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Bachelor of Paramedic Science > Procedures And Skills > Flashcards

Procedures And Skills Flashcards

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1
Q

Arterial Tourniquet Complications

A

Compartment syndrome
Embolism
Fractures
Ischemia
Permanent nerve damage, muscle injury, vascular injury, and/or skin necrosis
Pain
Reperfusion injury when released

NOTE: All risks must be balanced against the risk of exsanguination

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2
Q

Arterial Tourniquet Contraindications

A

Bleeding that can be controlled using simple measures such as direct AND/OR indirect pressure

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3
Q

Arterial Tourniquet Indications

A

Life threatening haemorrhage not controlled by direct AND/OR indirect pressure

Multiple casualties with extremity haemorrhage and lack of resources to maintain simple measure of haemorrhage control

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4
Q

BVM Sizes

A

BVM Sizes

Adult >23kg - 1500/1200mL

Paediatrics 6.5-23kgs - 550/330mL

Neonate _<_6.5kg - 300/160mL

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5
Q

What are the Cardiopulmonary Resuscitation (CPR) Complications?

A

Using the presence or absence of a pulse as the primary indicator of cardiac arrest is unreliable

Injury to the chest may occur in some patients.

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6
Q

Cardiopulmonary Resuscitation (CPR) Contraindications

A

Nil in this setting

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7
Q

What are the Cardiopulmonary Resuscitation (CPR) indications?

A

There are no signs of life:
* Unresponsive
* Not breathing normally
* Carotid pulse cannot be confidently palpated within 10 seconds OR
There are signs of inadequate perfusion:
* Unresponsive
* Pallor or central cyanosis
* Inadequate pulse, evidenced by:
* Less than 40 BPM in an adult or child 1 year or older
* Less than 60 BPM in an infant less than 1 year old
* Less than 60 BPM in a newly born (following appropriate ventilation strategy)

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8
Q

Care of an Amputated Body Part Complications

A

traumatic amputations can appear gruesome, the clinician must never be distracted from considering other hidden or less obvious injuries that may be more life threatening to the Pt

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9
Q

Care of an Amputated Body Part Contraindications

A

Nil in this setting

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10
Q

Care of an Amputated Body Part Indications

A

Traumatic amputation of a body part

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11
Q

Cervical Collar Complications

A

Discomfort

Anxiety

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12
Q

Cervical Collar Contraindications

A

Surgical airway

Penetrating neck trauma

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13
Q

Cervical Collar Indications

A

Suspicion of a cervical spine injury (SCI)

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14
Q

Chest Decompression Cannula Sizes

A

Chest Decompression Cannula Sizes

16 gauge <15kg or 3yrs

14 gauge 15-50kg, 4-14 years

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15
Q

Chest Seal Complications

A

Occlusion of the 3-channel vented dressing, causing a tension pneumothorax

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16
Q

Chest Seal Contraindications

A

Nil in this setting

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17
Q

Chest Seal Indications

A

Open pneumothorax

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18
Q

CombiCarrierII Complications

A

Pressure areas associated with prolonged use

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19
Q

CombiCarrierII Contraindications

A

Nil in this setting

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20
Q

CombiCarrier®II Indications

A

Patient extrication

Patient transfer

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21
Q

Non-Invasive Ventilation - CPAP Procedure

A
  • Place pt in seated position
  • Explain procedure to the pt (their understanding and cooperation is essential for successful CPAP)
  • Prepare equipment
  • Select the appropriate size face mask ensuring the inner circumference of the air cushion encompasses the bridge of the nose, side of the mouth and inferior border of the bottom lip (with mouth slightly open)
  • Size 4 - small adult (red)
  • Size 5 - large adult (blue)
  • Attach the vectored flow valve to the mask and the oxygen tubing, ensuring harness connector remains in place
  • Connect the oxygen tubing to a standard 15 L/min oxygen flow metre
  • Adjust oxygen flow rate to L/min to generate 5cm H2O continuous positive airway pressure
  • Monitor patient’s response to treatment (resp rate, SpO2, BP, chest sound & WOB) and increase airway pressure every 3-5 mins to a maxiumum of 15 cm H2O
  • If the pt shows evidence of deterioration, discontinue CPAP immediately and treat in accordance with appropriate CPG
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22
Q

Non-Invasive Ventilation - CPAP Sizes

A

Red Harness Connector
size 4 - small adult mask

Blue Harness Connector
size 5 - large adult mask

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23
Q

What are the defibrillation complications?

