skills Flashcards
OPA contraindications
trismus, intact gag reflex, neurological injury
NPA contraindications
middle third facial trauma, significant nasal trauam, brain injury
iGel contraindications
intact gag reflex, trismus, upper airway obstruction, suspected epiglottis
12 led ECG placement
V1 - 4th intercostal, right of sternum V2 - 4th intercostal, left of sternum V3 - between 2&4 V4 - 5th intercostal, mid clavicular line V5 - 5th intercostal, mid auxillar line V6 - 5th intercostal, auxillar line
LA - left under clavical
RA - right under clavical
LL - left costal margin, mid clavicular line
RL - right costal margin, mid clavicular line
CPAP contraindications
facial trauma, GCS <13, upper airway obstruction, pneumothorax, vomiting, life threatening arrhythmia, need for airway management, hypoventilation
Nasal prongs
2-6 L/min
Simple face mask
5-10 L/min
Nebuliser
?
GCS
Eyes 1-4
- No response
- Responds to pain
- Responds to commands
- Spontaneous
Speech 1-5
- No response
- Noises
- Incoherent words
- Disoriented
- Oriented
Motor 1-6
- No movement
- Extension
- Flexion
- Withdraws from pain
- Localises pain
- Obeys commands
RSA
Appearance Auscultation Conscious state Respiratory rate Respiratory rhythm Work of breathing Heart rate Speech Skin
Categories: no distress, mild, moderate, severe
PSA
Blood pressure
Heart rate
Skin
Conscious state
Categories: adequate, borderline, inadequate, extremely poor, none
Additional Obs
Pupils, SpO2, BGL, Temperature, ECG
AEIOU TIPS
A - alcohol E - epilepsy I - insulin O - overdose U - underdose T - trauma I - infection P - poison/psych S - stroke/sepsis
HEATAU
H - hypoxia E - exsanguination A - asthma T - tension pneumothorax A - anaphylaxis U - upper airway obstruction
Stroke assessment
MASS - positive if any occur (facial droop, slurred speech or unilateral weakness)
A - arm test (hold both arms up, see if one falls)
C - chat (right arm falls)
T - tap (left arm falls)
If no evidence of stroke mimic, deficits new or worse and symptoms started <24 hours ago, then ACT-FAST positive
Defib pads
Under right clavicle, above right nipple
Mid auxiliary line 6th intercostal
Paeds defib kj calculation
weight x 4, round up
5 patient rights
Route, time, drug, patient, dose
Inferior leads
L2, L3, aVF = right coronary artery
Septal leads
V1, V2 = left anterior descending artery
Anterior leads
V3, V4 = Left coronary artery
Lateral leads
L1, V5, V6, aVL = circumflex artery
Drug calculations
- work out the weight using the age (3y/o = 14kg)
- multiple by dose (600mcg/kg x 14 = 8400)
- if on hand drug comes in mg then convert mcg to mg - divide by 1000 to get mg (8400mcg -> 8.4mg)
- x the found dose by mL on hand, divide answer by mg we have on hand (presentation)
- 4x2 = 16.8. 16.8/8 = 02.1
Dose = 8.4mg Volume = 2.1mL
