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Complex Skills Theory/CPG’s > Theory/CPG’s > Flashcards

Theory/CPG’s Flashcards

1
Q

Indications for Cricothyrotomy (Vertical)

A
  • Cant intubate, Cant oxygenate. (CICO) situation with decreasing SpO2%.
  • Primary airway attempt if ETT, Supraglottic airway or BVM is not feasible. (E.g. massive facial trauma or burns)
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2
Q

Contraindications for Cricothyrotomy (Vertical)

A
  • Children <6years of age
  • Open tracheal injury
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3
Q

Explain DOPES acronym

A

Displacement
Oxygen
Pneumothorax
Equipment
Secretions

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4
Q

6 stages of intubation

A

1.Pre-oxygenation
2.Preparation
3.Position
4.Placement (confirmation)
5.Proof (structures)
6.Post intubation care

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5
Q

What are the 5 P’s of supraglottic airway

A
  1. Preoxygenate
  2. Preparation
  3. Placement
  4. Proof of Placement
  5. Post Care
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6
Q

IO access indications

A

Cannulation of the intraosseous space using EZ-IO:

Cardiac arrest:
- First line for paediatrics
- Consideration for first line in traumatic cardiac arrest
- Second line cardiac arrest management for adults following at least one failed intravenous (IV) access attempt, unless unable to locate appropriate site for IV access.

All other circumstances:
- Where immediate medication or fluid administration is required following at least one failed IV access attempt when unable to administer by any other appropriate route.

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7
Q

IO access contraindications

A
  • Fracture to the targeted bone.
  • IO within last 48 hours in the targeted bone.
  • Inability to locate landmarks or excessive tissue.
  • Prosthetic limb or joint (near insertion point).
  • Directly over, or distal to burns, cellulitis, infection or injury
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8
Q

Describe all 4 types of axis deviations and where they are located

A
  • Lead 1 positive and AvF positive = normal
  • Lead 1 positive and AvF negative = left axis
  • Lead 1 negative and AvF positive = right axis
  • Lead 1 negative and AvF negative = extreme right axis deviation
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9
Q

What equipment is needed for a Vertical Cricothyrotomy?

A
  • tube, sized 6.0
  • tape cut into 2 dog legged parts
  • cobs, BVM, Bac filter
  • scalpel
  • boujie
  • syringe
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10
Q

Explain the pelvic binder decision tool

A

Significant mechanism suggestive of pelvic fracture:
- pulse greater than or equal to 100bpm OR Systolic BP greater than or equal to 90mmHg
- Less than or equal to GCS13
- Distracting injury
- Abnormal clinical assessment of pelvis

Abnormal clinical assessment includes:
- anatomical deformity (e.g. asymmetry)
- significant pain on palpation
- pelvic instability

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11
Q

Pelvic binder indications

A
  • Haemodynamically compromised trauma patients meeting the pelvic binder decision tool criteria
  • Should be considered an immediate and urgent intervention in symptomatic cases
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12
Q

Pelvic binder contrainidcations

A
  • patients under 23kg
  • fall from standing
  • isolated hip fractures
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13
Q

Chart the APGAR score

A
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14
Q

Demonstrate the flow chart of New Born Life Support.

A
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15
Q

PPH arises from 4 sources. What are they?

A
  • Tone - 70% - soft boggy uterus assessed by palpating fundus. Good tone feels like a cricket ball.
  • Trauma - 20% to perineum, vaginal wall or cervix.
  • Tissue (retained) - 10%
  • Thrombin anomalies - 1%
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16
Q

Define a post partum haemorrhage and whats the difference between primary and secondary.

A
  • defined as blood loss >500mls

Primary:
- first 24hrs
- most common and potentially life threatening
- affects approx 6% of all deliveries

Secondary:
- after 24hrs and up to 6 weeks post natal
- less common affecting approx 1-3% of deliveries

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17
Q

What are the 4 positions a patient should be put in during continued shoulder dystocia

A
  • McRoberts position w/gentle traction for 30 seconds
  • if no relief commence Rubin 1 for 30 seconds whilst applying gentle down pressure to shoulder
  • if no change commence rocking rubin for 30 seconds (slow CPR type)
  • if no change roll patient into Reverse McRoberts Position
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18
Q

Whats defined as HTN in pregnancy?

A

Systolic of greater than or equal to 140mmHg and/or diastolic greater than or equal to 90mmHg.

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19
Q

Whats the fluid replacement indication criteria for burns and the formula involved.

A

Adults: >15% TBSA
Children 18 months or older: >10% TBSA
Children less than 18months: >8% TBSA

2ml X %TBSA X weight
- 50% of total over first 8hrs
- 50% of total over next 16hrs

20
Q

Whats the criteria for direct burns unit transfer?

