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Paramedicine Practice > Systematic Approach > Flashcards

Systematic Approach Flashcards

1
Q

Sit-Rep

A

Windscreen Situation Report - occurs before arriving on scene

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2
Q

Primary Survey

A 
DRABCc
Danger 
Response - AVPU 
Airway 
Breathing 
Circulation 
cervical spine
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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

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4
Q

History

A 
SAMPLE
Signs and Symptoms
Allergies
Medications
Past medical history
Last meal/doctor visit
Events prior
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5
Q

Injury details/Pain assessment

A 
OPQRST
Origin/onset
Provoke/palliation - better/worse
Quality - describe the pain
Radiation/Region
Severity - pain scale
Time
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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
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7
Q

Handover

A 
AMIST
Age, Name, Sex
Mechanism of Injury
Injury/Illness
Signs and Symptoms
Time of event and treatment (SAMPLE)
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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
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9
Q

Response

consider c spine

A

Alert, verbal stimuli, painful stimuli, unconscious

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10
Q

Airway

A

Clear airway

Scoop out

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11
Q

Breathing

A

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

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12
Q

Circulation

A

Patient pulse

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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

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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
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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

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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
Q

Normal BSL

Abnormal BSL

A

BSL = 4-7mmol/L

Hypoglycemia = below 4 mmol/L
Hyperglycemia = above 7mmol/L
26
Q

Focused Assessments (3)

A

Neurological status assessment
Respiratory status assessment
Perfusion status assessment

27
Q

Perfusion status assessment

A 
Pulse 
BP
Skin
Consciousness
* If the lips are blue the brain is too
28
Q

Neurological status assessment

A 
Level of consciousness (AVPU)
Pupillary activity
Motor Function 
Sensory Function 
VSS
29
Q

Respiratory status assessment

A 
Conscious state (AVPU)
General appearance
Speech
Ventilatory rate
Ventilatory rhythm
Ventilatory effort
Skin
Pulse
Chest Auscultations
30
Q

Physical Assessment - Head to Toe

A 
Systematic
Superior to inferior, Proximal to Distal
Expose, Palpate and Auscultate
Sensory and motor function
Pain
31
Q

Trauma Assessment - what to look for

A 
DCAP-BTLS
Deformities
Contusions
Abrasions
Punctures/Penetrations
Burns (electrical, chemical, flame)
Tenderness
Lacerations
Swelling
32
Q

Paediatric patient assessment

A

Remain calm and confident
Do not separate child and parent
Good rapport with parents
Honesty

33
Q

Chief complaint

A

Primary complaint - reason they called

consider mechanism of injury

34
Q

Clinical Reasoning

A

Growing Understanding from patient input, environment, knowledge, clinical problems, meta-cognition, cognition

35
Q

Clinical Reasoning Models (3)

A

Hypothetico-deductive reasoning
Pattern recognition
Intuition

36
Q

Hypothetico-deductive reasoning

*Backward reasoning

Problems

A

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
Q

Pattern Recognition

*Forward reasoning

Problems

A

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
Q

Intuition

A

Gut feeling - individual opinion based on experience

39
Q

Critical Thinking Process

A 
Concept formation
Data interpretation
Application of principle
Evaluate - continual reassessment
Reflection on actions - possible improvement/different approach

Paramedicine Practice (5 decks)

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