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Clinical Approach > RSA/PSA/CSA > Flashcards

RSA/PSA/CSA Flashcards

1
Q

medium child
age

A

5-11 years

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2
Q

small child
age

A

1-4 years

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3
Q

Large infant
age

A

3-12 months

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4
Q

Newborn age
age

A

birth to 24 hours

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5
Q

small infant
age

A

under 3 months

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6
Q

SGA
size

A

Size 1
- 2-5 kg and not max side of gastric tube

Size 1.5
- 5-12 kg and the max size of the gastric tube is 10

size 2.0
- 10-25kg and max size gastric tube 12

size 2.5
- 25-35 kg and max size of gastric tube 12

size 3.0
- 30-60 kg and max size of gastric tube 12

size 4.0
- 50-90 kg and max size of gastric tube 12

size 5.0
- 90+ kg and max size of gastric tube 14

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7
Q

SGA
Precautions and side effects

A

Precautions
- inability to prepare the patient in the sniffing position
- patients who require high airway pressure
- paediatric patient who may have enlarged tonsils
- vomit in the airway

Side effects
- correct placement does not prevent passive regurgitation or gastric distension

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8
Q

SGA
contraindications

A
  • intact gag reflex or resistance to insertion
  • strong jaw tone or trismus
  • suspected epiglottitis or upper airway obstruction
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9
Q

SGA
Indications

A
  • unconscious patient without gag reflex
  • ineffective ventilation with BVM and basic airway management
  • > 10 minutes of assisted ventilation required
  • unable to intubate
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10
Q

cool, pale, and clammy
20 bpm
60 BP
unconscious

A

extremely poor perfusion

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11
Q

cool, pale, and clammy
80 bpm
80 BP
alert and orientated to time and place

A

Borderline

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12
Q

cool, pale, and clammy
140 bpm
50 BP
altered conscious state

A

extremely poor perfusion

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13
Q

cool, pale, and clammy
40 bpm
40 BP
unconscious

A

extremely poor perfusion

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14
Q

cool, pale, and clammy
130bpm
60 BP
altered conscious state

A

Extremely poor perfusion

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15
Q

cool, pale, and clammy
70bpm
70BP
altered conscious state

A

Inadequate perfusion

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16
Q

warm pink and clammy
90bpm
90 BP
alert and orientated

A

Borderline perfusion

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17
Q

mildly anxious
full sentences
mild expiratory wheeze and some find crackles
21
slightly prolonged expiratory phase
90
normal skin
alert

A

moderate distress

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18
Q

Distressed and fighting to breathe
Unable to cough, with expiratory wheeze and inspiratory wheeze
26
prolonged expiratory phase
marked chest movement
120bpm
pale and sweaty
altered conscious state

A

Severe distress

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19
Q

distressed and anxious
words only
able to cough but has an expiratory wheeze and crackles at the bases
22
prolonged expiratory phases
marked chest movement with excessive use of accessory muscles
120
pale and sweaty
conscious may be altered

A

severe distress

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20
Q

Distressed
short phrases only
mild expiratory wheeze and some fine crackles
22
prolonged expiratory wheeze
marked chest movement with excessive
120bpm
pale and sweaty
may be altered

A

Moderate distress

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21
Q

Calm, quiet
Full sentences
mild expiratory wheeze
18
regular even cycles
slight increase in normal chest movement
80bpm
normal skin
alert

