Week 11: Introduction to Rural Emergencies 2 Flashcards
Explain why a primary survey is always a good idea to complete, even if only mentally, in all cases. Example: a burn victim presents to ED after being rescued from a house fire and has a large 3rd degree burn covering most of the forearm.
Following the ABCDE approach is always a good idea because it builds good habits and stops doctors from missing problems/injuries. Without a proper approach, it becomes easy to focus on the burn alone and assessment of smoke inhalation may be missed, which can be very dangerous.
What does DEFG stand for as an adjunct to to ABCDE
Don’t ever forget glucose
What is the aim of the AVPU acronym as part of the Disability section of the primary survey?
A - Is the patient AWAKE V - Does the patient respond to VERBAL stimuli P - Does the patient respond to PAINFUL stimuli U - The patient is completely UNRESPONSIVE
Describe the secondary survey including the AMPLE acronym
Complete head to toe check for injuries. AMPLE: A - allergies M - medications P - past medical history (relevant things like Diabtetes) L - Last meal E - Events surrounding injury (what exactly happened?)
Describe the 3 stages which a responder goes through during a 000 emergency call
Stage 1: - Exact location/address - Phone number in case needing to call back - Name of person speaking Stage 2: - What exactly happened - age of patient - responsive? - breathing? - colour? - bleeding/obvious injury - safety of caller and patient Stage 3: - More specific questions to assess nature of injury and patient condition - available people/resources - providing telephone assistance for first aid, including instructions if necessary
Briefly describe what an RFDS emergency kit is and how it works
- Contains basic equipment, drugs/medication for emergencies - Designed to be used under phone instructions from doctors - Trays and items numbered for easy location and restocking purposes
What are the common symptoms of an asthma attack?
- dyspnoea, difficulty breathing, gasping - wheezing - choughing
How might you classify severity of an asthma attack from mild to life-threatening?
Mild: Can stand and walk and talk in full sentences Severe: Any of: unable to talk in full sentences, visibly breathless, increased work of breathing, SpO2 90-94% Life-threatening: Any of: Drowsy, collapsed, exhausted, cyanotic, poor respiratory effort, SpO2<90%
What are the steps of first-aid for asthma attacks?
- Get patient to sit upright - 4 or more puffs of SABA depending on severity and oxygen supplementation in medical setting if severe or life-threatening - Wait 4 minutes to repeat bronchodilator - Call ambulance if the person still can’t breathe normally /intravenous magnesium in hospital setting - oral prednisolone (corticosteroids) within first hour
Briefly describe an anaphylactic reaction
- Pre-sensitisation is required. - Very severe and life threatening, as vital organ perfusion is jeopardised - Antigen enters the body of the patient - antigen binds to IgE on Mast cells/other leukocytes - Mast cell degranulates and releases proinflammatory mediators, most notably histamine - Histamine binds to airway receptors and causes bronchoconstriction - Histamine also causes blood vessel dilation and permeability - Difficulty breathing sets in due to bronchospasm, as well as potential swelling in airways - Hypotension may occur due to loss of ECF into intersitium and decreased effective circulating volume - Oedema and urticaria (hives) also occur resulting from permeability
How is anaphylaxis treated?
Epinephrine/adrenaline injection intramuscularly often via “epipen”
What are some signs of severe allergic reaction
-Difficulty breathing - Noisy breathing - swelling of the tongue - swelling/tightness of the throat - Difficulty talking/ hoarse voice - wheezing/persistent cough - pale/clammy - persistent dizziness/collapse - pale and floppy (young children)
Why is standing a concern for patients with an asthma attack?
Potential hypotension causes a risk of falling over.
