Flashcards
Week 10 skill sign off
Cards in this deck (50)
- 1OPA indicationsAll patients requiring airway support unless there is a good reason not too
- 2OPA ContraindicationsPatients who are conscious or semiconscious with an intact gag reflex
- 3OPA Potential Complications- Gagging, vomiting, aspiration
- Trauma to mouth structures
- Dental injury from biting
- Inadequate airway protection without adequate positioning - 4OPA Prep and Insertion- Measure from corner of mouth to earlobe
- Ensures patient is supine
- Insert concave upwards until the reaches back of tounge the rotate 180'
- Flange positioned above teeth and under lips and able to troubleshoot - 5NPA Indications- When requiring airway support but has trismus (tightening of facial muscles)
- Damage to oral cavity
- Or gag reflex and OPA cant be placed - 6NPA ContrandictionsNasal trauma or extensive maxillofacial trauma (facial trauma)
- 7NPA Potential complicatons-Epistaxis (nose bleed)
- Ulceration
- Sinusitis (swelling/inflamation of sinuses)
-Gag reflex - 8NPA Prep and insertion- Measure from corner of nose to earlobe
-Ensure patient is supine and locate largest nostril
-Lubricates NPA
-Inserts aiming straight back
-Trouble shoot: rotating or changing nostril - 9BVM Indications- Administration of high flow oxygen
- Providing PEEP (Positive end-expiratory pressure )
- Assisting or controlled ventalation - 10BVM Contradications- Nil
- Cautions: Active vomitting or insufficient breathing to open duckbill valve - 11BVM Potential Complications- Hyper/Hypoventilation
- Over ventalation leading to gastric inflation, increased intrathoracic pressure, barotrauma, asphyxiation due to duckbill valve not opening adequately - 12BVM Prep and Insertion- Have appropriate ajunct inserted (OPA/NPA)
- Correctly assembles BVM with all parts present
- Correctly demo single-handed CE & double-handed VE grips with head tilt chin lift
- Demos rule of 3's - 13BVM assemblyCorrect mask, filter, PEEP, BVM chamber, reservoir bag, O2 tubing, O2 source (10IPM)
- 14Explain Rule of 3's1/3 of bag
3 fingers
no more than 3 seconds - 15Sniffing Position Demo- Elevating the patient's head, extending the head at the neck, and aligning the ears horizontally with the sternal notch.
- 16Jaw Thrust Demo - Preferred for patients with suspected c-spine injuriesPlacing the index and middle fingers to physically push the posterior aspects of the lower jaw
- 17Head Tilt Chin Lift - Able to preform while performing CE grip and BVM ventalationRotate the head into a "sniffing" position, the other hand is used to lift the chin forward and up
- 18Sniffing Position - Explain differences in achieving this with adults, children, infants and obese patients- Adults; towel under head
- Obese; may require aditional padding under shoulders
- Children; (nothing)
- Infants; towel under shoulders - 19Sager Splint Indications- Suspected isolated fracture involving shaft of the femur
- 20Sager Splint ContridictionsNone
- 21Sager Splint Cautions- Time critical injuries
- Suspected fracture of pelvis
- Suspected fracture of the foot or ankle - 22Sager splint Application- Gain consent and expose and examine limb
-Assess limb baselines and provide analgesia
-Position, and apply upper strap, fit ankle harness
-extend shaft untill appropriate traction is applied
-apply remaining straps and reassess limb baseline - 23Assessing Limb BaselinesExpose and compare limbs
Assess :colour, pulse, CRT, warmth, movement, sensation - 24Suction Indications- Significant amounts of vomit or blood that threatens airway patency and/or limits ventilation
- 25Suction Contraindictions- Suction of saliva or pulmonary oedema fluid
- 26Suction Potential Complications- Damage to oropharynx (back of throat)
- Hypoxia (low oxygen)
-Stimulation of gag and cough reflex
- Bradycardia (low HR)
-Hypotension due to stimulation of the vagus nerve (low BP) - 27Suction Preperation- Apply PPE including safety glasses
-place patient in recovery position unless in cardiac
-allow fluids to clear the mouth via gravety
-Manually clear the mouth with OPA or finger or solid material if patient is unconscious - 28Suction Demo-Turn suction on to max
-place catheter into mouth, only as far as can be seen
- cover the suction hole to initiate suction
-Suction while withdrawing from mouth and in a circular motion, take no longer than 10s - 29Suction soft catheter use- Use if cant see where your placing suction such as through nostril
- 30C-collar Indications- The patients C-spine can not be clinically cleared AND
-Significant posteria midline tenderness
-and/or signs and symptoms of spinal cord injury - 31C-collar ContridictionsPateints who are unconscious
- 32C-collar Cautions- Patients with pre-existing c-spine abnormalities
- patients who are uncooperative
(significant abnormalities in primary servey take priority) - 33C-collar Potential complications- May worsen neck pain
- May promote the development pf pressure areas
-Makes airways more difficult
-may increase intracranial pressure - 34C-collar sizing and prep-Demonstrait correct sizing
- Ensure patient is in neutral alignment
-pre-form the collar into round shape - 35C-collar application-Gain consent and advise patient to not move head, remove jewellery etc
- Fit collar; Behind patient neck to around under chin
-Record application - 36C-collar info- Ensure spine is in neutral alignment
- Consider placing head blocks or towel to limit movement
- Consider sitting the patient to 15' for comfort or to assist breathing - 37Cardboard splint IndicationsFractures or dislocations of the;
- Ankle
- Tibia and/or fibula
-Patella
- Hand, wrist, radius, ulna
- Elbow - 38Cardboard splint ContridictionsNone
- 39Cardboard splint cautions- Time critical conditions: If the patient has time critical conditions, box splinting will cause unnecessary delay
- 40Cardboard splint potential complications-pain during splinting
- splints that are too small or tight can cause ischemia (restricted blood flow) increasing pain and cause tissue damage
- Splints too large or lose are ineffective - 41Cardboard splint Preparation- Expose and examine limb, provide analgesia as required
-Assemble equipment and cut shape
-pad the splint with towels to fill natural hollows and prevent movement - 42Cardboard splint Application- perform neurological and cardiovascular limb baselines
- Lift and position splint around limb
-secure with triangle bandages above and below
- Reasses limb baselines
- document application - 43Cardboard splint How can a natural wrist shape be maintained- To maintain the natural curve of wrist when in a splint, patient can hold a rolled bandage
- 44Tourniquet Indications-Severe bleeding from limb that is uncontrolled despite firm, direct pressure
-Bleeding from a limb that is immediately life threatening
-bleeding site can not be reached
-Crush injury that has been trapped for more than 60min - 45Tourniquet Contraindications-None
- 46Tourniquet CautionsNone
- 47Tourniquet potential complications- Severe pain
-tissue damage
- on limbs with two bones this limits pressure that can be applied
-May be difficult to control over particularly large bleeding from a thigh - 48Tourniquet Prep- Explain procedure and gain consent
-Elevate and expose
-apply direct pressure
- prepare CAT for application - 49Tourniquet Application- 5cm proximal to wound, never over a joint
-Secure untill bleeding has stopped and there is no distal pulse
-Leave wound exposed
-record time of application
-Check distal limb baselines; Pulse, skin colour, temp, CRT - 50On going Tourniquet assessments- Recheck Tourniquet following treatment, may requre futher tightening if blood pressure improves
- If bleeding continues ensure tournque is tight and consider placing another one proximal to the first
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- Diploma Introduction to Paramedic Practice Flashcards on Week 10 skill sign off , created by Shannon Ruscoe on 26/09/2024.
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- Shannon Ruscoe
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