A

Mild distress

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22
Q

child > 4 years old
CS - motor
none

A

1

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23
Q

child > 4 years old
CS - motor
abnormal extension to pain

A

2

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24
Q

child > 4 years old
CS - motor
abnormal flexion to pain

A

3

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25
Q

child > 4 years old
CS - motor
withdraws from pain

A

4

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26
Q

child > 4 years old
CS - motor
localises to pain

A

5

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27
Q

child > 4 years old
CS - motor
obeys command

A

6

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28
Q

child > 4 years old
CS - verbal
None

A

1

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29
Q

child > 4 years old
CS - verbal
Incomprehensible sounds

A

2

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30
Q

child > 4 years old
CS - verbal
Inappropriate words

A

3

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31
Q

child > 4 years old
CS - verbal
confused

A

4

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32
Q

child > 4 years old
CS - verbal
orientated

A

5

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33
Q

child > 4 years old
CS - eye-opening
None

A

1

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34
Q

child > 4 years old
CS - eye-opening
To pain

A

2

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35
Q

child > 4 years old
CS - eye-opening
To voice

A

3

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36
Q

child > 4 years old
CS - eye-opening
Spontaneous

A

4

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37
Q

child ≤ 4 years old
CS - motor
None

A

1

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38
Q

child ≤ 4 years old
CS - motor
Abnormal extension to pain

A

2

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39
Q

child ≤ 4 years old
CS - motor
Abnormal flexion to pain

A

3

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40
Q

child ≤ 4 years old
CS - motor
Withdraws from pain

A

4

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41
Q

child ≤ 4 years old
CS - motor
Localises to pain

A

5

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42
Q

child ≤ 4 years old
CS - motor
Spontaneous

A

6

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43
Q

child ≤ 4 years old
CS - verbal
None

A

1

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44
Q

child ≤ 4 years old
CS - verbal
Moans to pain

A

2

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45
Q

child ≤ 4 years old
CS - verbal
Persistently irritable

A

3

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46
Q

child ≤ 4 years old
CS - verbal
Cries but consolable

A

4

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47
Q

child ≤ 4 years old
CS - verbal
appropriate words/social smile

A

5

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48
Q

child ≤ 4 years old
CS - Eyes
None

A

1

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49
Q

child ≤ 4 years old
CS - Eyes
To pain

A

2

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50
Q

child ≤ 4 years old
CS - Eyes
To voice

A

3

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51
Q

child ≤ 4 years old
CS - Eyes
spontaneous

A

4

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52
Q

Paediatric weight
10 - 11 years

A

Age x 3.3kg

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53
Q

Paediatric weight
1-9 years

A

Age x 2 + 8kg

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54
Q

Paediatric weight
1 year

A

10kg

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55
Q

Paediatric weight
6 months

A

8kg

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56
Q

Paediatric weight
3 months

A

6kg

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57
Q

Paediatric weight
<24 hours

A

3.5kg

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58
Q

Newborn heart rate
HR and BP

A

HR 110-170
BP > 60mmHg systolic

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59
Q

small infant
HR and BP

A

HR 110-170bpm
BP > 60mmHg systolic

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60
Q

large infant
HR and BP

A

HR 105 - 165bpm
BP > 65mmHg systolic

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61
Q

small child
HR and BP

A

HR 85 - 150bpm
BP > 70mmHg systolic

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62
Q

medium child
HR and BP

A

HR 70 - 135bpm
BP > 80mmHg systolic

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63
Q

newborn RR

A

25 - 60 breaths/minute

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64
Q

small infant RR

A

25 - 60 breaths/minute

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65
Q

large infant RR

A

25 - 55 breaths/minutes

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66
Q

small child RR

A

20 - 40 breaths/minute

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67
Q

medium child RR

A

16 - 34 breaths/minute

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68
Q

SpO <85%
what to do/what level is it

A

Severe or critical illness
Hypoxaemia
non - rebreather mask (10-15L.min)
consider BVM as requied

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69
Q

Severe SpO2
what to do/what level is it

A

Hypoxaemia
SpO <85% or critical illness
non - rebreather mask (10-15L.min)
consider BVM as requied

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70
Q

SpO2 85 - 91%
what to do/what level is it

A

Mild - Moderate
Hypoxaemia
Titrate O2 to SpO2 92 - 96%
- nasal cannula (2-6L/min) or
- simple face mask (5-10L/min)

