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Trimester 7 > emergency methods > Flashcards

emergency methods Flashcards

1
Q

emotional bias is an AKA for this, it is one of the most well documented types of bias

A

implicit bias in healthcare

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2
Q

what are some ways to stay calm during trauma event?

A
  • follow assessment model to limit bias, feedback loops, emotional decision making
  • do not deviate or skip steps ever
  • emotional and intuitive thinking is one of the least accurate types of thinking
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3
Q

what type of thinking is the least accurate types of thinking

A

emotional and intuitive thinking

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4
Q

what are the 4 types of patients?

A
  • stable medical
  • stable trauma
  • unstable medical
  • unstable trauma
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5
Q

what are the 4 steps to approach categorization?

A
  • primary assessment/ categorization
  • secondary assessment/ ddx building and resource allocation
  • treatment
  • reassessment
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6
Q

a majority of what kind of patient would a chiro patient be?

A

stable

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7
Q

which patient can die without proper assessment and recognition?

A

unstable

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8
Q

list the approach to categorization

A

1- primary assessment- categorization
2- secondary assessment- ddx building and resource allocation
3- treatment
4- reassessment

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9
Q

what is purpose of primary asessment?

A
  • identify and correct life threats
  • categorize patient
  • begin to allocate resources (911)
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10
Q

list the general elements of primary assessment

A
  • scene safety
  • general audio/visual inspection- looking at possible hints of threats and preliminary hints of trauma- medical patient types
  • consent type and level of consciousness assessment
  • airway
  • breathing
  • circulation
  • patient categorization

** if these are “fail” call 911 from consciousness down

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11
Q

what is the purpose of the secondary assessment?

A
  • to build a clinical picture and ddx
  • identify red flags
  • identify yellow flags
  • allocate resources- imaging and other providers
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12
Q

what is the acronym for vitals?

A

Puerto Rican BABESS

  • P/ pulse
  • R/ respiration
  • B/ blood pressure
  • A/ AVPU
  • B/ breath sounds
  • E/ eyes
  • S/ skin
  • S/ SP02
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13
Q

what types of things are considered red flag items and should be considered medical emergency?

A
  • vital signs outside of normal values
  • physical exam with failing finding of - medical emergency exams- cukc physical exam- structural exam that is outside of scope to treat
  • hx consistent with potential cancer dx (consistent with vitals)
  • hx of trauma to area of complaint
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14
Q

a red flag is a ______ to treatment for the purpose of this class

A

contraindication

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15
Q

what are a few medical emergency examination that are in our scope?

A
  • Cincinnati prehospital stroke scale
  • distal pulse motor, sensory to an extremity following trauma
  • DVT tests
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16
Q

list medical time sensitive dx that unless prompt care is rendered death could result.

A
  • infection
  • bowel obstruction
  • appendicitis
  • cancer
  • DVT
  • AAA
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17
Q

what type of trauma time sensitive dx could be fatal if prompt care is not rendered.

A
  • hot/cold emergencies

- orthopedic emergencies

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18
Q

define SAMPLE history

A

S- symptoms- what seems to be bothering you?
A- allergies- are you allergic to anything
M- medications- do you currently take any medications
P- past medical history- do you have any current medical conditions
L- last oral intake- when was the last time you ate or drank anything- what was it?
E- events preceding- what were you doing when you started having these symptoms

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19
Q

what is OPQRST

A

used in conjunction with SAMPLE
O- onset- did the pain start gradually or all of a sudden
P- provocation- does anything make the pain feel better or worse
Q- quality- can you describe the pain
R- radiate- where is your pain? does it go anywhere else in your body?
S- severity- how would you rate your pain on a scale of 1-10
T- time- how long ago did you start feeling the pain?

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20
Q

AEIOU TIPS

A 
possible reasons someone might be unconscious or have an altered level of consciousness
A- alcohol
E- epilepsy
I- infection
O-opiates
U-uremia
T- trauma
I- insulin
P-poisoning
S-strokes
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21
Q

draw out medical model flow chart- what is in primary assessment box?

A
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22
Q

of the medical model flow chart what is included in the secondary assessments box?

A

draw it out

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23
Q

what is included in “vitals” draw it out. (3rd tier from seccondary assessment.)

A

draw it out

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24
Q

what is in the “history” box of secondary assessment? draw it out

A
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25
Q

what is in the box of “physical exams” included as next step in secondary assessment. draw it out.

A
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26
Q

what does “rendering care include in the medical model flow chart?

A

draw it out

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27
Q

after rendering care what is the next step? draw it out

A
28
Q

draw entire medical model flow chart out- starting with primary assessment

A
29
Q

what does AVPU stand for and where does it lie in the medical model flow chart?

A

AVPU stands for:
A- the patient AWAKE
V- the patient responds to VERBAL stimulation
P- the patient responds to PAINFUL stimulation
U- the patient is completely UNRESPONSIVE

30
Q

what are the colors for AVPU?

A

A- AWAKE green
V- VERBAL stimulation yellow
P- PAINFUL stimulation orange
U- UNRESPONSIVE red

31
Q

what are the H’s and T’s- causes of cardiac arrest?

