Skills Flashcards
According to the Bandaging skill what should you check before bandaging?
Circulation
Motor function
Sensation
According to the Bandaging skill where should you check for circulation, motor function, and sensation before bandaging?
Distal to injury
According to the Bandaging skill what technique should you use when covering with dressing?
Aseptic technique
According to the Bandaging skill how should you secure dressing?
With appropriate pressure and no excessive movement
According to the Bandaging skill how often should you check circulation, motor function, and sensation distal to the injury?
Before and after bandaging
According to the Bandaging skill what should you document?
All assessment findings and pts response to procedure
According to the Tourniquet skill what is the rationale behind the use of a tourniquet?
Use of a tourniquet is appropriate when upper or lower extremity hemorrhage cannot be controlled by applying direct pressure or a pressure dressing to the site of bleeding.
According to the Tourniquet skill what should you wear appropriate for the potential of blood exposure?
PPE
According to the Tourniquet skill prior to tourniquet placement what should you do?
Visually inspect injured extremity
According to the Tourniquet skill where should you avoid placement of a tourniquet?
Over a joint Angulated or open fracture Stab or gunshot wound sites Lower arm Lower leg
According to the Tourniquet skill why should tourniquet placement be avoided in the lower arm and/or lower leg?
Occlusion of the arterial supply may not be possible there
According to the Tourniquet skill what should you assess and document before and after placement?
Circulation
Motor
Sensation
According to the Tourniquet skill where should you assess circulation, motor, and sensation?
Distal to injury site
According to the Tourniquet skill when applying a tourniquet to the upper arm or upper leg what distance from the wound should the tourniquet be placed?
4 finger breadths proximal to wound
According to the Tourniquet skill how should you tighten the tourniquet?
Tighten incrementally to the least amount of pressure required to stop bleeding
According to the Tourniquet skill with what should you cover the wound?
Appropriate sterile dressing and/or bandage
According to the Tourniquet skill should the tourniquet be covered?
DO NOT cover tourniquet (keep tourniquet visible)
According to the Tourniquet skill what should you be sure that the receiving facility is aware of?
Tourniquet placement
Time tourniquet placed
According to the Tourniquet skill what are 4 things you should document?
- Estimated blood loss
- Vital signs
- Assessment of circulation, motor, and sensation distal to injury site before and after tourniquet application
- Time tourniquet applied
According to the Splinting skill what should you check before and after splinting?
Circulation
Motor function
Sensation
According to the Splinting skill where should you check for circulation, motor function, and sensation?
Distal to injury
According to the Splinting skill with what should you immobilize the injury?
Appropriate device
According to the Splinting skill how should the splinted extremity be positioned?
Elevated
According to the Traction Splinting skill in what situation should a traction splint never be applied?
Open Fracture
According to the Traction Splinting skill what should you check before and after application?
Circulation
Motor function
Sensation
According to the Traction Splinting skill where should you check for circulation, motor function, and sensation before and after application?
Distal to injury
According to the Traction Splinting skill how should a traction splint be applied?
Maintaining traction, elevation, and gentleness
According to the Traction Splinting skill who’s guidelines and instructions should you follow when applying a traction splint?
Manufacturer
According to the Spinal Immobilization-Supine skill what should happen with the face mask of a helmet?
Removed prior to transport
According to the Spinal Immobilization-Supine skill when should helmets and shoulder pads be left in place?
If the motion of the pts spine can be adequately and effectively restricted
According to the Spinal Immobilization-Supine skill if the helmet and shoulder pads must be removed how should they be removed?
As a unit
According to the Spinal Immobilization-Supine skill what 5 situations call for the helmet and shoulder pads to be removed as a unit?
- Helmet and chin strap do not hold the head securely
- Immobilization of helmet does not immobilize head
- Airway cannot be controlled or pt cannot be ventilated effectively
- Face mask cannot be removed after reasonable period of time
- Helmet prevents immobilization for transport in an appropriate position
According to the Spinal Immobilization-Seated skill what should you initially do?
Direct partner to establish and maintain neutral spine alignment
According to the Spinal Immobilization-Seated skill what should you check before and after spinal immobilization?
