Stable vs Unstable Flashcards
Respiratory Distress
Short Sentences
Difficulty Breathing
A
Anxious
Respiratory Failure
1 or 2 words
A-, V or P
Lethargic
Respiratory Arrest
Not breathing or
inadequate respirations
Limited Concussion Risk
No loss of consciousness
but S/Sx of Concussion
Concussion Low Risk
Any period only responsive to V or P
with S/Sx of Concussion
Concussion High Risk
Any unresponsiveness (U)
with S/Sx of Concussion
Or 2+h altered mental state
Or 65+ Or Blood Thinners
Or inc ICP or Skull Fracture
Concussion Risk Increases
High Velocity MOI
Prior History & S/Sx trending up
Additional significant injuries
Concussion Assessment
Mechanism + Brain Change = Concussion
Nervous System Principles
AVPU & watch trends
ABCs & watch for changes
Position Reassure Oxygen PosPressureVent
Mostly evacuate
Spine Assessment No Risk
Passes 6 Spine Assessment Questions
1. Reliable Patient
2. New & Significant Pain
3. Numbness or tingling
4. Palpate for pain along spine
5. Motor Exam
6. Dull/Sharp Sensory Exam
Spine Assessment Low Risk
- Tolerable Pain
- Move & weight bear with no significant pain incr
- Pass Numb/Tingle, Motor, Sensory Exam
Spine Assessment High Risk
- Fails Spine Assessment
- Pain intolerable
- Unable to move & weight bear easily
Stable Musculoskeletal Injury
Distal DSM - Normal
Deformity/Angulation - None
RoM - Near Normal
Weight Bearing - Near Normal
Pain - Limited
Swelling - Slow onset
Feelings of Instability - No
Unstable Musculoskeletal Injury
Distal CSM - Decreased
Deformity/Angulation - Any
RoM - Limited or none
Weight Bearing - None
Pain - Moderate to Severe
Swelling - Obvious & quick
Feelings of Instability - Yes
Unstable Musculoskeletal Low Risk
- Successfully immobilized
- Good CSM
- Manageable Pain
- Reduced dislocation
- No infection risk
Unstable Musculoskeletal High Risk
- Persistent compromised CSM
- Unstable deformity
- Open fracture or infection risk
- Femur or Pelvic fracture
- Acute swelling and severe pain
Wounds Low Risk
Dermis & Subcutaneous fat only
Clean straight edges
No devitalized tissue
Low risk of infection
Wounds High Risk
Deep wounds (fascia, tendons, ligaments, muscles, bone)
Contaminated, crushed or devitalized tissue
Open fractures
Animal bites
Large blood loss
Consider cosmetic or functional impairment
Remove all Impaled objects unless
Not easy to remove
Will cause significant tissue damage
Will cause significant pain increase
Lodged in the eye
Local Infection (low risk?)
Pain
Redness
Swelling
Warm to touch
Loss of function
Systemic Infection (high risk)
Spreading local infection signs
Fever & general malaise
Lymphangitis/red streaks
Severe infection becomes Vascular or Volume Shock
Burns No Risk
Superficial burns
Burns Low Risk
Full thickness burns
Partial thickness burns >1% of surface area
Any infected burns
Burns High Risk
Respiratory burns
Partial or full thickness burns >10% of surface area
Any full circumference burns to limbs
Allergy Low Risk
Any allergic reaction that is not Anaphylactic
Allergy / Anaphylaxis High Risk
Possible antigen exposure with
A. Severe Respiratory Distress or Failure
or B. High or Weak Pulse or altered mental state
or 2 of
C. Generalized Hives or Swollen Tongue/lips
D. Mild Respiratory Distress
E. Severe GI symptoms
F. Mild signs of low BP
Serious Medical Problems
Pain 24h or becoming localized
Pain with Critical S/Sx (i.e., Shock)
Blood in urine, vomit or stool
Pain with vomit or diarrhea for 24h
Persistent fever
Unable to maintain hydration or temperature
Non Serious Medical Problems
Specific problem with no Red Flags
Vomit or diarrhea wo persistent pain or shock
Pain that comes and goes or relieved by passing gas
No fever
No signs of dehydration
