices the patient may possess.
COMMUNICATION
DESTRUCTION
REMOVAL
Patients will be transported to the_________ _________ facility
Closest
Appropriate
Based on their _____ level, _______ patients will be transported to the closest appropriate_______ facility.
ACUITY
TRAUMA
TRAUMA
In some instances, this (the closest appropriate facility) will not be the closest_______ _______
Emergency Department
As with Trauma, other hospitals are sometimes designated for specialized care in______, ______, ____ exams, and _______ capabilities etc
STEMI
Stroke
SSA
Hyperbaric
When two receiving facilities are____-______ from the scene, the patient’s ______ of the two will be honored as the transport decision.
Equi-distance
preference
Med control __ __ contacted for _____ orders when there is any ______, or a problem, with transporting the patient to the closest appropriate facility.
May be
Destination
question
Legally, the only patient who can be transported______ his/her____ is one who constitutes a_____ to him/herself or_______, or is________ incompetent (minor, mentally disabled, etc)
Against Will Danger Others Legally
A patient who is alert and oriented to, _____, ______, ________, ______, and wished to refuse medical treatment, even for a very _______ condition, is ____ considered a danger to him/herself.
Person Place Time Events Serious NOT
A patient who has an _______ ________ status for any reason (________/______ ingestion, _____ injury, ______ state, _______ disability) may possibly be considered a danger to him/herself if he/she_____ treatment and transport.
Altered Mental Alcohol/Drug Head Postictal Mental Refuses
If a patient is a danger to him/herself or others/incompetent, does not want/consent to transport, and they require transport you should…
1.
2.
3.
- Assure safety of crew. Struggling is to be avoided. Don’t enter violent situation without PD.
- Contact PD for restraint assistance
- For safety, PD should accompany crew members in Rescue.
The_____ agency has the________ of transport.
Custodial
Discretion
Destination is determined by patient’s ______ condition and ________ facility as specified by protocols.
Medical
Appropriate
If a patient’s condition does not______ a destination, then the agency’s requests will be______.
Specify
Honored.
Responders should always consider the ____ of the patient, _______, and responding________. ______ ________ will secure the scene ________ Medical responders enter.
Safety Community Medical providers Law Enforcement BEFORE
The use of_____ is important to responders.
PPE
The donning of_____, _____. and ____ to mitigate a possible exposure _____ be used during contact with a ______ patient.
Gloves Goggles Mask SHALL combative
With all_______, ________ _______ will be contacted and will________ the_______ process.
Restraining
Law Enforcement
complete
restraining
Restraints should only be used in situations where the patient is________ _____ or a behavior that may be deemed a _____ to ____ or others.
Potentially Violent
Self
Administering restraints should be completed in a _______ and _______ manner. The should not inflict more _______ or _______.
Humane
Professional
Pain
Injury
Provider should consider _______ ________ addressed in the _______ ______ protocol.
Medical Problems
Excited Delirium
Restraint shall allow the patient to be monitored for _____ ____ and other treatment. The method shall protected the _____, ________, ________ status and not to compromise ______ status of the patient.
Vital Signs Airway Respiratory Vascular Neurologic
Restraining in the ______ position should be avoided.
Prone
If this process (Prone) is used it should be a ________ measure until______ is gained.
Temporary
Control
Patients should be placed in a ___ OR____ point______ position.
4
6
Restraint
4 to 6 point restraint=
Both wrists
Both ankles
Strap
Sheet above the knees
If backboard is Aux is used,___ careful attention to the _______ ______. Place_____ behind it_____ they become violent and begin striking their head on the board or the bar of the aux.
Pay
Patient’s head
Padding
IF
If the patient is in a______ position the patient should face the _____ ________, not the ______.
Lateral
FD Personnel
Wall
The use of the _____ can assist in the ______ of the patient over to the _____ _____ easier.
Board
Transferring
Hospital Bed
_____ restraints______ be used when possible over ______ restraints.
Soft
Should
Hard
List the 5 soft restraints
Cravats Sheets Posey Vest Velcro Padded Leather
If Law enforcement has applied handcuffs (______ ______) __ __ cuff the patient to the _____.
Hard restraints
Do not
Stretcher
Law Enforcement_____ _______ the patient in the ambulance __ the handcuffs are applied.
Will accompany
If
EMS crews ____ have means of________ releasing any restraints, medical _____ or a _____.
Must
immediately
scissors
key
A patient should never be _____ or ________ with their arms and legs tied behind their backs.
“hobbled”
“hog tied”
The patient should be_______ restrained to the stretcher or______ by any means
Restrained
Sandwiched
Any type of restraint that would restrict the______, ______(_________) by direct pressure or hyperextension of the ________ wall= prohibited
Chest
Abdomen
Diaphragm
Chest
No type of_____, ____ or object shall be placed over the patient’s______
Towel
Sheet
Face
The use of a _______ ________ mask or shield may be used.