A

Patient Injury including burns
Arcing between electrodes if pads are incorrectly placed
Foreign bodies (including cardiac leads) between the pads and patient
Pads with insufficient or degraded conduction

Explosion
Discharge of the shock could initiate an explosion if there is a combustible gas or fluid in the vicinity

Transmitted shock to the operator or bystanders.

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24
Q

What are the defibrillation contraindications?

A

Non Shockable rhythms:

  • Asystole
  • Pulseless Electrical Activity
  • Perfusing Rhythms
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25
Q

What are the defibrillation indications?

A

Ventricular Fibrillation

Pulseless Ventricular Tachycardia

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26
Q

Direct Laryngoscopy Complications

A

Trauma to mouth or upper airway, particularly teeth/dentures
Laryngospasm
Exacerbation of underlying C-spine injuries
Hypoxia due to delays in oxygenation while performing procedure
Vomiting/regurgitation

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27
Q

Direct Laryngoscopy Contraindications

A

Suspected or known epiglottitis

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28
Q

Direct Laryngoscopy Indications

A

Visualisation of the glottis for the purpose of:

  • Oral endotracheal tube insertion
  • Removal of foreign body
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29
Q

Dislocation Reduction - Patella Complications

A

Iatrogenic injury

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30
Q

Dislocation reduction - Patella Contraindications

A

Patella dislocation other than lateral

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31
Q

Dislocation reduction- Patella Indications

A

Clinical lateral patella dislocation

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32
Q

What are the emergency chest decompression - cannula contraindications?

A

Obvious non-survivable injury in the traumatic cardiac arrest

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33
Q

What are the emergency chest decompression - cannula indications?

A
  • Traumatic cardiac arrest (with torso involvement)
  • Suspected tension pneumothorax with respiratory and/or haemodynamic compromise:

RESPIRATORY: chest pain, dysponea, tachypnoea, surgical emphysema, diminished breath sounds on affected side, tracheal deviation, cyanosis
CARDIOVASCULAR: Tachycardia, ALOC, hypotension, JVD (may not be present with hypotension)

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34
Q

What are the emergency chest decompression - pneumodart indications?

A
  • Traumatic cardiac arrest (with torso involvement)
  • Suspected tension pneumothorax with respiratory and/or haemodynamic compromise

RESPIRATORY: chest pain, dyspnoea, tachypnoea, surgical emphysema, diminished breath sounds on affected side, tracheal deviation, cyanosis
CARDIOVASCULAR: Tachycardia, ALOC, hypotension, JVD (may not be present with hypotension)

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35
Q

What are the emergency chest decompression - pneumodart complications?

A
  • improper diagnosis and insertion can cause a simple pneumothorax or tension pneumothorax
  • incorrect placement may result in life-threatening injury to the heart, great vessels, or damage to the lung
  • bilateral pleural decompression in the spontaneously breathing Pt may result in significant respiratory compromise
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36
Q

What are the emergency chest decompression - pneumodart contraindications?

A

obvious non-survivable injury in the traumatic cardiac arrest
Patients less than 50 kg (≈ 14 years)

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37
Q

Equipment Required for Cannulation

A

Equipment Required for Cannulation

Top Shelf Cannultion Shall Be Organised and Fun

Tourniquet

Swab

Cannula

Sharps Kit

Bung

Op Site

Flush

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38
Q

Femoral Traction Splint - CT6 Complications

A

Iatrogenic injury due to poor application technique

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39
Q

Femoral Traction Splint - CT6 Contraindications

A

Fracture/dislocation of the knee

Ankle injury

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40
Q

Femoral Traction Splint - CT6 Indications

A

Mid shaft femoral fractures

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41
Q

Femoral Traction Splint - Slishman Femoral Traction Complications

A

Iatrogenic injury due to poor application technique

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42
Q

Femoral Traction Splint - Slishman Femoral Traction Indications

A

Femoral fractures involving the shaft

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43
Q

Femoral Traction Splint -Slishman Femoral Traction Contraindications

A

Fracture/dislocation of the knee

Ankle injury

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44
Q

General Discontinuation Criteria

A

General Discontinuation Criteria

CPR may be discontinued after 20mins of continuous resuscitation if ALL the following criteria are met:

• No return of ROSC at any stage during resuscitation
• Cardiac arrest was not witnessed by QAS personnel
• No shockable rhythm at any stage
If any of these have not been met, must call QAS Clinical Consultation and Advice line.