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71
Q

Mild - Moderate SpO2
what to do/what level is it

A

SpO2 85 - 91%
Hypoxaemia
Titrate O2 to SpO2 92 - 96%
- nasal cannula (2-6L/min) or
- simple face mask (5-10L/min)

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72
Q

≥ 92% what to do/what level is it

A

Adequate SpO2

no O2 required

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73
Q

Adequate SpO2

A

≥ 92%
No O2 required

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74
Q

medium child RR

A

16 - 34 breaths/minute

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75
Q

small child RR

A

20 - 40 breaths/minute``

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76
Q

large infant RR

A

25 - 55 breaths/minutes

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77
Q

small infant RR

A

25 - 60 breaths/minute

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78
Q

newborn RR

A

25 - 60 breaths/minute

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79
Q

Paediatrics
RR
16 - 34

A

medium child

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80
Q

Paediatrics
RR
20 - 40 breaths/minute

A

small child

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81
Q

Paediatrics
RR
25 - 55 breaths/minute

A

large infant

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82
Q

Paediatrics
RR
25 - 60 breaths/minute

A

newborn
small infant

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83
Q

Paediatrics
70 - 135bpm (HR)
> 80mmHg (BP)

A

medium child

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84
Q

Paediatrics
85 - 150bpm (HR)
> 70mmHg systolic (BP)

A

small child

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85
Q

Paediatrics
105 - 165 (HR)
> 65mmHg systolic (BP)

A

large infant

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86
Q

Paediatrics
110 - 170bpm (HR)
> 60mmHg systolic (BP)

A

newborn
Small infant

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87
Q

medium child
HR and BP

A

HR 70 - 135bpm
BP > 80mmHg systolic

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88
Q

small child
HR and BP

A

HR 85 - 150bpm
BP > 70mmHg systolic

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89
Q

large infant
HR and BP

A

HR 105 - 165bpm
BP > 65mmHg systolic

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90
Q

small infant
HR and BP

A

HR 110-170bpm
BP > 60mmHg systolic

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91
Q

Newborn heart rate
HR and BP

A

HR 110-170
BP > 60mmHg systolic

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92
Q

E - to pain
V - inappropriate words
M - withdraws to pain

A

9

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93
Q

E - to voice
V - incomprehensible sounds
M - extension to pain

A

7

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94
Q

E - to pain
V - confused
M - flexion to pain

A

9

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95
Q

E - spontaneous
V - inappropriate words
M - localises to pain

A

12

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96
Q

PSA
unconscious

A

no perfusion

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97
Q

PSA
altered or unconscious

A

extremely poor perfusion

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98
Q

PSA
either alert and orientated to time and place or altered

A

inadequate perfusion

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99
Q

PSA
alert and orientated to time and place

A

adequate perfusion
borderline perfusion

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100
Q

PSA
cool, pale, clammy

A

inadequate perfusion
borderline perfusion
extremely poor perfusion
no perfusion

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101
Q

PSA
warm, pink, dry

A

adequate perfusion

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102
Q

PSA
unrecordable

A

no perfusion

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103
Q

PSA
< 60 systolic or unrecordable

A

extremely poor perfusion

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104
Q

PSA
60 - 80 systolic

A

Inadequate perfusion

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105
Q

PSA
80 - 100 systolic

A

borderline perfusion

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106
Q

PSA
BP > 100 systolic

A

adequate perfusion

107
Q

PSA
no palpable pulse

A

no perfusion

108
Q

PSA
<50 or > 110 bpm

A

extremely poor perfusion

109
Q

PSA
<50 or >100 bpm

A

inadequate perfusion

110
Q

PSA
50 - 100 bpm

A

borderline perfusion

111
Q

PSA
60 - 100 bpm

A

adequate perfusion

112
Q

RSA
> 120 bpm

A

severe distress

113
Q

RSA
100 - 120 bpm

A

moderate distress

114
Q

RSA
60 - 100 bpm

A

normal
mild distress

115
Q

RSA
> 20
< 8 (bradypnoea)

