Pearls Flashcards
General Adult Assessment Pearls
Initial assessment and tx in accordance with approved triage methodology.
Correct life-threatening problems as identified.
Unable to adequately ventilate, pt must be transport to nearest facility.
Never withhold oxygen if pt is in respiratory distress.
Contact with online medical via radio.
Phone call only if patched through
from FAO.
General Adult Trauma Assessment pearls
Exam: mental status, skin, HEENT, heart, lungs, abd, extremities, back, neuro
Transport destination based on Trauma Field Triage Criteria Protocol
Procedures should not delay transport - complete enroute
BVM acceptable method of ventilation and airway management if pulse ox >= 90%
High index of suspicion for geriatric due to compensation of occult injuries
ABD, Flank pain, N/V pearls
Exam: Mental Status, skin, HEENT, heart, lung, abd, back, extremities, neuro.
Aneurysm - signs of neuro or hypoperfusuon w/ abd pain
Document mental status and vitals prior to antiemetics and pain management
Consider cardiac and perform EKG if patient >= 35 y/o
Retroperitoneal palpation for kidney pain
Consider pregnancy in women of childbearing age
Allergic Reaction pearls
Exam: mental status, skin, heart, lung
Anaphylaxis- acute and potentially lethal multi system allergic rxn
Epi: first-line drug administered for acute anaphylaxis. IM Epi (1:1,000) before or during IV/IO attempts
Contact medical control for refractory anaphylaxis
Consider ETCO2 monitoring
Fluid bolus prior to push-dose pressure for hypovolemia or distributive shock
Epi considerations: geriatric population, CAD HTN or tachycardia. Administered only if sxs severe
AMS pearls
Exam: mental status, skin, HEENT, heart, lungs, abd, extremities, back, neuro
Careful attention to head exam for signs of injury
AMS could be environmental or Haz-Mat exposure. Protect personal safety and other responders
ETOH not a common cause for unresponsiveness to pain
OD or hypoglycemia, administer Narcan or Glucose prior to advanced airway
Behavioral Emergency pearls
Law Enforcement for potentially violent patients
No circumstances for pt to be restrained prone
Exam: mental status, skin, heart, lung, neuro
Consider all medical/trauma for possible causes
Do not irritate with prolonged exam
Mandatory reporters if suspected abuse
Consider ETCO2 monitoring
Bradycardia pearls
Exam: mental status, HEENT, heart, lung, neuro
Bradycardia <50 bpm. Rhythm interpreted in context of sxs and pharmacological tx when symptomatic. Otherwise monitor.
Identifying sxs of hypoperfusion paramount
Do not delay pacing for IV access
Hypovolemia common cause of bradycardia. Oxygenate and ventilate pt as needed
Burns pearls
Burn pts = trauma pts. Evaluate multi system trauma
Stop burning process
Exam: mental status, HEENT, neck, heart, lung, abd, extremities, back, neuro
Consider early intubation w/ significant inhalation injuries
Potential CO exposure treat w/ 100% oxygen. Transport to hospital with hyperbaric chamber if CO inhalation.
Circumferential burns = dangerous for vascular compromise secondary to swelling
Burn pts prone to hypothermia - never apply ice or cool burns. Maintain nl body temp
Consider ETCO2 monitoring