A
  • greater than or equal to 10% TBSA for adults or >5% TBSA in paeds
  • airway burns
  • burns to hand, feet, perineum, genitalia, joints or neck
  • adults greater than or equal to 16yo to FSH and <16yo to PCH
21
Q

Indications for need thoracocentesis

A
  • TCA with torso involvement
22
Q

Needle thoracocentes contraindications

A
  • Patients not in cardiac arrest unless trained and authorised
  • Consider ASMA consult in a patient with suspected tension pneumothorax and respiratory and/or haemodynamic compromise.
23
Q

Modified valsalva contraindications

A
  • Recent or current acute myocardial infarction
  • Severe coronary artery disease
  • Haemodynamic instability (i.e. systolic BP below 90mmHg)
  • Known glaucoma or retinal myopathy
24
Q

What is a LEMON

A

Look
Evaluate
Mallipattie
Obstruction
Neck

25
Q

Indications for Magills forceps and direct laryngoscopy

A
  • To identify and remove a suspected foreign body from the hypopharynx that is preventing ventilation.
  • In order to create a patent airway and an ability to achieve adequate ventilation
26
Q

Contraindications to magills forceps and laryngoscopy

A
  • Conscious patient or Gag reflex intact
  • Do not use Magill forceps if obstruction below the vocal cords.
  • SpO2 reading of 90% and ventilation is achievable
  • Suspected epiglottitis.
27
Q

When should spinal precautions be applied?

A

Cervical spine pain
Altered mental state
Neurological deficit
Distracting injury
Iintoxications

28
Q

Indications for IV cannulation

A
  • Administration of intravenous fluids where oral intake is unavailable or unsuitable
  • Administration of intravenous medications where other routes are inappropriate or unsuitable
  • Unstable or deteriorating patients
29
Q

Contraindications to IV cannulation

A

Directly over or distal to:
- Burns
- Cellulitis
- Infection
- Injury
- Frail or immunocompromised patients unless clinically warranted
- More than 2 attempts by appropriately trained and skilled clinician
- More than 1 attempt of vascular access (IV/IO) in traumatic cardiac arrest

30
Q

When do you discontinue the use of an I-Gel

A
  • Effective ventilations (i.e.: adequate chest rise and fall) cannot be achieved (some air leakage can be expected)
  • GCS of the patient increases with a return of gag reflex or patient attempts to remove
  • i-Gel is faulty.
  • Regurgitation occurs and is anticipated to be compromising
31
Q

Stroke inclusion criteria

A
  • symptom onset <9hrs
  • possesses full ADL’s
  • BGL between 4-22mmol/L
32
Q

What are the metro acute stroke centres? (RACE of equal to or <4)

A
  • Sir Charles Gairdner Hospital
  • Fiona Stanley Hospital
  • Royal Perth Hospital
  • St. John of God - Midland
  • Joondalup Health Campus
33
Q

What are the 6 rights of medication administration

A

Right patient
Right medication
Right dose
Right time
Right route
Right documentation

34
Q

Pick a random age between 1-12yo and calculate weight and all the surrounding cardiac arrest drug calcs/treatments.

A
35
Q

Paediatric anatomical differences for respiratory/airway

A
  • larger/rounder head
  • floppy eppiglotis
  • short neck
  • hogher larynx
  • predominately nose breathers
  • fewer alveoli
  • diaphragmatic breathers
36
Q

What is the calculation to find hypotensive SBP in a paediatric? And what is the hypotensive level in ROSC?

A

70+ (2 x Age) = hypotensive BP

37
Q

What are the IMPACT principles?

A
  • standardised equipment placement
  • high quality focused compressions with minimal interruptions
  • use feedback and CPR quality devices
  • swap compressor every loop
  • controlled ventilation
  • calm, quite and coordinated scene
  • closed loop communication/ functional language
  • create an overview position if possible
  • create or move to a good working space
38
Q

Describe the acronym SLUDGEBBB

A

Salivaton
Lacrimaton
Urination
Defacation
GI upset
Emesis

Bronchorrhea
Bronchospasm
Bradycardia

39
Q

What are the components of the “diamond of death?”

A
  • Acidosis
  • Coagulopathy
  • Hypothermia
  • Hypocalcaemia
40
Q

What are the components of “Cushings triad?” In a TBI?

A
  • widening pulse pressure
    -Irregular/erratic breathing (
    -Bradycardia
41
Q

Indications for blood sample collection

A
  • Patients to be transported to an Emergency Department with successful Peripheral IV Access or External Jugular Access whose clinical presentation warrants pre-hospital blood sample collection.
  • Patients 16 years and older
42
Q

Contraindications for blood sample collection

A
  • Any patient whose clinical condition does not warrant IV cannulation.
  • Where prehospital blood collection will delay life saving treatment
  • Patients <16 years old.
43
Q

Indications for External Jugular Access

A
  • Administration of intravenous medications or fluids where peripherally inserted intravenous catheters (PIVC) or intraosseous catheters (IO) are inappropriate, unsuitable or unavailable
44
Q

Contraindications for External Jugular Access

A
  • Access is available by other means (PIVC/IO)
  • Patients in spinal precautions
    >1 attempt by appropriately trained and skilled clinician
  • Directly over or distal to:
    -Burns
    -Cellulitis
    -Infection
    -Injury
45
Q
A

Complex Skills Theory/CPG’s (1 decks)

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