PMACI - 4H's & 4T's

Question 1

HYPOXIA

Answer 1

• I-GEL in place
• ETCO2 value good box wave form (1.2 - 2.0)
• Billateral chest rise and fall
• Enough O2 in the tank

Question 2

HYPOVOLEMIA

Answer 2

• Any recent D&V
• No distended abdomen - no sign of internal bleeding
• No signs of triple A

Question 3

HYPERKALEMIA

Answer 3

• No fistulas or signs of dialysis
• Peak T waves on the ECG

Question 4

HYPOTHERMIA

Answer 4

• Room temperature
• Is patient warm to touch
  (ADRENALINE & ATROPINE ARE CONTRAINDICATED)

Question 5

TENSION

Answer 5

• On auscultation, no reduced air entry and equal chest rise
• No visible puncture wounds to the chest or any other trauma

Question 6

THROMBUS

Answer 6

• PMH of a DVT, PE or MI
• Did the patient clutch their chest on their way down / pain in chest
• Any swelling in the legs to indicate DVT

Question 7

TOXINS

Answer 7

• Are there any signs of drug paraphernalia
• Any recent change in medication

Question 8

TAMPONADE

Answer 8

• Was there any blunt force trauma
• Any penetrating trauma
• Recent heart surgery? (scars)