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45
Q

Haemostatic QuickClot Combat Gauze Complications

A

nil

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46
Q

Haemostatic QuickClot Combat Gauze Contraindications

A

Wounds involving exposed organs (e.g. bowels)

Sucking chest wounds

Injuries to the eyes and airways

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47
Q

Haemostatic QuickClot® Combat Gauze Indications

A

Traumatic (external) wounds requiring haemostasis

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48
Q

Helmet Removal Complications

A

Possible exacerbation of cervical injury

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49
Q

Helmet Removal Contraindications

A

Nil in this setting

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50
Q

Helmet Removal Indications

A

removal of a motorcycle helmet in the setting of trauma

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51
Q

I-Gel Sizes

A

I-Gel Sizes

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52
Q

Intramuscular Injections Complications

A

abscess formation
cellulitis
minor harmorrhage
nerve and blood vessel damage
pain (minor discomfort immediately following the injection is normal)

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53
Q

Intramuscular Injections Contraindications

A

Inadequate muscle mass at the selected injection site

Pts in cardiac arrest

ability to administer the medication by an equally effective and less invasive route

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54
Q

Intramuscular Injection Indications

A

required IM drug administration

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55
Q

Intranasal Drug Administration Complications

A

underdosing if not administered correctly

mild, short lasting nasal discomfort (typically burning) from the drug itelf

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56
Q

Intranasal Drug Administration Contraindications

A

suspected nasal fractures

blood/mucous obstructing the nasal passage

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57
Q

Intranasal Drug Administration Indications

A

the administration of medicaions via the NAS route

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58
Q

What are the intravenous cannulation (IV) complications?

A

drug/fluid extravasation into superficial tissue
localised or systemic catheter or line related infections (most commonly staphylococcus aureus)
redness, pain or swelling of the vein

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59
Q

What are the intravenous cannulation (IV) contraindications?

A

Whenever possible avoid sites of burns, infection, trauma or significant oedema

Pre-existing medical conditions that exclude particular limbs from being used include:
axillary lymph node clearance
lymphoedema
arteriovenous fistula

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60
Q

What are the intravenous cannulation (IV) indications?

A

Vascular access for the administration of medications, hydration fluids and/or blood products

Note: Is there a clinical requirement for this procedure?
Will it add value?
Do the benefits outweigh the risks?
Is there a simpler, less invasive alternative?
Can it be justified at this point in time?

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61
Q

Intravenous Drug Administration Complications

A

Air embolus
Infection, bacteraemia or sepsis
Misplacement or dislodgement resulting in extravasation and possible tissue necrosis
Pain or discomfort on medication administration

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62
Q

Intravenous Drug Administration Contraindications

A

Evidence of a misplaced or dislodged IV cannula

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63
Q

Intravenous Drug Administration Indications

A

Administration of medications via the IV route

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64
Q

Laryngeal Manipulation Complications

A

Incorrect application

May worsen visualisation of the larynx

Potential for airway trauma

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65
Q

Laryngeal Manipulation Contraindications

A

Active Vomiting

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66
Q

Laryngeal Manipulation Indications

A

Sub-optimal visualisation of the larynx during direct laryngoscopy

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67
Q

Laryngoscope Sizes

A

Laryngoscope Sizes

  • Infant - Miller Size 0
  • Small child - Miller Size 1
  • Large child - Macintosh size 2
  • Small adult - Macintosh size 3
  • Large adult - Macintosh size 4
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68
Q

Magill Forceps Complications

A

Trauma to the tissue surrounding the pharynx uvula and tongue

Manipulating a partially obstructed airway may cause the object to totally occlude the airway

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69
Q

Magill Forceps Contraindications

A

Patients with an effective cough

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70
Q

Magill Forceps Indications

A

Removal of pharyngeal foreign bodies causing airway obstruction in an obtunded patient

To facilitate the insertion of an orogastric tube

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71
Q

Manual In-Line Stabilisation (MILS) Complications

A

Difficult Laryngoscopy

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72
Q

Manual In-Line Stabilisation (MILS) Contraindications

A

Nil in this setting

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73
Q

Manual In-Line Stabilisation (MILS) Indications

A

Stabilisation of the head and neck in a patient with suspected cervical spine injury

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74
Q

Medication Labelling

A

Medication Labelling

  • Medication label must be fixed to syringe
  • Label must not prevent reading the volume markers
  • Ampoule must be secured to syringe
  • Tape should cover the sharp edge of the vial
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75
Q

What are the Modified Valsalva Manoeuvre Complications?

