Systematic Approach Flashcards

1
Q

Sit-Rep

A

Windscreen Situation Report - occurs before arriving on scene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Primary Survey

A
DRABCc
Danger 
Response - AVPU 
Airway 
Breathing 
Circulation 
cervical spine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Vital Signs - base line observations

A
Heart rate
Pulse rate
Respiratory rate
Glascow coma score
Blood pressure
Temperature
SpO2 Oxygen saturation
ECG
Skin colour
Pain level

Taken every 10-15 min
always take before administering a drug/treatment
If deteriorating reassess in 5 min intervals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

History

A
SAMPLE
Signs and Symptoms
Allergies
Medications
Past medical history
Last meal/doctor visit
Events prior
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Injury details/Pain assessment

A
OPQRST
Origin/onset
Provoke/palliation - better/worse
Quality - describe the pain
Radiation/Region
Severity - pain scale
Time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Summary Survey

A
DRABCcDEFGH
Danger
Response
Airway
Breathing
Circulation
Cervical spine
Disability
Expose
Family and Friends
Get meds and Go
History and Handover
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Handover

A
AMIST
Age, Name, Sex
Mechanism of Injury
Injury/Illness
Signs and Symptoms
Time of event and treatment (SAMPLE)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Danger

A
To yourself, partner, bystanders, patient
Consider safety and hazards
- Mechanism of injury
- How many patients
- Evidence of cause
- General impressions
- Other resources available
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Response

consider c spine

A

Alert, verbal stimuli, painful stimuli, unconscious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Airway

A

Clear airway

Scoop out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Breathing

A

Look, Listen and Feel (listen hard in loud environment - use stethoscope)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Circulation

A

Patient pulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Blood Pressure

A

The force per unit area exerted on a vessel wall by the contained blood - refers to systemic arterial blood pressure
Systolic/Diastolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Normal Blood Pressure readings

Abnormal BP

A
Adult = 120/80mmHg
Newborn = 80/40 
10yr = 100/60
Hypertension - 140/90
Hypotension - systolic below 100
Normotensive - normal BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pulse Rate

A

The alternating expansion and recoil of arteries during each cardiac cycle
Measurement = times pulse felt over 60 sec (at least 15 sec measured)
Look at quality and strength

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pulse Point Locations

A
Carotid
Subclavian
Brachial
Aorta
Ulna
Femoral
Popliteal
Dorsalis Pedis
17
Q

Normal Pulse Rates

Abnormal PR

A
Adult = 60-100 bpm
Newborn = 120-160 bpm
10yr = 70-115 bpm

Range due to varying amount of influencing factors

Tachycardia - too high
Bradycardia - too low

18
Q

Cardiac Output - Pulse

A

CO = HR x SV

The volume of blood ejected by each ventricle per minute

19
Q

Respiration Rate

A

The number of times per minute that a person breaths

Measured by counting breaths per minute

Look at rhythm and depth

20
Q

Normal Respiration rate values

Abnormal RR

A
Adult = 12-20
Newborn = 40-60
10yr = 15-20
Eupnea = Normal respiration
Tachypnoea = high RR
Bradypnoea = low RR
21
Q

Respiration depth

Normal values

A

Volume of air inhaled and exhaled

Adult = 500mls

22
Q

Temperature methods

Normal Values

Abnormal Temp

A

Tympanic thermometer recommended
Other methods = oral, rectal, forehead

Normal = 36-37.5 degrees celsius

Afebrile/normothermic = normal temp
Febrile/fever = high temp
Hypothermia = low temp
23
Q

Skin colour

Skin Turgor

Skin Moist/dry

A

Colour of skin - blue, yellow, burn, dark

Gently raise skin - does it return to normal shape or stay pinched (affected by age of patient)

Capillary refill - push down nail bed and does blood refill in less or more than 2 sec - skin return pink from white

24
Q

Glucometry - Blood Sugar Level

How is it measured

A

Regulation of BSL - production of insulin and glucagon by pancreas

Measured by glucometer to detect millimoles per liter of glucose in blood

25
Normal BSL Abnormal BSL
BSL = 4-7mmol/L ``` Hypoglycemia = below 4 mmol/L Hyperglycemia = above 7mmol/L ```
26
Focused Assessments (3)
Neurological status assessment Respiratory status assessment Perfusion status assessment
27
Perfusion status assessment
``` Pulse BP Skin Consciousness * If the lips are blue the brain is too ```
28
Neurological status assessment
``` Level of consciousness (AVPU) Pupillary activity Motor Function Sensory Function VSS ```
29
Respiratory status assessment
``` Conscious state (AVPU) General appearance Speech Ventilatory rate Ventilatory rhythm Ventilatory effort Skin Pulse Chest Auscultations ```
30
Physical Assessment - Head to Toe
``` Systematic Superior to inferior, Proximal to Distal Expose, Palpate and Auscultate Sensory and motor function Pain ```
31
Trauma Assessment - what to look for
``` DCAP-BTLS Deformities Contusions Abrasions Punctures/Penetrations Burns (electrical, chemical, flame) Tenderness Lacerations Swelling ```
32
Paediatric patient assessment
Remain calm and confident Do not separate child and parent Good rapport with parents Honesty
33
Chief complaint
Primary complaint - reason they called | consider mechanism of injury
34
Clinical Reasoning
Growing Understanding from patient input, environment, knowledge, clinical problems, meta-cognition, cognition
35
Clinical Reasoning Models (3)
Hypothetico-deductive reasoning Pattern recognition Intuition
36
Hypothetico-deductive reasoning *Backward reasoning Problems
4 stages Hypothesis generation, evaluation, refinement, verification Backward reasoning - hypothesis is generated and clinical information is gathered to prove or disprove the theory Faulty hypothesis Premature closure Verification stage
37
Pattern Recognition *Forward reasoning Problems
Process of making a judgement of basis of few critical pieces of info Direct autonomic retrieval of info from well structured knowledge base Forward reasoning - best used when timely decisions must be made Anchoring bias Confirmation bias
38
Intuition
Gut feeling - individual opinion based on experience
39
Critical Thinking Process
``` Concept formation Data interpretation Application of principle Evaluate - continual reassessment Reflection on actions - possible improvement/different approach ```