A

severe distress

116
Q

RSA
>20 RR

A

moderate distress

117
Q

RSA
16 - 20 RR

A

mild distress

118
Q

RSA
12 - 16 RR

A

normal

119
Q

RSA
distressed, anxious, fighting to breathe, exhausted, catatonic

A

severe distress

120
Q

RSA
calm or mildly anxious

A

mild distress

121
Q

RSA
calm, quiet

A

normal

122
Q

RSA
altered or unconscious

A

severe distress

123
Q

RSA
may be altered

A

moderate distress

124
Q

RSA
alert

A

normal
mild distress

125
Q

RSA
pale and sweaty, +/- cyanosis

A

severe distress

126
Q

RSA
pale and sweaty

A

moderate distress

127
Q

RSA
normal skin

A

normal
mild distress

128
Q

RSA
marked chest movement +/- use of accessory muscle

A

moderate distress

129
Q

RSA
slight increase in normal chest movement

A

mild distress

130
Q

RSA
normal chest movement

A

normal

131
Q

RSA
words only or unable to speak

A

severe distress

132
Q

RSA
short phrases only

A

moderate distress

133
Q

RSa
full sentences

A

mild distress

134
Q

RSA
clear and steady sentences

A

normal

135
Q

RSA
Asthma - prolonged expiratory phase

A

moderate distress
severe distress

136
Q

RSA
Asthma - may have a slightly prolonged expiratory phase

A

mild distress

137
Q

RSA
regular even cycles

A

normal

138
Q

RSA
unable to cough

A

severe distress

139
Q

RSA
Upper airway obstruction - inspiratory stridor

A

severe distress

140
Q

RSA
Asthma- expiratory wheeze +/- inspiratory wheeze, maybe no breath sounds (late)