A

Syncope

Prolonged hypotensive state

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76
Q

What are the Modified Valsalva Manoeuvre Indications?

A

Haemodynamically stable Supraventricular Tachycardia (SVT)

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77
Q

What are the Modified Valsalva Manoeuvre steps?

A
  1. Obtain a baseline ECG (12 lead if authorised)
  2. Explain the procedure to the pt
  3. Postion the patient in a semi-recumbent position
  4. Instuct the pt to perform a forced expiration into a sterile 10 mL syringe for 15 seconds
  5. Remove syringe and lay pt supine with legs raised straight to 45 degrees for 15 seconds
  6. Reposition pt to semi-recumbent position for 45 seconds
  7. Repeat 12 Lead ECG
  8. Confirm if modified valsalva has been successful, if not, consider repeating the procedure to a maximum of 3 attempts
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78
Q

What are the Modified Valsalva Manoeuvre Contraindications?

A

Glaucoma
Retinopathy
Atrial fibrillation/flutter
Aortic stenosis
AMI in past 3 months
SBP <90mmHg
Requirement for cardioversion
3rd trimester pregnancy

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79
Q

Nasopharyngeal Airway Complications

A

airway trauma, particularly epistaxis

incorrect size or placement will compromise effectiveness

exacerbate injury in base of skull fracture, with NPA potentially displacing into the cranial vault

can stimulate gag reflex in sensitive Pts, precipitating vomiting or aspiration

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80
Q

Nasopharyngeal Airway Contraindications

A

nil in this setting

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81
Q

Nasopharyngeal Airway Indications

A

Potential or actual airway obstruction

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82
Q

What are the nebulisation complications?

A

Nil in this setting

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83
Q

What are the nebulisation contraindications?

A

Nil in this setting

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84
Q

What are the nebulisation indications?

A

Nebuliser Mask:
The administration of medications via the NEB route

T-Piece Nebuliser:
the administration of medications via the NEB route in Pts requiring posive pressure ventilation via a BVM
the administration of medications via the NEB route in Pts receiving O2 CPAP

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85
Q

What are the non-invasive ventilation - CPAP complications?

A

corneal drying
aspiration
barotrauma
hypotension
gastric distension

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86
Q

What are the non-invasive ventilation - CPAP contraindications?

A

pts <16 years
GCS ≤ 8
hypotension (SBP <90 mmHg)
facial trauma
epistaxis
inadequate ventilatory drive
pneumothorax

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87
Q

What are the non-invasive ventilation - CPAP indications?

A

acute pulmonary oedema

88
Q

Non-Invasive Ventilation - CPAP O2 Concentration

A

8L/min 5.0cm H20 54% O2
12L/min 10.0cm H2O 62% O2
15L/min 15.0cm H2O 67% O2

89
Q

NPA Sizes

A

NPA Sizes

90
Q

OPA Size 9

A

adult male - yellow

91
Q

What are the oral drug administration complications?

A

Aspiration & airway compromise

92
Q

What are the oral drug administration contraindications?

A

Impaired conscious state or swallowing ability

93
Q

What are the oral drug administration indications?

A

administration of medications by the oral route

94
Q

Oropharyngeal Airway (OPA) Complications

A

Airway trauma from incorrect OPA Placement
Intolerance of OPA requiring removal
Can precipitate vomiting/aspiration in a patient with an intact gag reflex
Incorrect size or placement can potentially exacerbate an airway obstruction

