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ACLS > Skill stations > Flashcards

Skill stations Flashcards

1
Q

What mnemonic is used for the pre-hospital report?

A

MIST=MOI, Injuries, S/S in the field, Tx in the field.

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2
Q

What is the major concern of the across the room assessment?

A

Uncontrolled hemmorhage? Should you switch from ABC to CAB?

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3
Q

What does ABCDE stand for?

A

Airway/alertness (with cervical spine stablilzation), Breathing and ventilation, Circulation/control of hemmorhage, Disability (neurologic status), Exposure and environmental control.

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4
Q

What do “F” and “G” stand for?

A

Full set of vitals, Get resuscitation adjuncts.

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5
Q

Name the resuscitation adjuncts.

A

Lab studies, cardiac rate/rhythm, naso/oro tube considerations, oxygenation/ventilation assessment (capnography/pulse ox if needed), Pain assessment.

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6
Q

What comes after FG?

A

Reevaluate.

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7
Q

What come after reevaluation?

A

Secondary survey, which includes history and head to toe assessment.

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8
Q

What are the first 3 steps taken when notified a trauma Pt is coming in to the facility?

A

Activate the Trauma team, prepare the trauma room with a rapid infuser and trauma equipment, don PPE.

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9
Q

What is the first step taken when a trauma Pt arrives?

A

Across the room assessment….any uncontrolled external hemorrhage? State “no need to re-prioritize” if no hemorrhage.

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10
Q

After the across the room assessment, what comes next?

A

AVPU. Alert/verbal/painful/unconscious

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11
Q

What is the last step taken before a trauma Pt arrives?

A

Don PPE.

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12
Q

Your Pt comes in with a collar on following an MVA, after AVPU assessment, what is done next?

A

State the need for a second person to assist with cervical stabilization and perform jaw thrust maneuver.

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13
Q

How would yo demonstrate airway protection?

A

Tongue obstructing, loose/missing teeth, vomitus/blood, foreign objects, edema, snoring/gurgling/stridor?

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14
Q

After inspecting the airway of a trauma Pt, what is done next?

A

Decide if OPA needed, state the need for a definitive airway, reassess airway after OPA placement.

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15
Q

After airway placement, what is done next?

A

Determine if breathing is effective. Is breathing spontaneous? Chest rise symmetrical? Depth/pattern/rate? Increased work of breathing? Skin color? Open wounds/deformities? Sub Q. emphysema? Tracheal deviation? JVD? Breath sounds present/equal?

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16
Q

After assessing airway, what is done next?

A

State need for ventilation assistance with bag mask device and the need for airway placement.

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17
Q

How do you assess for correct endotracheal tube placement?

A

Attach CO2 detector, observe for chest rise/fall, auscultate over epigastrium and bilateral breath sounds, ahter 5-6 breaths observe CO2 detector, assess for improvement in skin color.

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18
Q

ET tube has been placed and Pt assessed. What next?

A

Assess ETT position by noting the number at the teeth and secure tube.

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19
Q

After assessing ETT placement, what is the last step in securing the airway?

A

State the need to continue assisted ventilation or begin mechanical ventilation.

20
Q

The airway is secure, A and B are complete, what is the first step in checking circulation?

A

Check circulation by inspection/palpation/auscultation.Inspect for uncontrolled hemorrhage, Palpate/auscultate a central pulse, inspect/palpate skin for color/temp/moisture.

21
Q

It is determined that circulation is acceptable, what is done next?

A

Check IV patency and determine if second line is needed. (may state need for type and cross at this time)

22
Q

IV’s are in place. What is done next?

A

State need for WARMED isotonic fluids in blood tubing at a controlled rate.

23
Q

After IV considerations, what is done next?

A

Glasgow coma scale. Eye opening, verbal response, and motor response.

24
Q

Describe the GSC assessment?

A

Eye opening:Spontaneous=4, to speech=3, to pain=2, none=0. Verbal:oriented =5, confused conversation=4, inappropriate words=3, incomprehensible sounds=2, none=1, motor response: obeys commands=6, localizes pain=5, withdrawal(normal flexion)=4, abnormal flexion (decorticate)=3, Extension(decerebrate)=2, none=1

25
Q

What is done after obtaining a GCS score?

A

Assess pupils.

26
Q

What is next after pupil assessment?

A

State the need for CT.

27
Q

What is done after assessing neurologic status?

A

Assess Exposure/environmental controls in 2 steps. First, remove all clothing, second, assess need for warming, which may be addressed in 1 of 5 ways. Warmed fluids, warmed O2, warm blankets, lights, increasing room temp.

28
Q

The environmental step is complete, what is the first step taken next?

A

You move on to resuscitation adjuncts. FGLMNOP. F=full set of vitals.

29
Q

After obtaining a full set of vitals, whats next?

A

Family

30
Q

After family adjunct, what is next?

A

Labs, including ABG/type and cross/lactic acid.

31
Q

What is done after labs?

A

M=monitor

32
Q

What is next after the Pt is placed on the monitor?

A

Determine if naso or oro gastric tube is needed. Remember, if head injury is suspected, oro tube may be needed.

33
Q

What does the “O” in LMNOP mean?

A

Oximetry/capnography.

34
Q

What is considered the normal range for capnography?

A

35-45 mmhg

35
Q

What does the “P” in LMNOP mean?

A

Pain assessment on an appropriate scale. Assume pain is present based on MOI, etc.

36
Q

What is the first step taken after pain assessed?

A

determine nonpharmacologic comfort measures. Ice, reposition, pad bony prominences, other as appropriate.

37
Q

After nonpharmacologic measures are taken for pain, what is done next?

A

Analgesia.

38
Q

After resuscitation adjuncts are completed (LMNOP), what is the next step?

A

History. Both MIST and past history.

39
Q

What are the first 3 steps in the head to toe assessment?

A

Inspect and palpate face/head. Inspect and palpate neck/demonstrate removal and replacement of cervical collar. Inspect and palpate chest.

40
Q

What are the 4th, 5th and 6th steps in the head to toe assessment?

A

Auscultate heart and breath sounds, Inspect abdomen and flanks. Auscultate bowel sounds.

41
Q

What are the 7th 8th and 9th steps to the head to toe assessment?

A

Palpate abdomen(4 quads). Inspect pelvis and perineum. Apply gentle downward/medial pressure to iliac crests.

42
Q

What are the 10th 11th and 12th steps to the head to toe assessment?

A

Apply gentle pressure to the symphysis pubis. Assess indications/contraindications for urinary catheter. Inspect/palpate extremities for neurovascular status and injury.

43
Q

What are the last 3 steps to the head to toe assessment?

A

State the need for cervical/spinal stabilization while turning Pt to inspect posterior. Inspect/palpate posterior surfaces. Consider spine board removal.

44
Q

After posterior surface inspection is completed, what is the next step?

A

Begin reevaluation adjuncts.Make sure all injuries are identified. Identify radiologic exams needed such as head CT, CXR, pelvic xray, Abdominal CT. Revise trauma score, clean and dress wounds, tetanus, antibiotic.

45
Q

After identifying all reevauationl adjuncts, what is the next step in the head to toe assessment and what are its 4 steps?

A

Identify findings that need reevaluation. Primary assessment, vital signs, pain, all injuries identified and the effectiveness of interventions.

46
Q

What is the last step in the trauma care progression?

A

Evaluate the need for transfer or prep for surgery.

ACLS (3 decks)

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