Loose fitting
If a patient continues to struggle after proper restraints the Paramedic should consider_______ _______ ________
Chemical restraint protocol
The responsibility of the patient will rest on the ______ _______ ________ individual
Highest medically trained
Documentation of restraint use should be________
Thorough
Ems personnel have a statutory obligation to report abuse of what ages?
(3 items)
Children ( under 18)
Elderly (65+)
Disabled persons (18+ and disabled)
How long do you have to report the abuse of a child, elderly person, or a disabled person?
48 hours within encountering the patient/victim
You may ______ delegate the reporting to anyone else (reporting abuse)
NOT
Citations within the statue eliminate the usual “________ ________” restrictions that normally apply.
patient confidentiality
Abuse hotline #1 - call prior to when?
1800-877-5300
Leaving your shift
Abuse hotline #2- call prior to when?
1800-252-5400
Leaving your shift
You may also report abuse to______
Any EPPD officer
How to treat suspected abuse
Follow applicable protocols
Report suspicious and observations to receiving hospital physician and chain of command.
“Suspected abuse”
If patient/caretaker refuse transport?
Call for PD assistance
SSA protocol
_________ _________ is a priority after stabilizing life threatening injuries
Evidence preservation
SSA protocol
Do not allow patient to wash _____, _____, or ________ ______ etc
Hands
Face
Brush Teeth
SSA Protocol
If patient has changed clothes, original clothings should be transported in a ________ _____ if possible (_____ ______), for evidence preservation
paper bag
not plastic
SSA Protocol
Reassure the patient that they are ____ ; provide _______ support as needed and appropriate.
Safe
Emotional
SSA
Unstable SSA patients should be transported to
Closest appropriate facility
SSA protocol
Stable patients will be transported to a _____ facility to complete forensic exam by a ______ ______ ______ ______ (_____)
SSA
Sexual Assault Nurse Examiner
SANE
SSA
Patient should be advised of the importance of being evaluated at a ______ designated facility for ______ examination as well as preservation of forensic evidence.
SSA
Adequate
SSA
When transmitting patient report; refer to patient of this nature as ____ or_____
SSA
Code 5
Indications of Supraglottic airway
Respiratory Arrest
Cardiac Arrest
After attempts at intubation are unsuccessful in a pulseless arrest
Difficult airway anticipated and rapid airway control is necessary
Supraglottic airway contraindications- 7 things
Ability to maintain oxygenation and ventilation with a less invasive method
Intact gag reflex
Known esophageal disease
Ingestion of caustic substance
Tracheotomy or laryngectomy
Suspected foreign airway obstruction
Patient isn’t within the appropriate size chart
Surpaglottic airway steps (first 4 steps)
- Proper PPE
- Select appropriate size
- Test cuffs prior to insertion
- Lubricate only lower cuffs with water soluble lube- don’t lube over anterior openings
Head position for supraglottic airway
Medical
Trauma
Medical- sniffing/ slight cervical hyperextension
Trauma- in line spinal immobilization
Confirm supraglottic airway placement by: a. b. c. d.
Auscultation
Chest movement
Capno
Waveform capno
King size 4-5 ft= size___ at ___-____ ML
3
45-60 ML
King size 5-6 ft= Size__ at ___-___ML
4
60-80 ML
6+= size_ at ___-___ ML
5
70-90
Removal of king airway if:
Can’t be tolerated by patient
Airway is no longer patent and can no longer be adequately ventilated
King removal 5 steps
- Place head in neutral position
- Have suction available
- Deflate cuffs completely
- Open mouth using scissor technique
- In one motion, smoothly slide King airway out.
With exception of____,_____,______, and ________ medications are for advanced or Paramedics.
Oxygen Aspirin Oral Glucose Epi-pen Albuterol
Applicable _______ _______/_____________ protocols allow admin of certain meds by _______ under the direction and ____ of a paramedic or_______
Hazardous material Mass casualty incident EMT-Bs supervision Medical control physician
Auto Pulse resuscitation system provides _____-____ automated CPR to victims of sudden cardiac arrest. The auto pulse has been shown to reduce_____ in the _____ during transport.
High-quality
Interruptions
Compressions
Autopulse- initial care
Current AHA CPR basic life support guidelines
Auto-pulse
Patient chest circumference permitted?
29.9-51.2 inches
Auto-pulse
Patient chest width permitted?
9.8- 15 inches
Auto pulse
Maximum patient weight permitted?
300 lbs.
Auto pulse
Age usage?
18 years and older
Auto pulse
Contraindications?
In cardiac arrest with Traumatic injuries
Under 18
Auto pulse
Step 1
Expose patient’s____ by removing all clothing. CPR ______ pad and ______ pads applied to chest while performing _______ CPR.