95
Q

Oropharyngeal Airway (OPA) Contraindications

A

conscious Pts

Pts with intact gag reflex

96
Q

Oropharyngeal Airway (OPA) Indications

A

Maintain airway patency

Bite block for intubated patients - CCP only

97
Q

Oxygen Mask Flow Rates

A

Oxygen Mask Flow Rates

nasal prongs = 2-4l/min

hudson mask = 6-8l/min

NEB = 6-8l/min

CPAP = 8, 12 15l/min

non-rebreather = 15l/min

BVM = 15l/min

98
Q

Pelvic Circumferential Compression Device - SAM PELVIC SLING Indications

A

Suspected pelvic fracture with evidence of haemodynamic compromise

99
Q

Pelvic Circumferential Compression Device SAM PELVIC SLING Contraindications

A

suspected isolated neck of femur fracture

suspected traumatic hip dislocation

100
Q

Phases of valsalva manouvre

A

1 - increased intrathoracic pressure increases BP

2 - decreased venous return reduces BP and increases systemic vascular resistance

3 - decrease intrathoracic pressure and BP and compensatory increase HR

4 - increased venous return causes increased cardiac output and BP
= reflex bradycardia

101
Q

What are the positive end expiratory pressure (PEEP) contraindications?

A

Absolute
- Hypotension (SBP <90mmHg)

Relative
- Broncho-pleural fistula
- Hypovolemia
- Pneumothorax
- Uni-lateral lung disease

102
Q

What are the positive end expiratory pressure (PEEP) indications?

A
  • Pulmonary oedema (cardiogenic and non-cardiogenic)
  • Asthma and COPD patients (with Sp02 <90% on a FiO2 >65%)
  • Profound hypoxaemia associated with:
    • Flail segment(s)
    • Pulmonary contusions
    • Aspiration
  • Newborn resuscitation
103
Q

What are the positive end expiratory pressure (PEEP) complications?

A

Caution in asthma and obstructive lung disease due to increased risk of air trapping and causing a pneumothorax. PEEP levels should be kept low (<5cm H20) for this group of patients

Hypotension

104
Q

Priming of a (Gravity Flow) Giving Set Complications

A

Air embolism

Infection

105
Q

Priming of a (Gravity Flow) Giving Set Contraindications

A

Nil in this setting

106
Q

Priming of a (gravity flow) Giving Set Indications

A

To prepare a giving set prior to the administration of fluids via an appropriately placed cannula

107
Q

Priming of a Microbore Extension Set Complications

A

air embolism

infection

108
Q

Priming of a Microbore Extension Set Contraindications

A

nil

109
Q

Priming of a Microbore Extension Set Indications

A

To prepare a Microbore Extension set prior to the administration of IV enoxaparin using a pre-filled graduated syringe

110
Q

Priming of an Alaris™ two-way extension set (with clamps) Indications

A

administration of simultaneous medications

111
Q

Priming of an Alaris™ two-way extension set (with clamps) Complications

A

air embolism

infection

112
Q

Priming of an Alaris™ two-way extension set (with clamps) Indications

A

To prepare an Alaris™ 2-way extension set (with clamps) prior to the administration of medications and/or fluids through an appropriately placed cannula.

113
Q

Prometheus Pelvic Splint Complications

A

pressure areas

tissue necrosis

114
Q

Prometheus Pelvic Splint Contraindications

A

Suspected isolated:

neck of femur fracture; or
hip dislocation

115
Q

Prometheus Pelvic Splint Indications

A

Mechanism of injury suggestive of pelvic fracture(s) with any of the following criteria:

  • Haemodynamic compromise (HR>100 or SBP <90mmHg)
  • GCS <13
  • Distracting injury
  • Abnormal clinical assessment of the pelvis with high likelihood of fracture
116
Q

Rapid Discontinuation Criteria

A

Rapid Discontinuation Criteria

CPR may be discontinued before the expiration of 20mins if:

  • Pt is unresponsive and pulseless for at least 10mins prior to the arrival of the paramedic
  • No CPR was provided during this period
  • Role criteria satisfied
  • Asystole or PEA <40/min.
117
Q

Recognition of Life Extinct

A
  • No palpable carotid pulse
  • No heart sounds heard for 30 continual seconds
  • No breath sounds heard for 30 continual seconds
  • Fixed dilated pupils
  • No response to central stimuli
118
Q

Respiratory/Bag Valve Mask Ventilation Complications

A

Gastric inflation

Pulmonary barotrauma

Undesirable cardiovascular effects such as hypotension, secondary to caval compression

119
Q

Respiratory/Bag Valve Mask Ventilation Contraindications

A

spontaneously breathing patients with adequate tidal volume and an appropriate respiratory rate (RR>10)

120
Q

Respiratory/Bag Valve Mask Ventilation Indications

A

Acute respiratory distress, hypoventilation (RR<10) or arrest requiring positive pressure ventilation

