Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DipIMC > Operational Practice > Flashcards

Operational Practice Flashcards

1
Q

Which agency regulates helicopter operations in Europe?

A

European Aviation Safety Agency (EASA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does the EASA define as a HEMS flight?

A

A flight by helicopter, operating under a HEMS approval to facilitate emergency medical assistance, where immediate and rapid transportation is essential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

To be a HEMS flights the EASA states you need to be carrying one of what 3 things?

A
  1. Medical personnel
  2. Medical supplies
  3. Ill/injured persons or other persons directly involved
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

If not meeting HEMS criteria what is a AA flight called?

A

Air ambulance mission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How large should a landing zone be for a helicopter?

A

Over twice size of discs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What regulates PPE in the UK?

A

Health and Safety Executive in the PPE at Work Regulations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the JESIP hierarchy of control measures?

A

ERICPD

Eliminate
Reduce
Isolate
Control
PPE
Discipline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What should be the standard of helmet?

A

Fire fighting standard
= EN443

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the European standard for High vis?

A

EN471

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the minimum class of garment for working on motorways/dual carriageways?

A

Class 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What specifications make a ‘class 3’ garment? (2)

A
  1. Mimimum 0.8m2 flourescent background
  2. Minimum 0.2m2 retro-reflective materials
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What 3 things should appropriate boots have?

A
  1. Toe cap to withstand > 200J
  2. Minimum height 4 inches
  3. Chemical resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What should flight suits be made of and what type of fire do they protect from?

A
  1. Nomex or Kermel
  2. Flash fire (4-5 secs flame)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What proportion of major trauma have SCI and of these how many have severe, time critical injuies?

A
  1. 0.7%
  2. 50%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the benefit of self extrication?

A

Shown to reduce movement of cervical and lumbar spine, improved further with a collar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe a ‘rapid extrication?’

A

Lateral extrication via closest apperture (usually door). Rescue board slid into car seat and patient rotated then laid down and pulled up board, MILS ideally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe a B post rip

A

Rear doors opened and cut lower then upper B-post, then entire side of vehicle can pivot on front hinge of A post

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a ‘roof off extrication’?

A

Historial gold standard
Removed removed, board placed behind patients back and seat lowered (if poss). Patient then pulled up board with MILS
Slow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can FRS do to improve access to a vehicle on its side?

A

Roof fold down:

  • upper supporting posts cut
  • roof folded down
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What do things can FRS do to improve access to a vehicle on its roof? (2)

A
  1. B-post rip
  2. Roll back onto wheels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is a dashboard roll used for?

A

Footwell entrapment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe chain cabling and what it is used for?

A

Chains to front and rear posts, winch used to apply traction.

Reverses vehicle damage forces associated with frontal collision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How long does chain cabling take?

A

12.5 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe the 3 parts to the FPHC extrication decision tool

A
  1. Can the casualty self extricate
  2. Is a snatch rescue indicated?
  3. Deliver quickest appropriate extrication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the FPHC recommended first line extrication method?

A

Self/minimally assisted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the acronym USTEP, what is it used for and who recommends it?

A

FPHC

Non-clinicians for helping self extricate

Understanding (get patient understand)
Support (emotionall)
Try moving (if unable then can’t self extricate)
Egress (clear route out)
Plan - where will they go next (chair/trolley)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Under what circumstances does FPHC state MILS is not needed?

A

Fully conscious and no neurology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

If patients have neurology what extrication measure does FPHC recommend

A

Rapid extrication with gentle handling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

When does the FPHC recommend using a hard collar in extrication? (2)

A
  1. Suspected serious neck injury
  2. GCS <15 + evidence of significant injury to any body compartment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

When should a binder be placed during extrication according to FPHC?

A

After extrication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the components of HAVNOT and what is it used for?

A

Predicting difficult airway

Hx of difficult airway
Anatomical abnormalities
Visual clues (beard, BMI etc)
Neck immobility
Opening mouth <3cm
Trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What acronym is used to predict difficult BMV?

A

Mask seal difficulty
Obesity, Obstructed airway
Age >55yrs
No teeth
Snorer, Stiff lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What acronym is used to predict difficult SAD insertion?