Chest
Feedback
Defribillator
Manual
Auto pulse
Step 2
Turn on auto pulse and _____ it above the patient’s_____ on the ground using the ____ on the auto pulse.
Align
Head
Guides
Auto pulse
Step 3
Sit up patient and_____ auto pulse into position and putting patient on the auto pulse ______ the patient’s _______ with the _____ ____, making sure the patient is _____ on the auto pulse.
Slide Aligning Airpits Yellow line Centered
Auto pulse
Step 5
Press the bands______ to ____ and secure the velcro fastener. Give a gentle ____ to the life band to ______ extend it while placing it over the patient’s______.
Together
Engage
Pull
Fully
auto pulse
Warning- do not…
Touch the patient or the life band while auto pulse platform is analyzing the patient’s size.
Auto pulse
After a ___ second pause, verify ______ and ____, compressions will start_______ at 30 to 2 ratio.
3
Alignment
Size
Compressions
Auto pulse
Turning off steps
Stop/Cancel followed by On/Off.
Auto pulse
Stop/Cancel button does what?
Cease the compression cycles and relax the life band.
Auto pulse
Do not _____ life band ____ removing it. _____ the life band may cause the auto pulse to report a ____ and will require specific steps to clear the fault.
Cut
Before
Cutting
Fault
Level I medical- airway
Compromised or uncorrectable
Level I- Breathing
Signs or symptoms of acute respiratory distress
Level I- Circulation
Signs or symptoms of shock or impending shock
Level I- Disability
Any presenting sign or_____ that in your____ judgement is highly suspicious of ______ mortality OR (Will list these in other cards)
Symptom
Best
Depressed level of consciousness =
Level I
Level 1 hypertension
Systolic ABOVE 220
Diastolic ABOVE 120
Level 1 Hypotension
Systolic BELOW 90
Level 1 brady or tachycardia
______ by any other ______ indicator
Accompanied
Unstable
Abnormal respiratory rate, depth, and/or effort; abnormal lung sounds=
Level 1
_____or Cyanotic skin=
Level 1
_______ not associated with a hot environment=
Diaphoresis
Level 1
______ (or similar)____ pain with or without accompanied radiation, nausea, sense of____ doom, or_____=
Crushing
Similar
Denial
Level 1
Stroke/TIA signs and symptoms within _____ hours of last seen normal with a positive ___ ______ ____ _______. (_______)
=
24 hours
Pre-hospital Stroke Assessment
Code Brain
Level 2
_____ lights and sirens to the ______ appropriate facility with the __________ of that hospital’s____ to care for the patient.
Without
Closest
Consideration
Ability
Level 2
___ medical emergency with ___ vital signs having a significant medical history, and _____ of the indicators for an ______ patient.
Any
Stable
None
unstable
Level 2
___ patient with a ____ index of _____.
Any
High
Suspicion
Level 2
_____ med control for _____ to upgrade to ____ and ____ with the patient remaining a Level 2 to the _______ appropriate______
Contact Permission Lights Sirens Closest Facility
Level 3
Transport_____ lights or siren to the patient’s ______ of ______ following the _____ transport policy.
Without
Facility
Choice
Current
Level 3
Criteria: ____ patient with no _______ Medical_______ and non-______ medical complaint; ___ medical patient who does not meet _____ 1 or ____ criteria
Stable Significant History emergency Any Level II
The ______ patient with no _____ ____ requires ______ protection.
Unconscious
Gag
Reflex
Airway
O2 sats at _____ may warrant______ intervention with ______ administration with ventilatory ______ with the goal to maintain spO2 of ___ to ___.
<85% Immediate 100% assistance 93% 99%
OPA should be used on all patients______ a gag reflex
Without
Maintain a good seal, with______ from other_______ ______
Assistance
Crew
Members
ETCo2 normal values=
35-45 mgHg
A supraglottic airway may be inserted by _____ skill levels. (The use of Colorimetric is____ if no ______ is available)
Any
Mandatory
ETCo2
____ attempts may be made to insert a ________ airway
Two
Supraglottic
Secure____ ______ and ______ strap before_____ the patient. Follow the commands of Auto Pulse as given.
Shoulder
Straps
Waist
Moving
The auto pulse has a _________ mode that will give __________ without pause when an ________ airway is in place.
Continuous
Compressions
Advanced
After either a_________ resuscitation or ________ of activities, press the ______/______ button followed by the___/___ button. The _____/_____ button will cease the compression cycle and relax the life band. The ____/___ button action will power down the auto pulse.
Successful Termination Stop/Cancel On/Off Stop/Cancel On/Off
Open the_____ fastener and ____ or _____ roll the patient ____ the auto pulse platform, as necessary.
Velcro
Lift
Log
Off
Discard the life band as it is a ______- use component. Treat the life band as ________ medical_____ and dispose of it accordingly.