121
Q

SAM Splint Complications

A

iatrogenic injury due to poor splint application technique

122
Q

SAM Splint Contraindications

A

Nil

123
Q

SAM® Splint Indications

A

suspected fractures and dislocations of the upper limbs

124
Q

Simple Bandaging and Slings Complications

A

Compromised perfusion due to restricted circulation

125
Q

Simple Bandaging and Slings Contraindications

A

Nil in this setting

126
Q

Simple Bandaging and Slings Indications

A

Wound cover and limb support

127
Q

Skin Closure - Steri-Strip Complications

A

Wound dehiscence

Infection

Cosmetic (e.g scarring)

128
Q

Skin Closure - Steri-Strip Contraindications

A

Deeper wounds unable to easily approximated

Wounds on mucosal surfaces or mucocutaneous junctions

Wounds under tension

Wounds on mobile parts of the body (eg joints)

129
Q

Skin closure - Steri-Strip Indications

A

Uncontaminated simple lacerations that are:

  • ≤ 2cm in length; AND
  • have easily apposed wound edges
130
Q

Spring Infusion Pump - Springfusor 30

A

Air embolism

Pain or discomfort on medication administration

Infection

Extravasation and possible tissue necrosis

131
Q

Spring infusion pump - Springfusor 30 Indications

A

intermittent IV infusion of small volumes as specified in QAS DTS’s

132
Q

Spring Infusion Pump - Springfusor 30 Contraindications

A

Evidence of misplaced or dislodged access

133
Q

What are the subcutaneous injection (SUBCUT) complications?

A

Pain

Bleeding

134
Q

What are the subcutaneous injection (SUBCUT) contraindications?

A

injection of medications into scar tissue, burns, bruises, infection or broken skin

135
Q

What are the subcutaneous injection (SUBCUT) indications?

A

Administration of medications via the SUBCUT route

136
Q

What are the sublingual drug administration contraindications?

A

Nil in this setting

137
Q

What are the sublingual drug administration complications?

A

Nil in this setting

138
Q

What are the sublingual drug administration indications?

A

The administration of medication via the SUBLING route

139
Q

Suction Rates

A

Suction Rates

Neonates 60-80mmHg

Paediatrics 80-100mmHg

Adults 80-120mmHg

140
Q

Supraglottic Airway I-gel Complications

A

Failure to provide adequate airway or ventilation

Patient intolerance

Hypoxia

Can precipitate vomiting and aspiration in a patient with intact airway reflexes

Oropharyngeal trauma

141
Q

Supraglottic Airway I-gel Contraindications

A

Conscious breathing patients

Continuous used for > 4 hours

142
Q

Supraglottic Airway I-gel Indications

A

Actual loss of airway patency and/or airway protection

143
Q

The Emergency Bandage Complications

A

nil in this setting

144
Q

The Emergency Bandage Contraindications

A

nil in this setting

145
Q

The Emergency Bandage Indications

A

Traumatic wounds requiring haemostasis

146
Q

Tooth Replantation Complications

A

Haemorrhage

Pain

Rejection

Tooth fusion to the bone

147
Q

Tooth Replantation Contraindications

A

Prioritisation of other traumatic injuries

Primary (baby) tooth

Out of socket time >60ins

Distressed patient

Compromised integrity of the avulsed tooth or supporting tissues (obvious deformity, decay)

Compromising medical condition (immunocompromised, severe congenital cardiac abnormalities, severe uncontrolled seizure disorders, severe mental disability, severe uncontrolled diabetes)

148
Q

Tooth Replantation Indications

A

Permanent (adult) tooth that is:

  • Avulsed tooth
  • Grossly mobile luxated nearing avulsion
149
Q

Triple Airway Manoeuvre Complications

A

Potential C-spine injury

150
Q

Triple Airway Manoeuvre Contraindications

A

Nil in this setting

151
Q

Triple Airway Manouevre Indications

A

Patients unable to maintain patency

152
Q

Vacuum Splint Complications

A

Vacuum splints may require further extraction of air to maintain rigidity during aeromedical transport

153
Q

Vacuum Splints Contraindications

A

Nil in this setting

154
Q

Vacuum Splints Indications

A

Suspected fractures and dislocations of arms, legs, or joints

Spinal immobilisation or full body splinting where appropriate for infants or small children

