Skills

Question 1

IGel Indications

Answer 1

Supraglottic device refers to i-Gel.

To manage and maintain a compromised airway in the patient with absent pharyngeal and laryngeal reflexes.

Question 2

IGel Contras

Answer 2

Intact gag reflex

Question 3

4 IGel Discontinue

Answer 3

• Effective ventilations (i.e.: adequate chest rise and fall) cannot be achieved (some air leakage can be expected)
• GCS of the patient increases with a return of gag reflex or patient attempts to remove
• i-Gel is faulty.
• Regurgitation occurs and is anticipated to be compromising

Question 4

Direct Laryngoscopy & Magill Forceps Indications

Answer 4

• To identify and remove a suspected foreign body from the hypopharynx that is preventing ventilation.
• In order to create a patent airway and an ability to achieve adequate ventilation

Question 5

4 Direct Laryngoscopy & Magill Forceps Contras

Answer 5

• Conscious patient or Gag reflex intact
• Do not use Magill forceps if obstruction below the vocal cords.
• SpO2 reading of 90% and ventilation is achievable
• Suspected epiglottitis.

Question 6

Peripheral IV Access

Indications

Answer 6

Intravenous access for fluid or drug administration.

Question 7

Peripheral IV Access

Contras

Answer 7

-Directly over or distal to:
—Burns
—Cellulitis
—Infection
—Injury
-Patients with chlorhexidine sensitivity/allergy, use 10% povidone-iodine swab

Question 8

Peripheral IV Access

Discontinue

Answer 8

If multiple failed attempts, consider whether vascular access is necessary to manage current patient presentation.

Question 9

External Jugular Access

Indications

Answer 9

Intravenous access for fluid or drug administration.

Question 10

External Jugular Access

Contras

Answer 10

-Directly over or distal to:
—Burns
—Cellulitis
—Infection
—Injury
-Patients with chlorhexidine sensitivity/allergy, use 10% povidone-iodine swab

Question 11

External Jugular Access

Discontinue

Answer 11

If multiple failed attempts, consider whether vascular access is necessary to manage current patient presentation.

Question 12

Prehospital Blood Sample Collection

Indications

Answer 12

The acquisition of pre-hospital phlebotomy has proven to result in shorter ED times by having the bloods sent to the lab earlier.

Question 13

Prehospital Blood Sample Collection

Contra

Answer 13

• Any patient whose clinical condition does not warrant IV cannulation.
• Children <16 years old.

Question 14

Dopes (D)

Answer 14

Displacement

• Check etCO2 value/waveform.
• Look at tube position; does it look displaced?
• Auscultate the chest
• Check placement after any move.

Question 15

Dopes (O)

Answer 15

Obstruction

• Inability or severe resistance to ventilation is a very good indicator of obstruction.
• Clear Foreign Body Airway Obstruction

Question 16

Dopes (P)

Answer 16

Pneumothorax

• Consider the signs and symptoms of pneumothorax/haemothorax.
• Consider ventilator settings.

Question 17

Dopes (E)

Answer 17

Equipment Failure

-Consider failure of equipment starting from the oxygen cylinder straight through to the iGel and back again.

Question 18

Dopes (S)

Answer 18

Secretions

• Thick mucus might obstruct iGel.
• Suction

Question 19

Intraosseous Access

Indications

Answer 19

Cannulation of the intraosseous space using EZ-IO:
-Cardiac arrest:
—First line cardiac arrest management for paediatrics
—Consideration for first line access in traumatic cardiac arrest
—Second line cardiac arrest management for adults following at least one failed intravenous (IV) access attempt.
-All other circumstances:
Where immediate medication administration is required following at least one failed intravenous (IV) access attempt when unable to administer via any other appropriate route.

Question 20

Intraosseous Access

Contras

Answer 20

• Fracture to the targeted bone. (Fracture)
• IO within last 48 hours in the targeted bone.(48)
• Inability to locate landmarks or excessive tissue.(Fat)
• Prosthetic limb or joint (near insertion point).(Fake)
• Patients with chlorhexidine sensitivity/allergy, use 10% povidone-iodine swab

Question 21

Intraosseous Access

Discontinue

Answer 21

If multiple failed attempts, consider whether vascular access is necessary to manage current patient presentation.