A

severe distress

141
Q

RSA
LVF - crackles at bases - to mid-zone

A

moderate distress

142
Q

RSA
Asthma - expiratory wheeze, +/- inspiratory wheeze

A

moderate distress

143
Q

RSA
LVF - there may be some fine crackles at the bases

A

mild distress

144
Q

RSA
asthma - mild expiratory wheeze

A

mild distress

145
Q

RSA
able to cough

A

normal
mild distress
moderate distress

146
Q

RSA
no crackles or scattered fine basal crackles

A

normal

147
Q

RSA
usually quiet no wheeze

A

normal

148
Q

PSA
unconscious

A

no perfusion

149
Q

PSA
altered or unconscious

A

extremely poor perfusion

150
Q

PSA
either alert and orientated to time and place or altered

A

inadequate perfusion

151
Q

PSA
alert and orientated to time and place

A

adequate perfusion
borderline perfusion

152
Q

PSA
cool, pale, clammy

A

borderline perfusion
inadequate perfusion
extremely poor perfusion
no perfusion

153
Q

PSA
warm, pink, dry

A

adequate perfusion

154
Q

RSA
HR - 140

A

severe distress

155
Q

RSA
HR - 105

A

moderate distress

156
Q

RSA
HR - 75

A

normal
mild distress

157
Q

RSA
HR - 90

A

normal
mild distress

158
Q

RSA
HR - 62

A

normal

159
Q

RSA
HR - 110

A

moderate distress

160
Q

RSA
HR - 125

A

severe distress

161
Q

RSA
HR - 80

A

normal
Mild

162
Q

RSA
RR - 21

A

moderate distress
severe distress

163
Q

RSA
RR - 8

A

severe distress

164
Q

RSA
RR - 17

A

mild distress

165
Q

RSA
RR - 26

A

severe distress

166
Q

RSA
RR - 12

A

normal

167
Q

RSA
RR - 6

A

severe distress

168
Q

RSA
RR - 22

A

moderate distress
severe distress

169
Q

RSA
RR - 18

A

mild distress

170
Q

RSA
RR - 14

A

normal

171
Q

PSA
Pulse - 50

A

borderline perfusion

172
Q

PSA
Pulse - 90

A

adequate perfusion
borderline perfusion

173
Q

PSA
Pulse - 30

A

inadequate perfusion
extremely poor perfusion

174
Q

PSA
Pulse - 62

A

adequate perfusion

175
Q

PSA
Pulse - 70

A

adequate perfusion
borderline perfusion

176
Q

PSA
Pulse - 105

A

inadequate perfusion

177
Q

PSA
Pulse - 120

A

extremely poor perfusion

178
Q

PSA
Pulse - 40

A

inadequate perfusion
extremely poor perfusion

179
Q

PSA
Pulse - 55

A

borderline perfusion

180
Q

PSA

Pulse - 80

A

adequate perfusion
borderline perfusion

181
Q

PSA
BP - 95

A

borderline perfusion

182
Q

PSA
BP - 105

A

adequate perfusion

183
Q

PSA
BP - 50

A

extremely poor perfusion

184
Q

PSA
BP - 61

A

Inadequate perfusion

185
Q

PSA
BP - 110

A

adequate perfusion

186
Q

PSA
BP - 90

A

borderline perfusion

187
Q

PSA
BP - 75

A

inadequate perfusion

188
Q

PSA
BP - 40

A

extremely poor perfusion

189
Q

PSA
BP - 90

A

borderline perfusion

190
Q

PSA
BP - 120

A

Adequate perfusion

191
Q

Red flag

A

HR - >120
RR - >30
BP - <90
SpO2 < 90% (unless chronic hyperaemia)
GCS < 13 - <15 if age is ≤15 yrs

192
Q

other illnesses affecting SpO2 levels

A

Cardiac arrest or resuscitation
Major trauma
Shock
Severe sepsis
Anaphylaxis
Status epilepticus
Ketamine sedation

193
Q

normal temperature

A

36.5-37.5

194
Q

normal blood glucose levels

A

4-8

195
Q

Time critical - Vital signs

A

HR - <60 or >120
RR - <10 or >30
Systolic BP - <90
SpO2 - <90%
≥16 GCS - <13
≤15 GCS - <15