155
Q

Waveform Capnography Complications

A

When performing effective CPR during cardiac arrest, EtCO2 values are not to be used to vary IPPV from the recommended rate

156
Q

Waveform Capnography Contraindications

A

nil in this setting

157
Q

Waveform Capnography Indications

A

CPR
Ongoing monitoring of ventilation
sedation

158
Q

Y Suction Catheter Sizes

A

6, 8, 12, 16 FG

159
Q

OPA Size 3

A

neonate - lilac

160
Q

OPA Size 4

A

infant - pink

161
Q

OPA Size 5

A

toddler - blue

162
Q

OPA Size 6

A

small child - black

163
Q

OPA Size 7

A

child - white

164
Q

OPA Size 8

A

adolescent/adult female - green

165
Q

Modified Valsalva Manouevre Pathophysiology

A

Straining increases intrathoracic pressure, compresses the aorta and increases systolic BP by ≥ 15mmHg for approximately 5 seconds. Venous return, preload and BP decreases which then increases cardiac output causing arterial vasoconstriction and increasing venous return and heart rate.

Releasing strain decreases intrathoracic pressure and BP below baseline for a few seconds and increases heart rate. Blood rushes back into the heart increasing cardiac output, stimulating the vagus nerve resulting in reflex bradycardia and BP returning to baseline

166
Q

What are the 12-Lead ECG low threshold circumstances?

A
  • ALOC
  • Syncope
  • Overdose
  • Envenomation
  • Electrolyte disorders
  • Grossly altered vital signs
167
Q

What are the 12-Lead ECG acquisition indications?

A

Any patient requiring detailed ECG analysis:
- suspected ACS
- cardiac dysrhythmias
- conduction disturbances
- electrolyte imbalances
- drug toxicity

168
Q

What are the 12-Lead ECG acquisition contraindications?

A

Nil

169
Q

What are the 12-Lead ECG acquisition complications?

A

Nil

170
Q

What are the ECG electrode placement locations?

A

V1 - 4th Intercostal space, right of the sternum
V2 - 4th Intercostal space, left of the sternum
V4 - 5th Intercostal space, on left midclavicular line
V3 - Midway between V2 and V4
V5 - Midway between V4 and V6
Optional - V4R - 5th intercostal space, on the right midclavicular line (annotate printout)

171
Q

How do you do a 12 Lead on a Lifepak 15?

A
  1. Press 12-LEAD button
  2. Enter age into AGE menu
  3. Enter sex into SEX menu
    12 lead is then acquired, analysed and printed
172
Q

How do you do EtCO2 monitoring on a Lifepak 15?

A
  1. Select EtCO2 accessory for the patient
  2. Open CO2 port door and insert FilterLine connector and turn clockwise until tight
  3. Verify CO2 area is displayed
  4. Display CO2 waveform in Channel 2 or 3
  5. Connect FilterLine set to the patient
  6. Confirm the EtCO2 waveform is displayed
173
Q

How do you do a 12 Lead on a Corpuls3?

A
  1. Press the Monitor Key
  2. Press the D-ECG soft-key
  3. Confirm that the diagnostic frequency of 0.05–150 Hz is displayed
  4. When ‘Ready for D-ECG’ is displayed, press the Start soft-key
  5. When requested, enter the patient’s gender and age, press the OK soft-key
  6. Press the Print soft-key
174
Q

What are the most frequent PEA rhythms?

A

sinus bradycardia
junctional
idioventricular

175
Q

What are the Corpuls3 joules for adults and children 9yrs and older?

A

200j

176
Q

What are the Corpuls3 joules for a paediatric Pt?

A

4j/kg

177
Q

What are the Lifepak 15 joules for adults and children 9yrs and older?

A

200j
300j
360j

178
Q

When doing CPR when is the heel of one hand used?

A

children 1-8 yrs of age

179
Q

When doing CPR when is the two hand technicque used?

A

children 9-12 years
adults

180
Q

When doing CPR when is the two finger technique used?

A

children less than 1 year incl newly born

181
Q

When doing CPR when is the two thumbs method used?

A

newly born
children less than 1 year

182
Q

How many direct laryngoscopy attempts are each officer allowed?

A

2

183
Q

What can you see the Cormack-Lehane airway Grade I classification?

