QA from class SET 1 Flashcards
What do you ALWAYS CHECK (4 things)
Powered Oxygen, Suction, DFIB and Coffee
Our Job by LAW:
“render care to ill or injured and to transport to the closest appropriate facility”
EMS
Emergency Medical Services
NOI
MEDICAL (nature of illness)
MOI
TRAUMA (mechanism of injury)
AVPU
Alert, responds to VOICE, responds to PAIN, unresponsive
GCS
Glascow Coma Scale. Eye (spont, verb, pain, no), Verbal (oriented, confused, words sounds, none), Motor response (obey commands, localising, normal flexion, abnormal flexion, extension, none)
Ivp
Intraveneous
NRB
non-rebreather mask
O2
Oxygen
Sx/Sy
Signs and Symptoms
Dx
Diagnosis
Hx
History
LMP
Last Menstrual Period
C/C
Chief Complaint
GPA
Gravida Para Abortis - (# preg, # births, # abortions)
PE
Physical Exam
5 regions
HEENT, CH, ABD, EXT, POST, NEURO
HEENT (5R)
Head, ears, nose, throat
CH (5R)
Chest
AB (5R)
Abdomen
POST (5R)
Posterior
EXT (5R)
Extremities
NEURO (5R)
Neurological
VSx
Vital Signs (ABCDE)
ABCDE
Airway, Breathing, Circulation, Disability, Exposure
What is charting ORDER?
Patient, Med, Dose, Route, Rate, Date, Time, INITIALS
What Does SAMPLER stand for?
SIGNS and SYMPTOMS, Allergies, Medications, Past Hx, Last in/out, Event leading up, Risk factors and signst that steer you away to diff Dx
Risk Factors by age: PEDI
pedi 0-18: Actual weight, NICU/PICU admission, premie, full term, twin, innoculations
Ristk factors by age: ADULT/Geri
18-65 weight, ethnicity, age, gender, hospitalizations,(.65GERI innoculations, family hx)
OPQRST
Onset of C/C (when), Palliation/Provocation (what makes it worse?), Quality (describe it), Region/Radiation/Recurrance (where and how often), Severity 1-10, Time (acute/chronic)
AEIOUTIPSS
Alcohol, Epilepsy, Insulin, Overdoze, Underdose, Trauma/Tox, Infections (temp hi/lo and WBC>10k), Psychiatric, Stroke (CPSS), Shock
ETOH
Alcohol
Sz
Seizure
BDZ
Benzodiazapines (anti-seizure)
Three Benzos (BDZ)
Valium, Ativan, Versed (diazepam, lorazepam, midazolam)
IDDM
Insulin Dependent Diabetes Mellitus
Three diabetes for hypoglycemia (<70 mg/dL)
glucose (ORAL), glucagon (IM), dextrose (IV)
One diabetes for HYPERglycemia (>300)
Fluid Bolus (IV FLUID)
Normal glucose
70-110 mg/dL
IM
intramuscular
CPSS
Cincinatti Prehospital Stroke Scale (face droop (unequal), Arm lift (not move or drift), Speech (slurr or mute)
AMS
Altered Mental Status
ORDER OF ASSESSMENT
SS.. vitals ABCD.. past (SAMPLERS), present (OPQRST), AMS (AEIOUTIPSS)
What is shock?
Body not gettting oxygen (low perfusion)
Types of Shock
Hypovolemic (blood loss), Distributive (anaphalactic, sepsis, Rxn, Neurogenic), Cardiogenic (HR fast or slow OR ACS), Obstructive (tension pneumothorax, cardiac temponade, pulmonary embolism)
Types of Shock (alternate)
FLD, TANK, PUMP, OBST
Types of Distributive Shock
Anaphalaxtic, Sepsis, Neurogenic[drugs] (allergies, infection or brain(drugs))
Types of Cardiogenic Shock
too Fast, too Slow or ACS (acute coronary syndrome)
Types of Obstructive Shock
Tension Pneumothorax (air between lung and ribs aka collapsed lung), Cardiac Temponade (fluid in pericardium restricting and squeezing the heart), Pulmonary Embolism (clot in the artery of the lungs stopping blood flow to lungs (so from lungs also))
FLD, TANK, PUMP, OBST
Hypovolemic (blood loss), Distributive (anaphalactic, sepsis, Rxn, Neurogenic), Cardiogenic (HR fast or slow OR ACS), Obstructive (tens pneumothorax, pulmonary embolism, cardiac temponade)
ACS
Acute Coronary Syndrome (acute, sudden lack of blood to the heart)
Bradycardia
Slow heart rate
NSR
normal sinus rythym (normal heart rate)
Stach
Sinus Tachycardia
Afib
Atrial Fibrilation - abnormal heart rate
RvR
rapid ventricular rate
Vfib
needs a reset- heart rate crazy- patternless (SHOCK ADVISED)
Vtach
super fast, needs a reset (SHOCK ADVISED)
When to stop treatment
be sure there are no signs of hypothermia1. Standard ALS has been delivered2. Asystole or PEA for OVER 20 minutes of CPR etc AND no reversible cause is evident AND patient is NOT PREGNANT AND med control gives order
When can you use “DO NOT RESUSCITATE”
If in doubt, save the patient. A DNR needs1. Competence 2. Capacity 3. Informed refusal
Diff between PEA and ASYSTOLE
Asystole is the flatline reading where all electrical activity within the heart ceases. PEA, on the other hand, may include randomized, fibrillation-like activity, but it does not rise to the level of actual fibrillation.
What does PEA stand for?
Pulseless electrical activity
PCR
Patient Care Report
5 body regions?
HEENT, CH, AB, POST, EXT, neuro
10 body systems?
Neurological, Upper GI, Cardiovascular, Pulmonary, Muscle Skeletal, Lower GI, Gastro/Urinary/renal, Reproductive, Metabolism/endocrine(hormones), immune/lymph, integumentary (SKIN)
10 body systems?
Neurological, Upper GI, Cardiovascular, Pulmonary, Muscle Skeletal, Lower GI, Gastro/Urinary/renal, Reproductive, Metabolism/endocrine(hormones), immune/lymph, integumentary (SKIN)
DCAP BTLS
deformities, contusions, abrasions, punctures/penetrations, burns, tenderness, lacerations and swelling
PRRQ
Present, rate, rhythm, quality
5 mortal injuries
Decapitation, Transection (neck to groin), Complete destruction of brain or heart, Incineration, Blunt or Penetrating no pulse injuries incompatible with life
3 signs of death
putrification (rot), rigor mortis (stiff), dependent lividity (pooling)
Not “dead” if they are
COLD - could be hypothermia
Beta 1 vs Beta 2
Beta 1 heart, Beta 2 lung
SCENE SAFETY? ALL
WMD, odors fumes, cultural social, situational environment, medical devices, cold/hot/warm zone,
SCENE SAFETY? ALL
WMD, odors fumes, cultural social, situational environment, medical devices, cold/hot/warm zone,
ADVANCED DIRECTIVES
DNR, Health Care proxy, MOLST/HOLST (in hosp)
DNR (about)
Don Not Resuscitate
Healthcare Proxy
allows other to make health decisions
malfeasance/misfeasance/nonfeasance (negligence)
Mal- unauthorized act outside scopeMis- appropriate, wrong manner (dose)Non- failing to perform expected act
Elder abuse form number
19a
Elder abuse form number
19a
Disabled Person abuse/neglect
19C
Children
51A
Section 12 v Section 8
Alcohol vs. Violence