196
Q

CSA (motor response)
none

A

1

197
Q

CSA (motor response)
extension to pain

A

2

198
Q

CSA (motor response)
flexion to pain

A

3

199
Q

CSA (motor response)
withdraws to pain

A

4

200
Q

CSA (motor response)
localises to pain

A

5

201
Q

CSA (motor response)
obeys command

A

6

202
Q

CSA (verbal response)
none

A

1

203
Q

CSA (verbal response)
incomprehensible sounds

A

2

204
Q

CSA (verbal response)
inappropriate words

A

3

205
Q

CSA (verbal response)
confused

A

4

206
Q

CSA (verbal response)
orientated

A

5

207
Q

CSA (eye-opening)
none

A

1

208
Q

CSA (eye-opening)
to pain

A

2

209
Q

CSA (eye-opening)
to voice

A

3

210
Q

CSA (eye-opening)
spontaneous

A

4

211
Q

5-11 years

A

medium child

212
Q

1-4 years

A

small child

213
Q

3-12 months

A

large infant

214
Q

birth to 24 hours

A

Newborn age

215
Q

under 3 months

A

small infant

216
Q

child > 4 years old
CS - motor
1

A

none

217
Q

child > 4 years old
CS - motor
2

A

abnormal extension to pain

218
Q

child > 4 years old
CS - motor
3

A

abnormal flexion to pain

219
Q

child > 4 years old
CS - motor
4

A

withdraws from pain

220
Q

child > 4 years old
CS - motor
5

A

localises to pain

221
Q

child > 4 years old
CS - motor
6

A

obeys command

222
Q

child > 4 years old
CS - verbal
1

A

none

223
Q

child > 4 years old
CS - verbal
2

A

Incomprehensible sounds

224
Q

child > 4 years old
CS - verbal
3

A

Inappropriate words

225
Q

child > 4 years old
CS - verbal
4

A

confused

226
Q

child > 4 years old
CS - verbal
5

A

orientated

227
Q

child > 4 years old
CS - eye-opening
1

A

none

228
Q

child > 4 years old
CS - eye-opening
2

A

To pain

229
Q

child > 4 years old
CS - eye-opening
3

A

To voice

230
Q

child > 4 years old
CS - eye-opening
4

A

Spontaneous

231
Q

child ≤ 4 years old
CS - motor
1

A

none

232
Q

child ≤ 4 years old
CS - motor
2

A

Abnormal extension to pain

233
Q

child ≤ 4 years old
CS - motor
3

A

Abnormal flexion to pain

234
Q

child ≤ 4 years old
CS - motor
4

A

Withdraws from pain

235
Q

child ≤ 4 years old
CS - motor
5

A

Localises to pain

236
Q

child ≤ 4 years old
CS - motor
6

A

Spontaneous

237
Q

child ≤ 4 years old
CS - verbal
1

A

None

238
Q

child ≤ 4 years old
CS - verbal
2

A

Moans to pain

239
Q

child ≤ 4 years old
CS - verbal
3

A

Persistently irritable

240
Q

child ≤ 4 years old
CS - verbal
4

A

Cries but consolable

241
Q

child ≤ 4 years old
CS - verbal
5

A

appropriate words/social smile

242
Q

child ≤ 4 years old
CS - Eyes
1

A

none

243
Q

child ≤ 4 years old
CS - Eyes
2

A

to pain

244
Q

child ≤ 4 years old
CS - Eyes
3

A

to voice

245
Q

child ≤ 4 years old
CS - Eyes
4

A

spontaneous

246
Q

Paediatric weight
Age x 3.3kg

A

10 - 11 years

247
Q

Paediatric weight
Age x 2 + 8kg

A

1-9 years

248
Q

Paediatric weight
10kg

A

1 year

249
Q

Paediatric weight
8kg

A

6 months

250
Q

Paediatric weight
6kg

A

3 months

251
Q

Paediatric weight
3.5

A

<24 hours

252
Q

EtCO2
range

A

35- 45mmHg

253
Q

Nebuliser face mask for drug administration
how many litres

A

8-10L/min

254
Q

CPAP
contraindications

A
  • Inability to manage own airway (alter conscious state, active vomiting or excessive secretions)
  • upper airway obstruction
  • Hypoventilation (patient must have adequate spontaneous respirations)
  • untreated tension pneumothorax (must be treated before considering CPAP)
  • Haemodynamic instability (severe hypotension, ventricular arrhythmias - should all be treated before considering)
  • Injuries that preclude mask application
255
Q

CPAP
precautions

A
  • hypovolemia
  • post chest decompression (closely monitor)
  • COPD (monitor for deterioration)
  • Hypotension
256
Q

CPAP
Indications for it to be removed

A
  • Cardiac/respiratory arrest
  • Pt agitation/intolerance
  • No improvements after 1hr
  • HR <50
  • SBP <90
  • GCS <13
  • Decreasing SpO2
  • Loss of airway control
  • Copious secretion
  • Active vomiting
  • Paramedic judgement of Pt deterioration
257
Q

Adolescents
Age

A

12-15 years

258
Q

Adolescents
HR and BP

A

60-120
>90

259
Q

Adolescents
RR

A

14-26

260
Q

Adolescents
weight

A

based on pt size

261
Q

Paediatrics
60 - 120bpm (HR)
> 90mmHg systolic (BP)

A

Adolescents

262
Q

Paediatrics
RR
14 - 26

A

Adolescents

263
Q

Paediatrics
age
12-15

A

Adolescents

Clinical Approach (4 decks)

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