A

complete glottis

184
Q

What can you see the Cormack-Lehane airway Grade II classification?

A

anterior glottis not seen

185
Q

What can you see the Cormack-Lehane airway Grade III classification?

A

epiglottis seen, but not glottis

186
Q

What can you see the Cormack-Lehane airway Grade IV classification?

A

epiglottis not seen

187
Q

What is the appropriate position of the head for direct laryngoscopy?

A

neutral position - with MILS if c-spine suspected
infant - slight elevation of the shoulders
small child - slight extension of the head
older child/adult - extension of the head (possibly elevation)

188
Q

What are the movements for the BURP positioning in laryngeal manipulation?

A

backwards (towards spine)
upwards (towards jaw)
rightwards (the Pt’s right)

189
Q

Which way does the bevel (shorter edge) of an NPA face when inserting?

A

nasal septum

190
Q

OPA size 10

A

large male - red

191
Q

What age Pt can an ACPII insert an i-gel?

A

> 8 yrs

192
Q

What are the BGL indications?

A

POC glucose assessment

193
Q

What are the BGL contraindications?

A

routine use in newly borns unless clinically indicated

194
Q

What are the BGL complications?

A

nil in this setting

195
Q

What are the pulse oximetry indications?

A

to determine Pt oxygen saturation
assessment of the newborn

196
Q

What are the pulse oximetry contraindications?

A

nil in this setting

197
Q

What are the pulse oximetry complications?

A

reliability depends on:
correct sensor size and placement
adequate arterial blood pulsation through the sensor site
excessive Pt movement
ambient light
dirt/mailpolish
methaemoglobinaemia
carbon monoxide
insifficient amplitude on the pulsing pleth wave

198
Q

What are the tympanic temperature indications?

A

monitoring of temperature when clinically indicated

199
Q

What are the tympanic temperature contraindications?

A

blood or drainage in the ear canal
acute or chronic inflammatory conditions of the external ear canal
perforated tympanic membranes

200
Q

What are the tympanic temperature complications?

A

nil

201
Q

What colour syringe do you use for the oral administration of liquid drugs?

A

purple

202
Q

What are the locations for emergency chest decompression - cannula and pneumodart?

A

2nd intercostal space midclavicular line of the affected side

203
Q

What age are paediatric patients?

A

12 or less

204
Q

How do you calculate paediatric’s weight?

A

(age x 3) + 7 = weight in kgs

205
Q

What is the weight of a neonate?

A

3.5 kgs

206
Q

What are the HR, RR and SBP of a neonate?

A

HR 100 - 160
RR 25 - 50
SBP 60 - 70

207
Q

What is the weight of a 6 month old?

A

7 kgs

208
Q

What are the HR, RR and SBP of a 6 month old?

A

HR 100 - 160
RR 25 - 50
SBP 70 - 100

209
Q

What are the HR, RR and SBP of a 1 year old?

A

HR 90 - 150
RR 25 - 50
SBP 70 - 100

210
Q

What are the HR, RR and SBP of a 2 - 5 year old?

A

HR 80 - 140
RR 20 - 30
SBP 80 - 110

211
Q

What are the HR, RR and SBP of a 6 - 12 year old?

A

HR 70 - 120
RR 15 - 25
SBP 90 - 115

212
Q

Inhalation − Metered Dose Inhaler (MDI) Indications

A

For the delivery of MDI medications

213
Q

Inhalation − Metered Dose Inhaler (MDI) Complications

A

MDI with spacer
- Poor procedural compliance reducing
drug delivery

MDI with connector (22M−22F)
- Nil in this setting

214
Q

Inhalation − Metered Dose Inhaler (MDI) Contraindications

A

MDI with spacer
- Foreign body airway obstruction

MDI with connector (22M−22F)
- Nil in this setting

215
Q

What are the emergency chest decompression - cannula complications?

A
  • Improper diagnosis and insertion may cause a simple or tension pneumothorax
  • Incorrect placement may result in life-threatening injury to the heart, great vessels or damage to the lung
  • Bilateral pleural decompression in the spontaneously breathing patient may result in significant respiratory compromise
216
Q

What are the components of the falls assessment tool?

A

Fall History - within previous 12 months
Medications - more than 4
Medical History - Stroke or Parkinson’s Disease
Stability - problems with balance
Core Strength- stand on their own without arms

Bachelor of Paramedic Science (19 decks)

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