Single
Contaminated
Waste
Alt Mental Status
Inappropriate response to ____ or ______ stimuli
Verbal
Physical
*Alt mental status* Hypo/Hyper\_\_\_\_\_\_\_\_ Hypo/Hyper\_\_\_\_\_\_\_\_ Hemi\_\_\_\_\_\_\_ Fever OD
Glycemia
Thermia
paresis
Alt mental status
Check ____ and _____ pulses
Central
Peripheral
Alt mental status
____ OD or Drug ___________, contact_______ control
Drug
Paraphernalia
Poison
Anaphylaxis
Position patient ____-_____ position (_______), IF conscious.
Semi-Fowler
Reclined
Anaphylaxis
If patient is _____, place supine with _______ elevated.
Unconscious
Legs
Anaphylaxis
Attempt to _______ allergen affecting patient.
Ascertain.
Anaphylaxis
If patient is exhibiting signs/symptoms of _____ allergic reaction, to include ______ distress, and/or _____, contact ______ ______ for possible _________ auto-______ administration.
Severe Respiratory Shock Medical Control Epinephrine Injector
*Anaphylaxis* Adult- 0._ _:\_\_\_ Pediatric- 0.\_\_ _:\_\_\_\_
- 3
1: 1000 - 15
1: 2000
CO
CO is a ______, odorless, ______ gas by product of most _____ reactions
Colorless
Invisible
Combustion
CO
Indication- CO screening should be performed on all ______, _______, and _____ staff during rehab. Be aware of those in ________ to the event. I.e _____ and all_____ of the buildings with CO detector activations.
Patients Firefighters Command proximity Police occupants
CO
Symptoms- 9 total
Headache Dizziness Weakness Vomiting SOB Chest Pain Palpitations (tachypnea) Nausea May describe flu like symptoms Confusion/alt mental status
CO
______ patient(s) and all_____ from area to _____ air
Obtain an _____ of______ time, if possible
Evacuate Personnel Fresh Estimate Exposure
CO
Support ___’s _____ flow _____ via____
ABC’s
High
Oxygen
MNR
CO
CO poisoning typically will yield normal _______ _______ levels, despite _________ intoxication. Treatment should ____ be guided in any way by readings obtained.
Pulse Oximetry
Significant
NOT
CO
Measure SpCO level (available on _____ and ______)
When using SpCo monitoring attention to ____ probe _______ and _____ from light will ____ accuracy of measuring SpCO levels.
Battalions LifePak 15 Proper Placement Shielding Improve
CO
If ___ is altered in any way, measure ___ _____ _____ with ________.
LOC Blood Glucose Level Glucometer
CO
<3%=
No Further evaluation of SpCO required
&
Transport is the Patient’s prerogative.
CO
SpCO 3%-10%
If noted as a smoker this may be normal for them.
Transport- Assess for signs and symptoms. Symptomatic/Asymptomatic and should be medically evaluated.
CO
>3% greater than 25%
With LOC, neurological impairment admin high flow 02, consider CPAP if Avail.
Transport to a hospital with HBO (Hyperbaric Oxygen)
Level 1
CO
>3 but less than 25%
Not exhibiting decreased levels of consciousness or neurological impairment admin high-flow O2.
Monitor for other signs of CO poisoning.
Transport- Level 2 to the closest appropriate facility.
CO
>15%
Prenant patients with SpCO reading of greater than 15%, even if asymptomatic, administer high flow O2.
Level 1 medical- transport to hospital with HBO- Hyperbaric oxygen.
Diabetic
History of _____ excess: ,_____ missed meal, _____, vomiting or______
Insulin
overdose
exercise
Diarrhea
Diabetic
Respirations- 3 items
Shallow, slow, or snoring
Diabetic
What do you do about 02?
Provide 02, monitor Sats
Diabetic
BGL of
60
Symptomatic
Diabetic
If patient is____ and able to swallow with an ____ ___ reflex administer 1 ___ of instant glucose or _____ ________
Alert Intact Gag tube Sugar Substitute
Excited Delirium
Patients that are hyper _______ with _______ behavior and are _______ to pain, combative, hyper___, and _____cardic
Aggressive Bizarre Impervious Hyperthermic Tachycardic
Excited delirium
Patient’s are typically in a struggle with _____ _________ that involves physical, ______ chemical (tear gas, _____) or ECD use (_____) followed by a period of ____ and sudden _____.
This is a _________ emergency!
Law enforcement Noxious Mace Taser Quiet Death Medical
Excited delirium
If patient is ________- apply ____ packs to neck, ______ and _____ or cooling with water, ______ (do not promote______)
Hyperthermic Cold Axilla groin fanning
Hyperglycemia
Patients with hyperglycemia may progress to _______ __________ (___) that may cause severe ______ and Metabolic _________.