Circulation
Motor function
Sensation
According to the Spinal Immobilization-Seated skill where should you check for circulation, motor function, and sensation before and after spinal immobilization?
In all 4 extremities
According to the Spinal Immobilization-Seated skill which should you apply to the pt first? Cervical collar or Short device?
Cervical collar
According to the Spinal Immobilization-Seated skill whose recommendations are you to follow in applying the short spinal device?
Manufacturer’s
According to the Spinal Immobilization-Seated skill which part of the body is secured to the short spinal device first?
Torso
According to the Spinal Immobilization-Seated skill after applying the short spinal board to the Torso what part of the body should then be secured?
Head
According to the Spinal Immobilization-Seated skill what should you consider about pt respirations when applying the short spinal board?
Do not compromise or impede respirations
According to the Spinal Immobilization-Seated skill should the pt be transported while secured to the short spinal board?
NO. Remove pt from shot spinal device prior to transport
According to the Bronchodilator Administration skill what should you inform the pt of?
The order for medication
According to the Bronchodilator Administration skill what should you inquire of the pt?
Allergies
Recent Doses of other bronchodilators
According to the Bronchodilator Administration skill what should you verbalize you have checked?
For contamination
Expiration date
According to the Bronchodilator Administration skill who’s standard should you follow in assembling the nebulizer?
Manufacturers standard
Local protocol
According to the Bronchodilator Administration skill what oxygen flow should you provide?
Manufacturers recommendations
According to the Bronchodilator Administration skill when should you position nebulizer device on pt?
After adjusting oxygen flow and allowing mist to fill breathing tube or mask
According to the Peripheral Venipuncture skill what should you avoid?
Contamination of equipment
According to the Peripheral Venipuncture skill what should you confirm when confirming the order?
Solution
Rate
According to the Peripheral Venipuncture skill what should you inform the pt of?
The order for IV access and/or fluid therapy
According to the Peripheral Venipuncture skill what should you verbalize as you are checking?
Correct IV solution
For contamination
Expiration date
According to the Peripheral Venipuncture skill after connecting tubing to fluid bag what should you next do?
Clear pulse
According to the Peripheral Venipuncture skill what should you check after applying a constricting band?
Distal pulse
According to the Peripheral Venipuncture skill where should your site be located in reference to the constricting band?
Below the constricting band
According to the Peripheral Venipuncture skill what technique should you use when cleansing the skin with an alcohol prep?
Circular motion working outward
According to the Peripheral Venipuncture skill what should you inspect the catheter and needle for?
Defects
According to the Peripheral Venipuncture skill when inspected the catheter and needle for defects what should you avoid?
Advancing the catheter over the needle
According to the Peripheral Venipuncture skill how many attempts do you get to perform venipuncture?
3
According to the Peripheral Venipuncture skill what should you consider if the venipuncture is unsuccessful?
IO
According to the Peripheral Venipuncture skill after performing venipuncture where should you attach the tubing?
The hub
According to the Peripheral Venipuncture skill prior to attempting to verify flow what should you first do?
Remove constricting band
According to the Peripheral Venipuncture skill once flow has been verified what is the next step?
Secure catheter and dress sit
According to the Peripheral Venipuncture skill what rate should the flow be set at?
As ordered
According to the Peripheral Venipuncture skill what do you do with contaminated equipment?
Dispose
According to the Intramuscular Drug Injection skill what 3 things are you checking for when confirming an order?
Medication
Dosage
Route
According to the Intramuscular Drug Injection skill what should you ask of the pt?
Allergies
According to the Intramuscular Drug Injection skill what should you check the medication for?
Contamination
Expiration date
According to the Intramuscular Drug Injection skill after drawing up correct amount of the medication what is the next step in preparation?
Expel air from syringe
According to the Intramuscular Drug Injection skill what 3 sites should you choose from for injection?
Thigh
Gluteal
Deltoid
According to the Intramuscular Drug Injection skill in the order of most preferred to least preferred rate the 3 sites from which you should choose for an injection?
- Thigh
- Gluteal
- Deltoid
According to the Intramuscular Drug Injection skill how many time should you check the medication prior to injecting?
3 times
According to the Intramuscular Drug Injection skill prior to needle insertion what should you do?