A

Restricted mouth opening < 3 fingers
Obstruction at larynyx or below
Distorted airway
Stiff cervical collar, Stiff lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the acronym SHORT?

A

Predicting difficult cricothyroidotomy

Surgery, Scars, Short neck
Haematoma
Obesity, Oedema
Radiotx
Trauma, Tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the sizes of OP airway and who are they used for? (7)

A

000 - neonate
00 - infant
0 - small child
1 - child
2 - small adult
3 - medium adult
4 - large adult

36
Q

How are OPAs measured?

A

Incisors to angle of jaw

37
Q

What size NPA is used usually for:
1. Men
2. Women

A
  1. 7.0
  2. 6.0
38
Q

How should NPAs be measured?

A

Nostril to tragus of ear

39
Q

Describe the IGel sizes

A
40
Q

What is the mechanism of action of ketamine?

A

NMDA receptor antagonist

41
Q

What type of drug is ketamine?

A

Procyclidine derivative

42
Q

What causes the bronchodilation/sympathomimetic actions of ketamine?

A

It is a partial antagonist of muscarinic receptors

43
Q

What is the onset time of ketamine:
IV
IM

A

30 secs

6 mins

44
Q

What is propofol?

A

2-6 di-isopropyl phenol

45
Q

What is the mechanism of action of propofol?

A

Potentiates action of GABA at GABA receptor?

46
Q

Which paralytic is:
1. depolarizing
2. repolarizing

A
  1. Suxamethonium
  2. Rocuronium
47
Q

What are the disadvantages of suxamethonium? (4)

A

Bradycardia
Hyperkalaemia
Raises ICP/ intra-ocular pressure
Malignant hyperthermia

48
Q

Why do paediatric patients become bradycardic when SATs drop?

A

Dominant parasympathetic system

49
Q

When does DAS recommend using needle cricothyroidotomy?

A

< 8 years old unless previous ENT experience

50
Q

How should a needle cricothyroidotomy be performed?

A

-14 to 16G cannula inserted angled 45 degrees caudally
- syringe attached and when loss of resistance flatten angle of cannula and advance further 2-3mm
- remove needle and attach pre-prepped 3 way tap with all ports open with 02 tubing
- set oxygen to rate L/min (patients age)
- occlude 3 way tap for 1 sec, open for 4 secs, 1:4 (if not completely obstructed should be some passive exhalation via airway)

51
Q

What blades should be used for:
- pre-term
- term
- 1 year (infant)
- 2 year
- > 2 years

A
  • pre-term = Miller 0
  • term = Miller 1
  • 1 year (infant) = MAC 1
  • 2 year = MAC 2
  • > 2 years = MAC2 or 3
52
Q

How much oxygen Fi02 is delivered via NC?

A

4% per 1L/min (up to 4L)

53
Q

When should a NRB be used?

A

If need Fi02 >50%

54
Q

How much oxygen does each venturi allow?

A

Blue = 24 %
White = 28%
Yellow = 35%
Red = 40%
Green = 60%

55
Q

What are the different oxygen cylinders capacities?

A
56
Q

What are the 3 receptor types involved in shock physiology?

A
  1. Arterial baroreceptors
  2. Cardiac C-fibres
  3. Arterial chemorecptors
57
Q

Which receptor triggers the baroreceptor reflex?

A

Arterial baroreceptors

58
Q

Describe the baroreceptor reflex in shock

A
  • Pressure receptors within aortic arch and carotid sinus that respond to stretch
  • decreased volume activates these leading to an increased HR and peripheral vasoconstriction
59
Q

Where are cardiac c-fibres located and what reflex do they initiate?

A
  • Left ventricle
  • Depressor reflex
60
Q

Describe the Depressor Reflex in shock?

A
  • cardiac c-fibres are mechanorecptors in the LV that respond to excessive cardiac activity in context of hypovolaemia
  • leads to bradycardia and peripheral vasodilation
61
Q

Where are arterial chemoreceptors located?

A

Carotid and aortic body

62
Q

Describe arterial chemoreceptors role in shock?