A 
H's
hypovolemia
hypoxia
hydrogen ions
hyperkalemia/hypokalemia
hypothermia
hypoglycemia
T's 
Toxins/Tablets
tamponade
tension pneumothorax
thrombosis mycardial infarction
thromboembolism
trauma
32
Q

what are the steps to “stop the bleed”

A
  1. apply pressure with hands
  2. apply dressing and press
  3. apply tourniquet- wrap, wind, secure, time
    CALL 911
33
Q

what is the purpose of the primary assessment ?

A
  1. to identify and correct life threats
  2. categorize patient
  3. begin to allocate recourses
34
Q

what are the 6 elements of the primary assessment?

A
  1. scene safety
  2. general audio visual inspection- introduction and consent
  3. level of consciousness
  4. airway
  5. breathing
  6. circulation
35
Q

what is included in scene safety?

A 
- rapid visual assessment which includes:
age/sex
audible breathing
suspected trauma or medical in nature
body fluids
patient position and eye contact
skin color
36
Q

when asking for consent it can be done in _____ or ____ and ____ it can also be _____ at anytime

A
  • when asking for consent it can be done in writing on intake paperwork or verbal and implied it can also be withdrawn at anytime.
37
Q

written or verbal consent depends on level of consciousness and the patient being _____

A

AWAKE

38
Q

what levels of consciousness are considered “implied consent”

A

V- verbal stimulation
P- Painful stimulation
U- unresponsive

39
Q

what is purpose of the airway assessment?

A

to find and correct life threats associated with the airway- clear vs. obstructed

40
Q

what is correction for a closed airway

A

head tilt- chin lift- jaw thrust

41
Q

what is correction for an obstructed airway?

A

side lying position- heimlich

42
Q

what is the purpose of breathing assessment?

A

to find and correct life threats associated with breathing and oxygenation

43
Q

what are the assessment steps for breathing ?

A
  1. assess rate, dept, quality
  2. assess breath sounds
  3. SP02 saturation
44
Q

what are corrective steps for breathing assessment?

A
  1. patient position
  2. identify problem and allocate a resource
  3. identify problem and allocate a resource
45
Q

is mouth to mouth something that you would do?

A

NO

46
Q

what is the purpose of the circulation assessment?

A

to identify and correct life threats associated with circulation

47
Q

what are some assessment and corrective steps that one takes for circulation assessment?

A

assessment steps: / corrective steps
pulses/ CPR
skin color temp moisture/ identify problem and allocate resources
hemorrhage/ tourniquet

48
Q

what does it mean when patient fails the primary assessment?

A

they are considered UNSTABLE

49
Q

how do we prioritize our secondary assessment elements?

A
  • VS
  • History
  • physical exams
  • treatment and re-assessment
50
Q

what is the purpose of secondary assessment?

A
  1. to build a clinical picture and ddx
  2. identify red flags
  3. identify yellow flags
  4. allocate recourses- imaging etc.
51
Q

what are the assessment steps in order?

A
  1. primary
  2. secondary
  3. interventions and treatments
  4. re-assess
52
Q

the purpose of the primary assessment is

A
  1. to identify and correct life threats
  2. categorize patient
  3. begin to allocate recourses
53
Q

interventions must be based on?

A

assessment findings

54
Q

what must you do post intervention to re-establish priorities and patient needs?

A
  • re-assess primary assessment and secondary assessment
55
Q

what is the physical exams hierarchy?

A
  1. medical emergency exams
  2. CUKC physical examination
  3. structural exams
  4. functional exams
  5. movement exams
  6. palpation
56
Q

this state is a change in hemodynamic stability that prevents adequate blood flow to the brain.

A

syncope

57
Q

syncope is considered a ____ not a ____

A

a sign/symptom not a dx- it is not reflective of underlying pathology

58
Q

what are some things that cause syncope?

what are some things that DO not cause syncope?

A
  • vaso vagal stimulation
  • blood loss
  • fast heart rate
  • slow heart rate
  • blood loss
  • fluid retention
  • dehydration
  • brain bleeds
59
Q

what is the most common cause of seizures?

A

-epilepsy- it is primary seizure disorder- may be generalized or partial when epilepsy is the underlying seizure producer

60
Q

this seizure is due to the involvement of both cerebral hemispheres and the RAS- nerve pathways in brain stem- sleep, wake, motor control of posture.

A

generalized / global

61
Q

only one cerebral hemisphere involved- broken down further into simple or complex- simple maintains LOC and complex- AMS

A

partial - focal

62
Q

extreme muscle regidity- may arch patients back- hyperextension of back is the fourth phase referred to as hypertonic- hypertonicity not always seen

A

tonic phase

63
Q

alternating rhythmic muscle contraction and relaxation- incontinence is a common sign- oral trauma may occur- breathing may be inadequate or absent

A

clonic phase

64
Q

you are rendering care to a 55 yof who passes out in your lobby. as you initially assess the patient you determine that a head tilt chin lift is indicated. as you perform this maneuver you notice that her snoring subsides- what is your next step?

A

determine if rate, depth and quality of respiration are adequate

65
Q

you are rendering care to a 23 yom who began to seize during your exam. you determine that your patient is unresponsive to pain, and you have not detected any productive respirations. what is your next best step?

A

Trimester 7 (13 decks)

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