Cleanse the site with alcohol
According to the Intramuscular Drug Injection skill after performing needle insertion and prior to administering the medication what should you do?
Aspirate for the absence of blood return
According to the Intramuscular Drug Injection skill what are you looking for when aspirating a needle that has just been inserted?
Absence of blood return
According to the Intramuscular Drug Injection skill after injecting the medication and withdrawing the needle what should you do with the site?
Apply pressure
According to the Intravenous Drug Administration skill what 3 things should you confirm about the order?
Dosage
Medication
Route
According to the Intravenous Drug Administration skill what should you ask the pt?
Allergies
According to the Intravenous Drug Administration skill what 2 things should you check the medication for?
Contamination
Expiration date
According to the Intravenous Drug Administration skill before connecting the syringe to the IV tubing port what should you do?
Expel air from syringe
According to the Intravenous Drug Administration skill which medication port on an IV tube should you choose to inject medication?
The one closest to the IV site
According to the Intravenous Drug Administration skill before attaching the syringe to the port what should you do?
Cleanse the port with alcohol
According to the Intravenous Drug Administration skill how many times should you check the medication before administering?
3
According to the Intravenous Drug Administration skill what are the 2 places on an IV tube where you can connect a syringe for drug administration?
Medication port
Stopcock
According to the Intravenous Drug Administration skill how do you ensure a patent IV line?
Aspirate for blood
Check for infiltration
Check for IV flow
According to the Intravenous Drug Administration skill where should you occlude flow prior to giving medication?
Above the medication port
According to the Intravenous Drug Administration skill after administering thed medication and removing the needle/syringe what should you do?
Flush tubing
According to the Intravenous Drug Administration skill how should most drugs be pushed?
SLOW
According to the Intravenous Drug Administration skill what is meant by SLOW IV push?
Over 3-5 minutes
According to the Intravenous Drug Administration skill what medication is the exception to the SLOW IV push?
Adenosine
According to the Intravenous Drug Administration skill what situation is the exception to the SLOW IV push?
Cardiac arrest
According to the Intranasal Drug Administration skill what should you attach to the syringe after drawing up the medication?
Atomizer
According to the Intranasal Drug Administration skill how much extra medication should be drawn up?
0.1ml
According to the Intranasal Drug Administration skill why should an extra 0.1ml of medication be drawn up?
To account for the dead space within the atomizer at the of the procedure
According to the Intranasal Drug Administration skill what is the ideal volume per nostril?
0.2-0.3ml
According to the Intranasal Drug Administration skill what is the max volume per nostril?
1ml
According to the Intranasal Drug Administration skill what should you do with your free hand while administering the medication?
Hold the crown of the head stable
According to the Intranasal Drug Administration skill how should the atomizer be placed against the nostril?
Snugly
According to the Intranasal Drug Administration skill how should the atomizer be aimed in the nostril?
Slightly up and outward (towards the top of the ear on the same side as the nostril)
According to the Intranasal Drug Administration skill how should the syringe be plunged?
Briskly
According to the Intranasal Drug Administration skill how much of the medication should be plunged into each nostril?
Half
According to the External Jugular Vein Access skill how should the pt be position?
Supine
Head down position
Head slightly turned to the side opposite the intended venipuncture site
According to the External Jugular Vein Access skill how should the catheter be aligned?
In the direction of the vein with the point aimed toward the shoulder on the side of the venipuncture
According to the External Jugular Vein Access skill where should the puncture of the external jugular vein take place?
Midway between the angle of the jaw and the mid-clavicular line
According to the External Jugular Vein Access skill what should you use caution not to allow to enter the catheter?
Air
According to the External Jugular Vein Access skill how should the catheter be secured?
Carefully without taping around the pts neck
According to the Endotracheal Drug Administration skill what 7 medications are approved for endotracheal drug administration?
- Epinephrine
- Vasopressin
- Narcan
- Atropine
- Albuterol
- Atrovent
- Duoneb
According to the Endotracheal Drug Administration skill what should you confirm about the order?
Medication
Dosage
Route
According to the Endotracheal Drug Administration skill what should you inquire of the pt about?
Medication allergies
According to the Endotracheal Drug Administration skill what should you check the medication for?
Contamination
Expiration date
According to the Endotracheal Drug Administration skill what is the dose for endotracheal drug administration for a medication compared to the dose given by IV?
Double the IV dose per protocol
According to the Endotracheal Drug Administration skill what should you instruct your partner to do prior to giving the medication?
Hyperventilate the pt
According to the Endotracheal Drug Administration skill what should you instruct your partner to do after giving the medication?
Hyperventilate the pt
According to the Piggyback Drug Administration skill what should you confirm about the order?
Medication
Dosage
Route
According to the Piggyback Drug Administration skill what should you inquire the pt about?
Allergies
According to the Piggyback Drug Administration skill what should you check the medication for?
Contamination
Expiration date
According to the Piggyback Drug Administration skill where should the medication be injected for piggyback drug administration?
Into secondary IV bag and mix solution
According to the Piggyback Drug Administration skill what should be done with the IV bag which has been injected with medication?
Labeled with name of drug and amount added
According to the Piggyback Drug Administration skill how do you expel air from piggyback solution and tubing?
Connect tubing and needle to solution to expel air
According to the Piggyback Drug Administration skill how do you insure the patency of the original IV line?
Lower original bag to observe for blood return
Check for infiltratoin and flow
According to the Piggyback Drug Administration skill where should the tubing connected to the solution bag be connected for administration into pt?
Medication port of the tubing of the original IV bag
According to the Piggyback Drug Administration skill what should you do before you begin infusion and adjust flow rate?
Recheck medication label
According to the PICC Line/ Central Line Access skill how do you prep the port?
With sterile technique (chloraprep swab and sterile gloves)
According to the PICC Line/ Central Line Access skill before infusing a medication what should occur with the system?
Aspirate the system
Flush the system with 10cc NS to confirm fluid flows through the system
According to the PICC Line/ Central Line Access skill if you are unable to aspirate blood what should you do?
STOP the procedure
According to the PICC Line/ Central Line Access skill when a PICC Line is finished being used what should be done?
PICC lines should always be flushed with Heparin at the ER when they are finished being used
According to the Dialysis Catheter Access skill when should the dialysis catheter be accessed?
Only in EMERGENT SITUATION when and IV/IO is unable to be accessed
According to the Dialysis Catheter Access skill after identifying the site of the dialysis catheter line what tools are used to prep the port with a sterile technique?
Chloraprep swab
Sterile gloves
According to the Dialysis Catheter Access skill what should first be done with the system to be used?
Aspirate for blood
According to the Dialysis Catheter Access skill after aspirating for blood what is the next thing to be done with the system to be used?
Flush the system with 10cc NS solution
According to the Dialysis Catheter Access skill why do you flushed the system with 10cc NS solution?
To confirm that fluid flows through the system
According to the Dialysis Catheter Access skill what should you do if you are unable to aspirate blood?
STOP the procedure
According to the Medi-port access skill what should occur after identifying the sit of the medi-port?
Prep area with sterile technique (Chloraprep swab and sterile gloves)
According to the Medi-port access skill what should a 10cc syringe filled with NS be connected to?
An extension set
According to the Medi-port access skill what should happen after an extension set has been connected to a 10cc syringe filled with NS?
Expel all air and clamp shut
According to the Medi-port access skill what kind of needle is used to access the medi-port?
Non-coring needle
According to the Medi-port access skill how is the non-coring needle inserted into the medi-port?
Through the skin and portal septum at a 90 degree angle
According to the Medi-port access skill how should the non-coring needle be secured?
With tape or a transparent dressing
According to the Medi-port access skill after securing the medi-port and taping all connections what should occur before infusing any solution?
Release clamp, aspirate for blood, flush system with NS to confirm that fluid flows through the system
According to the Medi-port access skill if you are unable to aspirate blood what is the next step?
STOP the procedure and remove the needle
According to the Medi-port access skill if the aspiration and flush are successful what is the next step?
Clamp extension set and remove the syringe
According to the Medi-port access skill one the IV solution is attached to the extension set what is the next step?
Release clamp and infuse IV fluid
According to the Medi-port access skill what should be done with a Medi-port when they are finished being used?
Flushed with Heparin at the ER
According to the Umbilical Vein Cannulation skill what is the indication for umbilical vein cannulation?
Newborn infant requiring resuscitation with intravenous fluid and/or intravenous medication
According to the Umbilical Vein Cannulation skill what are the contraindications for umbilical vein cannulation?
NONE
According to the Umbilical Vein Cannulation skill what is the first step in the umbilical vein cannulation?
Trim the infant’s umbilical cord with a scalpel just proximal to the clamp to provide a fresh end
According to the Umbilical Vein Cannulation skill where should you trim the umbilical cord?
Just proximal to the clamp
According to the Umbilical Vein Cannulation skill with what should you clean the umbilical cord end?
Chloraprep swab
According to the Umbilical Vein Cannulation skill how many vessels are in the umbilical cord?
3
According to the Umbilical Vein Cannulation skill how many of the 3 vessels located in the umbilical cord are arteries?
2
According to the Umbilical Vein Cannulation skill how many of the 3 vessels located in the umbilical cord are veins?
1
According to the Umbilical Vein Cannulation skill what does an umbilical artery look like?
Small with a thick wall
According to the Umbilical Vein Cannulation skill what does an umbilical vein look like?
The largest vessel in the umbilical cord with a thin wall
According to the Umbilical Vein Cannulation skill what gauge angiocath should be placed in the umbilical vein?
16 or 18 gauge without the needle
According to the Umbilical Vein Cannulation skill when placing the angiocath in the umbilical vein how is the cord stabilized?
With constant manual stabilization
According to the Umbilical Vein Cannulation skill after placing the angiocath in the umbilical vein what should you do?
Aspirate for blood return
According to the Umbilical Vein Cannulation skill if you get no blood return on aspiration what is your next step?
Reposition the catheter
According to the Umbilical Vein Cannulation skill once the angiocath has found its proper place and blood return has been aspirated what is the next step?
Attach a 3 way stopcock/extensin set and flush with 10cc NS
According to the Umbilical Vein Cannulation skill how is the cannulation secured in place?
Umbilical tape
Use enough pressure to secure but also to allow fluid to flow
According to the Intraosseous Insertion skill what is the indication for intraosseous insertion?
Anytime in which vascular access is difficult to obtain in emergent, urgent, or medically necessary cases.
According to the Intraosseous Insertion skill what are the 3 sizes of IO needles?
- 15mm
- 25mm
- 45mm
According to the Intraosseous Insertion skill what color is the 15mm needle?
Pink
According to the Intraosseous Insertion skill what size person is the pink 15mm needle appropriate for?
3-39kg
According to the Intraosseous Insertion skill what color is the 25mm needle?
Red
According to the Intraosseous Insertion skill what size person is the red 25mm needle appropriate for?
40kg and over
According to the Intraosseous Insertion skill what color is the 45mm needle?
Yellow
According to the Intraosseous Insertion skill what size person is the yellow 45mm needle appropriate for?
40kg and over with excessive tissue
According to the Intraosseous Insertion skill what are the possible sites for IO placement?
Proximal tibia
Proximal humerus
According to the Intraosseous Insertion skill what are the 4 contraindications for IO insertion?
- Fracture of the bone selected for IO infusion
- Excessive tissue at insertion site with the absence of anatomical landmarks
- Previous significant orthopedic procedures (IO within 24 hour, prosthesis)
- Infection/burn at the site selected for insertion
According to the Intraosseous Insertion skill if any of the 4 contraindications for IO insertion are met what should be done?
Consider alternate sites
According to the Intraosseous Insertion skill within how many hours of a previous IO insertion at the site is IO insertion contraindicated?
Within 24 hours
According to the Intraosseous Insertion skill of the 4 considerations for IO insertion #1 has you ensure what prior to infusion?
A rapid and vigorous 10ml flush with NS
According to the Intraosseous Insertion skill of the 4 considerations for IO insertion #1 what should you do if there is NO FLUSH?
NO FLOW
According to the Intraosseous Insertion skill of the 4 considerations for IO insertion #2 recommends what to facilitate the infusion of fluids through the IO?
Pressure bag
According to the Intraosseous Insertion skill of the 4 considerations for IO insertion #3 would have you consider what prior to the 10ml NS flush?