Diabetic Ketoacidosis
DKA
Dehydration
Acidosis
Hyperglycemia
Pulses: ______cardic and _____ pulses
Tachycardic
Thready
Hyperglycemia
Respirations=
Kassmaul
Hyperglycemia
Patient may present with ____tension, dry ______ membranes, skin may be___ (consider ____thermia), and a _____ odor (fruity smell)
Hypotension mucous Cool Hypothermia Ketone
Hyperglycemia
Other symptoms may be ______ pain, nausea, vomiting, poly_____ which is excessive ______, and poly____ which is excessive _____. Along with sustained _____ glucose levels.
Nausea Polyuria Urination Polydipsia Urination Elevated
Hyperglycemia
As a basic you can evaluate _____ status, administer ______ and _____ oxygen saturations, and check ____.
Mental
Oxygen
Monitor
BGL
Hyperglycemia
A patient is considered hyperglycemic if they are >___mg/dl and _________
250
Symptomatic
Hypertension & Hypertensive Crisis
Assess for _______ of breath, _______ mental status, ______ headache, ______ (nose bleed), ______ (ringing ears), change in ______ acuity, ______, ECG_____, Nausea, and ______.
Shortness Altered Vertigo Epistaxis Tinnitus Visual Seizure Changes Vomting
Hypertension & Hypertensive Crisis
BLS- ___’s per patient’s ____, ______ monitoring, _____ signs, and there is epistaxis ____ to stop by______ nostril or _____ clip.
ABC needs Glucose Vital Attempt Pinching Nose
Hyperthermia
____ cooling is essential
Rapid
Hyperthermia
Three types of heat emergency=
Heat Cramps
Heat Exhaustion
Heat Stroke
Hyperthermia
Any heat related condition with a temp of >___ F or ____C or any _____ _____ of ________ should be treated as heat stroke and transported ______.
104 40 Altered Level Consciousness Rapidly
Hyperthermia
Remove patient to a _____, _____ area.
Cool
Shaded
Hyperthermia
Remove patient’s ______ and cool patient with wet _____; low-pressure ____ ______ may be used to continually re-___ the patient.
Clothing Sheets Water Hoses wet
Hyperthermia
Manually __ the patient to promote cooling by ________.
Cool
Evaporation
Hyperthermia
Apply ____ packs to, ____, axilla, and _____.
Cold
Neck
Groin
Hyperthermia
DO NOT ____ __ ____. Dangerous reversal to ______ may occur.
Pack in Ice
Hypothermia
Hypothermia and Frostbite
Hypothermia core body temp BELOW___ and ___ celcius
- 0
35. 0
Hypothermia and Frostbite
Mild hypothermia= ___ to ____ F and ___ to ____ C.
95
90
35
32
Hypothermia and Frostbite
Moderate Hypothermia is ___ to ___ F and ___ to ___ C
90.0
82.0
32
28
Hypothermia and Frostbite
Severe hypothermia is
82
28
Hypothermia and Frostbite
If a patient is not in _____ arrest, and they have adequate respirations _____ handling could cause _____ arrest.
Cardiac
Rough
Cardiac
Hypothermia and Frostbite
A patient who isn’t in cardiac arrest with adequate respirations should be _______ to a _____ environment, have _____ clothing removed, _____ in dry blankets, and have their ____ covered and _____ against further heat loss.
Moved Warm wet covered head insulated
Hypothermia and Frostbite
Frostbite injuries should be handled as follows: _____ remove _____ from injured part, _____ injured part from ____, trauma, and ______. Loosely _____ injured parts with _____ sterile dressing.
Gently Clothing Protect Pressure Friction Cover Dry
Hypothermia and Frostbite
Do not ____ or ___ a frostbitten area. Do not attempt __-______ of the injured part.
Massage
Rub
Re-warming
Hypothermia and Frostbite
Cardiac arrest with respirations less than 5 per minute.
Ventilate _____ at _-__ per minute.
Basic BLS with application of ___.
After first ____ (if given), ______ use of AED, and proceed with BLS and CPR only.
Continued _________ is contraindicated in acute hypothermia.
Slowly 8-10 AED Shock Discontinue Defibrillation
Nausea and vomiting
Criteria- Nausea, ______ vomiting or those ______ vomiting after arrival with no other ______ or _____.
Prolonger
Actively
Symptoms
Complaints
Nausea and vomiting
Assess and support ___’s
Oxygen and airway _____ to maintain Sp02 of at least __%
Place patient is position of _____. ______ ______ recumbent position, or ____ with legs elevated with ____ at hips unless ______ compromise or ____________.
Asses ___ and treat for _______ if protocol is met
ABC Maintenance 94 Comfort Left Lateral Supine Flexion Respiratory Contraindicated BGL Hypoglycemia
Near Drowning
Info needed: Description and ______ of fluid in which submerged.
_____of time submerged. More than ____ hour = refer to obvious DOS protocol.
Those _____ than ___ hour or ______ time should be ________.
