Skills sign off Flashcards
Suction Indications
Significant amount of blood, vomit that threaten airway patency
Suction contras
Suction of saliva or pulmonary oedema fluid
Suction Potential complications/cautions
Damage to oropharanx
Hypoxia
Stimulation of gag/cough relfex
Braydicardia/hypotention due to vagal nerve stimulation
How to use suction
turn to max
Place catheter inside no futhur than you can see
Suction while withdrawing from mouth and in a circular motion
Do it no longer than 10 secs at a time
OPA Indications
Routinely placed in all patients requiring airway support
OPA contras
Patients who are conscious with gag relfex
OPA cautions
gagging, vomiting, aspiration, trauma to mouth, Dental injury, Inadequate airway
NPA indications
airway needs to be maintained but patient has trismus, mouth cavity been damaged OPA cant be placed
NPA Contras
Nasal trauma Maxillofacial trauma
NPA Cautions
Epistaxis, Ulceration, Sinusitis, gag relfex
BVM Indications
Administration of Hi flow
PEEP
Assisting ventilations
BVM Contras/cautions
Contras: None
Cautions: Active Vomiting, insufficient breathing to open duck bill valve
BVM Complications
Hyper/hypo ventalation, gastric inflation, intrathoratic pressure, barotrauma, asphxiation due to duckbill valve not opening
Cardboard splint Indications
Fractures disslocations of
Ankle
Tib/fib
Hand, wrist, radius, ulna
ElbowC
Cardboard splint contras
None
Cardboard splint cautions
Time critical
Cardboard splint complications
Pain during splinting
To small/tight can cause ischemia
to large dont provide enough support
Cat tourniquet Indications
Servere bleeding despite direct pressure
Bleeding that is immediatley life threatening
Crush injury that has been going on for more than 60 mins
Cat tourniquet Contras/Cautions
None
Cat tourniquet Complications
Severe pain
Tissue damage
Limbs with two bones may limit pressure able to apply
Bleeding may be difficult to control if on a thigh or any large limb
C spine collar indications
C spine cannot be cleared clinically
Specific posterior midline tenderness
Signs and symptoms of spinal cord injury
C spine collar contras
Patients who are unconscious
C spine collar cautions
pre excisting c spine abnormalities
Uncooperative patients
C spine collar complications
may worsen neck pain
may promote the development of pressure in areas
makes airway management more difficult
may raise ICP
What is the different for sniffing position in neonates, children and adults.
Neonates you want to put a towel under their back/shoulders.
Children you don’t need anything to realign the head.
Adults you need to put somthing under their head
Do you need to put more towels under an obese person for sniffing position?
YES. You often need to put more towels under their back/ shoulders and their head to align it properly
What is aim of sniffing position? It is proffered for intubation?
YES it is the optimal position for intubation. The aim is to have the ears parallel to the sternal notch.
Sagar splint indications
Suspected femur fracture involving the shaft. NOT a NOF
Sagar splint cautions
Not critical personal with ATP should be present
Time critical injury
Suspected fracture to pelvis
Suspected fracture to foot/ankle
What are the 5 R’s for medications
Right patient
Right dose
Right Time
Right medication
Right Route
What are the 4C’s for medications
Clarity
Concentration (e.g. duilte, label etc)
Container
Check expiration
What are the Indications for a LMA
GCS 3 and poor airway despite OPA/NPA/ maneuvers
Cardiac arrest where ETT can’t be placed
Rescue airway in failed intubation
What are the contras/cautions for a LMA
Active vomiting
Presence of gag reflex
Trismus/restricted mouth opening
Upper airway obstruction
Distorted airway
What are some potential complications for a LMA
Inability to obtain a good seal
Regurgitation
Aspiration
Kinking of the airway tube
Laryngospasm
Cough
Upper airway trauma
Gas insufflation
Dislodgement
What is the acronym for predicting a LMA insertion may be troublesome
R - restricted mouth opening
O - Obstruction, obesity, obstetrics
D - disrupted/distorted airway
S - still lungs (poor compliance)
RODS
How do you trouble shoot a LMA
D - dislodged
O - obstruction
P - pneumothorax
E - Equipment failure
S - stacked breaths
What are the indications for Magill Forceps (FBAO)
Foreign body airway obstruction
The patient is unconscious and not moving sufficient air
The foreign body can not be removed under direct vision with a finger sweep
What are the contras/cautions for Magill forceps
Contras:
Conscious patient
Cautions:
None
What are the complications for Magill forceps
Gagging
Vomiting
Foreign body may be difficult to remove
Foreign body may be in multiple pieces
Damage to the soft tissue of mouth
Damage to teeth
What are the indications/contras/cautions for IM injections
Indications: Administration of a medication via IM
Contras/cautions: Evidence of infection/trauma at the injection site.
What are the potential complications for IM injection
Pain at injection site
Bleeding at injection site
Tissue necrosis
Infection