Cardiac lidocaine flush for anesthetic
According to the Intraosseous Insertion skill of the 4 considerations for IO insertion #4 would have you do what if a humeral IO is placed?
Tie arms across the chest
According to the Intraosseous Insertion skill what should you do if the pt is conscious?
Explain the procedure
According to the Intraosseous Insertion skill what kind of gloves should you wear?
Non-sterile latex free
According to the Intraosseous Insertion skill with what should you cleanse the site?
Alcohol swab
According to the Intraosseous Insertion skill after cleansing the site what should you allow to happen before insertion?
Allow the site to air dry thoroughly
According to the Intraosseous Insertion skill to stabilize the site for a humeral IO what should you do?
Position arm across chest
According to the Intraosseous Insertion skill when inserting the IO needle how should you position the driver and needle?
At the insertion site with the needle set at a 90 degree angle to the bone surface
According to the Intraosseous Insertion skill before using the drill what should you do with the needle?
Gently pierce the skin with the needle until it touches bone
According to the Intraosseous Insertion skill how do you use the drill to penetrate the bone cortex?
By squeezing the driver’s trigger and applying gentle, consistent, steady, downward pressure
According to the Intraosseous Insertion skill what should you be cautious not to do when driving the needle into the bone?
Use excessive force
According to the Intraosseous Insertion skill how long can it take in some patients to have successful insertion?
Greater than 10 seconds
According to the Intraosseous Insertion skill when should you release the driver’s trigger?
When a sudden “give or pop” is felt upon entry
According to the Intraosseous Insertion skill while driving how can you tell when you have drilled into the correct spot/
A sudden “give or pop” is felt
According to the Intraosseous Insertion skill after removing the driver from the set while stabilizing the catheter hub what is the next step?
Remove stylet from catheter
According to the Intraosseous Insertion skill how do you remove the stylet from the catheter?
Turning counter-clockwise
According to the Intraosseous Insertion skill with what should you flush the catheter with?
10ml of NS
According to the Intraosseous Insertion skill if the patient is responsive to pain what should you consider prior to the flush?
2% Lidocaine (cardiac lidocaine)
According to the Intraosseous Insertion skill what is the dose of 2% Lidocaine given if a pt is responsive to pain?
2ml
According to the Intraosseous Insertion skill when is a dose of 2% Lidocaine given if a pt is responsive to pain?
Prior to the 10ml NS flush
According to the Intraosseous Insertion skill what should you assess for during the flush?
Potential IO complications
According to the Intraosseous Insertion skill what tool do you utilize for infusion?
Pressure bag delivery system
According to the Transcutaneous Pacing skill what 3 things should you confirm first?
Presence of dysrhythmia
Patients hemodynamic status
12 lead EKG
According to the Transcutaneous Pacing skill should you have an IV established?
Yes
According to the Transcutaneous Pacing skill what are your treatment options you should consider for sedation if needed?
Etomidate
Ketamine
According to the Transcutaneous Pacing skill by what route is Etomidate given?
IV/IO
According to the Transcutaneous Pacing skill what is the IV/IO adult dose of Etomidate?
0.1 mg/kg
According to the Transcutaneous Pacing skill by what route is Ketamine given?
IV/IO
According to the Transcutaneous Pacing skill what is the IV/IO adult dose of Ketamine?
1mg/kg
According to the Transcutaneous Pacing skill when should you choose Ketamine over Etomidate?
SBP < 90
According to the Transcutaneous Pacing skill for what reason do you adjust the EKG size?
So machine can sense intrinsic QRS activity
According to the Transcutaneous Pacing skill what are the 2 methods of applying the pacemaker electrodes?
- Anterior-posterior
2. Posterior-posterior
According to the Transcutaneous Pacing skill after turing the monitor/defibrillator on what should you do next?
Select the proper lead
According to the Transcutaneous Pacing skill what is the usual desired pacing rate?
60-70
According to the Transcutaneous Pacing skill after selecting the desired pacing rate what are you observing for on the monitor?
“Sense” marker on each QRS complex
According to the Transcutaneous Pacing skill if no “sense” markers are present on each QRS complex what is your next course of action?
Increase QRS size
According to the Transcutaneous Pacing skill when do you depress the “start” button?
Once sensing