Note _____ and type of _____. Consider a diving incident.
Possibility of _____ or _____/medication consumption.
Temperature Note One Less One Unknown Resuscitated Depth Type Alcohol Drug
Near Drowning
Airway management- ______, oral, ______, suction
Lung sounds: ___- or signs of _______ edema, ________ distress.
_____ spine ______ to removing patient from ______
Wet clothing should be ____. Keep patient ___ and _____.
Ventilations Nasal Rales Pulmonary Respiratory Stabilize Prior Water Removed Warm Dry
**Respiratory** BLS steps \_\_\_\_\_ patient in a \_\_\_\_\_ of comfort \_\_\_\_\_\_\_ Oxygen as \_\_\_\_ The goal is patient care is to reach an Oxygen sat of \_\_\_
Place
Position
Administer needed
96%
Respiratory
Caution- High _______ of _____ may suppress the COPD patient’s _______ to an ________ level.
Concentrations
Oxygen
Respirations
Inadequate
Respiratory
COPD- Cautions
Be prepared to ________ ventilations but __ ____ decrease oxygen ________.
Assist
DO NOT
Concentrations
Respiratory
COPD cautions
______ withhold oxygen from a ______ patient.
The goal of patient care for a COPD patients is to reach an oxygen saturation of __-__%
NEVER
Hypoxic
88-92%
Respiratory
If a patient has a ______ and _____ inhaler, you may ____/____ them to take puffs as prescribed. (some patients may have _____ puffs prescribed)
Prescribed Unexpired Assist Allow Several
Respiratory
Be prepared to assist _______ with ___ for patients who are ______ (__resp/min)
Ventilations BVM Bradypnic 10 Tachypnic 30
Seizures
Assess and support ___s
Airway management, o2, Pulse ox, and maintain sats of >__%
__ ___ force anything between ____.
Anticipate ______
Protect patient from injury. ____ hazardous objects away from patient and protect ____ and _____ spine from injury.
ABC 94% DO NOT Teeth Vomiting Move Head Cervical
Seizure
__ ___ forcefully ____ an actively seizing patient.
Protect _-____ if patient fell.
If no trauma, place patient is position of ____, or ___ _____ ____ position.
Do not Restrain C-Spine Comfort Left Lateral Recumbent
Seizure
If pediatric patient with temperature >___._ (__ C) provide supportive care and ______ cooling by ______ the patient.
100.4
38
Passive
Undressing
Seizure
If patient is actively seizing for _ or more minutes, look for a history (Trauma,____, Pregnancy, _____ ________)
5
COPD
Severe Hypertension
Sepsis
Recent surgery __ __ days
<10
Sepsis
Symptom
Cough with thick _______
Sputum
**Sepsis Symptom** #s Temp >\_\_\_ F (\_\_ C) or \_\_ Resp >\_\_ Systolic
101 38 96.8 36 90 20 90 65
Sepsis
O2 saturation >__%
94
**Asthma*
Status _______ is an acute exacerbation of asthma that does not respond to standard treatments of ________ and _______
Asthmaticus
Bronchodilators
Steroids
**Asthma*
Approx ___,___ deaths _____ worldwide due to ______.
250,000
Annually
Asthma
Asthma
Goal for for patient care is to reach a 02 sat of __%
96%
Asthma
Symptoms include wheezing, _____ __ _____, _____ tightness, and coughing. Other possible signs include _____ and cyanosis.
Shortness of breath
Chest
Retractions
Asthma
Sats for a patient with COPD=
88-92%
*Asthma* Patient can be admin'd Albuterol: Between ages of _ and \_\_ Physician \_\_\_\_\_\_\_\_ history of asthma Been prescribed a \_\_\_\_-\_\_\_\_ before Is \_\_\_\_\_ and/or \_\_\_\_\_ of \_\_\_\_\_.
5-70 Diagnosed Beta-agonist Wheezing Short of breath
Asthma
If patient has a previous ______ history (Angina, AMI, HF, Dysrhythmias) contact ___ ______ for authorization to admin ________.
Cardiac
Med Control
Albuterol
Asthma
Nebulized albuterol may be admin’d _____ for a total of _____ doses if condition does not improve.
Twice
3
Stroke
Symptom- Unusual or severe _____ or ____ pain.
Neck
Face
Stroke
Aphasia/Dysphasia=
Unable to speak, slurred speech, or difficulty speaking
Stroke
Sensory loss to ___ or ___ limbs
One
More
Stroke
Ataxia= 3 things
Poor balance
Clumsiness
Difficulty walking
Stroke
Non-traumatic, visual ______/____ (_____ effect)
Disturbance
Loss
Curtain
Stroke
O2 sats =
> 94%
Stroke
Position patient with ___ and ___ elevated to __ degrees, or in ______ of ______.
Head
Chest
30
Position of comfort
Stroke
Focus history= last ___ seen ______ signs/symptoms
Time
without
Stroke
Protect ________, if noted __________, evaluate body temperature.
Extremeties
hemiparesis
Level 1 trauma
Airway: Obstruction and/or _______
Respiratory rate: Respiratory ______, or Respiratory _____ of __/min
Systolic:
Intubation Compromise Rate 10 29 90 13
Level 1 trauma Pedi
Respiratory rate
20
1
Ventilator
Level 1 Pedi
Systolic < 70+ (_x___)
2
Age
Level 1
All penetrating injuries to the:
Head Neck Torso Groin Extremities proximal to the Knee or Elbow
Level 1
Chest wall deformity/instability=
Flail chest
Level 1
Limb ________
Paralysis
Level 1
Amputation ______ to the ____ or _____
Proximal
Wrist
Ankle
Level 1
Pelvic _____
Fractures
Level 1
Open or ______ skull _____
Depressed
Level 1
C____, De-______, or _______ pulseless extremity
Crushed
De-gloved
Mangled
Level 2 Trauma
____ mechanism of injury and the _____ of ____-energy impact. Transport to trauma center ______ lights and sirens
Assess
Evidence
High
Without
Level 2 trauma
Contact ______ _____ for permission to upgrade to _____ and ____ with the patient remaining at the level II status for the _____ appropriate ______ hospital.
Medical Control Lights Sirens Closest Trauma
Level 2 trauma- Burns
__ Degree burns= involve the ____ (including ears), ____, feet, ____, perineum or ______ joints.
2nd Face Hands Genitalia Major
Level 2 trauma- burns
>__% total BSA
&
___ degree burns
10
3rd
Level 2 trauma- falls
_____ falls greater than ___ ft (1 story = __ft)
Adult
20
10
Level 2 trauma- falls
Children falls >__ or __ times the height of the child
10
2
Level 2 trauma- high risk auto crash
Intrusion, including_____ >__ inches occupant site > __ inches ___ site in the occupants (_______) compartment.
Ejection (_____ or ______) from vehicle
______ in the same passenger compartment
Vehicle ______ data consistent with high risk of injury
Roof 12 18 any Interior Full Partial Death Telemetry
Level 2 trauma
____ versus pedestrian/bicyclist thrown, run over, or with significant (>__) impact.
Motorcycle collision > __ MPH
Vehicle
20
20
Level 3 trauma
_____ patient not meeting Level 1 or 2 criteria.
Stable
Considerations for transporting patient to a trauma center
Older adults: ____ of death increases after __
SBP
Risk 55 110 65 Low Ground Severe
Trauma Special considerations
Children ____ be triaged ________ to a pediatric _____ trauma center.
Should
Preferentially
Capable
Trauma- anti-coagulation and bleeding disorders
Watch those with head injuries for ______ deterioration.
Rapid
Trauma & burns
Burns with trauma mechanism triage to ________ trauma facility
Appropriate
Department Protocol
___ patients will be transported Level 2 or Level I for a ____ drowning. If physiological ____ or ____ are present. Transport to the appropriate ______ designated hospital.
All Near Signs Symptoms Trauma
Abdominal Trauma
If evisceration is present, ____ with ____ dressing _____ with sterile normal saline and _____ loosely in place.
Cover
Sterile
Moistened
Bandage
Abdominal Trauma
__ ____ attempt to replace protruding ____ into abdominal cavity.
Do Not
Tissue
**Burns: Thermal, Chemical, Electrical and Inhalation Injuries*
Ensure _____ process is _____
The use of ____ water or _____ ______ solution and the removal of any smoldering ______ should be applied if indicated.
Burning Stopped Tepid Normal Saline Clothing
**Burns: Thermal, Chemical, Electrical and Inhalation Injuries*
Do not ___ ___ clothing that is ____ to a burn, ___ around it.
Pull Away
Stuck
Cut
**Burns: Thermal, Chemical, Electrical and Inhalation Injuries*
Look for evidence of _______ injury.
(H_______, S______, So___ S____, F____ B___, or singed Nasal or Facial hair.
Inhalation Hoarseness Stridor Sooty Sputum Facial Burns
**Burns: Thermal, Chemical, Electrical and Inhalation Injuries*
__ ____ use the __________ airway in a patient with Thermal or Chemical airway injury. If airway management is indicated, ____________ airway is the preferred adjunct.
Do Not
Supraglottic
Orapharengeal
**Burns: Thermal, Chemical, Electrical and Inhalation Injuries*
Remove J____, B____, S____ from burn areas.
Apply a ____ sterile ____, clean or ______ sheet to burned area.
Keep _____ intact.
Monitor to prevent _______
Estimate burn size with ______
Jewelry Belts Shoes Dry Dressing Sterile Blisters Hypothermia Rule of Nines
**Burns: Thermal, Chemical, Electrical and Inhalation Injuries*
Second Degree burns- transport any patient with >__% BSA and burns involving the F___, (including ears), h___, f___, g____, p____, or major ____ associated with trauma to a _____ center as a level___.
10 Face Hands Feet Genetalia Perineum Joints Trauma Two
Chemical Burns
_____ contaminated clothing
____ area immediately with ______ amounts of water. Use s_____, g____ h____, or low pressure Fire Suppression app if necessary.
Remove Flush Copious Shower Garden Hose
Chemical Burns
If ___ are affected, have patient remove C____ L____ if present and irrigate with _____ amount of _____ water or ____ at the scene and _____.
Eyes Contact Lenses Copious Sterile Saline Enroute
Chemical Burns
In ____ chemical burns (____ lime, etc) addition of ____ may produce a very _______ substance.
To treat, remove the patient’s____ and _____ the ______ _____ away from the skin. Then ______ with copious amounts of water.
Dry Dry Water Corrosive Clothing Brush Dry Chemical Irrigate
Electrical Burn
Conduct ____-___ exam for ____ & ____ burns, P____, Muscle Spasms, and abnormal pulse and or /.
Asses for F____ and D______ associated with severe M_____ S____ or Falling.
_____ induced by electrical shock may mimic r____ m____ DO NOT ______ Cpr.
Head toe Entry Exit Paralysis B/P Fractures Dislocations Muscle Spasms Tetany Rigor Mortis Withhold
Lightning strike
After a lightening strike or other high-voltage contact involving _____ patients apply “_____ triage.”
Patient in Cardiac Arrest are __ priority for _____ treatment and transport.
Multiple
Reverse
Top
Advanced
Chest Trauma
Assess b_____ s____.
Cover suspected _____ chest wounds with an _______ dressing (sealed on _ sides)
Stabilize Fr____ and/or f____ segments
Breath sounds Open Occulsive 3 Fractures Flail
Chest trauma
Be v_____ for developing T______ Pneumothorax
Vigilant
Tension
Chest Trauma
If Tension Pneumothorax is s_____, release the ____ over the wound and allow any air under p____ to escape.
Then r____ the wound with _ sides of dressing secured and one f___ edge, and monitor the patient.
Suspected Seal Pressure re-seal 3 free
Epistaxis
If epistaxis is spontaneous and the patient is a____ with s_____ vital signs, have the patient L____ F____ (if there is no neck or spine injury), and using M______ pressure, P_____ the nostrils together.
Alert Stable Lean Forward Moderate Pinch
Epistaxis
Pt with epistaxis is hypotensive/ Altered, with no trauma mechanism, what do you do?
Place them in a lateral recumbent position.
Admin 02
Be aware of vomiting
Epistaxis
If epistaxis due to trauma
Immobilize C spine.
Eye injury
Laceration to eye/eye lid
___ ____ apply pressure to the eye ball
Cover ___ eyes with loose dressing
______ avulsed parts in a clean plastic bag
Do not
both
Preserve
Eye Injuries
Foreign bodies
Do NOT ____ eye
Noted foreign body _____ to _____ with normal saline
Wipe
ATTEMPT
IRRIGATE
Eye Injuries
Non-impaled= cover____ eye(s)
BOTH
*Eye injuries* Impaled- \_\_\_ \_\_\_\_ remove. \_\_\_\_\_\_ with a paper cup and bulky dressing. Cover the \_\_\_\_\_\_ eye.
Do NOT
Stabilize
Unaffected
Eye Injury
Avulsed eye=
Cover+sterile dressing+ sterile saline/normal saline/ tap water+ ASAP
eye injuries
Chemical burns=
Irrigate+ tap water/ saline/ normal saline+ asap+ throughout transport.
Fractures/Dislocations
Assess _____ circulation and sensory & motor function before and after splinting (CMS)
For suspected _____ and ____ fractures a ______ splint is REQUIRED
Distal
Femur
Pelvic
Traction
Fractures/dislocations
Severely _______ fractures with compromised _____ may require alignment prior to _______.
Angulated
Circulation
Immobilization
Fractures/dislocations
Dislocations of the E____, W_____, K____, or A_____ are emergencies in which time passed until r________ is critical in determining thee future use of the joint. Do not p_____ transport to carry out procedures or E______ immobilization.
Elbow Wrist Knee Ankle Reduction Prolong Extensive
Fractures and Dislocations
The two fractures which are immobilized by a sling and swathe are?
Clavicle
Humerus
Shoulder dislocation is treated how?
Splinted in position found
Elbow fracture OR Dislocation are immobilized how?
Splinted in position found
Radius/Ulna fracture is immobilized how?
Rigid splint and sling.
Wrist fracture is immobilized how?
Splint in position found
All victims of trauma have ______ injury until proven ______
Spinal
Otherwise