A
  • in carotid and aortic body that responds to acidosis and hypoxia
  • increased minute volume and surpresses cardiac c-fibre mediated reflex
  • leads to ‘air hunger’ and acts to augment venous return via thoracic pump
63
Q

Describe the physiology involved in shock associated with blunt trauma

A
  • Baroreceptor and arterial chemoreceptor predominate. Therefore tachycardia and peripheral vasonstriction and increased minute volume
  • Tissue injury and pain suppress c-fibres therefore depressor reflex less common
64
Q

Describe the physiology involved in shock and penetrating trauma

A
  • Major vascular and haemorrhage can occur without significant tissue injury/pain
  • At a critical right atrial pressure cardiac c-fibre medicated depressor reflex causes vagal mediated bradycardia and decreased peripheral vasoconstriction.
  • Results in drop in cardiac output and worsened shock
  • biphasic response
65
Q

Describe the physiology of shock in arterial injury shock

A
  • Sudden loss of elastic arterial diastolic recoil due to major arterial vascular injury
  • decreased arterial diastolic pressure leads to imparted LV coronary pressure and immediate/profound shock
  • more common in penetrating trauma
66
Q

Desrcibe TBI related shock

A
  • Catecholamine surge and sympathetically mediated local noradreanline affects myocardium
  • Concurrently increased ventricular afterload, hypoxia, hypercapnia and other shocked sates leads to myocyte injury and acute onset cardiomyopathy
67
Q

What is in the ‘heightful 8’ signs/symps shock?

A
  1. Diaphoresis
  2. Pallor
  3. Venous collapse
  4. Decreased ETC02
  5. Air hunger
  6. Altered mental states
  7. Abnormal HR
  8. Hyptotension
68
Q

Describe te pre-hospital haemostatic ladder (5 parts)

A
  1. Wound dressing
  2. Direct pressure and elevation
  3. Indirect pressure
  4. Haemostatics
  5. Tourniquets
69
Q

What are the 2 types of haemostatic gauze and give an example of both?

A

1.Factor concentrators - Quickclot
2. Mucoadhesive agents - Celox

70
Q

How to factor concentrator haemostatic gauze work?

A

Granules absorb water, concentrate coag factors, promotes clotting

71
Q

How do mucoadhesive haemostatic gauze work?

A

Chitosan based
Anionic attraction of red cells, increases adherences to wound surface

72
Q

Where does a proximal tibial IO go in an:
1. adult
2. child

A
  1. 1 finger medial to tibial tuberosity
  2. 1 finger below and 1 finger medial to tibial tuberosity
73
Q

Where does a distal tibial IO go in an:
1. adult
2. child

A
  1. 3 fingers above tip of medial malleolus
  2. 2 fingers above tip of medical malleolus
74
Q

Where is a femoral IO placed?

A

2 fingers above patella just off midline (medially)

75
Q

When is a femoral IO useful?

A

Infants

76
Q

How is resp rate measured using monitoring

A

Small AC current via ECG lead 1 (adult) or II (paeds) measures change in thoracic impedance

77
Q

What are the flow rates through each cannula size?

A
78
Q

How does a pulse oximeter work?

A
  • measures absorption of red (660nm) and infrared light (940nm)
  • oxy and deoxy haemoglobin have differing absorptions and the proportion is measured around 50 x / sec
79
Q

What is the issue with CO poisoning and oximetry?

A

Most oximeters unable to differentiate between carboxyhaemoglobin and oxyghaemoglobin therefore will interpret patients saturation as incorrectly high

80
Q

Why do patients with methaemoglobinaemia have low saturations?

A

Pulse oximeter doesn’t measure methaemoglobin and therefore will show low SATs for given Pa02

81
Q

What is a normal range for ETC02

A

4.0-5.7 kPA

82
Q

Describe the sections of a normal capnography waveform

A
83
Q

What values of causes the colormetric capnography to be:
- yellow
- purple

A

Yellow = ETCO2 >15mmHg
Purple = ETC02 <4mmHg

84
Q

What size should the optic sheath measure on US?

A

<5mm when measured 3mm away from optic disc

85
Q

What does an optic sheath size >6mm suggest?

A

ICP >20cm H20

86
Q

What is the oxygen concentration for transfer?

A

(MV x transfer time + ventilator consumption) x 2

87
Q
A

DipIMC (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions