Skills Station

Question 1

What are the first three things you should do when notified that a patient is arriving?

Answer 1

1. Activate trauma or resuscitation team
2. Prepare pedi equipment, Broselow tape and pedi protocols and dosing guidelines.
3. Don PPE

Question 2

What is the first thing to do after the patient arrives?

Answer 2

1. An across the room PAT assessment deciding whether to reprioritize to C-ABC in the face of hemorrhage.

Question 3

Describe the different neuro assessments as they pertain to different stages of the process?

Answer 3

1. PAT uses TICLS to assess alertness
2. Primary Survey A (alertness) uses AVPU - A for AVPU
3. Primary Survey D uses GCS or FOUR Score

Question 4

After being told the patient has arrived, what is the first thing you should do?

Answer 4

An Across the Room assessment using the PAT

Question 5

After assessing the PAT what next?

Answer 5

Categorize the patient as sick, sicker, sickest

Question 6

After the PAT, what assessment comes next?

Answer 6

Alertness and Airway

Question 7

How is alertness assesses in the Primary Survey A?

Answer 7

AVPU

Question 8

How is airway assessed in Primary Survey A?

Answer 8

"Is the pipe clear"?  (Tongue teeth trash)
Open airway (head tilt or jaw thrust)
Identify FOUR of the following;
1. is the tongue obstructing
2. loose or missing teeth
3. foreign objects
4. blood, vomit, or secretions
5. any edema
6. any snoring, gurgling, or stridor
7. bony deformity

Question 9

List appropriate interventions for airway

Answer 9

1. suction airway
2. place folded towel under shoulders
3. allow to maintain preferred position
4. insert oral or nasal airway
5. indicate need for intubation

Question 10

How are Breathing and Ventilation assessed in Primary survey B?

Answer 10

Use inspection, auscultation and palpation (look, listen and feel)
Identify FOUR
1. Is there spontaneous breathing
2. is there normal chest rise
3. What are the depth, pattern and rate
4. Is there increased Work of Breathing?
     a. abnormal positioning
     b. grunting
     c. retractions/accessory muscles
     d. head bobbing
     e. nasal flaring
5. What is the skin color
6. Are there open wounds or deformities
7. Are breath sounds present and equal?
8. Any SC emphysema?
9. Any tracheal deviation or jugular distention?

Question 11

Interventions for Breathing and Ventilation?

Answer 11

1. Apply O2
2. BVM
3. needle thoracentesis
4. need for intubation
5. need for chest tube

Question 12

How are Circulation and Control of Hemorrhage assessed?

Answer 12

1. Inspects for any uncontrolled hemorrhage
2. Palpates CENTRAL and PERIPHERAL pulses
3. Inspects and palpates skin for COLOR, TEMP, and MOISTURE
4. Assess cap refill

Question 13

Interventions for Circulation

Answer 13

1. Control bleeding
2. CPR
3. IV access
4. Apply cardiac monitor ONLY of dysthymia
   suspected of causing issue
5. administer fluids

Question 14

How to assess Disability under Primary Survey D

Answer 14

1. GCS
     best eye opening
     best verbal
     best motor
2. FOUR SCORE
     eyes
     motor
     brainstem reflexes
     respiration status

Question 15

Interventions for Disability

Answer 15

1. obtain a glucose

2. indicate need for intubation

Question 16

Assess Exposure and Environment

Answer 16

1. Remove all clothing
2. inspect for all signs of bleeding or injury
   3.

Question 17

Interventions for Primary E

Answer 17

1. blankets
2. warming lights
3. increase room temp.
4. warmed fluids
5. warmed O2

Question 18

Primary F

Answer 18

1. Full set of vital signs

2. Family presence

Question 19

Primary G

Answer 19

Get adjuncts LMNOP
     Lab
     Monitor
     Naso or orogastric tube
     Oxygen, POX and Capnography

Pain assessment and treatment
     ice
     repositioning
     padding over bony prominences
     verbal reassurance

Question 20

Assess Secondary H

Answer 20

Obtain history
Sample/Mist

Head to toe asessment
* verbalize need for catheter if needed
* ausculatate heart/lungs/abdomen

Question 21

Assess secondary H head to toe

Answer 21

head and face
neck
chest listens to lungs and heart tones
abdomen and flanks listens to bowel sounds
palpates abdomen
inspects perineum and pelvis
states need to assess for catheter
inspects all four extremities

Question 22

Secondary assessment I

Answer 22

Inspects posterior surfaces

Question 23

Reevaluation and post-resuscitation care. What interventions or diagnostics do you anticipate for this patient?

Answer 23

imaging
consultations
psychosocial support
antibiotics
pain medications
social services
law enforcement
lab studies
wound care
oral rehydration
IV with dextrose

• State the need o reevaluate the primary survey
• State need to reevaluate vital signs
• State the need to reevaluate pain
• State the need to reevaluate all ID abnormalities and effectiveness of interventions.

Evaluate the need to transfer